EP1901687A2 - Outil d'expansion de poche epitheliale et dispositif combine de decollement epithelial et de sculpture de la cornee - Google Patents

Outil d'expansion de poche epitheliale et dispositif combine de decollement epithelial et de sculpture de la cornee

Info

Publication number
EP1901687A2
EP1901687A2 EP06758781A EP06758781A EP1901687A2 EP 1901687 A2 EP1901687 A2 EP 1901687A2 EP 06758781 A EP06758781 A EP 06758781A EP 06758781 A EP06758781 A EP 06758781A EP 1901687 A2 EP1901687 A2 EP 1901687A2
Authority
EP
European Patent Office
Prior art keywords
cornea
corneal
epithelium
reformer
epithelial
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP06758781A
Other languages
German (de)
English (en)
Inventor
Edward Perez
E. Thomas Wheelock
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Tissue Engineering Refraction Inc
Original Assignee
Tissue Engineering Refraction Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tissue Engineering Refraction Inc filed Critical Tissue Engineering Refraction Inc
Publication of EP1901687A2 publication Critical patent/EP1901687A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/013—Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/013—Instruments for compensation of ocular refraction ; Instruments for use in cornea removal, for reshaping or performing incisions in the cornea
    • A61F9/0133—Knives or scalpels specially adapted therefor

Definitions

  • the described devices are useful in the field of ophthalmology.
  • the devices and methods for using them involve separating or lifting corneal epithelium from the eye in a substantially continuous layer to form a flap or pocket.
  • the devices generally utilize a non-cutting separator or dissector that is configured to separate the epithelium at naturally occurring cleavage surfaces in the eye, particularly between the epithelium and the corneal stroma (Bowman's membrane), specifically separating in the region of the lamina lucida.
  • the dissector may oscillate during the noted separation.
  • the separator or dissector may also have a structure that expands the epithelial pocket after formation.
  • the separator or dissector may also include structure that alone or in combination with various energy sources, reforms the underlying cornea in a refractive procedure or treats other maladies. After such steps, the epithelium tissue member may then be replaced on the cornea or onto an ocular lens after placement of that ocular lens on the eye.
  • Refractive surgery refers to a set of surgical procedures that change the native optical or focusing power of the eye. These changes alleviate the need for glasses or contact lenses that an individual might otherwise be dependent on for clear sight.
  • the majority of the focusing power in the human eye is dictated by the curvature of the air-liquid interface, where there is the greatest change in the index of refraction.
  • This curved interface is the outer surface of the cornea.
  • the refractive power of this interface accounts for approximately 70% of the total magnification of the eye.
  • Light rays that make up the images we see pass through the cornea, the anterior chamber, the crystalline lens, and the vitreous humor before they are focused on the retina to form an image. It is the magnifying power of this curved, air-corneal interface that provided the field of refractive surgery with the opportunity to surgically correct visual deficiencies.
  • epikeratophakia A largely flawed and failed procedure called epikeratophakia was developed in the era of RK. It is now essentially an academic anomaly.
  • Epikeratophakia provided a new curvature to the outer curvature of the cornea by grafting onto the cornea a thin layer of preserved corneal tissue. Lyophilization is the preservation method used in epikeratophakia where the cornea is freeze-dried. The tissue is not acellularized but is rendered non-living. During the process of freeze drying, the cornea is also ground to a specific curvature.
  • the epikeratophakia lens was placed into the eye surgically. An annular 360° incision was placed into the cornea after completely removing the epithelium from where the epikeratophakic lens would sit.
  • PRK photorefractive keratectomy
  • an ablative laser e.g., an excimer laser
  • PRK photorefractive keratectomy
  • the epithelium is destroyed when achieving a new outer surface curve. Over the ensuing post-operative days, the epithelium has to grow or heal back into place. This epithelial healing phase was problematic for most patients since the epithelially denuded and ablated cornea was painful. It is also initially difficult to see, and this "recuperative time" can last from days to a week or more.
  • LASIK PRK corneal laser ablation
  • the LASIK procedure also known as laser in situ keratomileusis, is synonymous in the public mind with laser vision correction.
  • LASIK an outer portion (or chord-like lens- shaped portion) of the cornea (80 to 150 microns thick) is surgically cut from the corneal surface. This is performed by a device called a microkeratome.
  • the microkeratome is a device which cuts a circular flap from the surface of the cornea which remains hinged at one edge. This flap is reflected back and an ablative (excimer) laser is used to remove or to reform a portion of the exposed surgical bed. The flap is laid back into place.
  • LASEK Laser Assisted Subepithelial Keratomileusis
  • the basal epithelial cells express keratins 5 and 14 and have the potential to differentiate into the squamous epithelial cells of the corneal epithelium that produce keratins 6 and 9.
  • the corneal epithelium has a number of important properties: 1) it is clear; 2) it is impermeable; 3) it is a barrier to external agents; and 4) it is a highly innervated organ. Nerves from the cornea directly feed into the epithelium, and thus, defects of this organ produce pain.
  • Epithelial cells are attached side-to-side by transmembrane molecules called desmosomes.
  • hemidesmosome Another transmembrane protein, the hemidesmosome, connects to collagen type 7 and is present on the basolateral surface of basal epithelial cells. Hemidesmosomes anchor epithelium to the underlying collagenous portion of the stroma. The junction between the epithelium and corneal stroma is referred to as basement membrane zone (BMZ).
  • BMZ basement membrane zone
  • the epithelium is then raised by pushing the epithelium, e.g., with a Week sponge, in a manner similar to striping a wall of paint.
  • the exposed collagenous portion of the corneal stroma is then ablated to reshape its surface.
  • a weakened epithelium is then rolled back into place to serve as a bandage.
  • this "bandage" fails to restore the epithelium to its original state, i.e., it does not preserve the integrity of the epithelium, thereby reducing its clarity, impermeability to water, and barrier function.
  • the ability of the epithelium to adhere to the corneal stromal surface is impaired.
  • U.S. Patent Nos. 6,099,541 and 6,030,398 to Klopotek describe an microkeratome apparatus and method for cutting a layer of corneal epithelium to prepare the eye for LASIK or other reshaping procedures. The epithelium, if replaced, is attached using surgical techniques. [0016] None of the cited references shows or suggests my described devices. REFERENCES
  • the description includes mechanical non-cutting devices and methods to form a separation of the epithelium from the eye or to lift a generally continuous layer of epithelium from its supporting underlying structure.
  • the epithelial delaminator is used to create an epithelial flap or a pocket.
  • the flap or pocket may be used in conjunction with a refractive surgical procedure or with placement of refractive lens.
  • the epithelial delaminator may be mechanical in nature. Such mechanical delaminators lift epithelium in a generally continuous layer from the anterior surface of the eye by application of a dissecting, non-cutting, mechanical force. Mechanical delaminators specifically include blunt dissectors and wire-based dissectors having wires that are passive or active as applied to the eye.
  • the described devices and methods may be used variously to form epithelium tissue members such as pockets or flaps and to reform the underlying corneal surface without removing the device, de-epithelialize the cornea in preparation for a reshaping or reforming procedure such as LASEK, to form a pocket for inclusion of a contact lens, or to expand a pocket so-formed if desired.
  • FIGs. IA - ID show a schematicized version of a generalized method of using the generic devices described here.
  • Figs. 2 A - 2E show various directional and cross-sectional views of the combination device for forming an epithelial tissue member and reforming a cornea beneath it.
  • Fig. 3A shows cross section of the combination corneal reforming device in a generalized placement of laser emission sites.
  • Fig. 3B shows a bottom view of the device of Fig. 3 A.
  • Fig. 4 shows a section of corneal reforming device utilizing lasers and a heat absorptive and conductive contact layer.
  • Fig. 5 shows a device similar to that of Fig. 4, but instead including discrete, heat conducting members.
  • Figs. 6 and 7 depict examples of formations of discrete, heat conducting sites suitable for use with the variation shown in Fig. 5.
  • Fig. 8A depicts an RF device in which the dissector (shown in Fig. 8B) comprises a number of RF-receiving sites that are heated upon application of RF, and an external RF antenna source having selectable RF transmission sites for cooperatively heating the receiving sites situated upon the dissector.
  • the antenna source is shown in a bottom view in Fig. 8C.
  • Figs. 9A and 9B show additional variations of the combination RF source dissector.
  • Fig. 10 shows a combination dissector that includes a number of thermal heat sources.
  • Fig. 11 shows a side, sectional view of a device similar to that in Fig. 10, but also having discrete heat conduction sites.
  • Figs. 12A and 12B provide a side view of a dissector that is configured to form and to expand an epithelial pocket.
  • Figs. 13A and 13B show cross-sectional views of dissector such as that found in Figs. 12A and 12B with a hinged rotation member.
  • Figs. 14A and 14B show side, sectional views of a dissector having a hydraulically expandable member.
  • Figs. 15A and 15B show side, sectional views of expandable dissector that expands in the center of the device.
  • any integument surface such as the skin, respiratory epithelium, gut epithelium, and cornea
  • epithelial cell layer that is adherent to an underlying basement membrane.
  • epithelium is separated from its basement membrane and underlying collagenous tissue, a subepithelial blister is formed.
  • gross separation less than lmm in diameter is known as vesiculation and separation greater than 1 millimeter in diameter, a true blister.
  • a continuous layer of corneal epithelium may be separated from or lifted from the anterior surface of the eye by applying various mechanical forces to this anterior surface, or to the basal cell layer, or to the junction between the basal cell layer and the Bowman's Layer or membrane (the “lamina lucida”).
  • continuous as used herein means "uninterrupted”.
  • mechanical force refers to any physical force produced by a person, instrument, or device. Examples of mechanical forces include suction, shearing, and blunt forces.
  • epithelium such as corneal epithelium by epithelial delaminators.
  • epithelial delaminator refers to any instrument or device that separates epithelium from the basement membrane by application of a mechanical force.
  • Epithelium may also be separated from or lifted from the anterior surface of the eye by contacting the surface with a chemical composition that induces separation of the epithelium from the underlying stroma.
  • Figs. IA - ID show, in a collective sense, a process for using the described combination dissector and corneal reforming device.
  • Fig. IA provides a side view of an eye (200) and the approach of combination dissector-corneal reformer (202) as described below.
  • the leading edge (204) and other appropriate edges of combination dissector (202) are configured in such a way that it is sufficiently blunt that, when passing axially along the corneal surface after having penetrated the epithelium, that it will not cut or remove tissue from the anterior surface of the cornea, i.e., Bowman's membrane.
  • the dissector-reformer (202) may be oscillated from side to side or axially, if so desired by the designer.
  • the device provides an epithelial tissue member that remains attached to the cornea at at least some portion of the edge of the separated epithelial tissue, perhaps in a pocket-shaped form.
  • Fig. IB shows, in a cross section, the placement of the dissector body (208) beneath the epithelium (210) to form, in this variation, a pocket-shaped epithelial tissue member (206).
  • FIG. 1C shows the blade body (208) positioned on eye (200) with the opening
  • the device may be used to apply energy in very specific ways to the corneal surface to reform its shape.
  • Fig. ID shows a step of withdrawing combination device (202) from eye (200) leaving whatever results of any steps practiced.
  • the epithelial member (206) closes over the eye and, as is its nature, will provide some amount of healing to the cornea.
  • Figs. 2A - 2E show one variation of the combined dissector and corneal reformation device.
  • Fig. 2 A shows a perspective view of a generalized version of the combination device (220) having a blade body (222) and a blade edge (224). Again, the blade may be oscillated from side to side or axially or in any combination of the two directions.
  • the edge may be oscillated from side to side or axially or in any combination of the two directions.
  • (224) is, again, sufficiently blunt that although it will initially penetrate the epithelial layer of the eye, it will not cut tissue from the underlying cornea.
  • Fig. 2B shows, in cross section, the device shown in Fig. 2A. Visible on the cornea side (226) of dissector body (222) are a number of or an array of energy-emitting points (228) (better seen in the bottom view (Fig. 2D)).
  • These energy-emitting sites (228) may be any variety of types. For instance, they may be laser diodes (e.g., such as those manufactured by Tyco Electronics, Laser Diode
  • the reforming light source may alternatively be placed remotely to the blade body (222) and the light introduced to the exit points (228) through fiber optics.
  • Energy conduits (230) are shown in the support (232). As shown in the cross-section of support (232), conduits (230) may be electrically conductive wire or ribbon if the energy sources are light- emitting or resistive thermal sources and located in the blade body (222) or may be fiber optic in nature if the energy source is remote from blade body (222). Indeed, the energy conduits may be fluidic in nature allowing passage of heated, cooled, or reactive fluids their passage to the eye surface.
  • Fig. 2C shows a top view of the device shown in Fig. 2A.
  • Figs. 3 A and 3B show one variation of my combination device in which laser diodes (228) are mounted in blade body (222), specifically emitting light from the side (229) of the blade body (222) adjacent the epithelium when the blade is located beneath the epithelium.
  • the light-emitting laser diodes (228) emanate directly from their location and shine directly onto and impinge upon the cornea for reformation of the shape of that cornea.
  • Opaque fluid or one containing a heat absorptive and heat conductive material such as a slurry of small particles of biocompatible metal, e.g., platinum or gold, may be introduced into the eye beneath the blade body during use to enhance absorption of the light and its conversion into heat.
  • energy conduits (232) are simply electrical conductors that power the diodes (228).
  • the sequence of number of, and position of the diodes to be activated is a routine determination.
  • the diodes may be independently fired as necessary for the appropriate correction. They may be sequentially fired, at some positions more than others, to achieve desired correction for, e.g., various ocular aberrations such as myopia, astigmatism, or even presbyopia. Again, depending upon the nature of the energy source chosen, this arrangement may be used either for introduction of light for corneal reformation or heat for corneal reformation or for light to produce heat for corneal reformation.
  • Fig. 4 shows a variation of my described device (230) in which laser diodes (232) are placed behind a light absorptive, heat conductive member (234).
  • conductor (234) may be substantially continuous in a region intended to cover a specific region of the cornea that the user wishes to reform.
  • selected members of a collection of laser diodes are activated and provide light to the absorber- conductor (234).
  • the absorber-conductor (234) absorbs the light and is thereby heated in the region of the diode.
  • the warmed or heated region of conductor (234) in turn heats the cornea for reformation of the adjacent corneal tissue.
  • the device operates similarly when the light source is remotely located and the energy is introduced onto the conductor (234) via optical fibers.
  • Fig. 5 provides a cross section of a blade body (240) that is similar in design and construction to that seen in Fig. 4.
  • the conductors ((242) larger, (244) smaller) are heated by laser diodes (232).
  • Figs. 6 and 7 show two variations of the design found in Fig. 5. As seen in Figs. 6 and 7, these discrete absorber-conductors (244, 246) may be situated or placed in the blade body in various patterns suitable for the user to treat the cornea to correct vision as desired.
  • the patterns may be chosen so to treat a specific type of ocular aberration or the patterns may be generalized so that the application of heat may be selected or regionalized during the time that the dissector body is in contact with the cornea and is beneath the epithelium. That is to say that treatment of myopia might be had by heating only the regions of the cornea in the periphery of the cornea.
  • the size of the various absorber-conductors (244, 246) and their separation may be provided by a skilled designer depending only upon the necessity for isolation of the various, discrete absorber-conductors from each other and the size of the corneal region to be treated. Again, materials having high absorptivity and high thermal conductivity are quite suitable.
  • Figs. 8A, 8B, and 8C provide a description of another variation of the combination dissector-corneal reformer.
  • the device utilizes radio frequency (RF) to effect the corneal reformation or modification.
  • RF radio frequency
  • One is an RF transmitter provided exterior to the eye and the other piece, the dissector, contains one or more susceptors or RF receivers or members of an "antenna array" that receives the RF and upon doing so is locally heated.
  • the heated susceptors are heated by the RF and that heat is conducted to the anterior surface of the cornea to be reformed.
  • Fig. 8A shows the placement of various components in use. It is a cross section of the various components.
  • the anterior region of the eye (300) with its various lamellar components is depicted.
  • the dissector blade body (304) with the various discrete energy- receiving regions or susceptors (306) is also shown.
  • Each of these susceptors (306) is of material, e.g., a ferromagnetic metal or alloy, that when placed in a site to receive RF will become heated.
  • the material may be chosen and engineered in such a way as to provide modest or controllable temperature rises by mixtures with other materials, e.g., phase change materials such as paraffins or salts designed to absorb significant heat at specific temperatures, or may be physically treated to provide a smooth temperature gradient cross device, e.g., by granulation and mixing of different crystalline particulate materials, each having different melting points. It may be preferable to thermally insulate each discrete member from the next if the isolation of effect upon the cornea is desired. Similarly, isolation of the RF emitting regions on the antenna wand (310) (in Figs. 8A and 8C). [0063] Returning to Fig.
  • the antenna component (310) with its multiple discrete antenna sections (312) is shown to be exterior to the epithelium (314).
  • the dissector with RF receiving elements or susceptors (306) is shown to be positioned between epithelium (314) and cornea (300).
  • this variation might operate in the following fashion: one discrete antenna, e.g., (310a) would be activated and begin transmitting RF. Because of its relative proximity, susceptor (306a) would be heated. The heat from susceptor (306a) would be conducted to the nearby cornea causing contraction in region (316), thereby further causing a revision of the shape of the cornea and changing its refractive properties. As is the case with LASIK or LASEK or PRK, the careful planning of the imposition of light and heat upon the cornea changes the refraction properties of the margin of the cornea for the purpose of improving the vision in the eye.
  • FIG. 9 A shows another partial cross section of a blade body (350) having integrated discrete RF emission members coupled with discrete RF susceptors (354) in the same body (350).
  • Fig. 9B shows another variation of the blade body (360) that utilizes RF emitters (362) that pass RF energy directly into the cornea for reformation.
  • RF emitters 362
  • Each of the RF emitting regions in each of these variations may be independently caused to emit RF energy or may be used in unison or in patterns, both spatial patterns and time-wise patterns, to effect the desired refractive change in the cornea.
  • Fig. 10 shows another variation in which blade body (370) is equipped with discrete electrically resistive heating elements (372).
  • a single addressable lead (374) goes to each resistive, heating element (372).
  • the return line for the current flow takes place via a common bus (376).
  • Fig. 11 depicts a blade body (380) having a number of resistive heating elements (372) that in this case are each adjacent a heat conductor (374) that is able to focus or to defocus the application of heat to the adjacent cornea.
  • the generic combination device here is one that is able to separate the epithelium from the cornea and to cause or to take part in refractive procedure prior to its retraction from beneath the epithelial tissue.
  • the volume of the epithelial tissue member or pocket formed is insufficient to allow introduction of other treatment devices into the pocket. Some type of larger device may simply be needed.
  • Fig. 12A provides a generic description of the function of the device.
  • the expander (400) includes a blunt tip (402) permitting penetration of the epithelium and separation of the epithelial tissue from the cornea without cutting the corneal tissue.
  • the blade body region (404) is at least partially expandable as shown by arrows (406) in Fig. 12B. This movement may be caused by hydraulic actuation, electrical movement (motor or heating of a pre-formed shaped-memory nitinol member), or other motive actuators.
  • Fig. 13A shows one variation (406) including an inflatable balloon (408) situated in an interior space between two members: a movable, epithelium-side member (410) and a stationary cornea side member (412).
  • FIG. 13B provides a cross section, side view of the blade body (406) with the interior balloon (408) expanded.
  • Fig. 14A shows a similar variation (430) in which the inflatable balloon (432) is in contact with the epithelium during the introduction of the blade body (430) and its subsequent expansion.
  • Fig. 14B shows the expanded balloon (432).
  • constructing the balloon from a hard slippery material, e.g., NYLON or TEFLON, the type often used in constant diameter cardiovascular balloons may provide some advantages.
  • Figs. 15A and 15B shows cross-sectional views of another variation (440) in which the epithelium side surface of blade body (442) expands from the center rather than via a leading hinge as has been the case shown in Figs. 12A through 14B.
  • Fig. 15A shows the blade (440) prior to expansion
  • Fig. 15B shows the blade (440) after expansion.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)
  • Prostheses (AREA)
  • Eyeglasses (AREA)

Abstract

Les dispositifs de l'invention sont utilisés en ophtalmologie. Les dispositifs et les procédés d'utilisation de ces dispositifs permettent de séparer ou de décoller l'épithélium cornéen de l'oeil sous la forme d'une couche sensiblement continue pour obtenir un lambeau ou une poche. En particulier, les dispositifs utilisent généralement un dissecteur ou un séparateur non coupant qui est conçu pour séparer l'épithélium au niveau des surfaces de clivage naturelles de l'oeil, en particulier entre l'épithélium et le stroma cornéen (membrane de Bowman), et décoller spécifiquement la région de la lamina lucida. Le dissecteur peut osciller au cours du décollement. Le séparateur ou dissecteur peut également posséder une structure qui dilate la poche épithéliale après sa formation. Par ailleurs, le séparateur ou dissecteur peut posséder une structure qui, seule ou en combinaison avec diverses sources d'énergie, permet de sculpter la cornée sous-jacente lors d'une opération de chirurgie réfractive ou pour traiter d'autres maladies. L'élément de l'épithélium peut être alors replacé sur la cornée ou sur une lentille oculaire après la pose de la lentille oculaire sur l'oeil.
EP06758781A 2005-04-28 2006-04-27 Outil d'expansion de poche epitheliale et dispositif combine de decollement epithelial et de sculpture de la cornee Withdrawn EP1901687A2 (fr)

Applications Claiming Priority (2)

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US67660105P 2005-04-28 2005-04-28
PCT/US2006/016419 WO2006116732A2 (fr) 2005-04-28 2006-04-27 Outil d'expansion de poche epitheliale et dispositif combine de decollement epithelial et de sculpture de la cornee

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EP1901687A2 true EP1901687A2 (fr) 2008-03-26

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EP (1) EP1901687A2 (fr)
JP (1) JP2008539052A (fr)
KR (1) KR20080014804A (fr)
CN (1) CN101370451A (fr)
AU (1) AU2006239235A1 (fr)
BR (1) BRPI0611156A2 (fr)
CA (1) CA2606460A1 (fr)
IL (1) IL186937A0 (fr)
MX (1) MX2007013422A (fr)
TW (1) TW200716073A (fr)
WO (1) WO2006116732A2 (fr)

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Publication number Priority date Publication date Assignee Title
CA2498717A1 (fr) 2002-09-13 2004-03-25 Ocular Sciences, Inc. Dispositifs et procedes pour ameliorer la vision
US7883520B2 (en) 2006-04-10 2011-02-08 Forsight Labs, Llc Corneal epithelial pocket formation systems, components and methods
US20190201710A1 (en) * 2016-09-27 2019-07-04 KeraMed, Inc. System, device, and method for cross-linking corneal tissue
CN107913120B (zh) * 2017-12-11 2023-10-03 上海市同济医院 板层角膜分离器

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US20050049621A1 (en) * 1998-08-12 2005-03-03 Vladimir Feingold Intracorneal lens placement method and apparatus
JP2001095833A (ja) * 1999-09-30 2001-04-10 Nidek Co Ltd 角膜手術装置
US7153316B1 (en) * 2001-11-09 2006-12-26 Mcdonald Marguerite B Surgical instruments and method for corneal reformation
CN1310629C (zh) * 2002-01-17 2007-04-18 爱德华·佩雷兹 用于在角膜上制备上皮瓣以及在上皮瓣下放置眼内装置和透镜的上皮分层装置
CN101039639A (zh) * 2004-06-16 2007-09-19 组织工程折射公司 上皮分层装置

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KR20080014804A (ko) 2008-02-14
CN101370451A (zh) 2009-02-18
IL186937A0 (en) 2008-02-09
MX2007013422A (es) 2008-01-18
CA2606460A1 (fr) 2006-11-02
TW200716073A (en) 2007-05-01
JP2008539052A (ja) 2008-11-13
WO2006116732A2 (fr) 2006-11-02
BRPI0611156A2 (pt) 2010-08-17
WO2006116732A3 (fr) 2007-05-24
AU2006239235A1 (en) 2006-11-02

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