Eye therapy
Embodiments apply a cross-linking agent to a region of corneal tissue. The cross-linking agent improves the ability of the corneal tissue to resist undesired structural changes. For example, the cross-linking agent may be Riboflavin or Rose Bengal, and the initiating element may be photoactivating light, such as ultraviolet (UV) light. In these embodiments, the photoactivating light initiates cross-linking activity by irradiating the applied cross-linking agent to release reactive oxygen radicals in the corneal tissue. The cross-linking agent acts as a sensitizer to convert O 2 into singlet oxygen which causes cross-linking within the corneal tissue. The rate of cross-linking in the cornea is related to the concentration of O 2 present when the cross-linking agent is irradiated with photoactivating light. Accordingly, the embodiments control the concentration of O 2 during irradiation to increase or decrease the rate of cross-linking and achieve a desired amount of cross-linking.
1. A system for controlling cross-linking in corneal tissue, comprising:
an applicator that applies a cross-linking agent to a cornea;
a light source that provides photoactivating light to the cornea and activates the cross-linking agent causing cross-linking in corneal fibrils to preserve a structure of the cornea;
a monitoring system that determines an amount of cross-linking in the cornea; and
a delivery device that provides a gas mixture at a surface of the cornea, the gas mixture determining an O 2 content for activation of the cross-linking agent in the cornea, the delivery device being configured to selectively increase or decrease the O 2 content provided at the surface of the cornea to control the rate of cross-linking in response to the amount of cross-linking in the cornea determined by the monitoring system.
2. The system according to claim 1 , further comprising a cross-linking-agent source storing the cross-linking agent, wherein the cross-linking agent is Riboflavin.
3. The system according to claim 1 , further comprising a cross-linking-agent source storing the cross-linking agent, wherein the cross-linking agent is Rose Bengal.
4. The system according to claim 1 , wherein the photoactivating light is ultraviolet light.
5. The system according to claim 1 , wherein the delivery device includes a ring that includes one or more ports that direct the gas mixture at the cornea.
6. The system according to claim 1 , wherein the delivery device includes an enclosure that maintains the gas mixture at a pressure higher than an ambient pressure against the surface of the cornea.
7. The system according to claim 1 , wherein the monitoring system employs polarimetry to measure corneal birefringence and to determine the amount of cross-linking in the cornea in real time.
8. The system according to claim 1 , wherein the delivery device initially provides a first gas mixture that determines a first O 2 content in the cornea and, in response to the amount of cross-linking determined by the monitoring system, provides a second gas mixture that determines a second O 2 content in the cornea, the first gas mixture and the second gas mixture providing different amounts of O 2 , the delivery device providing dynamic control of cross-linking in the cornea.
9. The system according to claim 8 , wherein the delivery device is configured such that one of the first and second gas mixtures consists of one or more non-O 2 gases.
10. The system according to claim 9 , wherein the delivery device is configured such that the non-O 2 gas is N 2 gas.
11. The system according to claim 1 , wherein the cross-linking agent is saturated or supersaturated with O 2 to increase the O 2 content in the cornea when the applicator applies the cross-linking agent.
12. The system according to claim 1 , further comprising a vessel that stores the cross-linking agent under O 2 pressure and provides a higher equilibrium concentration of O 2 for the cross-linking agent.
13. The system according to claim 1 , wherein the cross-linking agent is mixed with another substance that is saturated or supersaturated with O 2 .
14. The system according to claim 13 , wherein the other substance is a gel, the applicator being configured to apply the mixture of the cross-linking agent and the gel.
15. The system according to claim 13 , further comprising a cross-linking-agent source storing the cross-linking agent, wherein the cross-linking agent is Riboflavin.
16. The system according to claim 13 , further comprising a cross-linking-agent source storing the cross-linking agent, wherein the cross-linking agent is Rose Bengal.
17. The system according to claim 13 , wherein the photoactivating light includes ultra-violet (UV) light.
18. The system according to claim 1 , further comprising a second applicator that applies another substance that is saturated or supersaturated with O 2 , the second applicator applying the other substance to the cornea separately from the cross-linking agent.
19. The system according to claim 18 , wherein the second applicator is configured such that the other substance is a gel.
20. The system according to claim 1 , wherein the delivery device is configured to provide the gas mixture at the surface of the cornea at a steady state.
21. The system according to claim 6 , wherein the enclosure includes one or more walls, at least a portion of the one or more walls being translucent to allow photoactivating light to pass through the enclosure to irradiate the cornea and activate the cross-linking agent.
22. A system for controlling cross-linking in corneal tissue, comprising:
a vessel that stores a cross-linking agent under O 2 pressure higher than ambient pressure and provides a higher equilibrium concentration of O 2 for the cross-linking agent, the cross-linking agent being saturated or supersaturated with O 2 ;
an applicator that applies the cross-linking agent to corneal fibrils in the corneal tissue, the saturation or supersaturation of the cross-linking agent increasing the O 2 content in the corneal tissue when the applicator applies the cross-linking agent; and
a light source that provides photo activating light to the corneal fibrils and activates the cross-linking agent, the activated cross-linking agent causing cross-linking in the corneal fibrils to preserve the structure of the corneal fibrils.
23. A system for controlling cross-linking in corneal tissue, comprising:
a vessel that stores a gel agent under O 2 pressure higher than ambient pressure and provides a higher equilibrium concentration of O 2 for the gel, the gel being saturated or supersaturated with O 2 ;
an applicator that applies a cross-linking agent to corneal fibrils in the corneal tissue; and
a light source that provides photo activating light to the corneal fibrils and activates the cross-linking agent, the cross-linking agent causing cross-linking in the corneal fibrils to preserve the structure of the corneal fibrils,
wherein the gel is applied to the cornea with the cross-linking agent, the saturation or supersaturation of the gel increasing the O 2 content in the cornea.
24. The system according to claim 23 , further comprising a cross-linking-agent source storing the cross-linking agent, wherein the cross-linking agent is Riboflavin.
25. The system according to claim 23 , further comprising a cross-linking-agent source storing the cross-linking agent, wherein the cross-linking agent is Rose Bengal.
26. The system according to claim 23 , wherein the photoactivating light includes ultra-violet (UV) light.
27. The system according to claim 23 , wherein the applicator applies a mixture of the cross-linking agent and the gel.
28. The system according to claim 23 , further comprising a second applicator that applies the gel to the cornea separately from the cross-linking agent.