Systems and methods for treating glaucoma with laser pulses and visualizing the anterior angle of the eye
A laser system for treating target tissue layers of an anterior chamber angle of an eye, including a delivery system and various imaging systems is being disclosed here. The system includes novel configurations using small digital cameras, OCT and other diagnostic devices that are integrated with a goniolens to visualize and target the to be treated tissue layers and that in some configurations remain connected and active during the laser treatment. Furthermore, several novel illumination systems and standalone digital camera goniolens systems are being presented here.
1 . A modular goniolens assembly for visualizing and treating an anterior angle region of an eye, the assembly comprising:
a housing component configured to permit the assembly to be handled by a physician, the housing component having one or more individual modules for illuminating and/or visualizing the eye and a battery for powering the one or more individual modules; and
a goniolens body coupled to the housing and having a contact surface adapted to contact a cornea of the eye and an irregular shaped upper surface, opposite the contact surface, that provides aligned window surfaces that accept one or more individual modules in a predetermined alignment such that an aiming direction into the eye of the one or more individual modules is preset
to enhance visibility of the anterior angle region;
wherein the housing component is removably couplable to the goniolens body for aligning the one or more individual modules relative to the goniolens body; and
wherein the goniolens assembly is configured to provide standalone illumination and/or visualization of the anterior angle region and to facilitate delivery of laser treatment pulses to the anterior angle region.
2 . The assembly of claim 1 , further comprising a mechanical docking interface configured to detachably connect the goniolens assembly to a main laser console.
3 . The assembly of claim 2 , wherein the mechanical docking interface comprises an alignment feature ensuring co-linearity of a treatment laser beam with an optical axis of the goniolens body.
4 . The assembly of claim 1 , wherein the one or more individual modules comprises a digital camera integrated with the goniolens body and oriented to capture images of the trabecular meshwork.
5 . The assembly of claim 4 , wherein the digital camera is configured to wirelessly transmit real-time video to an external display or control system when the assembly is undocked.
6 . The assembly of claim 4 , wherein the goniolens body comprises an internal reflective surface configured to redirect a portion of the laser beam toward the trabecular meshwork while transmitting light to the digital camera.
7 . The assembly of claim 1 , further comprising a handle extending from the goniolens body to facilitate handheld manipulation and rotation around the eye's optical axis.
8 . The assembly of claim 1 , wherein the one or more individual modules comprises an illumination source that includes at least one LED array emitting both visible and infrared wavelengths for selective tissue contrast enhancement.
9 . The assembly of claim 1 , wherein the mechanical docking interface includes a locking mechanism that engages automatically upon axial alignment with the main laser console.
10 . The assembly of claim 1 , further comprising a sterile barrier element attached to the contact surface, the sterile barrier element being disposable after a single use.
11 . The assembly of claim 1 , wherein the one or more individual modules comprises an illumination source that is arranged to project light onto a retina of the eye to induce partial pupil constriction and thereby expose more of the trabecular meshwork to the digital camera.
12 . An integrated ophthalmic system for diagnostic imaging and laser treatment of an anterior angle region of an eye, the system comprising:
a laser module generating ultrashort pulses for selectively disrupting trabecular meshwork tissue;
a goniolens having a contact surface for coupling with the cornea and an integrated mirror to direct the laser beam to the anterior angle region, the goniolens having an irregular shaped upper surface, opposite the contact surface, against which an illumination module and a camera module are supported in a plurality of alignment positions;
an imaging unit configured to direct at least one of an OCT beam or a confocal beam into the eye;
an operator user interface comprising a switch for activating the laser module and a display for showing images captured by the camera module; and
a system controller configured to coordinate the laser module, the camera module, and the imaging unit to enable combined diagnostic imaging and targeted laser application to the trabecular meshwork.
13 . The system of claim 12 , wherein the system controller automatically merges real-time images from the camera module with depth information from the imaging unit for enhanced surgical guidance.
14 . The system of claim 12 , wherein the integrated mirror in the goniolens is coated to reflect the wavelength of the laser module while transmitting light within a visible or near-infrared band to the camera module.
15 . The system of claim 12 , further comprising a foot switch operatively coupled to the operator user interface provides variable vibrational feedback indicating different laser pulse energy levels.
16 . The system of claim 12 , further comprising a flange configured to accommodate a suction ring for stabilizing the goniolens against the cornea during laser application.
17 . The system of claim 12 , further comprising a rotating mirror assembly disposed between the laser module and the goniolens, the rotating mirror assembly being adapted to pivot the laser beam around at least 180 degrees of the trabecular meshwork circumference.
18 . The system of claim 12 , wherein the imaging unit comprises a confocal fluorescence detection device arranged to detect fluorescent emissions from trabecular meshwork tissue when excited by low-power scanning.
19 . The system of claim 12 , wherein the laser module is configured to generate pulses in a femtosecond to nanosecond range and deliver them at a repetition rate of up to 500 KHz.
20 . The system of claim 12 , further comprising a memory module configured to record both real-time video from the digital camera module and the imaging data from the imaging unit for post-operative analysis.