Transcorneal and fiberoptic laser delivery systems and methods for the treatment of eye diseases wherein energy is delivered by wavelengths transparent to the cornea to effect target tissues in the eye for the control of intraocular pressure in diseases such as glaucoma by delivery systems both external to and within ocular tissues. External delivery may be affected under gonioscopic control. Internal delivery may be controlled endoscopically or fiberoptically, both systems utilizing femtosecond laser energy to excise ocular tissue. The femtosecond light energy is delivered to the target tissues to be treated to effect precisely controlled photodisruption to enable portals for the outflow of aqueous fluid in the case of glaucoma in a manner which minimizes target tissue healing responses, inflammation and scarring.

A look-up table for use in determining an energy parameter for photodisrupting ocular tissue with a laser is generated by determining a plurality of individual spot size distributions, wherein each of the plurality of individual spot size distributions is based on a different set of simulated data and includes an expected spot size of a laser focus at each of a plurality of locations within a modeled target volume of ocular tissue. The plurality of individual spot size distributions are combined to obtain a final spot size distribution that includes a final expected spot size of the laser focus at the plurality of locations of the focus within the modeled target volume of ocular tissue. An energy value is assigned to the plurality of locations of the focus within the modeled target volume of ocular tissue based on the final expected spot size at that location.

A system for ophthalmic surgery on an eye includes: a pulsed laser which produces a treatment beam; an OCT imaging assembly capable of creating a continuous depth profile of the eye; an optical scanning system configured to position a focal zone of the treatment beam to a targeted location in three dimensions in one or more floaters in the posterior pole. The system also includes one or more controllers programmed to automatically scan tissues of the patient's eye with the imaging assembly; identify one or more boundaries of the one or more floaters based at least in part on the image data; iii. identify one or more treatment regions based upon the boundaries; and operate the optical scanning system with the pulsed laser to produce a treatment beam directed in a pattern based on the one or more treatment regions.

An optical interface device having an opening for an optical path that can be non-circular and having engagement members having gradually varying angles of engagement. An embodiment of the interface device can be a one size fits all device, providing a configuration that fits in all typical eye openings, including narrow palpebral fissures and small eyes, while providing optical path access to features and structures of the eye. An embodiment of the interface device engages the limbus, cornea and sclera.

An ophthalmic laser treatment system and method providing for a liquid optical interface (LOI) with a patient eye surface (PES) using an elliptical ocular suction ring (OSR) is disclosed. A disposable ocular patient interface (OPI) provides for simultaneous differential vacuum mating of the PES, OSR, OPI, and an optical window retainer (OWR). The PES, OSR, OPI, and OWR form an enclosed volume in which liquid may be interjected to cover the PES during laser treatment. A vacuum suction pump (VSP) provides controlled vacuum to the OPI ensuring proper differential vacuum mating (DVM) between the PES, OSR, OPI, and OWR during laser treatment. The OWR connects to a laser objective bracket (LOB) via an ocular force sensor (OFS) and an optical separator bracket (OSB). The OFS senses applied pressure to the PES and provides data to a computerized control device (CCD) that limits applied pressure to the PES during laser treatment.

A system for ophthalmic surgery on an eye includes: a pulsed laser which produces a treatment beam; an OCT imaging assembly capable of creating a continuous depth profile of the eye; an optical scanning system configured to position a focal zone of the treatment beam to a targeted location in three dimensions in one or more floaters in the posterior pole. The system also includes one or more controllers programmed to automatically scan tissues of the patient's eye with the imaging assembly; identify one or more boundaries of the one or more floaters based at least in part on the image data; iii. identify one or more treatment regions based upon the boundaries; and operate the optical scanning system with the pulsed laser to produce a treatment beam directed in a pattern based on the one or more treatment regions.

A method and system of treating connective tissue to increase flexibility of the connective tissue or decrease tension in the connective tissue includes forming perforations in the connective tissue to at least 90% of the depth or thickness of the connective tissue and maintaining the perforations in the connective tissue. The method alters the tissue to enhance the fundamental mechanisms involved the immunology, biochemistry, and molecular genetics of the metabolism of the connective tissue.

An ab externo automated laser treatment system for treating an eye in a subject, includes a non-contact laser source configured to generate a laser beam having at least one wavelength to treat the eye by directing the laser beam from a location spaced from the eye, wherein the at least one wavelength is a near-infrared wavelength in the range of about 0.5-2.2 μm, a laser scanner optically coupled to the non-contact laser source to receive the laser beam from the non-contact laser source and to scan the laser beam relative to the eye, and a processor, and memory including stored computer-readable instructions that, responsive to execution by the processor, cause the laser treatment system to direct the laser beam to a plurality of trans-scleral treatment locations to be irradiated in a predetermined treatment pattern on an external surface of the eye, wherein the trans-scleral treatment locations are 0-4 mm posterior to the corneolimbal junction, and wherein the laser beam is repetitively directed to the same irradiated trans-scleral treatment locations on the surface of the eye, and the trans-scleral treatment locations are irradiated at intervals sufficient to induce protective thermal preconditioning and therapeutic bio-stimulation of one or more of the trabecular meshwork and/or ciliary body without photocoagulation of the tissue of the eye. Trans-pupillary systems, patient interfaces, and methods are also disclosed.

The invention provides an excimer laser system including a means for calibrating laser output to compensate for increased variation in laser optical fibers.

An ophthalmic laser ablation system is described with various optional features, some especially suitable for non-penetrating filtration on an eye. In one example, focusing of an ablation laser uses a movable lens coupled to a pair of converging light sources, which converge at the focal distance of the lens. In another example, laser ablation settings are selected for optimal ablation and minimal amount of thermal damage of a layer of percolating scleral tissue.