An antimicrobial treatment system comprises a wearable photoactivation device. The wearable photoactivation device includes a body configured to be positioned on a head of a subject over one or more eyes of the subject. The body includes one or more windows or openings that allow the one or more eyes to see through the body. The body includes one or more photoactivating light sources coupled to the body and configured to direct photoactivating light to the one or more eyes according to illumination parameters. The illumination parameters determine a dose of the photoactivating light that activates, according to photochemical kinetic reactions, a photosensitizer applied to the one or more eyes and generates reactive oxygen species that provide an antimicrobial effect in the one or more eyes, without substantially inducing cross-linking activity that produces biomechanical changes in the one or more eyes.
In a corneal measurement system, an optical element focuses an excitation light to an area of corneal tissue at a selected depth. In response, a fluorescing agent applied to the cornea generates a fluorescence emission. An aperture of a pinhole structure selectively transmits the fluorescence emission from the area of corneal tissue at the selected depth. A detector captures the selected fluorescence emission transmitted by the aperture and communicates information relating to a measurement of the selected fluorescence emission captured by the detector. A controller receives the information from the detector and determines a measurement of the fluorescing agent in the area of corneal tissue at the selected depth. The system may include a scan mechanism that causes the optical element to scan the cornea at a plurality of depths, and the controller may determine a measurement of the fluorescing agent in the cornea as a function of depth.
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/14 - Arrangements specially adapted for eye photography
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A system for treating an eye includes a light source configured to provide photoactivating light that photoactivates a cross-linking agent applied to a cornea. The system includes one or more optical elements configured to receive the photoactivating light and produce a beam that defines a spot of the photoactivating light. The system includes a scanning system configured to receive the beam of the photoactivating light and to scan the spot of the photoactivating light along a first axis and a second axis to form a scan pattern on the cornea to generate cross-linking activity.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
Methods employ bioresorbable corneal implants to treat corneal ectatic disorders and/or refractive errors. The corneal implants may be formed from a porous microstructure that can encourage the proliferation of endogenous keratocytes. As such, the corneal implants act as tissue scaffolds that promote tissue growth to increase the biomechanical stability and/or change the shape of the cornea. Over time, the corneal implants may resorb via hydrolysis or enzymatic breakdown, negating the risks of inflammation, scarring, or foreign body response. The corneal implants may also employ drug coating(s) to promote tissue growth.
A micro-device for corneal cross-linking treatment includes a body including an outer portion and an inner portion. The inner portion is coupled to the outer portion which is disposed about a periphery of the inner portion. When the body is against an eye surface, the outer portion contacts the eye surface and the inner portion defines a chamber over a cornea of the eye. The micro-device includes an illumination system including a micro-optical element and an optical fiber. The micro-optical element includes micro-LEDs configured to direct photoactivating light through the inner portion to the cornea of the eye when the body is positioned against the surface of the eye. The photoactivating light generates cross-linking activity with a cross-linking agent applied to the cornea. The optical fiber couples the micro-optical element to a light source and includes a surface configured to reflect the photoactivating light to the micro-optical element.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
6.
PHOTOACTIVATION SYSTEMS AND METHODS FOR CORNEAL CROSS-LINKING TREATMENTS
A system for treating an eye includes a laser light source providing photoactivating light. The system includes a scanning system to receive the photoactivating light as a laser beam and to move the laser beam over a cornea treated with a cross-linking agent. The system includes a controller that provides control signal(s) to programmatically control the laser light source and the scanning system. The control signal(s) cause the laser beam to visit region(s) of the cornea more than once according to a scan pattern and expose the region(s) to the photoactivating light. The photoactivating light causes the cross-linking agent in the exposed region(s) to react with oxygen to generate cross-linking activity in the exposed region(s). The scan pattern causes a predetermined period of time to pass between visits by the laser beam to the exposed region(s), the predetermined period of time allowing oxygen in the exposed region(s) to replenish.
Example eye treatments detennine an area at a surface of a cornea for delivery of a cross-linking agent. The example treatments disrupt tissue at the area at the surface of the con1ea up to a depth corresponding to apical layers of superficial squamous cells of the cornea, e.g., no greater than approximately 10 μm to approximately 15 lm. The example treatments apply a cross-linking agent to the area at the surface of the cornea. The cross-linking agent is transmitted through the disrupted area at a greater rate relative to non disrupted areas of the cornea. The example treatments deliver photoactivating light to the cornea. The photoactivating light activates the cross-linking agent to generate cross-linking activity in the cornea.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
In a corneal measurement system, an optical element focuses an excitation light to an area of corneal tissue at a selected depth. In response, a fluorescing agent applied to the cornea generates a fluorescence emission. An aperture of a pinhole structure selectively transmits the fluorescence emission from the area of corneal tissue at the selected depth. A detector captures the selected fluorescence emission transmitted by the aperture and communicates information relating to a measurement of the selected fluorescence emission captured by the detector. A controller receives the information from the detector and determines a measurement of the fluorescing agent in the area of corneal tissue at the selected depth. The system may include a scan mechanism that causes the optical element to scan the cornea at a plurality of depths, and the controller may determine a measurement of the fluorescing agent in the cornea as a function of depth.
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/14 - Arrangements specially adapted for eye photography
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
An automated process receives input tomography data and generates an optimized (customized) treatment pattern for an individual patient without relying on the physician's analysis and judgment. For example, a method for treating a cornea includes receiving tomographic data for a cornea. The method includes identifying a keratoconic defect in the cornea based on the tomographic data, The method includes segmenting the keratoconic defect into treatment zones based on predefined, geometric parameters, wherein the treatment zones indicate where a cross-linking agent is to be applied on the cornea and photoactivated to treat the keratoconic defect.
An automated process receives input tomography data and generates an optimized (customized) treatment pattern for an individual patient without relying on the physician's analysis and judgment. For example, a method for treating a cornea includes receiving tomographic data for a cornea. The method includes identifying a keratoconic defect in the cornea based on the tomographic data, The method includes segmenting the keratoconic defect into treatment zones based on predefined, geometric parameters, wherein the treatment zones indicate where a cross-linking agent is to be applied on the cornea and photoactivated to treat the keratoconic defect.
An automated process receives input tomography data and generates an optimized (customized) treatment pattern for an individual patient without relying on the physician's analysis and judgment. For example, a method for treating a cornea includes receiving tomographic data for a cornea. The method includes identifying a keratoconic defect in the cornea based on the tomographic data. The method includes segmenting the keratoconic defect into treatment zones based on predefined geometric parameters, wherein the treatment zones indicate where a cross-linking agent is to be applied on the cornea and photoactivated to treat the keratoconic defect.
An example antimicrobial treatment system includes an illumination system configured to deliver illumination that activates a photosensitizing agent applied to a cornea. The system also includes a controller configured to control the illumination system. The controller detects an ulcerative region on a cornea and causes the illumination system to deliver the illumination to activate the photosensitizing agent applied to the ulcerative region according to a set of parameters for treating the ulcerative region. The illumination is restricted to the ulcerative region, and activation of the photosensitizing agent in the ulcerative region generates an antimicrobial effect.
An example antimicrobial treatment system includes an illumination system configured to deliver illumination that activates a photosensitizing agent applied to a cornea. The system also includes a controller configured to control the illumination system. The controller detects an ulcerative region on a cornea and causes the illumination system to deliver the illumination to activate the photosensitizing agent applied to the ulcerative region according to a set of parameters for treating the ulcerative region. The illumination is restricted to the ulcerative region, and activation of the photosensitizing agent in the ulcerative region generates an antimicrobial effect.
A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.
An example system for corneal treatment includes an illumination system to generate cross-linking in at least one selected region of a cornea treated with a cross-linking agent by delivering photoactivating light according to one or more photoactivation parameters. The system includes a controller to receive input relating to one or more treatment parameters, which include the one or more photoactivation parameters. The controller is configured to output information for adjusting the one or more treatment parameters by (A) determining from the input, a distribution of cross-links for the at least one selected region of the cornea; (B) determining, from the distribution of cross-links, a shape change for the cornea; and (C) determining, from the shape change for the cornea, a change in vision for the subject. Responsive to the output from the controller, the illumination system is configured to adjust at least one of the one or more photoactivation parameters.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
This disclosure features bis(diazirine) derivatives of the formulae (I) (1-a) or (1-b) that generate cross-linking in the cornea in response to exposure to an electromagnetic irradiation (e.g. UV-light). The compounds are useful, e.g. for treating a subject (e.g. a human) having a disease, disorder or condition in which abnormal shaping of the cornea (e.g. thinning of the cornea, e.g. bilateral thinning of the cornea, e.g. bilateral thinning of the central, paracentral, or peripheral cornea, or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms, and/or progression of the disease, disorder or condition. Examples of such diseases, disorders or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular examples of such diseases, disorders or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g. postoperative ectasia, e.g. post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism and presbyopia. In some embodiments, the claimed methods can be performed in the absence of added or supplemental oxygen levels, which can be advantageous in some applications. Preferred exemplary compounds are e.g. bis(diazirine) amino acid derivatives, such as e.g. example 1:
This disclosure features bis(diazirine) derivatives of the formulae (I) (1-a) or (1-b) that generate cross-linking in the cornea in response to exposure to an electromagnetic irradiation (e.g. UV-light). The compounds are useful, e.g. for treating a subject (e.g. a human) having a disease, disorder or condition in which abnormal shaping of the cornea (e.g. thinning of the cornea, e.g. bilateral thinning of the cornea, e.g. bilateral thinning of the central, paracentral, or peripheral cornea, or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms, and/or progression of the disease, disorder or condition. Examples of such diseases, disorders or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular examples of such diseases, disorders or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g. postoperative ectasia, e.g. post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism and presbyopia. In some embodiments, the claimed methods can be performed in the absence of added or supplemental oxygen levels, which can be advantageous in some applications. Preferred exemplary compounds are e.g. bis(diazirine) amino acid derivatives, such as e.g. example 1:
C07D 403/12 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing two hetero rings linked by a chain containing hetero atoms as chain links
A61P 27/10 - Ophthalmic agents for accommodation disorders, e.g. myopia
C07D 403/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing three or more hetero rings
C07D 401/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing three or more hetero rings
C07D 229/02 - Heterocyclic compounds containing rings of less than five members having two nitrogen atoms as the only ring hetero atoms containing three-membered rings
17.
Systems and methods for photoactivating a photosensitizer applied to an eye
An antimicrobial treatment system comprises a wearable photoactivation device. The wearable photoactivation device includes a body configured to be positioned on a head of a subject over one or more eyes of the subject. The body includes one or more windows or openings that allow the one or more eyes to see through the body. The body includes one or more photoactivating light sources coupled to the body and configured to direct photoactivating light to the one or more eyes according to illumination parameters. The illumination parameters determine a dose of the photoactivating light that activates, according to photochemical kinetic reactions, a photosensitizer applied to the one or more eyes and generates reactive oxygen species that provide an antimicrobial effect in the one or more eyes, without substantially inducing cross-linking activity that produces biomechanical changes in the one or more eyes.
This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt and/or hydrate and/or prodrug of the compound) that that generates cross-linking in the cornea in response to exposure to an electromagnetic irradiation. This disclosure also features compositions containing the same as well as other methods of using and making the same. The chemical entities are useful, e.g., for treating a subject (e.g., a human) having a disease, disorder, or condition in which in which abnormal shaping of the cornea (e.g., thinning of the cornea, e.g., bilateral thinning of the cornea, e.g., bilateral thinning of the central, paracentral, or peripheral cornea; or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms and/or progression of the disease, disorder, or condition. Non-limiting examples of such diseases, disorders, or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular non-limiting examples of such diseases, disorders, or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g., post-operative ectasia, e.g., post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism, and presbyopia.
C07D 241/44 - Benzopyrazines with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to carbon atoms of the hetero ring
C07D 403/04 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07D 413/04 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07F 9/6524 - Heterocyclic compounds, e.g. containing phosphorus as a ring hetero atom having four or more nitrogen atoms as the only ring hetero atoms
C07D 417/04 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07D 403/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing three or more hetero rings
C07D 401/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing three or more hetero rings
A61K 33/00 - Medicinal preparations containing inorganic active ingredients
A61K 45/06 - Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
A61K 31/498 - Pyrazines or piperazines ortho- or peri-condensed with carbocyclic ring systems, e.g. quinoxaline, phenazine
A61K 31/525 - Isoalloxazines, e.g. riboflavins, vitamin B2
An example system for tracking motion of an eye during an eye treatment includes an image capture device configured to capture a plurality of images of an eye. The system includes controller(s) including processor(s) that receive the plurality of images from the image capture device. The processor(s) implement a plurality of trackers. Each tracker is configured to detect a respective feature in the plurality of images and provide, based on the respective feature, a respective set of data relating to motion of the eye. The respective features detected by the plurality of trackers are orthogonal relative to each other and the respective sets of data provided by the plurality of trackers are independent of each other. The processor(s) coalesce the sets of data from the plurality of trackers and determine an indicator of the motion of the eye based on the coalesced sets of data.
A61B 3/113 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining or recording eye movement
A61B 3/00 - Apparatus for testing the eyesInstruments for examining the eyes
Devices and approaches for activating cross-linking within corneal tissue to stabilize and strengthen the corneal tissue following an eye therapy treatment. A feedback system is provided to acquire measurements and pass feedback information to a controller. The feedback system may include an interferometer system, a corneal polarimetry system, or other configurations for monitoring cross-linking activity within the cornea. The controller is adapted to analyze the feedback information and adjust treatment to the eye based on the information. Aspects of the feedback system may also be used to monitor and diagnose features of the eye. Methods of activating cross-linking according to information provided by a feedback system in order to improve accuracy and safety of a cross-linking therapy are also provided.
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61F 9/008 - Methods or devices for eye surgery using laser
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
21.
PHOTOACTIVATION SYSTEMS AND METHODS FOR CORNEAL CROSS-LINKING TREATMENTS
A system for treating an eye includes a laser light source providing photoactivating light. The system includes a scanning system to receive the photoactivating light as a laser beam and to move the laser beam over a cornea treated with a cross-linking agent. The system includes a controller that provides control signal(s) to programmatically control the laser light source and the scanning system. The control signal(s) cause the laser beam to visit region(s) of the cornea more than once according to a scan pattern and expose the region(s) to the photoactivating light. The photoactivating light causes the cross-linking agent in the exposed region(s) to react with oxygen to generate cross-linking activity in the exposed region(s). The scan pattern causes a predetermined period of time to pass between visits by the laser beam to the exposed region(s), the predetermined period of time allowing oxygen in the exposed region(s) to replenish.
A system for treating an eye includes a laser light source providing photoactivating light. The system includes a scanning system to receive the photoactivating light as a laser beam and to move the laser beam over a cornea treated with a cross-linking agent. The system includes a controller that provides control signal(s) to programmatically control the laser light source and the scanning system. The control signal(s) cause the laser beam to visit region(s) of the cornea more than once according to a scan pattern and expose the region(s) to the photoactivating light. The photoactivating light causes the cross-linking agent in the exposed region(s) to react with oxygen to generate cross-linking activity in the exposed region(s). The scan pattern causes a predetermined period of time to pass between visits by the laser beam to the exposed region(s), the predetermined period of time allowing oxygen in the exposed region(s) to replenish.
A system for treating an eye includes a laser light source providing photoactivating light. The system includes a scanning system to receive the photoactivating light as a laser beam and to move the laser beam over a cornea treated with a cross-linking agent. The system includes a controller that provides control signal(s) to programmatically control the laser light source and the scanning system. The control signal(s) cause the laser beam to visit region(s) of the cornea more than once according to a scan pattern and expose the region(s) to the photoactivating light. The photoactivating light causes the cross-linking agent in the exposed region(s) to react with oxygen to generate cross-linking activity in the exposed region(s). The scan pattern causes a predetermined period of time to pass between visits by the laser beam to the exposed region(s), the predetermined period of time allowing oxygen in the exposed region(s) to replenish.
A micro-device for corneal cross-linking treatment includes a body including an outer portion and an inner portion. The outer portion is disposed about a periphery of the inner portion. The inner portion is shaped such that, when the body is positioned against a surface of an eye, the outer portion contacts the surface of the eye and the inner portion defines a chamber over a cornea of the eye. The micro-device includes an illumination system including a micro-optical element coupled to the body. The micro-optical element is configured to direct photoactivating light to the cornea of the eye when the body is positioned against the surface of the eye. The photoactivating light generates cross-linking activity with a cross-linking agent applied to the cornea.
A corneal cross-linking system includes a light source configured to emit a photoactivating light. The system includes a spatial light modulator configured to receive the photoactivating light from the light source and provide a pixelated illumination. The spatial light modulator defines a maximum area for the pixelated illumination. The system includes a controller configured to cause the spatial light modulator to project a first pixelated illumination onto the cornea to photoactivate a cross-linking agent applied to a treatment area. The first pixelated illumination has an area that is smaller than the maximum area defined by the spatial light modulator. The controller is configured to determine movement of the cornea. In response to the movement, the controller controls the spatial light modulator to project a second pixelated illumination to the treatment area based on a translation and/or transformation of the first pixelated illumination to continue photoactivating the cross-linking agent.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
Formulations, are used for eye treatments, e.g., cross-linking treatments. For example, a therapeutic formulation includes a photosensitizer and delivery agent(s), wherein the delivery agent(s) include at least one of: anesthetic agent(s), analgesic agent(s), tonicity agent(s), or shear-thinning, or viscosity-increasing agent(s). In another example, a method includes applying preparatory formulation(s) to increase a permeability of a corneal epithelium, and applying therapeutic formulation(s) to the epithelium, where the preparatory formulation(s) include zinc metalloproteinase, copper metalloproteinase, papain, bromelain, actinidin, ficain, N-acetylcysteine, ambroxol, carbocisteine, and/or erdosteine. In yet another example, a method includes applying therapeutic formulation(s) to a corneal epithelium to deliver the therapeutic formulation(s) to a stroma, and applying enhancement formulation(s) to the epithelium in response to applying the therapeutic formulation(s), where: the enhancement formulation(s) remove the therapeutic formulation(s) from the epithelium; close tight junctions of the epithelium; promote oxidation for the therapeutic agent(s); and/or further deliver the therapeutic formulation(s) to the stroma.
An example system for corneal treatment includes an illumination system to generate cross-linking in at least one selected region of a cornea treated with a cross-linking agent by delivering photoactivating light according to one or more photoactivation parameters. The system includes a controller to receive input relating to one or more treatment parameters, which include the one or more photoactivation parameters. The controller is configured to output information for adjusting the one or more treatment parameters by (A) determining from the input, a distribution of cross-links for the at least one selected region of the cornea; (B) determining, from the distribution of cross-links, a shape change for the cornea; and (C) determining, from the shape change for the cornea, a change in vision for the subject. Responsive to the output from the controller, the illumination system is configured to adjust at least one of the one or more photoactivation parameters.
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
Systems and methods employ bioresorbable corneal implants to treat corneal ectatic disorders and/or refractive errors. The corneal implants may be formed from a porous microstructure that can encourage the proliferation of endogenous keratocytes. As such, the corneal implants act as tissue scaffolds that promote tissue growth to increase the biomechanical stability and/or change the shape of the cornea. Over time, the corneal implants may resorb via hydrolysis or enzymatic breakdown, negating the risks of inflammation, scarring, or foreign body response. The corneal implants may also employ drug coating(s) to promote tissue growth.
This disclosure features bis(diazirine) derivatives of the formulae (I) (l-a) or (l-b) that generate cross-linking in the cornea in response to exposure to an electromagnetic irradiation (e.g. UV-light). The compounds are useful, e.g. for treating a subject (e.g. a human) having a disease, disorder or condition in which abnormal shaping of the cornea (e.g. thinning of the cornea, e.g. bilateral thinning of the cornea, e.g. bilateral thinning of the central, paracentral, or peripheral cornea, or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms, and/or progression of the disease, disorder or condition. Examples of such diseases, disorders or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular examples of such diseases, disorders or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g. postoperative ectasia, e.g. post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism and presbyopia. In some embodiments, the claimed methods can be performed in the absence of added or supplemental oxygen levels, which can be advantageous in some applications. Preferred exemplary compounds are e.g. bis(diazirine) amino acid derivatives, such as e.g. example 1:
C07D 229/02 - Heterocyclic compounds containing rings of less than five members having two nitrogen atoms as the only ring hetero atoms containing three-membered rings
A61K 31/195 - Carboxylic acids, e.g. valproic acid having an amino group
A61K 31/197 - Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
A61K 31/198 - Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
A61K 31/396 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having three-membered rings, e.g. aziridine
A61P 27/10 - Ophthalmic agents for accommodation disorders, e.g. myopia
C07D 401/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing three or more hetero rings
C07D 403/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing three or more hetero rings
C07D 413/14 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing three or more hetero rings
30.
BIS(DIAZIRINE) DERIVATIVES AS PHOTO-CROSSSLINKER FOR TREATING CORNEAL ECTATIC DISORDERS
This disclosure features bis(diazirine) derivatives of the formulae (I) (l-a) or (l-b) that generate cross-linking in the cornea in response to exposure to an electromagnetic irradiation (e.g. UV-light). The compounds are useful, e.g. for treating a subject (e.g. a human) having a disease, disorder or condition in which abnormal shaping of the cornea (e.g. thinning of the cornea, e.g. bilateral thinning of the cornea, e.g. bilateral thinning of the central, paracentral, or peripheral cornea, or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms, and/or progression of the disease, disorder or condition. Examples of such diseases, disorders or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular examples of such diseases, disorders or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g. postoperative ectasia, e.g. post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism and presbyopia. In some embodiments, the claimed methods can be performed in the absence of added or supplemental oxygen levels, which can be advantageous in some applications. Preferred exemplary compounds are e.g. bis(diazirine) amino acid derivatives, such as e.g. example 1:
C07D 229/02 - Heterocyclic compounds containing rings of less than five members having two nitrogen atoms as the only ring hetero atoms containing three-membered rings
C07D 413/14 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing three or more hetero rings
C07D 401/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing three or more hetero rings
C07D 403/14 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing three or more hetero rings
A61K 31/396 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having three-membered rings, e.g. aziridine
A61K 31/195 - Carboxylic acids, e.g. valproic acid having an amino group
A61K 31/197 - Carboxylic acids, e.g. valproic acid having an amino group the amino and the carboxyl groups being attached to the same acyclic carbon chain, e.g. gamma-aminobutyric acid [GABA], beta-alanine, epsilon-aminocaproic acid or pantothenic acid
A61K 31/198 - Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
In a corneal measurement system, an optical element focuses an excitation light to an area of corneal tissue at a selected depth. In response, a fluorescing agent applied to the cornea generates a fluorescence emission. An aperture of a pinhole structure selectively transmits the fluorescence emission from the area of corneal tissue at the selected depth. A detector captures the selected fluorescence emission transmitted by the aperture and communicates information relating to a measurement of the selected fluorescence emission captured by the detector. A controller receives the information from the detector and determines a measurement of the fluorescing agent in the area of corneal tissue at the selected depth. The system may include a scan mechanism that causes the optical element to scan the cornea at a plurality of depths, and the controller may determine a measurement of the fluorescing agent in the cornea as a function of depth.
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
An eye treatment positions a mask device over first and second eyes. A posterior side of the mask device is proximate to the face and the anterior side is distal from the face. The mask device includes an outer wall extending between the anterior and posterior sides and defining a chamber extending across the first and second eyes. The anterior side includes a first transmission region that allows a photoactivating light for the first eye to be delivered into a first section of the chamber positioned over the first eye. The anterior side includes a second transmission region that allows a photoactivating light for the second eye to be delivered into the second section positioned over the second eye. The system includes at least one gas source storing a gas that is different than ambient air. The system includes a gas delivery system that delivers the gas into the chamber.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61F 9/008 - Methods or devices for eye surgery using laser
This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt and/or hydrate and/or prodrug of the compound) that that generates cross-linking in the cornea in response to exposure to an electromagnetic irradiation. This disclosure also features compositions containing the same as well as other methods of using and making the same. The chemical entities are useful, e.g., for treating a subject (e.g., a human) having a disease, disorder, or condition in which in which abnormal shaping of the cornea (e.g., thinning of the cornea, e.g., bilateral thinning of the cornea, e.g., bilateral thinning of the central, paracentral, or peripheral cornea; or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms and/or progression of the disease, disorder, or condition. Non-limiting examples of such diseases, disorders, or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular non-limiting examples of such diseases, disorders, or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g., post-operative ectasia, e.g., post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism, and presbyopia.
A61K 31/498 - Pyrazines or piperazines ortho- or peri-condensed with carbocyclic ring systems, e.g. quinoxaline, phenazine
C07D 241/44 - Benzopyrazines with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to carbon atoms of the hetero ring
C07D 401/12 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
C07D 403/04 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07D 413/04 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07D 417/04 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group containing two hetero rings directly linked by a ring-member-to-ring- member bond
This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt and/or hydrate and/or prodrug of the compound) that that generates cross-linking in the cornea in response to exposure to an electromagnetic irradiation. This disclosure also features compositions containing the same as well as other methods of using and making the same. The chemical entities are useful, e.g., for treating a subject (e.g., a human) having a disease, disorder, or condition in which in which abnormal shaping of the cornea (e.g., thinning of the cornea, e.g., bilateral thinning of the cornea, e.g., bilateral thinning of the central, paracentral, or peripheral cornea; or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms and/or progression of the disease, disorder, or condition. Non-limiting examples of such diseases, disorders, or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular non-limiting examples of such diseases, disorders, or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g., post-operative ectasia, e.g., post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism, and presbyopia.
A61K 31/498 - Pyrazines or piperazines ortho- or peri-condensed with carbocyclic ring systems, e.g. quinoxaline, phenazine
C07D 241/44 - Benzopyrazines with hetero atoms or with carbon atoms having three bonds to hetero atoms with at the most one bond to halogen, e.g. ester or nitrile radicals, directly attached to carbon atoms of the hetero ring
C07D 401/12 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, at least one ring being a six-membered ring with only one nitrogen atom containing two hetero rings linked by a chain containing hetero atoms as chain links
C07D 403/04 - Heterocyclic compounds containing two or more hetero rings, having nitrogen atoms as the only ring hetero atoms, not provided for by group containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07D 413/04 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and oxygen atoms as the only ring hetero atoms containing two hetero rings directly linked by a ring-member-to-ring- member bond
C07D 417/04 - Heterocyclic compounds containing two or more hetero rings, at least one ring having nitrogen and sulfur atoms as the only ring hetero atoms, not provided for by group containing two hetero rings directly linked by a ring-member-to-ring- member bond
A system for treating an eye includes a light source configured to provide photoactivating light that photoactivates a cross-linking agent applied to a cornea. The system includes one or more optical elements configured to receive the photoactivating light and produce a beam that defines a spot of the photoactivating light. The system includes a scanning system configured to receive the beam of the photoactivating light and to scan the spot of the photoactivating light along a first axis and a second axis to form a scan pattern on the cornea to generate cross-linking activity.
A system for treating an eye includes a light source configured to provide photoactivating light that photoactivates a cross-linking agent applied to a cornea. The system includes one or more optical elements configured to receive the photoactivating light and produce a beam that defines a spot of the photoactivating light. The system includes a scanning system configured to receive the beam of the photoactivating light and to scan the spot of the photoactivating light along a first axis and a second axis to form a scan pattern on the cornea to generate cross-linking activity.
A system for treating an eye includes a light source configured to provide photoactivating light that photoactivates a cross-linking agent applied to a cornea. The system includes one or more optical elements configured to receive the photoactivating light and produce a beam that defines a spot of the photoactivating light. The system includes a scanning system configured to receive the beam of the photoactivating light and to scan the spot of the photoactivating light along a first axis and a second axis to form a scan pattern on the cornea to generate cross-linking activity.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
To treat corneal ectatic disorders, systems and methods can precisely apply photoactivating light to specified areas of a cornea treated with a cross-linking agent. An example system includes a light source that provides a photoactivating light to photoactivate a cross-linking agent applied to an eye. The system includes optical element(s) that transmit the photoactivating light to the eye according to a pattern defined by a plurality of treatment zones. The treatment zones are delivered to different respective areas on the eye. The plurality of treatment zones includes at least a first treatment zone and a second treatment zone. The first treatment zone provides a first dose of the photoactivating light. The second treatment zone provides a second dose of the photoactivating light. The first dose is greater than the second dose. The first treatment zone is disposed within an inner boundary of the second treatment zone.
An example system for tracking motion of an eye during an eye treatment includes an image capture device configured to capture a plurality of images of an eye. The system includes controller(s) including processor(s) that receive the plurality of images from the image capture device. The processor(s) implement a plurality of trackers. Each tracker is configured to detect a respective feature in the plurality of images and provide, based on the respective feature, a respective set of data relating to motion of the eye. The respective features detected by the plurality of trackers are orthogonal relative to each other and the respective sets of data provided by the plurality of trackers are independent of each other. The processor(s) coalesce the sets of data from the plurality of trackers and determine an indicator of the motion of the eye based on the coalesced sets of data.
A61B 3/113 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining or recording eye movement
G16H 50/70 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
40.
SYSTEMS AND METHODS FOR EYE TRACKING DURING EYE TREATMENT
An example system for tracking motion of an eye during an eye treatment includes an image capture device configured to capture a plurality of images of an eye. The system includes controller(s) including processor(s) that receive the plurality of images from the image capture device. The processor(s) implement a plurality of trackers. Each tracker is configured to detect a respective feature in the plurality of images and provide, based on the respective feature, a respective set of data relating to motion of the eye. The respective features detected by the plurality of trackers are orthogonal relative to each other and the respective sets of data provided by the plurality of trackers are independent of each other. The processor(s) coalesce the sets of data from the plurality of trackers and determine an indicator of the motion of the eye based on the coalesced sets of data.
A61B 3/113 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining or recording eye movement
G16H 50/70 - ICT specially adapted for medical diagnosis, medical simulation or medical data miningICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients
41.
SYSTEMS AND METHODS TREATING FOR CORNEAL ECTATIC DISORDERS
To treat corneal ectatic disorders, systems and methods can precisely apply photoactivating light to specified areas of a cornea treated with a cross-linking agent. An example system includes a light source that provides a photoactivating light to photoactivate a cross-linking agent applied to an eye. The system includes optical element(s) that transmit the photoactivating light to the eye according to a pattern defined by a plurality of treatment zones. The treatment zones are delivered to different respective areas on the eye. The plurality of treatment zones includes at least a first treatment zone and a second treatment zone. The first treatment zone provides a first dose of the photoactivating light. The second treatment zone provides a second dose of the photoactivating light. The first dose is greater than the second dose. The first treatment zone is disposed within an inner boundary of the second treatment zone.
To treat corneal ectatic disorders, systems and methods can precisely apply photoactivating light to specified areas of a cornea treated with a cross-linking agent. An example system includes a light source that provides a photoactivating light to photoactivate a cross-linking agent applied to an eye. The system includes optical element(s) that transmit the photoactivating light to the eye according to a pattern defined by a plurality of treatment zones. The treatment zones are delivered to different respective areas on the eye. The plurality of treatment zones includes at least a first treatment zone and a second treatment zone. The first treatment zone provides a first dose of the photoactivating light. The second treatment zone provides a second dose of the photoactivating light. The first dose is greater than the second dose. The first treatment zone is disposed within an inner boundary of the second treatment zone.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.
A corneal cross-linking system includes a light source configured to emit a photoactivating light. The system includes a spatial light modulator configured to receive the photoactivating light from the light source and provide a pixelated illumination. The spatial light modulator defines a maximum area for the pixelated illumination. The system includes a controller configured to cause the spatial light modulator to project a first pixelated illumination onto the cornea to photoactivate a cross-linking agent applied to a treatment area. The first pixelated illumination has an area that is smaller than the maximum area defined by the spatial light modulator. The controller is configured to determine movement of the cornea. In response to the movement, the controller controls the spatial light modulator to project a second pixelated illumination to the treatment area based on a translation and/or transformation of the first pixelated illumination to continue photoactivating the cross-linking agent.
A micro-device for corneal cross-linking treatment includes a body including an outer portion and an inner portion. The outer portion is disposed about a periphery of the inner portion. The inner portion is shaped such that, when the body is positioned against a surface of an eye, the outer portion contacts the surface of the eye and the inner portion defines a chamber over a cornea of the eye. The micro-device includes an illumination system including a micro-optical element coupled to the body. The micro-optical element is configured to direct photoactivating light to the cornea of the eye when the body is positioned against the surface of the eye. The photoactivating light generates cross-linking activity with a cross-linking agent applied to the cornea.
A corneal cross-linking system includes a light source configured to emit a photoactivating light. The system includes a spatial light modulator configured to receive the photoactivating light from the light source and provide a pixelated illumination. The spatial light modulator defines a maximum area for the pixelated illumination. The system includes a controller configured to cause the spatial light modulator to project a first pixelated illumination onto the cornea to photoactivate a cross-linking agent applied to a treatment area. The first pixelated illumination has an area that is smaller than the maximum area defined by the spatial light modulator. The controller is configured to determine movement of the cornea. In response to the movement, the controller controls the spatial light modulator to project a second pixelated illumination to the treatment area based on a translation and/or transformation of the first pixelated illumination to continue photoactivating the cross-linking agent.
An antimicrobial treatment system comprises a wearable photoactivation device. The wearable photoactivation device includes a body configured to be positioned on a head of a subject over one or more eyes of the subject. The body includes one or more windows or openings that allow the one or more eyes to see through the body. The body includes one or more photoactivating light sources coupled to the body and configured to direct photoactivating light to the one or more eyes according to illumination parameters. The illumination parameters determine a dose of the photoactivating light that activates, according to photochemical kinetic reactions, a photosensitizer applied to the one or more eyes and generates reactive oxygen species that provide an antimicrobial effect in the one or more eyes, without substantially inducing cross-linking activity that produces biomechanical changes in the one or more eyes.
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Medical services; Surgery; Medical services, namely, a non-surgical procedure using a combination of a cross-linking agent, UV radiation, and supplemental oxygen; Surgery, namely, a surgical procedure using a combination of a cross-linking agent, UV radiation, and supplemental oxygen.
49.
Systems and methods for cross-linking treatments of an eye
Example eye treatments determine an area at a surface of a cornea for delivery of a cross-linking agent. The example treatments disrupt tissue at the area at the surface of the cornea up to a depth corresponding to apical layers of superficial squamous cells of the cornea, e.g., no greater than approximately 10 μm to approximately 15 μm. The example treatments apply a cross-linking agent to the area at the surface of the cornea. The cross-linking agent is transmitted through the disrupted area at a greater rate relative to non disrupted areas of the cornea. The example treatments deliver photoactivating light to the cornea. The photoactivating light activates the cross-linking agent to generate cross-linking activity in the cornea.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
09 - Scientific and electric apparatus and instruments
10 - Medical apparatus and instruments
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
(1) Software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus
(2) Medical instruments for treating eye conditions and diseases; medical apparatus and devices utilizing radiation to treat eye conditions and diseases (1) Vision surgery services; treatment of eye conditions and diseases
Formulations, are used for eye treatments, e.g., cross-linking treatments. For example, a therapeutic formulation includes a photosensitizer and delivery agent(s), wherein the delivery agent(s) include at least one of: anesthetic agent(s), analgesic agent(s), tonicity agent(s), or shear-thinning, or viscosity-increasing agent(s). In another example, a method includes applying preparatory formulation(s) to increase a permeability of a corneal epithelium, and applying therapeutic formulation(s) to the epithelium, where the preparatory formulation(s) include zinc metalloproteinase, copper metalloproteinase, papain, bromelain, actinidin, ficain, N-acetylcysteine, ambroxol, carbocisteine, and/or erdosteine. In yet another example, a method includes applying therapeutic formulation(s) to a corneal epithelium to deliver the therapeutic formulation(s) to a stroma, and applying enhancement formulation(s) to the epithelium in response to applying the therapeutic formulation(s), where: the enhancement formulation(s) remove the therapeutic formulation(s) from the epithelium; close tight junctions of the epithelium; promote oxidation for the therapeutic agent(s); and/or further deliver the therapeutic formulation(s) to the stroma.
A61K 31/525 - Isoalloxazines, e.g. riboflavins, vitamin B2
A61K 31/14 - Quaternary ammonium compounds, e.g. edrophonium, choline
A61K 31/198 - Alpha-amino acids, e.g. alanine or edetic acid [EDTA]
A61K 31/245 - Amino benzoic acid types, e.g. procaine, novocaine
A61K 31/045 - Hydroxy compounds, e.g. alcoholsSalts thereof, e.g. alcoholates
A61K 31/726 - Glycosaminoglycans, i.e. mucopolysaccharides
A61K 47/34 - Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
In a corneal measurement system, an optical element focuses an excitation light to an area of corneal tissue at a selected depth. In response, a fluorescing agent applied to the cornea generates a fluorescence emission. An aperture of a pinhole structure selectively transmits the fluorescence emission from the area of corneal tissue at the selected depth. A detector captures the selected fluorescence emission transmitted by the aperture and communicates information relating to a measurement of the selected fluorescence emission captured by the detector. A controller receives the information from the detector and determines a measurement of the fluorescing agent in the area of corneal tissue at the selected depth. The system may include a scan mechanism that causes the optical element to scan the cornea at a plurality of depths, and the controller may determine a measurement of the fluorescing agent in the cornea as a function of depth.
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
In a corneal measurement system, an optical element focuses an excitation light to an area of corneal tissue at a selected depth, fit response, a fluorescing agent applied to the cornea generates a fluorescence emission. An aperture of a pinhole structure selectively transmits the fluorescence emission from the area of corneal tissue at the selected depth. A. detector captures the selected fluorescence emission transmitted by the aperture and communicates information relating to a measurement of the selected fluorescence emission captured by the detector. A controller receives the information front the detector and determines a measurement of the fluorescing agent in; the area of corneal tissue at die selected depth. The system may include a scan mechanism that causes the optical element to scan the cornea, at a plurality of depths, and the controller may determine a measurement of the fluorescing agent in the cornea as a function of depth.
05 - Pharmaceutical, veterinary and sanitary products
09 - Scientific and electric apparatus and instruments
10 - Medical apparatus and instruments
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Pharmaceutical preparations for the treatment of eye diseases and conditions. Software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus. Medical instruments for treating eye conditions and diseases; medical apparatus and device utilizing radiation to treat eye conditions and diseases. Vision surgery services; treatment of eye conditions and diseases.
05 - Pharmaceutical, veterinary and sanitary products
10 - Medical apparatus and instruments
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Pharmaceutical preparations for the treatment of eye diseases and conditions Medical instruments for treating eye conditions and diseases; Medical apparatus and devices utilizing radiation to treat eye conditions and diseases; Software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus Vision surgery services; Treatment of eye conditions and diseases
56.
SYSTEMS AND METHODS FOR CROSS-LINKING TREATMENTS OF AN EYE
Example eye treatments determine an area at a surface of a cornea for delivery of a cross-linking agent. The example treatments disrupt tissue at the area at the surface of the cornea up to a depth corresponding to apical layers of superficial squamous cells of the cornea, e.g., no greater than approximately 10 μm to approximately 15 μm. The example treatments apply a cross-linking agent to the area at the surface of the cornea. The cross-linking agent is transmitted through the disrupted area at a greater rate relative to non disrupted areas of the cornea. The example treatments deliver photoactivating light to the cornea. The photoactivating light activates the cross-linking agent to generate cross-linking activity in the cornea.
An example system for treating an eye includes a light source configured to emit photoactivating light. The system includes one or more optical elements configured to direct the photoactivating light from the light source towards an eye treated with a photos ensitizer. The system includes a permeable structure configured to be positioned on the eye. The permeable structure is configured to transmit the photoactivating light from the one or more optical elements to the eye. The photoactivating light activates the photosensitizer to generate cross-linking activity in the eye. The permeable structure may applanate the eye. The system may include an oxygen delivery device coupled to an oxygen source, where the permeable structure transmits oxygen from the oxygen delivery device to the eye and the oxygen determines in part the cross-linking activity generated in the eye.
A drug delivery device includes a drug-eluting element defined by a plurality of outer surfaces including a delivery surface and one or more other non-delivery surfaces. The delivery surface is positioned against tissue of an eye and shaped to define an area of targeted tissue to receive a drug. The drug-eluting element holds the drug when the delivery surface is not positioned against the tissue. Responsive to the delivery surface being positioned against the tissue, the drug-eluting element releases the drag to the area of targeted tissue through the delivery surface. Hie drug delivery device includes one or more barrier structures disposed along the one or more non-delivery surfaces of the drug-eluting element. The one or more barrier structures substantially inhibit release of the drug from the drug-eluting element through the one or more non-delivery surfaces.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61M 31/00 - Devices for introducing or retaining media, e.g. remedies, in cavities of the body
59.
Systems and methods for delivering drugs to an eye
A drug delivery device includes a drug-eluting element defined by a plurality of outer surfaces including a delivery surface and one or more other non-delivery surfaces. The delivery surface is positioned against tissue of an eye and shaped to define an area of targeted tissue to receive a drug. The drug-eluting element holds the drug when the delivery surface is not positioned against the tissue. Responsive to the delivery surface being positioned against the tissue, the drug-eluting element releases the drug to the area of targeted tissue through the delivery surface. The drug delivery device includes one or more barrier structures disposed along the one or more non-delivery surfaces of the drug-eluting element. The one or more barrier structures substantially inhibit release of the drug from the drug-eluting element through the one or more non-delivery surfaces.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61K 31/525 - Isoalloxazines, e.g. riboflavins, vitamin B2
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Medical services; Surgery; Medical services, namely, a non-surgical procedure using a combination of a cross-linking agent and radiation; Surgery, namely, a surgical procedure using a combination of a cross-linking agent and radiation.
61.
SYSTEMS AND METHODS FOR TREATING AN EYE WITH A MASK DEVICE
An eye treatment positions a mask device over first and second eyes. A posterior side of the mask device is proximate to the face and the anterior side is distal from the face. The mask device includes an outer wall extending between the anterior and posterior sides and defining a chamber extending across the first and second eyes. The anterior side includes a first transmission region that allows a photoactivating light for the first eye to be delivered into a first section of the chamber positioned over the first eye. The anterior side includes a second transmission region that allows a photoactivating light for the second eye to be delivered into the second section positioned over the second eye. The system includes at least one gas source storing a gas that is different than ambient air. The system includes a gas delivery system that delivers the gas into the chamber.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
62.
SYSTEMS AND METHODS FOR CROSS-LINKING TREATMENTS OF AN EYE
A corneal treatment system includes an illumination system configured to deliver photoactivating light to a cross-linking agent applied to a cornea. The system includes a controller that receives input relating to a desired biomechanical change in the cornea and executes program instructions to: (i) determine, from a photochemical kinetic model, a three- dimensional distribution of cross-links for the cornea to achieve the desired biomechanical change in the cornea, where the photochemical kinetic model calculates the distribution of cross-links based on cross-linking from (A) reactions involving reactive oxygen species (ROS) including at least peroxides, superoxides, and hydroxyl radicals, and (B) reactions not involving oxygen; and (ii) determine at least one set of treatment parameters to achieve the distribution of cross-links. The at least one set of treatment parameters includes illumination parameters for the delivery of the photoactivating light. The illumination system delivers the photoactivating light according to the illumination parameters.
Medical instruments for treating eye conditions and diseases; medical apparatus and devices, namely, eyewear, goggles, and/or masks for controlling a gas content at an eye during a medical procedure or treatment.
Medical instruments for treating eye conditions and diseases, namely, keratoconus, corneal ectasia, myopia, hyperopia, presbyopia, post cataract residual myopia, and hyperopia; medical apparatus and devices, namely, eyewear, goggles, and masks for controlling a gas content at an eye during a medical procedure and during treatment for an eye condition
65.
SYSTEMS AND METHODS FOR TREAMENTS OF AN EYE WITH A PHOTOSENSITIZER
A formulation for an eye treatment includes a photosensitizer and a permeability enhancing composition. The permeability enhancing composition includes one or more permeability enhancers. The permeability enhancing composition has a hydrophilic and lipophilic balance increases a permeability of an area of the eye for the photosensitizer. The hydrophilic and lipophilic balance can be characterized by a Hydrophile-Lipophile Balance (HLB) number. For example, the area of the eye may include a corneal epithelium, the photosensitizer may include riboflavin, and the permeability enhancing composition may have a corresponding HLB number between approximately 12.6 and approximately 14.6.
A61K 31/525 - Isoalloxazines, e.g. riboflavins, vitamin B2
A61K 47/34 - Macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyesters, polyamino acids, polysiloxanes, polyphosphazines, copolymers of polyalkylene glycol or poloxamers
A system for treatment of corneal tissue includes one or more light sources that generate excitation light delivered to corneal tissue treated with a cross-linking agent. The excitation light causes the cross-linking agent to fluoresce by emitting an emission light at a plurality of emission wavelengths. The system includes an image capture system that captures image(s) of the corneal tissue. The image(s) indicate at least two of the emission wavelengths. The system includes a controller that receives the image(s). The controller: identifies each of the at least two emission wavelengths in the image(s); determines, from the image(s), respective characteristics associated separately with each of the at least two emission wavelengths; and provides information relating to cross-linking activity generated by the cross-linking agent in the corneal tissue based on the respective characteristics associated with each of the at least two emission wavelengths.
An antimicrobial treatment system comprises a wearable photoactivation device. The wearable photoactivation device includes a body configured to be positioned on a head of a subject over one or more eyes of the subject. The body includes one or more windows or openings that allow the one or more eyes to see through the body. The body includes one or more photoactivating light sources coupled to the body and configured to direct photoactivating light to the one or more eyes according to illumination parameters. The illumination parameters determine a dose of the photoactivating light that activates, according to photochemical kinetic reactions, a photosensitizer applied to the one or more eyes and generates reactive oxygen species that provide an antimicrobial effect in the one or more eyes, without substantially inducing cross-linking activity that produces biomechanical changes in the one or more eyes.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
05 - Pharmaceutical, veterinary and sanitary products
10 - Medical apparatus and instruments
Goods & Services
Pharmaceutical preparations for the treatment of eye diseases and conditions Medical instruments for treating eye conditions and diseases; medical apparatus and devices utilizing radiation to treat eye conditions and diseases; software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus; Ophthalmological diagnostic apparatus and devices
69.
SYSTEMS, METHODS, AND COMPOSITIONS FOR CROSS-LINKING TREATMENTS OF AN EYE
Systems, methods, and compositions generate cross-linking activity for treatment of eye disorders. Various agents, additives, buffers, etc., may be employed in formulations with a cross-linking agent to enhance treatment. For example, a composition for applying treatment to a cornea of an eye includes a cross-linking agent that generates cross-linking activity in the cornea in response to exposure to a photo-activating light. The composition also includes an iron additive and citrate buffer. In some cases, the cross-linking agent may include riboflavin. In other cases, the iron additive may include FeSO4. In further cases, the iron additive may be dissolved in the citrate buffer.
An example system determines biomechanical properties of eye tissue. The system includes a confocal microscopy system configured to scan the incident light across a plurality of cross-sections of the tissue. The incident light is reflected by the plurality of cross-sections of tissue as scattered light. The system includes a spectrometer to receive the scattered light and provide spectral information for the scattered light. The system includes processor(s) to determine a Brillouin frequency shift from the spectral information and to generate a three-dimensional profile of the corneal tissue according to the Brillouin frequency shift. The three-dimensional profile provides an indicator of one or more biomechanical properties of the tissue. The spectrometer includes a multipass optical device that generates an interference pattern from the scattered light. The interference pattern provides the spectral information for the scattered light. The spectrometer includes a camera to detect the interference pattern from the optical device.
A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Medical instruments for treating eye conditions and diseases; medical apparatus and devices utilizing radiation to treat eye conditions and diseases; software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus; Ophthalmological diagnostic apparatus and devices. Surgery; vision surgery services; Treatment of eye conditions and diseases; Ophthalmological diagnostic services.
Medical instruments for treating eye conditions and diseases; medical apparatus and devices utilizing radiation to treat eye conditions and diseases; software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus; Ophthalmological diagnostic apparatus and devices
74.
SYSTEMS AND METHODS FOR DETERMINING BIOMECHANICAL PROPERTIES OF THE EYE FOR APPLYING TREATMENT
A system for determining biomechanical properties of corneal tissue includes a light source configured to provide an incident light and a confocal microscopy system configured to scan the incident light across a plurality of cross-sections of corneal tissue. The incident light is reflected by the corneal tissue as scattered light. The system also includes a filter or attenuating device configured to block or attenuate the Rayleigh peak frequency of the scattered light, a spectrometer configured to receive the scattered light and process frequency characteristics of the received scattered light to determine a Brillouin frequency shift in response to the Rayleigh peak frequency being blocked or attenuated by the filter or attenuating device, and a processor configured to determine a three-dimensional profile of the corneal tissue according to the determined Brillouin frequency shift. The three-dimensional profile provides an indicator of one or more biomechanical properties of the corneal tissue.
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
75.
SYSTEMS AND METHODS FOR DETERMINING BIOMECHANICAL PROPERTIES OF THE EYE FOR APPLYING TREATMENT
A system for determining biomechanical properties of corneal tissue includes a light source configured to provide an incident light and a confocal microscopy system configured to scan the incident light across a plurality of cross-sections of corneal tissue. The incident light is reflected by the corneal tissue as scattered light. The system also includes a filter or attenuating device configured to block or attenuate the Rayleigh peak frequency of the scattered light, a spectrometer configured to receive the scattered light and process frequency characteristics of the received scattered light to determine a Brillouin frequency shift in response to the Rayleigh peak frequency being blocked or attenuated by the filter or attenuating device, and a processor configured to generate a three-dimensional profile of the corneal tissue according to the determined Brillouin frequency shift. The three-dimensional profile provides an indicator of one or more biomechanical properties of the corneal tissue.
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/14 - Arrangements specially adapted for eye photography
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
76.
SYSTEMS, METHODS, AND COMPOSITIONS FOR CROSS-LINKING
Various agents and additives for cross-linking treatments are identified in disclosed studies. The characteristics of the various agents and additives may be advantageously employed in formulations applied in cross-linking treatments of the eye. In some embodiments, riboflavin is combined with Iron(II) to enhance the cross-linking activity generated by the riboflavin. In other embodiments, cross-linking treatments employ an Iron(II) solution in combination with a hydrogen peroxide pre-soak. In yet other embodiments, 2,3-butanedione is employed to increase the efficacy of corneal cross-linking with a photosensitizer, such as riboflavin. In further embodiments, folic acid is employed in combination with a photosensitizer, such as riboflavin, to enhance cross-linking activity. In yet further embodiments, 2,3-butanedione, folic acid, a quinoxaline, a quinoline, dibucaine, Methotrexate, menadione, or a derivative thereof is applied as a cross-linking agent.
A61K 31/495 - Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two nitrogen atoms as the only ring hetero atoms, e.g. piperazine
A61K 31/525 - Isoalloxazines, e.g. riboflavins, vitamin B2
System and methods for a corrective eye procedure include at least one application device configured to be positioned at a selected area of an eye (e.g., equatorial sclera, posterior sclera, cornea, etc.). The at least one device includes at least one channel and at least one illumination guide. A cross-linking agent source is coupled to the at least one channel. An illumination source is coupled to the at least one illumination guide. The at least one device delivers the cross-linking agent to the selected area of the eye. The at least one device delivers photo-activating light from the illumination source to the selected area of the eye after the cross-linking agent has been delivered. The photo-activating light includes one or more doses necessary for activating the cross-linking agent and for activating TGF-β isoforms to improve health of extracellular matrices in the selected area of the eye.
A glaucoma treatment system includes: a cannula body configured to be positioned in an area of Schlemm's canal; an illumination guide extending along the cannula body; at least one drug source coupled to the cannula body; a cross-linking agent source coupled to the cannula body; and an illumination source coupled to the illumination guide. The at least one drug source includes a drug that promotes outflow of aqueous humor through the trabecular meshwork and into Schlemm's canal. The cannula body delivers the drug from the at least one drug source to the area of Schlemm's canal, and in response to changes in the outflow of aqueous humor, delivers the cross-linking agent to the area of Schlemm's canal. The illumination guide delivers photo-activating light from the illumination source to the area of Schlemm's canal. The photo-activating light activates the cross-linking agent, thereby stabilizing changes in the area of Schlemm's canal.
Systems and methods for treating an eye select locations for making incisions in areas of the cornea according to astigmatic keratotomy or radial keratotomy, make incisions in the selected areas of the cornea, apply a cross-linking agent to the selected areas of the cornea, and deliver photoactivating light from a light source to the selected areas of the cornea to initiate cross-linking activity in the selected areas of the cornea.
According to aspects of the present disclosure, a kit for transepithelial delivery of a cross-linking agent to a cornea includes a first vessel containing an initial formulation that includes a cross-linking agent and a first active ingredient configured to open corneal epithelial tight junctions when applied to a cornea and one or more second vessels each containing a respective secondary formulation that includes the cross-linking agent for application to the cornea after the initial formulation is applied to the cornea.
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
(1) Vision surgery, namely, eye surgery; treatment of eye conditions and diseases, namely, a procedure using a cross-linking agent and a cross-linking activation energy to change the shape of the cornea without incisions, used for refractive correction with cross-linking alone; Medical services, namely, a procedure using a combination of riboflavin drops and UVA irradiation to change the shape of the cornea without incisions, used for refractive correction with cross-linking alone.
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Vision surgery; treatment of eye conditions and diseases namely, a procedure using a cross-linking agent and a cross-linking activation energy to change the shape of the cornea without incisions, used for refractive correction with cross-linking alone; Medical services, namely, a procedure using a combination of riboflavin drops and UVA irradiation to change the shape of the cornea without incisions, used for refractive correction with cross-linking alone.
83.
SYSTEMS AND METHODS FOR CORNEAL CROSS-LINKING WITH PULSED LIGHT
A method for controlling activation of a cross-linking agent applied to an eye includes applying the cross-linking agent to a selected region of a cornea of the eye and initiating cross-linking activity in the selected region by activating the cross-linking agent with pulsed light illumination. The pulsed light illumination has a selectable wavelength, irradiance, dose, and on/off duty cycle. The wavelength, the irradiance, the dose, and the on/off duty cycle are adjusted in response to a determination of photochemical kinetic pathways for cross-linking activity and to control photochemical efficiency, depth of cross-linking, and density of cross-linking.
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
Medical instruments for treating eye conditions and diseases; medical apparatus and devices utilizing radiation to treat eye conditions and diseases; software for use in treatment of eye conditions and diseases, sold as a component of an ophthalmic medical treatment apparatus
Embodiments apply light energy in medical treatments. To enhance or control the effect of the light energy, embodiments apply the light energy after tissue has been treated, e.g., with a photosensitizing agent. For example, embodiments may treat target tissue with riboflavin before exposure to ultraviolet light. For example, a system for cataract surgery includes a removal system configured to remove a first lens from an eye, wherein a capsular bag remains in the eye after removal of the first lens. The system includes an application system configured to treat lenticular epithelial cells in the capsular bag with the photosensitizing agent. The system includes a delivery system with a light source and an optical device. The optical device delivers light to the treated lenticular epithelial cells. Energy from the light destroys the lenticular epithelial cells in the capsular bag to reduce the growth of epithelial cells that cause posterior capsule opacification.
A method for controlling activation of Riboflavin applied to an eye includes applying the Riboflavin to a selected region of a cornea of the eye and initiating cross-linking activity in the selected region by activating the Riboflavin with pulsed light illumination. The pulsed light illumination has an irradiance, dose, and an on/off duty cycle. The irradiance, the dose, and the on/off duty cycle are adjusted in response to a determination of photochemical kinetic pathways for Riboflavin cross-linking activity and to control photochemical efficiency.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61K 31/525 - Isoalloxazines, e.g. riboflavins, vitamin B2
In systems and methods for generating cross-linking activity in an eye, a feedback system monitors a biomechanical strength of the eye in response to the photoactivation of a cross-linking agent applied to an eye. The feedback system includes a perturbation system that applies a force to the eye and a characterization system that determines an effect of the force on the eye. The effect of the force provides an indicator of the biomechanical strength of the eye. The characterization system determines the effect of the force on the eye by measuring an amount of deformation caused by the force or a rate of recovery from the deformation.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
44 - Medical, veterinary, hygienic and cosmetic services; agriculture, horticulture and forestry services
Goods & Services
Medical services; Medical services in the field of ophthalmology; Providing refractive ophthalmic procedure services; Surgery; Laser vision surgery services; Treatment of eye conditions and diseases
05 - Pharmaceutical, veterinary and sanitary products
Goods & Services
Pharmaceutical preparations for treatment of eye conditions and diseases, namely, formulations applied to the cornea, to the exception of antiviral pharmaceutical preparations and cancer therapy.
05 - Pharmaceutical, veterinary and sanitary products
Goods & Services
Pharmaceutical preparations for treatment of eye conditions and diseases, namely, formulations applied to the cornea, to the exception of antiviral pharmaceutical preparations.
Devices and approaches for monitoring time based photo active agent delivery or photo active marker presence in an eye. A monitoring system is provided for measuring the presence of a photo active marker by illuminating the eye so as to excite the photo-active marker and then observing characteristic emission from the photo active marker. Example systems incorporate Scheimpflug optical systems or slit lamp optical systems to observe cross sectional images of an eye to monitor instantaneous distribution, diffusion pattern, and rate of uptake of a photo active agent applied to an eye. Systems and methods further allow for utilizing the monitored distribution of photo active agent in the eye as feedback for a cross-linking system.
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/14 - Arrangements specially adapted for eye photography
Systems and methods include a cutting instrument that creates incisions in selected areas of the cornea; an eye therapy system that applies reshaping forces to the cornea; and a controller that determines the selected areas of the cornea for the incisions and the reshaping forces from the eye therapy system, such that the reshaping forces and the incisions combine to achieve corrective reshaping of the cornea. Other systems and methods include measuring an eye to determine a required amount of reshaping of a cornea; determining one or more doses of cross-linking agent and one or more corresponding doses of photoactivating light according to the required amount of reshaping; applying the cross-linking agent to the cornea; and delivering, from a light source, the photoactivating light to the area of the eye, the photoactivating light combining with the cross-linking agent to induce the corrective reshaping of the cornea.
Devices and approaches for activating cross-linking within at least one eye component of an eye to stabilize and strengthen corneal tissue or other tissues of the eye. Cross-linking is activated within the at least one eye component by conveying a cross-linking agent to regions of the at least one eye component and then activating the cross-linking agent by delivering an initiating element to the at least one eye component. Approaches disclosed herein allow for precisely controlling the three dimensional region of strengthened tissue by conveying the cross-linking agent to regions of the at least one eye component. Approaches allow for conveying the cross-linking agent to a depth below the corneal surface such that cross-linking is activated below the corneal surface.
Devices and approaches for activating cross-linking within corneal tissue to stabilize and strengthen the corneal tissue following an eye therapy treatment. A feedback system is provided to acquire measurements and pass feedback information to a controller. The feedback system may include an interferometer system, a corneal polarimetry system, or other configurations for monitoring cross-linking activity within the cornea. The controller is adapted to analyze the feedback information and adjust treatment to the eye based on the information. Aspects of the feedback system may also be used to monitor and diagnose features of the eye. Methods of activating cross-linking according to information provided by a feedback system in order to improve accuracy and safety of a cross-linking therapy are also provided.
e) when in step c) the comparison does not yield a sufficient agreement between the simulated change and the change in the eye tissue to be achieved, at least one of the treatment parameters in step b) is/are modified and steps b), c) and d) are then performed again therewith.
A61B 19/00 - Instruments, implements or accessories for surgery or diagnosis not covered by any of the groups A61B 1/00-A61B 18/00, e.g. for stereotaxis, sterile operation, luxation treatment, wound edge protectors(protective face masks A41D 13/11; surgeons' or patients' gowns or dresses A41D 13/12; devices for carrying-off, for treatment of, or for carrying-over, body liquids A61M 1/00)
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
G06F 19/00 - Digital computing or data processing equipment or methods, specially adapted for specific applications (specially adapted for specific functions G06F 17/00;data processing systems or methods specially adapted for administrative, commercial, financial, managerial, supervisory or forecasting purposes G06Q;healthcare informatics G16H)
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61F 9/008 - Methods or devices for eye surgery using laser
100.
Apparatus for the cross-linking of ocular tissue with electromagnetic radiation
An apparatus for generating an alteration of biomechanical properties of ocular tissue, into which a photosensitizer (14) has been introduced, contains means (18, 20) for radiating into the tissue electromagnetic radiation (12′) which reacts with the photosensitizer for the purpose of generating a cross-linking. The setting means permit an inhomogeneous distribution of the irradiance in the tissue and a setting of the depth of action (16′).
A61B 18/18 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
