IPC분류정보
국가/구분 |
United States(US) Patent
등록
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국제특허분류(IPC7판) |
|
출원번호 |
US-0745191
(2000-12-21)
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발명자
/ 주소 |
- Frey, Rudolph W.
- Burkhalter, James H.
- Gray, Gary P.
- Zepkin, Neil
- Downes, Jr., George Richard
- McWhirter, John E.
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출원인 / 주소 |
|
대리인 / 주소 |
Allen, Dyer, Doppelt, Milbrath & Gilchrist, P.A.
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인용정보 |
피인용 횟수 :
24 인용 특허 :
127 |
초록
▼
An ophthalmic laser system includes a laser beam delivery system and an eye tracker responsive to movement of the eye operable with a laser beam delivery system for ablating corneal material of the eye through placement of laser beam shot on a selected area of the cornea of the eye. The shots are fi
An ophthalmic laser system includes a laser beam delivery system and an eye tracker responsive to movement of the eye operable with a laser beam delivery system for ablating corneal material of the eye through placement of laser beam shot on a selected area of the cornea of the eye. The shots are fired in a sequence and pattern such that no laser shots are fired at consecutive locations and no consecutive shots overlap. The pattern is moved in response to the movement of the eye.
대표청구항
▼
An ophthalmic laser system includes a laser beam delivery system and an eye tracker responsive to movement of the eye operable with a laser beam delivery system for ablating corneal material of the eye through placement of laser beam shot on a selected area of the cornea of the eye. The shots are fi
An ophthalmic laser system includes a laser beam delivery system and an eye tracker responsive to movement of the eye operable with a laser beam delivery system for ablating corneal material of the eye through placement of laser beam shot on a selected area of the cornea of the eye. The shots are fired in a sequence and pattern such that no laser shots are fired at consecutive locations and no consecutive shots overlap. The pattern is moved in response to the movement of the eye. al., "Accurate 3D Corneal Surface Measurement Using an Automated Mapping Approach," SPIE, vol. 2434, 1995, pp. 328-334. Salmon, et al., "Comparison of Elevation, Curvature, and Power Descriptors for Corneal Topographic Mapping," Optometry & Vision Science, vol. 72, No. 11, 1195, pp. 800-808. Pavlopoulos, et al, "The Effect of Artificial Tears on Computer-assisted Corneal Topography in Normal Eyes and After Penetrating Keratoplasty," American Journal of Ophthalmology, vol. 119, Jun. 1995, pp. 712-722. Roberts, "Characterization of the Inherent Error in a Spherically-Biased Corneal Topography System in Mapping a Radially Aspheric Surface," Journal of Refractive & Corneal Surgery, vol. 10, Mar./Apr. 1994, pp. 103-111. Thornton, "Clinical Evaluation of Corneal Topography," J. Cataract Refract. Surg., vol. 19, Supplement 1993, pp. 198-202. Rabinowitz, et al., "Computer-assisted Corneal Topography in Keratoconus," Refractive & Corneal Surgery, vol. 5, Nov./Dec. 1989, pp. 400-408. Wilson, et al., "Accuracy and Precision of the Corneal Analysis System and the Topographic Modeling System," Cornea, vol. 11, No. 1, 1992, pp. 28-35. Bogan, et al., Computer-assisted Videokeratography of Corneal Topography After Radial Keratotomy, Arch. Opthalmol., vol. 109, Jun. 1991, pp. 834-841. Bogan, et al., "Classification of Normal Corneal Topography Based on Computer-assisted Videokeratography," Arch. Ophthalmol., vol. 108, Jul. 1990, pp. 945-949. Reidy, et al., "The Corneal Topography of Epikeratophakia," Refractive & Corneal Surgery, vol. 6, Jan./Feb. 1990, pp. 26-31. Dingeldein, et al., "The Topography of Normal Corneas," Arch. Opthalmol, vol. 107, Apr. 1989, pp. 512-518. McDonnell, et al., "Topographic Analysis and Visual Acuity After Radial Keratotomy," American Journal of Ophthalmology, vol. 106, No. 6, Dec. 1988, pp. 692-695. McDonnell, et al., "Corneal Topographic Changes After Radial Keratomy," Opthalmology, vol. 96, No. I, Jan. 1989, pp. 45-49. Kiely, et al., "The Mean Shape of the Human Cornea," Optica Acta, vol. 29, No. 8, 1982, pp. 1027-1040. Bafna, et al., "Corneal Power Calculated by the Paraxial Formula and Snell's Law in Normal Corneas," Investigative Ophthalmology & Visual Science, vol. 37, No. 3, Feb. 1996, Poster No. 2589. Matallana, et al, "3-D Video Corneal Topography True Elevation Mapping," Investigative Ophthalmology & Visual Science, vol. 37, No. 3, Feb. 1996, Poster No. 2590. Aoyama, et al, "Quantitative Evaluation of Corneal Astigmatism Using Computer Corneal Topography and Newly Developed Software," Investigative Ophthalmology & Visual Science, vol. 37, No. 3, Feb. 1996, Poster No. 2591. Celikkoi, et al, "Neural Network Analysis of Videokeratography Following Excimer Laser Photorefractive Keratectomy," Investigative Ophthalmology & Visual Science, vol. 37, No. 3, Feb. 1996, Poster No. 2592. Walsh, et al., "Objective Technique for the Determination of Monochromatic Aberrations of the Human Eye," J. Opt. Soc. Am. A, vol. 1, No. 9, Sep. 1984, pp. 987-992. Williams, et al., "Adaptive Optics for High Resolution Retinal Imaging," Investigative Ophthalmology & Visual Science, vol. 37, No. 3, Feb. 1996, p. 1055. Charman, "Wavefront Aberration of the Eye: A Review," Optometry and Vision Science, vol. 68, No. 8, pp. 574-583. Bartsch, et al., "Resolution Improvement in Confocal Scanning Laser Tomography of the Human Fundus," 1994 Technical Digest Series, vol. 2 (Optical Society of America, Washington D. C.), 1994, pp. 134-137. Bille, et al., "Scanning Laser Tomography of the Living Human Eye," Noninvasive Diagnostic Techniques in Ophthalmology, Chapter 28, edited by Masters, B.R., Springer-Verlag, 1990, pp. 528-547. Liang, Junzhong, A New Method to Precisely Measure the Wave Aberrations of the Human Eye with a Hartmann-Shack Wavefront Sensor, Inaugural Dissertation, Dec. 1991, pp. 1-115, Heidelberg, Germany. Bille, et al., "Imaging of the Retina by Scanning Laser Tomography," New Methods in Microscopy and L ow Light Imaging, vol. 1161, 1989, pp. 417-425. Cubalchini, "Modal Wave-front Estimation from Phase Derivative Measurements," J. Opt. Soc. Am., vol. 69, 1979, pp. 972-977. "Modal Wave-front Estimation from Phase Derivative Measurements," Referenced in Bille, U.S. Patent No. 5,062,702 IDS, 1990. Freischlad, et al., "Modal Estimation of a Wave Front from Difference Measurements Using the Discrete Fourier Transform," J. Opt. Soc. Am., vol. 3, No. 11, Nov. 1986, pp. 1852-1861. Klyce, et al., "Imaging, Reconstruction, and Display of Corneal Topography," New Methods in Microscopy and Low Light Imaging, vol. 1161, 1989, pp. 409-416. Baker, "Optical Surface Testing of the Cornea," New Methods in Microscopy and Low Light Imaging, vol. 1161, 1989, pp. 427-437. Southwell, "Wave-front Estimation from Wave-front Slope Measurements," J. Opt. Soc. Am., vol. 70, No. 8, Aug. 1980, pp. 998-1005. tain said hose. 5. A disposable douche assembly as in claim 1 wherein said lower portion includes an indented area for receiving a thumb of a user. 6. A disposable douche assembly as in claim 1 wherein an end cap is removable secured to said hose, said end cap is secured to said hose once said nozzle is removed and disposed. 7. A disposable douche assembly as in claim 1 wherein said valve assembly includes an inlet, a first outlet and a second outlet, said inlet is secured to said water source, first outlet is secured to an existing shower head, said second outlet is secured to said hose, said safety device is a washer and is located between said second outlet and said hose. 8. A disposable douche assembly as in claim 1 wherein said valve assembly is controlled via a handle and indicia are exteriorly located on said valve assembly for indicating outlet selected. 9. A disposable douche assembly as in claim 1 wherein said nozzle includes a chamber for receiving medicine for allowing said medicine mix with water for forming a solution and to exit via said nozzle. 10. A disposable douche as in claim 1 wherein said hose includes outer ends and each end includes an internally threaded member, said internally threaded member constitutes said attaching device and said nozzle includes externally threaded member and said valve assembly includes externally threaded member. 11. A disposable douche as in claim 1 wherein said nozzle includes a tip and said tip includes an opening. e shunt device of claim 1, wherein the distal portion has a lumen therethrough that allows the passage of fluid into Schlemm's canal. 14. The shunt device of claim 1, wherein the distal portion has one or more fenestrations therein that allow the passage of fluid into Schlemm's canal. 15. The shunt device of claim 1, wherein the proximal portion has one or more lumens therethrough that facilitate the passage of fluid into the distal portion of the shunt. 16. The shunt device of claim 15, wherein the proximal portion has two lumens therethrough that facilitate the passage of fluid into the distal portion of the shunt in opposite directions. 17. The shunt device of claim 1, wherein the proximal portion has one or more fenestrations therein that facilitate the passage of fluid into the distal portion of the shunt. 18. The shunt device of claim 17, wherein a lumen of the proximal portion communicates with one or more fenestrations oriented to open towards the inner surface of the cornea and away from the iris. 19. The shunt device of claim 1, further comprising a plurality of proximal portions intersecting the distal portion. 20. The shunt device of claim 1, wherein at least a portion of the distal portion is selected from the group consisting of a round tubular channel, an ovoid tubular channel, a semi-tubular channel, and a partially open trough-like channel. 21. The shunt device of claim 1, wherein at least a portion of the distal portion is a partially open trough-like channel open posteriorly toward one or more collecting channels of the eye. 22. The shunt device of claim 1, wherein at least a portion of the device is constructed from porous material. 23. The shunt device of claim 1, in which the terminal aspect of the proximal portion is angled internally towards the anterior chamber with respect to the proximal portion. 24. An aqueous humor shunt device to divert aqueous humor in an eye from the anterior chamber into Schlemm's canal, the shunt device comprising a distal portion having at least one terminal aspect sized and shaped to be received within a portion of Schlemm's canal and a proximal portion having at least one terminal aspect sized and shaped to be received within the anterior chamber of the eye, wherein device permits fluid communication from the proximal portion in the anterior chamber to the distal portion in Schlemm's canal, wherein the shunt device is non-linear prior to insertion. 25. The shunt device of claim 24, wherein said distal portion of the shunt has an outer diameter of about 0.1 mm to 0.5 mm and a length of about 1 mm to 20 mm, and wherein said proximal portion has a length of about 0.1 to 3 mm. 26. The shunt device of claim 24, wherein said distal portion has a curve having a radius which approximates the radius of Schlemm's canal of a human eye, wherein the radius is between about 3 mm and 10 mm. 27. The shunt device of claim 26, wherein said curve has a radius of about 6 mm. 28. The shunt device of claim 24, wherein the proximal portion of the shunt intersects the distal portion and wherein the distal portion branches in two opposite directions from the intersection with the proximal portion permitting fluid communication from the anterior chamber in either direction along Schlemm's canal. 29. The shunt device of claim 28, wherein the proximal portion of the shunt intersects the distal portion at about the midpoint of the length of the distal portion. 30. The shunt device of claim 24, wherein the distal portion extends in one direction within Schlemm's canal. 31. The shunt device of claim 24, wherein the distal portion comprises a lumen that extends in either direction along Schlemm's canal. 32. The shunt device of claim 24, wherein the device further comprises one or more unidirectional valves. 33. The shunt device of claim 24, wherein the proximal portion extends from the distal portion at an angle to avoid occlusion from contact with corneal endothelium tissue or iris tissue when the distal portion is located within Schlemm's canal. 34. The shunt device of claim 24, wherein said distal portion has an outer diameter of about 0.30 mm. 35. The shunt device of claim 24, wherein said proximal portion is tubular having a lumen with an internal diameter of between about 0.1 mm and 0.5 mm. 36. The shunt device of claim 24, wherein said proximal portion is tubular with a lumen with an internal diameter of about 0.2 mm. 37. The shunt device of claim 24, wherein said proximal portion has a length of about 2 mm. 38. The shunt device of claim 24, wherein said distal portion has a length of about 6 mm. 39. The shunt device of claim 24, wherein the distal portion has a lumen therethrough that allows the passage of fluid into Schlemm's canal. 40. The shunt device of claim 24, wherein the distal portion has one or more fenestrations therein that allow the passage of fluid into Schlemm's canal. 41. The shunt device of claim 24, wherein the proximal portion has one or more lumens therethrough that facilitate the passage of fluid into the distal portion of the shunt. 42. The shunt device of claim 41, wherein the proximal portion has two lumens therethrough that facilitate the passage of fluid into the distal portion of the shunt in opposite directions. 43. The shunt device of claim 24, wherein the proximal portion has one or more fenestrations therein that facilitate the passage of fluid into the distal portion of the shunt. 44. The shunt device of claim 43, wherein a lumen of the proximal portion communicates with one or more fenestrations oriented to open towards the inner surface of the cornea and away from the iris. 45. The shunt device of claim 24, further comprising a plurality of proximal portions intersecting the distal portion. 46. The shunt device of claim 24, in which an aqueous humor wicking extension of between about 1.0 mm to 16.0 mm in length extends from said terminal aspect of the distal portion. 47. The shunt device of claim 24, wherein at least a portion of the distal portion is selected from the group consisting of a round tubular channel, an ovoid tubular channel, a semi-tubular channel, and a partially open trough-like channel. 48. The shunt device of claim 24, wherein at least a portion of the distal portion is a partially open trough-like channel open posteriorly toward one or more collecting channels of the eye. 49. The shunt device of claim 24, wherein at least a portion of the device is constructed from porous material. 50. The shunt device of claim 24, in which the terminal aspect of the proximal portion is angled internally towards the anterior chamber with respect to the proximal portion. 51. An aqueous humor shunt device to divert aqueous humor in an eye from the anterior chamber into Schlemm's canal, the shunt device comprising a distal portion having at least one terminal aspect sized and shaped to be received within a portion of Schlemm's canal and a proximal portion having at least one terminal aspect sized and shaped to be received within the anterior chamber of the eye, wherein device permits fluid communication from the proximal portion in the anterior chamber to the distal portion in Schlemm's canal, wherein the shunt device is constructed of a flexible material and permits bi-directional fluid flow within Schlemm's canal when inserted. 52. The shunt device of claim 51, wherein said distal portion of the shunt has an outer diameter of about 0.1 mm to 0.5 mm and a length of about 1 mm to 20 mm, and wherein said proximal portion has a length of about 0.1 to 3 mm. 53. The shunt device of claim 51, wherein said distal portion has a curve having a radius which approximates the radius of Schlemm's canal of a human eye, wherein the radius is between about 3 mm and 10 mm. 54. The shunt device of claim 53, wherein said curve has a radius of about 6 mm. 55. The shunt device of claim 51, wherein the proximal portion of the shunt intersects the distal portion at about the midpoint of the length of the dis tal portion. 56. The shunt device of claim 51, wherein the proximal portion extends from the distal portion at an angle to avoid occlusion from contact with corneal endothelium tissue or iris tissue when the distal portion is located within Schlemm's canal. 57. The shunt device of claim 51, wherein said distal portion has an outer diameter of about 0.30 mm. 58. The shunt device of claim 51, wherein said proximal portion is tubular having a lumen with an internal diameter of between about 0.1 mm and 0.5 mm. 59. The shunt device of claim 51, wherein said proximal portion is tubular with a lumen with an internal diameter of about 0.2 mm. 60. The shunt device of claim 51, wherein said proximal portion has a length of about 2 mm. 61. The shunt device of claim 51, wherein said distal portion has a length of about 6 mm. 62. The shunt device of claim 51, wherein the distal portion has a lumen therethrough that allows the passage of fluid into Schlemm's canal. 63. The shunt device of claim 51, wherein the distal portion has one or more fenestrations therein that allow the passage of fluid into Schlemm's canal. 64. The shunt device of claim 51, wherein the proximal portion has one or more lumens therethrough that facilitate the passage of fluid into the distal portion of the shunt. 65. The shunt device of claim 64, wherein the proximal portion has two lumens therethrough that facilitate the passage of fluid into the distal portion of the shunt in opposite directions. 66. The shunt device of claim 51, wherein the proximal portion has one or more fenestrations therein that facilitate the passage of fluid into the distal portion of the shunt. 67. The shunt device of claim 66, wherein a lumen of the proximal portion communicates with one or more fenestrations oriented to open towards the inner surface of the cornea and away from the iris. 68. The shunt device of claim 51, further comprising a plurality of proximal portions intersecting the distal portion. 69. The shunt device of claim 51, in which an aqueous humor wicking extension of between about 1.0 mm to 16.0 mm in length extends from said terminal aspect of the distal portion. 70. The shunt device of claim 51, wherein at least a portion of the distal portion is selected from the group consisting of a round tubular channel, an ovoid tubular channel, a semi-tubular channel, and a partially open trough-like channel. 71. The shunt device of claim 51, wherein at least a portion of the distal portion is a partially open trough-like channel open posteriorly toward one or more collecting channels of the eye. 72. The shunt device of claim 51, wherein at least a portion of the device is constructed from porous material. 73. The shunt device of claim 51, in which the terminal aspect of the proximal portion is angled internally towards the anterior chamber with respect to the proximal portion. ar positioned within said barrel transverse to said sides of said barrel; a first tooth positioned on said arm, said first tooth having a leading edge facing said sharp end of said needle and a trailing edge facing said plunger end of said barrel; a second tooth positioned on said arm between said first tooth and said plunger end of said arm, said second tooth having a leading edge facing said sharp end of said needle and a trailing edge facing said plunger end of said; said first tooth and said second tooth positioned to encounter said bar when said sheath is advanced from said exposed position to said covered position, said first tooth configured to pass over said bar when force is applied to said arm in the direction of said sharp end of said needle, said trailing edge of said first tooth configured to prevent said first tooth from passing over said bar when force is applied to said arm in the direction of said plunger end of said barrel, said second tooth configured to prevent said second tooth from passing over said bar when force is applied to said arm in the direction of said sharp end of said needle, whereby said bar may be locked between said first tooth and said second tooth; and wherein said needle, said sheath, said bar, said arm, said first tooth and said second tooth are configured so that said sheath is in said covered position when said bar is positioned between said teeth, whereby said sheath may be locked in said covered position by advancing said teeth until said bar is positioned between said teeth. 2. A safety syringe according to claim 1 further comprising a diaphragm slidably disposed around said barrel end of said needle, said needle configured to provide fluid passage through said diaphragm, said diaphragm configured to create a substantially fluid tight seal between said diaphragm and said barrel walls, said diaphragm positioned to engage said plunger when said plunger is depressed whereby said diaphragm may be advanced toward said sharp end of said needle, said diaphragm further positioned to engage said arm when said diaphragm is advanced toward said sharp end of said needle, whereby said sheath may be advanced by depression of said plunger. 3. A safety syringe according to claim 2 wherein said plunger end of said arm is provided with an enlarged head and wherein said diaphragm has a needle side facing said sharp end of said needle and a plunger side facing said plunger, said needle side of said diaphragm containing a groove sized to engage said enlarged head of said arm, whereby said diaphragm may provide resistance to forces exerted against said sheath in the direction of said sharp end of said needle when said groove is engaged with said head. 4. A safety syringe according to claim 3 wherein said bar is positioned to block the passage of said diaphragm toward said sharp end of said needle. 5. A safety syringe according to claim 3 further comprising at least one leg depending from said sheath, said leg positioned to encounter said bar when said sheath is in said exposed position whereby said bar and said leg will prevent said sheath from continuing to move away from said sharp end of said needle. 6. A safety syringe according to claim 2 further comprising at least one leg depending from said sheath, said leg positioned to encounter said bar when said sheath is in said exposed position whereby said bar and said leg will prevent said sheath from continuing to move away from said sharp end of said needle. 7. A safety syringe according to claim 1 further comprising at least one leg depending from said sheath, said leg positioned to encounter said bar when said sheath is in said exposed position whereby said bar and said leg will prevent said sheath from continuing to move away from said sharp end of said needle. 8. A safety syringe according to claim 1 wherein said barrel is configured to lock said plunger in place when said plunger has advanced said sheath into said covered position. 9. A safe ty syringe according to claim 8 wherein said barrel and said plunger are sized so that said plunger will fit completely into said barrel when said plunger is fully depressed. 10. A safety syringe according to claim 1 further comprising at least two arms. 11. A safety syringe according to claim 10 wherein each of said arms has a first tooth and a second tooth positioned to engage said bar as said sheath is advanced from said exposed position to said covered position, each said arm, said first teeth and said second teeth further configured to lock said bar between said first teeth and said second teeth when said sheath is in said covered position. 12. A safety syringe comprising a barrel having a needle end, a plunger end, and sides extending therebetween; a plunger slidably disposed in said barrel, said plunger having a washer end positioned closest to said needle end of said barrel, said washer end configured to create a substantially fluid 1 tight seal with said barrel sides; a needle, having a sharp end and a barrel end, mounted in said barrel such that said sharp end of said needle extends beyond said needle end of said barrel; a sheath slidably disposed over said needle, said sheath having an exposed position wherein said sharp end of said needle is not covered by said sheath and a covered position wherein said sharp end of said needle is covered by said sheath; at least one arm having a sheath end facing said sheath and a plunger end facing said plunger, said arm operatively connecting said sheath and said plunger whereby said sheath may be moved from said exposed position to said covered position upon depression of said plunger; and a locking mechanism configured to secure said sheath in said covered position comprising: a locking ring positioned on the sides of said barrel facing said plunger, said locking ring creating a constriction in the diameter of said barrel; at least one locking tooth positioned on said plunger, said plunger locking tooth configured to engage said locking ring upon advancement of said plunger, whereby the engagement of said plunger locking tooth with said locking ring will prevent the retraction of said plunger, said locking mechanism further comprising a bar positioned within said barrel transverse to said sides of said barrel; a tooth positioned on said arm, said tooth having a leading edge facing said sharp end of said needle and a trailing edge facing said plunger end of said barrel; said tooth positioned to encounter said bar when said sheath is advanced, said tooth configured to prevent said tooth from passing over said bar when force is applied to said arm in the direction of said sharp end of said needle, said tooth, said sheath, said needle, and said arm positioned so that said tooth will not engage said arm until said sheath is in said covered position. 13. 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