Abstract: A system and method for producing a high repetition pulsed microjet for use in medical applications. The device includes a stagnation chamber and a hydraulic pump for pumping a sterile fluid into the stagnation chamber. A flexible walled volume disposed in the stagnation chamber and filled with a hydraulic fluid. The hydraulic piston is cyclically displaced towards/away from the stagnation chamber thereby increasing/decreasing the pressure of the hydraulic fluid on the flexible walled volume. In turn, the flexible walled volume is compressed and the sterile fluid is expelled through an orifice in the flexible walled volume under pressure producing the pulsed microjet. This process may be repeated to produce repetitive pulsed microjets. In addition, the flow conduction of the hydraulic fluid between the hydraulic pump and stagnation chamber may be controlled by inserting a blocking device therebetween.

Abstract: A system and method for producing a high repetition pulsed microjet for use in medical applications. The device includes a stagnation chamber and a hydraulic pump for pumping a sterile fluid into the stagnation chamber. A flexible walled volume disposed in the stagnation chamber and filled with a hydraulic fluid. The hydraulic piston is cyclically displaced towards/away from the stagnation chamber thereby increasing/decreasing the pressure of the hydraulic fluid on the flexible walled volume. In turn, the flexible walled volume is compressed and the sterile fluid is expelled through an orifice in the flexible walled volume under pressure producing the pulsed microjet. This process may be repeated to produce repetitive pulsed microjets. In addition, the flow conduction of the hydraulic fluid between the hydraulic pump and stagnation chamber may be controlled by inserting a blocking device therebetween.

Abstract: The present invention provides a new approach to reshaping of the cornea, e.g., for refraction change, using multiple, displaced planar cuts and a custom shaping template. Large refractive change and/or substantial tissue removal can be obtained by a two-cut approach to reshaping of the cornea to a desired shape using a template or applanator. The process begins with a planar template being applied to the cornea. The template includes one or more moveable sections or cams positioned to provide an overall flat contact surface with the cornea. Then, a first cut is made by a water microjet producing a hinged flap. The first cut is parallel to but displaced from the anterior cornea surface in contact with the template. Then the template cam or cams are repositioned to change the shape of the cornea surface in situ in preparation for the second cut. The hinged flap is not moved; it remains in contact with the stromal bed. The second cut is along the same path as the first cut.

Abstract: A system and method for producing a high repetition pulsed microjet for use in medical applications. The device includes a stagnation chamber and a hydraulic pump for pumping a sterile fluid into the stagnation chamber. A flexible walled volume disposed in the stagnation chamber and filled with a hydraulic fluid. The hydraulic piston is cyclically displaced towards/away from the stagnation chamber thereby increasing/decreasing the pressure of the hydraulic fluid on the flexible walled volume. In turn, the flexible walled volume is compressed and the sterile fluid is expelled through an orifice in the flexible walled volume under pressure producing the pulsed microjet. This process may be repeated to produce repetitive pulsed microjets. In addition, the flow conduction of the hydraulic fluid between the hydraulic pump and stagnation chamber may be controlled by inserting a blocking device therebetween.

Abstract: The present invention provides a new approach to reshaping of the cornea, e.g., for refraction change, using multiple, displaced planar cuts and a custom shaping template. Large refractive change and/or substantial tissue removal can be obtained by a two-cut approach to reshaping of the cornea to a desired shape using a template or applanator. The process begins with a planar template being applied to the cornea. The template includes one or more moveable sections or cams positioned to provide an overall flat contact surface with the cornea. Then, a first cut is made by a water microjet producing a hinged flap. The first cut is parallel to but displaced from the anterior cornea surface in contact with the template. Then the template cam or cams are repositioned to change the shape of the cornea surface in situ in preparation for the second cut. The hinged flap is not moved; it remains in contact with the stromal bed. The second cut is along the same path as the first cut.

Abstract: Improvement of visual acuity beyond the “20—20” standard or achievement of “super acute vision” is effected by means of either selective refractive surgery or by use of a centering corneal contact lens which non-refractively corrects for natural spherical aberrations of the eye.

Abstract: A method and device for the high speed fluid (preferably water) jet removal of dental caries. The water jet is of a controlled upper and lower speed and pressure with a low speed and pressure being of at least 5 to 10 kpsi, sufficient to pierce and flush decayed tissue of a caries with a small beam fluid jet diameter. A pulsed or continuous fluid jet is used to remove and completely flush caries material from a tooth in a time period of under a second with a maximum stagnation pressure of about 30 kpsi, at which point healthy dentin is affected. A coherent or pseudo-coherent water jet operating at high stagnation pressure (range 10,000 to 20,000-psi and no more than 30-kpsi), in a brief burst (.apprxeq.1 second) and small beam diameter (30 to 100-.mu.m) will cleanly remove caries without damage to the tooth structure in particular the sound dentin at the boundary of the caries. No anaesthetic is accordingly required in the absence of a possible exposed nerve.

Abstract: A method and device for the clean, non-traumatic removal of a diseased or otherwise eroded, cut, damaged, or dystrophied epithelium layer from the cornea of an eye, for the enhanced regeneration thereof or as the first step in a PRK procedure. The device includes a source for high speed, water-jet with sufficient speed and pressure to cleanly remove the epithelium layer from the Bowman's layer but at a speed which does not affect the harder, underlying Bowman's layer. The device further includes a preferably flat, impinging surface adapted to be directly placed on the epithelium with a laterally extending portion. The flat surface lightly applanates the cornea. The waterjet is adapted to impinge on the flat surface whereby the surface causes the waterjet to laterally radiate and continuously "brush" off the epithelium until the Bowman's layer is reached. Continued waterjet impingement, for a limited period thereafter, does not affect the Bowman's layer and merely harmlessly irrigates the eye.

Abstract: A method for improving integrity and accuracy of removal or hinged removal of elevated tissue layers particularly of a cornea. The area of tissue removal is isolated from remaining tissue by a shallow complete perimeter cut, substantially normal to the tissue surface. With a cornea, a perimeter in the form of a circumference is shallowly scored into the cornea tissue for a depth somewhat greater than that of the tissue to be removed (and of an appropriate diameter) by means of a surgical trephine. Corneal tissue, normally under tension tends to separate at the score site to form a groove with the circumscribed area becoming additionally slightly elevated from the adjacent corneal tissue because of release of tension across the groove site. Lateral edges of the circumscribed area are free of surface layer tissue which is harder to cut at an angle to the layer. Lateral cutting of the corneal tissue which extends above the groove is a perfect cut of a cylindrical slice with use of a cylindrical trephine.

Abstract: A method and device for highly accurate corneal topographical mapping and a device for effecting the mapping for use in effecting vision correction by removal of corneal tissue. The method and device involve use of a modified optical interferometer with directing of a coherent light beam, such as from a laser, to the anterior surface of a cornea; splitting the beam so that half the beam is directed to a reference object having a predetermined shape; capturing the reflected light from the cornea and the reference object so as to form an interference pattern; and using the interference pattern to determine deviations or displacements of the corneal surface from the known reference shape. The deviations are then utilized in corneal tissue removing procedures, such as RK, PRK and RLK, by determination of the extent and position of tissue removal.

Abstract: A device and method for the selective removal of corneal tissue, and change of curvature thereof, for refractive vision correction, and for removal of corneal tissue for therapeutic treatment of the cornea; by means of a deforming template in conjunction with a water jet keratome. The template is adapted to deform the cornea to provide a regular surface which can be transversely cut by the water jet, while the cornea is supported against movement. The water jet can be adjusted to cleanly separate defective epithelium tissue from the Bowman's layer. Use of the water jet keratome provides a cut corneal tissue surface of smoothness and polish, substantially equivalent to that of the original surface, thereby enhancing healing and transplantation effectiveness.

Abstract: A method for the selective removal of corneal tissue, and change of curvature thereof, for refractive vision correction, by means of a correction template in conjunction with a planar cutting high pressure water jet micro-keratome. The correction template is adapted to provide a planar cutting guide, on the corneal tissue, for the refractive correction required, with the template being shaped with a non-planar surface of predetermined configuration (related to the desired correction). The non-planar surface of the template is fitted to the area of the cornea to be refractively corrected, whereby the corneal tissue to be removed is selectively deformed so as to be substantially conformed to and held against the non-planar surface. Application of a vacuum between the template and cornea aids in this holding.