KR20130110235A - 비-균일성 출력 빔을 사용하는 레이저 치료를 위한 방법 및 시스템 - Google Patents
비-균일성 출력 빔을 사용하는 레이저 치료를 위한 방법 및 시스템 Download PDFInfo
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Abstract
본 발명은 비-균일성 레이저 방사선을 사용하는, 피부 재생 치료와 같은 치료를 위한 방법 및 장치에 관한 것이다. 레이저 방사선의 높은-강도 부분은 치료 구역의 선택된 부분 내에서 콜라겐 파괴 및 수축을 야기하며, 한편 방사선의 더 낮은 강도는 치료 구역의 다른 부분에 걸쳐 콜라겐 생산을 이끄는 섬유아세포 자극을 일으킨다. 레이저 공급원, 예를 들어 Nd:YAG 레이저로부터의 출력 빔은 치료 빔 내에서 낮은 강도 영역에 의해 둘러싸여 있는 복수의 높은 강도 영역으로 구성되는, 비 균일성 에너지 프로파일을 가지는 큰 직경 빔을 제공하도록 빔을 변경하는 광학 시스템과 통합된다. 더 높은 강도 영역은 제 1 치료(예를 들어, 콜라겐 수축)를 위해 충분한 온도로 표적 조직의 선택 부분을 가열하고, 한편 더 낮은 강도 영역은 제 2 치료(예를 들어, 자극된 콜라겐 생산)를 위한 충분한 에너지를 제공한다. 피부에 다른 손상 또는 화상의 위험을 줄이면서, 조직의 큰 구역, 바람직하게는 7-10 mm 직경이 동시에 처리될 수 있다. 다른 구체예에서, 본 발명은 비 균일성 에너지 출력 빔을 제공하기 위해 섬유 다발을 사용하고, 다른 구체예에서, 본 발명은 회절 렌즈 어레이를 사용하여 비 균일성 출력 빔을 생산한다. 냉각 시스템은 또한 레이저 치료 시스템과 통합될 수 있다. 펄스 광원은 통합된 피부 재생 치료에서 레이저 치료 시스템과 또한 통합될 수 있다.
Description
본 발명은 비-균일성 레이저 방사선을 사용하는 치료를 위한 방법 및 장치에 관한 것이다.
본 출원은 미국 가출원 제 60/673,914호(2005년 4월 22일 출원)의 이익을 청구하는 미국 출원 제 11/347,672(2006년, 2월 3일 출원)의 일부계속 출원이며, 이의 전체 내용은 본원에 참조로서 통합되어 있다.
성형외과 의사, 피부과 의사 및 이의 환자들은 계속적으로 노화에 효과가 있는 치료를 위한 새롭고 개선된 방법을 찾고 있다. 노화되거나 광 손상된 피부의 재생을 위한 하나의 일반적인 과정에는 이산화탄소 레이저를 사용하는 레이저 피부 재생(resurfacing)이 있다. 이산화탄소 레이저 에너지는 외부 피부 층의 기화를 일으키는 조직 물에 의해 흡수된다. 이산화탄소 레이저는 거의 30년 동안 이용되어 왔다. 그러나, 단지 지난 몇 년간에는 이 레이저가 주위 피부에 최소한의 열 손상을 일으키면서 단지 얇은 조직 층을 제거하기 위해 사용되었다. 이산화탄소 레이저가 피부의 약 150 마이크론을 제거할 수 있지만, 그 피부는 이러한 과정 하에서 치료하는데 한 달 이상 걸릴 수 있다.
Er:YAG 레이저는 이산화탄소 층보다 조직의 훨씬 더 얇은 층을 박리하기 위해 이용된다. 그러나 이는 응고 특성에 결점이 있으며, 이에 따라 사용하는 동안에 이산화탄소 레이저보다 더욱 많은 출혈을 일으킨다. 비 박리성 피부 재생(non-ablative skin rejuvenation)은 피부의 상부 층을 벗기지 않는 방법이지만, 이는 깊게-침투하는 레이저를 사용하여 외부 피부 층 밑의 피부의 층을 치료하는 것이며, 보기 흉한 혈관 및 색소병변을 치료하고, 밑에 있는 콜라겐을 수축 및 변경하고, 피부를 팽팽하게 하고 주름을 제거하여 더욱 젊은 외형을 제공한다. 그러나, 이 방법은 효율이 낮고, 이의 최상층 또는 상부 층의 손상을 최소화하기 위해 또한 고통의 발생을 줄이기 위해 침습적 냉각 방법이 피부에 사용되어야 한다. 사용되는 "플루언스(fluence)" 또는 에너지 밀도는 평방 센티미터당 10 줄(Joule) 이상이고, 더욱 효과적이기 위해서 이 플루언스는 종종 평방 센티미터 당 30 줄에 다다른다. 이러한 에너지의 수준은 종종 고통 및 피부 손상을 일으킨다.
안데르손(Anderson) 등에 의한 미국 공개 특허 출원 제 2002/0161357 Al호는 환자의 피부의 치료되지 않은 부분 내에 치료/손상의 "섬(island)"을 만들기 위해 초점된 방사선 빔을 사용하여 환자의 피부 상에 치료를 수행하기 위한 방법 및 장치를 기재하고 있다. 그러나, 이러한 방법에서 치료 빔의 파라미터는 피부 재생 치료를 위해 최적이 아니다.
또 다른 치료 방법은 조(Cho) 등에 의한 미국 특허 제 6,077,294호가 공개되어 있으며, 이의 전체 내용은 참조로서 본원에 통합되었다. 이 특허는 약 585 나노미터의 파장을 가지는 펄스화된 다이(dye) 레이저 및 평방 센티미터 당 5 줄 미만의 에너지를 이용하는 비침투성 피부 치료를 위한 시스템 및 방법을 기재하고 있다. 피부 아래 콜라겐을 손상시키고 "수축"시키기 위해 더 높은 에너지 펄스를 사용한 초기 기술에 대조적으로, '294 특허에서의 빔의 상대적으로 낮은 에너지는 더욱 젊고 투명한 피부를 위한 피부의 밸리(valley)를 재생시키고, "채우기(fill in)" 위해 콜라겐을 자극하도록 고안되어 있다.
본 발명은 비-균일성 레이저 방사선을 사용하는 치료를 위한 방법 및 장치를 제공하는 것을 목적으로 한다.
본 발명은 비-균일성 레이저 방사선을 사용하는 치료를 위한 방법 및 장치에 관한 것이다. 바람직하게는, 본 발명은 피부 재생 치료를 위해 사용되며, 여기서 레이저 방사선의 높은-강도 부분은 치료 구역의 선택 부분 내에 콜라겐 파괴 및 수축을 일으키며, 한편 방사선의 더 낮은 강도 부분은 치료 구역의 다른 부분에 걸쳐 콜라겐 생산을 이끄는 섬유모세포 자극을 이끈다.
바람직하게는, 본 발명의 방법 및 시스템은 고체-상태 레이저 공급원, 예를 들어 Nd:YAG 레이저를 활용한다. 레이저 공급원으로부터의 출력 빔은 광학 시스템과 커플링되는데 상기 광학시스템은 치료 빔 내 더 낮은 강도 영역에 의해 둘러싸여 있는 복수의 높은-강도 영역으로 구성되는 비-균일성 에너지 프로파일을 가지는 큰-직경 빔을 제공하기 위해 빔을 변형시킨다. 더 높은 강도 영역은 제 1 치료(예를 들어 콜라겐 수축)을 위해 충분한 온도로 표적 조직의 선택 부분을 가열하며, 한편 더 낮은-강도 영역은 제 2 치료(예를 들어 자극된 콜라겐 생산)를 위해 주위 조직에 충분한 에너지를 제공한다. 이에 따라, 조직의 큰 구역, 바람직하게는 7-10 mm의 직경은 피부의 다른 손상 또는 화상의 위험을 줄이면서, 동시에 치료될 수 있다.
하나의 구체예에서, 본 발명은 섬유 다발을 사용하여 비-균일성 에너지 출력 빔을 제공한다. 또 다른 구체예에서, 본 발명은 회절 렌즈 어레이를 사용하여 비-균일성 출력 빔을 제공한다.
본 발명의 한 측면에 따라 인간 피부를 치료하는 방법은 레이저 공급원, 예를 들어 Nd:YAG 레이저로부터의 출력 빔을 생성하는 단계; 비-균일성 에너지 프로파일을 가지는 치료 빔을 제공하기 위해 상기 빔을 변경시키는 광학 시스템으로 상기 빔을 커플링시키는 단계로서, 상기 치료 빔이 치료 빔 내에 낮은 강도 영역에 의해 둘러싸여 있는 복수의 높은 강도 영역으로 구성되어 있는 단계; 및 높은 강도 영역이 콜라겐을 수축시키기에 충분한 제 1 온도로 표적 조직의 선택 부분을 가열하도록 하며, 한편 낮은 강도 영역이 콜라겐 생산을 자극하기 위해 주위 조직에 충분한 에너지를 제공하도록, 표적 조직 구역에 상기 치료 빔을 향하게 하는 단계를 포함한다. 바람직하게는, 제 1 치료는 콜라겐 수축을 포함하고 제 2 수축은 콜라겐 자극을 포함한다. 출력 빔은 약 1.3 내지 1.6 마이크론, 바람직하게는 약 1.41 내지 1.44 마이크론 사이의 파장을 가질 수 있고, 0.1 내지 100 밀리세컨드, 바람직하게는 약 1 내지 5 밀리세컨드의 펄스 지속시간을 가질 수 있다. 치료 빔의 평균 플루언스는 약 10 J/cm2 미만일 수 있다. 일반적으로는, 치료 빔의 평균 플루언스는 약 5-6 J/cm2 사이이다. 더 낮은 강동 영역 내 평균 플루언스는 일반적으로 약 2-3 J/cm2이다.
광학 시스템은 예를 들어 1000 내지 2000개의 별도 섬유들을 가지는 섬유 다발, 및 섬유 다발로 빔을 커플링시키기 위한 초점 렌즈를 포함할 수 있다. 바람직하게는 1 내지 5 mm 두께의 광학 윈도우는 상기 다발의 원위 말단에 위치될 수 있으며, 상기 광학 윈도우는 상기 다발 내 각 섬유로부터 나오는 빔이 표적 조직에 도달하기 전에 발산하도록 하고 서로가 부분적으로 겹쳐지도록 한다. 특정 구체예에서, 전송 섬유는 레이저 공급원으로부터 섬유 다발로 출력 빔을 운송할 수 있고, 상기 섬유 다발은 핸드피스에 위치될 수 있다.
또 다른 구체예에서, 광학 시스템은 바람직하게는 약 2000 이하의 렌즈로 구성되고, 레이저 공급원과 치료 구역 사이 광학 경로 사이에 배열되어 있는 회절 렌즈 어레이를 포함할 수 있으며, 이로써, 상기 어레이 내 각 렌즈는 방사선의 낮은 강도 영역에 둘러싸여 있는 높은-강도 영역을 제공한다. 상기 어레이 내 각 렌즈는 약 150 내지 450 마이크론 사이의 직경을 가질 수 있고, 전체 렌즈 어레이는 약 7 내지 10 mm 사이의 직경을 가질 수 있다. 바람직하게는, 레이저 출력 빔의 평균 플루언스는 약 10 J/cm2 미만이다.
또 다른 구체예에서, 본 발명의 레이저 시스템은 출력 빔을 생산하는 레이저 공급원; 및 비-균일성 에너지 프로파일을 가지는 치료 빔을 제공하기 위해 출력 빔을 변경하는 광학 시스템으로서, 상기 치료 빔이 치료 빔 내 낮은-강도 영역에 의해 둘러싸여 있는 복수의 높은-강도 영역으로 구성되어, 상기 높은 강도 영역이 제 1 치료를 위한 충분한 온도로 표적 조직의 선택 부분을 가열하며, 더 낮은 강도 영역이 제 2 치료를 위한 주위 조직에 충분한 에너지를 제공하는 광학 시스템을 포함한다. 레이저 공급원은 Nd:YAG 레이저일 수 있고, 일반적으로 약 1.3 내지 1.6 마이크론 바람직하게는 약 1.41 내지 1.44 마이크론의 파장을 가지는 출력 빔, 및 0.1 내지 100 밀리세컨드 바람직하게는 약 1 내지 5 밀리세컨드의 펄스 지속시간을 생산한다. 광학 시스템은 섬유 다발, 바람직하게는 다발의 원위 말단과 표적 조직 사이에 광학 윈도우를 가지는 섬유 다발을 포함할 수 있다. 대안적으로는, 광학 시스템은 공급원과 치료 구역 사이에 광학 경로 내 회절 렌즈 어레이를 포함할 수 있으며, 상기 어레이 내 각 렌즈는 방사선의 낮은 강도 영역에 의해 둘러싸여 있는 높은 강도 영역을 제공한다.
또 다른 구체예에 따르면, 레이저 시스템은 출력 빔을 생산하는 레이저 공급원; 복수의 개별적 섬유를 포함하는 섬유 다발로서, 상기 섬유 다발이 근위 말단과 원위 말단을 가지는 섬유 다발; 섬유 다발의 근위 말단으로 출력 빔을 커플링시키기 위한 초점 렌즈; 및 섬유 다발의 원위 말단에 광학 윈도우로서 상기 광학 윈도우가 다발 내 각 섬유로부터 나오는 빔이 광학 윈도우를 통해 빔이 지나가면서 발산되도록하여 각 빔이 다발 내 인접한 섬유들로부터 빔과 부분적으로 겹쳐지도록 하는 광학 윈도우를 포함한다. 상기 광학 윈도우는 투명 물질, 예를 들어, 유리를 포함할 수 있거나, 섬유 다발의 원위 말단과 치료 구역 사이에 빈 공간을 가지는 스페이서를 포함할 수 있다.
또 다른 구체예에 따르면, 레이저 시스템은 출력 빔을 생산하는 레이저 공급원; 레이저 공급원과 치료 구역 사이에 광학 경로 내에 배열되어 있는 회절 렌즈 어레이로서, 상기 어레이 내 각 렌즈가 방사선의 낮은 강도 영역에 의해 둘러싸여 있는 높은-강도 영역을 제공하는 회절 렌즈 어레이를 포함한다.
특정 구체예에서, 본 발명의 레이저 시스템 및 방법은 비-균일성 에너지 프로파일을 가지는 치료 빔을 제공하기 위한 광학 시스템을 포함하는 팁 하우징으로서, 상기 팁 하우징의 원위 말단이 환자의 표적 조직 구역에 대항하게 접촉하도록 구성된 팁 하우징; 및 팁 하우징에 냉각된 공기를 운송하는 관으로서, 상기 관이 팁 하우징의 원위 말단 상에 직접 냉각된 공기를 향하도록 각을 이루고 있는 출구를 포함하는 관을 포함한다.
또다른 구체예에서, 본 발명의 레이저 시스템은 펄스 빛 시스템, 예를 들어, 색소 병변을 치료하기 위한, 레이저 시스템에 통합되어 있는 플래쉬 램프 시스템을 추가로 포함한다.
본 발명은 피부 손상의 위험을 최소화하는 레이저 방사선 및 더 낮은 피크 에너지의 높은 흡수에 의해 특징이 되는 환자의 큰 구역을 덮는 레이저 치료를 제공한다. 한 측면에서, 본 발명은 단일 치료 구역에서 동시에 콜라겐 수축뿐만 아니라 자극된 콜라겐 생산을 이롭게 달성한다. 피부 재생 치료에 추가로, 본 발명의 원리는 또한 광학 방사선 치료의 다른 타입에서 사용을 위해 연장될 수 있고, 제한 없이 여드름 치료, 제모 및 혈관 또는 색소 병변 치료를 포함한다.
본 발명의 상기 및 다른 목적, 특징 및 이점은 본 발명의 바람직한 구체예의 하기 더욱 특별한 기재로부터 명백할 것이며, 동일 참조 번호는 상이한 도면을 통해 동일한 부분을 지칭하는 하기 도면에서 예시되어 있다. 도면은 스케일, 강조가 필요하지 않지만, 대신에 본 발명의 원리를 예시함에 있다.
도 1a는 섬유 다발 및 광학 윈도우를 포함하는 레이저 치료 시스템을 예시한다.
도 1b는 도 1a의 레이저 치료 시스템을 위한 피부 상의 빔 프로파일의 플롯이다.
도 2는 연장된 말단 면을 가진 짧은 섬유 다발을 포함하는 레이저 치료 시스템을 예시한다.
도 3은 4 수준을 가지는 회절 렌즈를 보여준다.
도 4는 2 수준을 가지는 회절 렌즈를 보여준다.
도 5는 8 수준을 가지는 회절 렌즈를 보여준다.
도 6은 육각형 패턴을 가지는 회절 렌즈 어레이를 보여준다.
도 7은 연장된(elongated) 육각형 패턴을 가지는 회절 렌즈 어레이를 보여준다.
도 8은 회절 렌즈 어레이를 위한 치료 빔 프로파일을 보여준다.
도 9는 본 발명의 한 측면에 따라 회절 렌즈 어레이를 위한 중심 뜨거운 영역의 상대적 직경의 함수, d/D로서, 상대적으로 뜨거운 구역 플루언스 요소, F1/Fav의 플롯을 보여준다.
도 10은 회절 렌즈 어레이로부터 비-균일성 출력 빔으로 처리되는 피부의 온도 프로파일을 보여준다.
도 11은 냉각 기작을 가지는 레이저 치료 핸드피스의 팁을 보여준다.
도 12는 피부 재생 치료를 위한 통합된 레이저 및 펄스 빛 시스템을 보여준다.
도 1a는 섬유 다발 및 광학 윈도우를 포함하는 레이저 치료 시스템을 예시한다.
도 1b는 도 1a의 레이저 치료 시스템을 위한 피부 상의 빔 프로파일의 플롯이다.
도 2는 연장된 말단 면을 가진 짧은 섬유 다발을 포함하는 레이저 치료 시스템을 예시한다.
도 3은 4 수준을 가지는 회절 렌즈를 보여준다.
도 4는 2 수준을 가지는 회절 렌즈를 보여준다.
도 5는 8 수준을 가지는 회절 렌즈를 보여준다.
도 6은 육각형 패턴을 가지는 회절 렌즈 어레이를 보여준다.
도 7은 연장된(elongated) 육각형 패턴을 가지는 회절 렌즈 어레이를 보여준다.
도 8은 회절 렌즈 어레이를 위한 치료 빔 프로파일을 보여준다.
도 9는 본 발명의 한 측면에 따라 회절 렌즈 어레이를 위한 중심 뜨거운 영역의 상대적 직경의 함수, d/D로서, 상대적으로 뜨거운 구역 플루언스 요소, F1/Fav의 플롯을 보여준다.
도 10은 회절 렌즈 어레이로부터 비-균일성 출력 빔으로 처리되는 피부의 온도 프로파일을 보여준다.
도 11은 냉각 기작을 가지는 레이저 치료 핸드피스의 팁을 보여준다.
도 12는 피부 재생 치료를 위한 통합된 레이저 및 펄스 빛 시스템을 보여준다.
본 발명의 바람직한 구체예의 상세한 설명은 아래와 같다.
도 1a에 도시되어 있는 바와 같이, 장치는 출력 빔을 발하는 레이저 공급원을 포함한다. 상기 빔은 하나 이상의 초점 렌즈를 사용하여 광학 섬유의 다발과 통합된다. 상기 다발은 바람직하게는 1000 내지 2000의 별개의 섬유를 포함한다. 전형적으로, 각 섬유는 약 100 내지 200 마이크론의 직경을 가진다. 따라서 상기 출력 레이저 빔은 1000-2000 더 작은 빔을 가리키고, 이의 각각은 개별적 광학 섬유 내 섬유 다발의 길이를 가로지른다. 상기 섬유 다발은 환자의 피부와 직접 접촉하도록 유지될 수 있는 광학 윈도우에 이의 원위 말단에서 끝난다. 윈도우는 약 1-5 mm 두께이고, 오염으로부터 섬유 다발의 출력 면을 보호하고, 또한 각 섬유로부터 나오는 빔이 환자의 피부에 도달하기 전에 발산하도록 하여, 바람직하게는 각 빔이 다발 내 인접 섬유로부터의 빔과 부분적으로 겹쳐지도록 한다.
다발 내 섬유들은 단단히 함께 묶여있을 수 있거나, 기계적 스페이서를 사용하여 서로로부터 떨어져 있을 수 있다. 다발의 원위 말단에 기계적 스페이서의 사용은 더 큰 구역에 걸쳐 다발로부터 에너지를 펼치게 하고, 환자를 위해 고통 감도를 줄이도록 한다. 일반적으로, 섬유 다발 내 모든 섬유들로부터의 피부 상 통합된 지점 크기는 약 7 내지 10 mm 직경이다.
도 1a의 구체예를 위한 바람직한 치료 방법에 있어서, 바람직하게 Nd:YAG 레이저인 레이저 공급원은 1.3 내지 1.6의 파장, 바람직하게는 약 1.40 내지 1.44 마이크론의 파장, 및 0.1 내지 100 밀리세컨드, 바람직하게는 약 1 내지 5 밀리세컨드의 펄스 지속시간을 가지는 출력 레이저 펄스를 생산한다. 왜냐하면, 레이저는 피부에 의해 잘 흡수되는 파장에서 작동되기 때문에, 레이저는 상대적으로 낮은 에너지에서 작동될 수 있고, 피부에 화상 또는 손상의 위험을 줄일 수 있다.
작동에 있어서, 광학 윈도우는 환자의 피부에 대항하여 지지 되고, 레이저 공급원은 에너지가 가해져 섬유 다발과 광학 윈도우를 통해 공급원으로부터 지나가는 레이저 빛의 펄스를 생산하고, 환자의 피부 속으로 투과한다. 광학 윈도우가 약 1-5 mm 두께이기 때문에, 윈도우는 또한 섬유 다발의 출력 말단과 환자의 피부 사이에 스페이서로서 제공된다. 따라서, 레이저 빛이 다발 내 각 섬유로부터 발하면서, 빛은 발산되고, 이는 환자의 피부로 윈도우를 통해 지나간다. 바람직한 구체예에서, 섬유는 약 100-200 마이크론 직경이고, 각 섬유로부터 나오는 빔은 윈도우를 통해 투과된 후, 환자의 피부 상에 150 내지 900 마이크론 직경의 지점을 생산한다. 광학 섬유로부터 나오는 빛의 발산하는 특성 때문에, 각 지점의 중심에서 빛은 상대적으로 높은 에너지 빛일 것이고, 한편 각 지점의 주위에서의 빛은 훨씬 더 낮은 에너지를 가질 것이다. 따라서, 전체 섬유 다발을 위한 7 내지 10 mm의 통합된 지점 크기를 넘어, 약 1000 내지 2000 더 작은 치료 지점, 일반적으로 약 150-900 마이크론 직경이 있고, 각각은 방사선의 더 낮은 플루언스 "더 찬 영역(cooler zone)"에 의해 둘러싸여 있는 지점의 중심에 더 높은 플루언스 "핫 지점"으로 구성된다. 중심 "핫 지점"에 에너지는 하부 조직을 수축시키고, 콜라겐을 손상시키고 콜라겐 수축을 생산하기에 충분하다. 일반적으로, 높은-강도 영역 또는 "핫 지점"에 에너지는 70℃ 이상으로 표적 조직의 온도를 올리기에 충분하다. 그러나, 핫 지점을 둘러싸고 있는 "더 찬 영역"에 방사선은 일반적으로 조직을 손상시키고 이 구역 아래 조직에 콜라겐 수축을 일으키기에 충분하지 않다. 이 더 낮은 강도 "더 찬 영역"에서 제공되는 에너지는 몇도 정도 피부의 온도를 올릴 것이고(또는 감지할 만한 온도 상승을 야기하지 않을 것이고) 따라서 조직을 손상 또는 "충격"을 주지 않을 것이다. 그러나, 이 더 낮은 강도 방사선은 조직 내 섬유아세포를 자극하여 콜라겐을 생성하고 더욱 젊고 투명한 피부를 위한 피부를 "채움(fill in)" 하는데 일반적으로 더욱 적당하거나 바람직하다.
바람직한 구체예에서, 다발 내 섬유들은 각 섬유로부터의 방사선의 지점 크기가 인접하거나 환자의 피부 상에 다발 내 인접한 섬유들로부터 지점과 부분적으로 겹쳐지도록 배열된다. 이와 같이, 본 발명은 피부 재생 치료의 두 모드를 동시에 제공할 수 있다: 섬유 다발로부터의 각 출력 지점의 중심에서 "핫 지점"에 더 높은 에너지 콜라겐 수축 치료, 및 통합된 섬유-다발 출력 빔의 전체 구역을 통해 전체적으로 자극된 콜라겐 생산.
섬유 다발 운송 시스템을 사용하는 레이저 치료 방법의 예는 도 1b에 도시되어 있고, 이는 다발 내 4 개의 섬유에 대한 피부 상에 위치의 함수로서 피부 상에 상대적 강도의 플롯이다. 실질적으로, 섬유 다발은 번들을 형성하기 위해 규칙적으로 공간된 배열로 1000-2000개의 개개 섬유로 구성될 것이다. 이 구체예에서, 다발 내 인접 섬유 사이에 중심-대-중심의 거리는 약 500 마이크론이다. 각 섬유의 직경은 약 200 마이크론이고, 섬유의 개구수(numerical aperture (NA))는 약 0.2이다. 섬유 다발의 총 직경은 약 9 밀리미터이다. 각 섬유로부터 나오는 레이저 에너지는 발산되며, 이는 투명한 윈도우를 통해 투과되어, 각 섬유로부터의 피부 상 지점 크기는 약 250 마이크론 이상의 직경이다. 따라서, 각 섬유로부터의 지점은 일반적으로 인접하거나 다발 내 인접한 섬유로부터의 지점과 부분적으로 겹쳐진다. 이는 도 1b에 도시되어 있고, 여기서 전체 구역이 적어도 낮은-강도 펄스로 치료되고, 한편 각 지점의 중심이 에너지의 훨씬 더 큰 양을 받음을 볼 수 있다. 점선은 치료 구역을 통한 평균 강도를 나타낸다. 이 예에서, 각 지점의 중심에서 피부 상 피크 플루언스는 약 9 J/cm2이고, 한편 각 지점의 주변에서의 플루언스는 2 J/cm2이다. 총 구역 플루언스는 약 5 J/cm2이다.
치료 구역의 여러 부분에서 받는 플루언스는 예를 들어 레이저 공급원으로부터의 총 에너지 출력을 높이거나 낮춤, 번들 내 섬유들 사이에의 중심-대-중심 거리를 변화시킴, 빔의 디버전스를 변화시키기 위해 상이한 NA를 가진 섬유를 사용함 및/또는 빔 디버전스의 더 많거나 줄어든 양이 가능하도록 광학 윈도우의 두께를 바꿈에 의해 다양할 수 있고,조절될 수 있다. 따라서 빔 프로파일은 여러 상이한 질환 및 레이저 치료 방법에 적합할 수 있다.
도 2는 공급원으로부터 광학 윈도우로 레이저 출력 빔을 커플링하는 긴-섬유 다발 대신에 이 구체예는 더 짧은 섬유 다발을 함유하는 핸드피스로 레이저 공급원으로부터 레이저 에너지를 운송하는 단일 전송 섬유를 사용하는 것을 제외하고, 도 1의 구체예와 유사한 또 다른 구체예를 보여준다. 핸드피스에서, 단일 섬유로부터 출력 레이저 펄스가 짧은 섬유 다발로 커플링된다. 이전 구체예에서와 같이, 짧은 섬유 다발은 복수의 개별적 광학 섬유, 바람직하게는 1000 내지 2000 개의 섬유로 구성된다. 짧은 섬유 다발은 이의 근위 말단에 더 작은 번들 직경을 가지며 단일 전송 섬유로부터의 출력 빛이 다발과 효과적으로 커플링하도록 한다. 섬유 다발은 이의 출력에서 확장된 면을 제공하기 위해 예를 들어, 기계적 스페이서를 사용하여 이의 근위 말단으로부터 이의 원위 말단으로 "흩어진다(fan out)". 바람직하게는, 확장된 면은 약 7 내지 10 mm의 직경을 가지고, 도 1의 구체예에서와 같이 광학 윈도우에 커플링된다. 도 2의 구체예는 도 1과 함께 기재되어 있는 것과 동일한 치료 파라미터를 사용한다.
도 3-8을 참조하여, 본 발명의 또 다른 구체예는 표적 조직에서 비 균일성 가열을 제공하기 위해 회절 렌즈 어레이를 사용하는 것을 예시하고 있다. 다중 수준 회절 렌즈는 다양한 두께를 가지는 광학적으로 투명한 물질로 만들어진 다수의 중심 고리로 구성된다. 각 중심 고리의 상부 표면은 평평하고 그래서 굴절성 효과는 거의 무시된다. 다양한 두께 고리는 전파되는 입사 광학 빔 상에 공간적 상 지연 패턴을 일으킨다. 전파되는 광학 빔은 회절 렌즈의 판 뒤에 공간적 상 지연 패턴을 전달하고, 공간적으로 다양한 광학 강도의 광 패턴(illumination pattern)을 생산한다. 광학 강도는 건설적 간섭을 위한 조건을 만족시키는 기하학적인 포인트에서 높고, 파괴적 간섭을 위한 조건을 만족시키는 포인트에서 낮다. 일반적으로 회절 렌즈의 고안은 주요한 회절 최대(또는 최소)가 렌즈의 판으로부터/일정 거리에서 광학 축 상에 있도록 최적화된다. 거리는 렌즈의 초점 길이이다. 일반적으로 회절 렌즈 고안의 목적은 주된 회절 최대치에서 입사(incident) 파워의 분획을 증가시키는 것이다. 그러나, 상기 분획은 항상 수준의 수, 렌즈의 F-수 및 다른 고안 파라미터에 의존하여 1 미만이다. 사실, 회절 렌즈 패턴을 입사 파워의 임의의 분획(1 미만)이 주된 최대 내에 있고 나머지 파워가 부된 최대 내에 분배되도록 회절 렌즈 패턴을 고안하는 것이 가능하다.
다중 수준 회절 렌즈의 여러 예는 도 3-5에 횡단면으로 도시되어 있다. 도 3은 4 수준을 가지는 회절렌즈이고, 도 4는 2 수준을 가지는 회절 렌즈를 도시하고 있고, 도 5는 8 수준을 가지는 회절 렌즈를 보여주고 있다.
본원 발명의 하나의 구체예에서, 레이저 치료 장치 및 방법은 비-균일성 에너지 프로파일을 가지는 출력 빔을 생산하기 위해 어레이에 배열되어 있는 복수의 회절 렌즈를 활용한다. 더욱 특이적으로, 회절 렌즈 어레이는 레이저 공급원과 치료 구역 사이에 광학 경로에 배열되어 있어, 어레이에 각 렌즈는 방사선의 더 낮은-플루언스 영역에 의해 둘러싸여 있는 더 높은 플루언스 "핫 지점"의 구역을 위해 제공된다. 피부 재생 치료에서, 예를 들어, 더 높은-에너지 구역은 "핫 지점"에서 콜라겐을 손상시키고 수축시키기에 충분한 가열을 제공하며, 한편 이 핫 지점들의 외부에 있는 더 낮은 강도 방사선 영역은 전체 치료 구역에 걸쳐 콜라겐 재성장을 자극하도록 겹쳐지고 통합된다.
이 구체예에서, 레이저 공급원은 바람직하게는 약 1.3 내지 1.6 마이크론, 바람직하게는 1.40 내지 1.44 마이크론 사이의 파장을 가지는 방사선의 펄스 및 약 0.1 내지 100 밀리세컨드, 바람직하게는 1 내지 5 밀리세컨드의 펄스 지속시간을 생산한다. 레이저 공급원은 예를 들어 Nd:YAG 레이저일 수 있다. 광학 시스템은 레이저 공급원으로부터 치료 구역으로 빔을 전송한다. 회절 렌즈 어레이는 환자의 피부에 인접해 있는 광학 시스템의 원위 말단에 바람직하게 배열되어 있다. 어레이는 서로에 인접해 있는 복수의 별도의 회절 렌즈를 포함한다. 일반적으로, 어레이 내에 2000 이하의 렌즈, 바람직하게는 약 1800 렌즈가 있다. 각 렌즈는 약 150 내지 450 마이크론의 직경이고, 바람직하게는 약 250 마이크론의 직경이다. 회절 렌즈의 전체 어레이는 일반적으로 약 7 내지 10 mm의 직경이다. 어레이는 입력 빔을 레이저 공급원으로부터(이는 또한 약 7-10 mm 직경이다) 어레이 내 각 개별적 렌즈의 중심 부분에 상응하는 복수의 더 높은-강도 "핫 지점" 및 각 핫 지점을 둘러싸는 더 낮은 강도 영역으로 향하게 한다. 환자의 조직에서의 통합된 효과는 더 낮은 강도 방사선의 구역에 의해 둘러싸여 있는 각 회절 렌즈의 중심에 상응하는 피부 내 복수의 더 높은 강도 영역을 생산하는 것이다. 이는 도 8의 치료 빔 프로파일에 도시되어 있다. 이 그래프에서 볼 수 있는 바와 같이, 전체 치료 구역은 치료 방사선의 적어도 낮은 수준을 받고, 특정 공간-떨어진(spaced-apart) 부분은 더 높은 용량의 레이저 방사선을 받는다. 피부 재생의 경우에, 예를 들어, 레이저 에너지는 콜라겐 층으로 깊게 투과되면, 여기서 상기 콜라겐은 가열되어 "핫 지점" 내 온도를 수축시키며, 한편 전체 치료 구역은 콜라겐 재생에 효과가 있도록 처리된다. 피부 재생 치료에 부가하여, 회절 렌즈 어레이는 다른 장치에서의 사용을 위해 최적이 될 수 있다. 예를 들어 여드름의 치료 및 제모. 회절 렌즈 어레이로부터 상이한 빔 프로파일은 상이한 장치를 위해 사용될 수 있다.
회절 렌즈는 사용자에 의해 선택된 레이저 플루언스 셋팅에 의해 결정되는 평균 균일한 플루언스, Fav에 의해 방사선이 조사되는 것으로 간주된다. 일반적으로 이 구체예에서 레이저의 평균 플루언스는 약 10 J/cm2 미만이고, 바람직하게는 약 9 J/cm2이다. 예시의 목적을 위해, 직경 D를 가진 각 회절 렌즈는 간단화된 고안을 가지도록 가정되어 있어 이는 F1을 가지는 것으로 가정되는 직경 d를 가지는 핫 구역 및 균일한 플루언스 F2를 가지는 주변을 생산한다. 렌즈 고안은 주변에 대한 핫 구역의 플루언스 비, β를 생산하도록 가정된다(β= F1/F2). 이 간단화하는 가정 하에서, 핫 구역 플루언스, F1의 근사치를 구하기 위한 간단한 화학식을 끌어내는 것은 가능하다.
도 9는 중심 핫 영역의 상대적 직경 함수, d/D로서 상대적 핫 영역 플루언스 요소 F1/Fav의 플롯을 보여준다. 예로서, 회절 렌즈가 β= 5, 직경 D = 250 μm, 핫 구역 직경 d = 100 μm를 가지도록 고안되고, 레이저가 평균 플루언스 Fav = 9 J/cm2를 가지도록 선택된다면, 핫 구역 플루언스는 F1 = 3.05 x 9 J/cm2 = 27.4 J/cm2이다.
제 2 예로서, 회절 렌즈가 β = 5, 직경 D = 350 μm, 핫 구역 직경 d = 200 μm을 가지도록 고안되고, 레이저가 평균 플루언스 Fm, = 9 J/cm2를 가지도록 선택된다면, 핫 구역 플루언스는 F1 = 2.17 x 9 J/cm2 = 19.5 J/cm2이다.
도 6 및 7은 본 발명에 따른 회절 렌즈 어레이의 두 예시적인 구체예를 예시한다. 도 6에서, 회절 렌즈들은 육각형 패턴으로 배열되어 있다. 도 7에서, 렌즈들은 길게 늘어진(elongated) 육각형 패턴으로 배열되어 있다.
도 10은 회절 렌즈 어레이를 통한 1440 nm 레이저로 방사선이 조사된 피수의 부분을 위한 피크 조직 온도 분배를 보여준다. 그래프로부터 볼 수 있는 바와 같이, 제 1 회절 렌즈는 가로 축 상 약 200 μm에서 중심되고, 제 2 회절 렌즈는 약 600 μm에서 중심된다. 이 그래프로부터 볼 수 있는 바와 같이, 상대적으로 높은 피크 온도(예를 들어 70℃ 이상)로 가열되는 회절 렌즈의 각각에 중심된 약 200 μm 너비의 조직의 구역이 있다. 이 높은 온도 영역은 실질적으로 피부의 표면으로부터 약 350 μm의 깊이로 연장된다. 도 1a 및 1B의 섬유 번들 구체예와 함께 상기 논의된 바와 같이, 이 온도들은 콜라겐 수축을 일으키는데 충분하다. 이 높은-온도 치료 영역의 외부에, 피크 온도는 빠르게 떨어진다. 예를 들어, 수평 축 상 약 300 μm 및 500 μm 사이 구역에서, 피크 피부 온도는 일반적으로 35℃(또는 그 미만) 및 50℃이고, 일반적으로 약 40℃ 미만이다. 이미 논의된 바와 같이, 이 낮은 강도 영역은 콜라겐 자극 치료를 제공한다.
도 11은 비-균일성 에너지 프로파일을 가지는 출력 빔을 제공하기 위해 회절 렌즈 어레이를 가지는 레이저 치료 장치의 팁(10)의 단면도이다. 작동자는 팀(10)을 환자의 피부(30)에 대항하여 직접적으로 적용한다. 레이저 공급원(도시되지 않음)은 출력 빔(23)을 생산하도록 에너지가 가해지고, 출력 빔은 광학 파이버(20)에 의해 팁(10)으로 운송된다. 출력 빔(23)은 광학 섬유(20)의 말단으로부터 나오고, 회절 렌즈 어레이(61)로 방향된다. 회절 렌즈 어레이(61)에 인접하여 환자의 피부(30)에 직접적으로 접촉하는 광학 윈도우(60)가 있다. 광학 윈도우(60)는 도 1과 함께 기재되어 있는 광학 윈도우와 유사하고, 환자의 피부와 섬유 다발의 출력 말단 사이에 스페이서로서 기능한다. 광학 윈도우(60)는 회절 렌즈 어레이(61)와 일체일 수 있다. 바람직하게는 윈도우는 우수한 열 전도성 물질, 예를 들어 유리로 만들어진다. 광학 섬유(20), 렌즈 어레이(61) 및 광학 윈도우(60)는 모두 바람직하게 실린더 모양 하우징인, 팁 하우징(40) 내에 있다. 팁 하우징(40)은 플라스틱으로 만들어질 수 있다. 팁 하우징(40) 외부에 냉각 기작(11)이 있다. 바람직하게는, 냉각 기작(11)은 치료 장치의 팁(10)에 냉각된 공기 공급원(도시되지 않음)으로부터 냉각된 공기(51)를 운송하는 관(50)을 포함한다. 관(50)은 바람직하게는 팁 하우징(40)에 대하여 각을 이루는 출구를 포함하여, 냉각된 공기(51)는 팁 하우징(40)의 원위 말단에서 방향된다(다시 말해, 여기서 팁(10)은 환자의 피부(30)와 접해 있다). 이 배열은 레이저 치료 중 피부의 효과적인 냉각을 제공한다. 비록 팁(10) 및 냉각 기작(11)이 도 3-8의 회절 렌즈 어레이 구체예와 함께 본원에서 도시되어 있지만, 이 고안은 도 1 및 2와 함께 기재되어 있고 도시되어 있는 바와 같이, 섬유 다발을 가지는 레이저 장치로 또한 사용될 수 있음을 이해할 것이다.
도 12는 본 발명의 한 측면에 따라 피부 재생 치료를 위한 집중된 레이저 및 펄스 빛 시스템을 보여준다. 도시된 바와 같이, 시스템(100)은 레이저 공급원(103), 바람직하게는 약 1.4 마이크론 파장 및 약 3 msec 펄스 너비에서 작동하는 Nd:YAG 레이저와 같은 고체-상태 레이저를 포함하는 하우징(101)을 포함한다. 레이저 공급원(103)으로부터의 빛은 하우징(101)으로부터 제 1 핸드피스(105)로 뻗어 있는 광학 섬유 운송 시스템(20)으로 커플링된다. 제 1 핸드피스(105)는 본원에서 이전에 기재되어 있는 임의의 구체예와 함께 비균일성 에너지 프로파일을 가지는 빔을 생산하기 위한 광학 시스템을 포함한다. 핸드피스(105)는 도 11과 함께 이전에 기재되어 있듯이 팁(10)을 포함할 수 있다. 시스템은 도 11과 함께 이전에 기재되어 있듯이 냉각 시스템을 또한 사용할 수 있다.
통합된 시스템(100)은 또한 바람직하게 플래시 광원(115)을 포함하는 펄스 빛 부분을 포함한다. 바람직한 구체예에서, 플래시 공급원은 560 내지 950 nm의 파장 및 5 내지 35 밀리세컨드의 펄스 너비를 가지는 치료 펄스를 생산하는 제논(Xenon) 플래시램프를 포함한다. 플래시램프(115)는 하우징(101) 내 위치되어 있는 고압 공급원(109)으로부터 플래시(115)로 파워를 제공하는 고압 케이블(111)에 의해 하우징(101)에 연결되어 있는 제 2 핸드피스(113)에 위치되어 있다. 펄스 부분은 플래시램프를 냉각하기 위해, 통상적으로 알려진 바와 같이, 물 순환 시스템(도시되지 않음)을 또한 바람직하게 포함한다. 펄스 빛 시스템은 도 11과 함께 기재되어 있듯이 냉각 시스템을 또한 사용할 수 있다. 한 구체예에서, 공기 냉각기 및 관은 냉기를 핸드피스(115)로 운송한다. 핸드피스(115)의 팁은 사파이어 윈도우를 포함한다. 사파이어 윈도우의 근위 측의 가장자리(다시 말해 플래시램프 공급원에 가장 가까운 측)는 냉각 시스템으로부터 찬 공기에 의해 냉각된다. 사파이어 윈도우의 원위 표면은 치료를 위해 환자의 피부에 접촉한다.
작업 중, 제 2 핸드피스(113)는 환자의 피부에 근접하여 지지되고, 플래시램프(115)는 치료 펄스를 제공하도록 에너지가 가해진다. 펄스 빛 부분의 지점 크기는 일반적으로 레이저 부분보다 더 크고, 일반적으로 약 11 x 55 mm (또는 6 cm2)이다. 펄스 빛 부분은 따라서 상대적으로 짧은 시간 기간 내 환자의 피부의 큰 구역을 치료할 수 있다. 펄스 빛 부분의 최대 플루언스는 전형적으로 약 20 J/cm2이다.
통합된 시스템의 펄스 빛 부분은 색소 병변 및 특정 혈관 병변을 치료하는데 적합하다. 펄스 빛 부분은 효과적으로 예를 들어, 디스크로미아(dischromia), 노화되는 피부와 관련되는 공통적 질환, 뿐만 아니라, 표면상 색소화된 병변, 정맥(superficial pigmented lesions, veins) 및 태양에 손상된 피부와 관련된 장미증의 홍조를 효과적으로 치료한다. 시스템의 레이저 부분은 이전에 논의된 바와 같이 콜라겐 생산 및 피부 탄력의 자극을 위해 효과적이다. 통합된 시스템에서 레이저 치료 및 펄스 빛 치료의 조합은 피부의 재생 치료를 위한 완전하고 효과적인 시스템을 제공한다. 레이저 및 펄스 빛 시스템은 공통 하우징 내 통합되고, 바람직하게는 공통 조절 시스템(117)을 사용하며, 레이저 공급원(103) 및 플래시램프 공급원(115) 둘 모두를 구동하기 위한 동일한 전기 구동 서킷(119)을 사용할 수 있다.
본 발명은 이의 바람직한 구체예에 참조로서 기재되어 있고, 특별히 도시되어 있지만, 이는 형태 및 세부 내용에 있어서 여러 변화는 첨부된 청구 범위에 의해 한정되는 본 발명의 범위를 벗어남 없이 본원에서 만들어질 수 있음을 당업자는 이해할 것이다.
Claims (1)
- 출력 빔을 생산하는 레이저 공급원; 및
비-균일성 에너지 프로파일을 가지는 치료 빔을 제공하기 위해 출력 빔을 변경시키는 광학 시스템으로서, 상기 치료 빔이 치료 빔 내에 낮은-강도 영역에 의해 둘러싸여 있는 복수의 높은-강도 영역으로 구성되며, 상기 높은-강도 영역이 표적 조직의 선택 부분을 제 1 온도로 가열하여 콜라겐을 수축시키고, 한편 상기 낮은-강도 영역이 주위 조직에 충분한 에너지를 공급하여 콜라겐 생성을 자극하는, 광학 시스템을 포함하는 치료 시스템.
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US67391405P | 2005-04-22 | 2005-04-22 | |
US60/673,914 | 2005-04-22 | ||
US11/347,672 US7856985B2 (en) | 2005-04-22 | 2006-02-03 | Method of treatment body tissue using a non-uniform laser beam |
US11/347,672 | 2006-02-03 | ||
PCT/US2006/015180 WO2006116141A1 (en) | 2005-04-22 | 2006-04-21 | Methods and systems for laser treatment using non-uniform output beam |
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KR1020077026906A Division KR20080028356A (ko) | 2005-04-22 | 2006-04-21 | 비-균일성 출력 빔을 사용하는 레이저 치료를 위한 방법 및시스템 |
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KR20130110235A true KR20130110235A (ko) | 2013-10-08 |
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KR1020137024861A KR20130110235A (ko) | 2005-04-22 | 2006-04-21 | 비-균일성 출력 빔을 사용하는 레이저 치료를 위한 방법 및 시스템 |
KR1020077026906A KR20080028356A (ko) | 2005-04-22 | 2006-04-21 | 비-균일성 출력 빔을 사용하는 레이저 치료를 위한 방법 및시스템 |
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KR1020077026906A KR20080028356A (ko) | 2005-04-22 | 2006-04-21 | 비-균일성 출력 빔을 사용하는 레이저 치료를 위한 방법 및시스템 |
Country Status (6)
Country | Link |
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US (4) | US7856985B2 (ko) |
EP (1) | EP1899010B1 (ko) |
JP (1) | JP5058976B2 (ko) |
KR (2) | KR20130110235A (ko) |
CA (1) | CA2605604C (ko) |
WO (1) | WO2006116141A1 (ko) |
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Cited By (2)
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KR101581763B1 (ko) * | 2015-06-22 | 2016-02-23 | 건국대학교 산학협력단 | 펄스 레이저 및 흡수계수가 높은 매질을 이용한 체성감각 유도 시스템 |
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US8317779B2 (en) | 2012-11-27 |
KR20080028356A (ko) | 2008-03-31 |
US7856985B2 (en) | 2010-12-28 |
US8322348B2 (en) | 2012-12-04 |
US20110152847A1 (en) | 2011-06-23 |
US20130178917A1 (en) | 2013-07-11 |
US20060247609A1 (en) | 2006-11-02 |
JP2008536653A (ja) | 2008-09-11 |
EP1899010A1 (en) | 2008-03-19 |
WO2006116141A1 (en) | 2006-11-02 |
US20100217248A1 (en) | 2010-08-26 |
CA2605604C (en) | 2014-06-10 |
JP5058976B2 (ja) | 2012-10-24 |
CA2605604A1 (en) | 2006-11-02 |
EP1899010B1 (en) | 2015-01-28 |
US10434324B2 (en) | 2019-10-08 |
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