Abstract: A scanning optical system for delivering electromagnetic radiation onto tissue to be treated is cooperative with a lightguide or optical fiber. Radiation to be delivered is provided by a source thereof via the optical fiber. The optical system includes an optical projection arrangement comprising a plurality of lenses cooperatively arranged with the lightguide. A first of the lenses is arranged to receive radiation emerging from the lightguide. The beam of radiation is passed through the projection arrangement to form a treatment spot the radiation on the tissue. Scanning is effected by causing relative motion between the exit-end of said lightguide and at least the first lens, transverse to the optical axis of the projection arrangement. The treatment spot undergoes a related transverse motion over the tissue. In one example scanning is effected by moving the first lens with the lightguide fixed. The first lens is moved using an arrangement of piezo-electric actuators.

Abstract: A fiber optic connector for coupling focused radiant energy from a laser to a fiber optic conductor includes a secondary transmission path and one or more reflectors and/or heat sinks for deflecting errant radiant energy to a location where it be safely dissipated. In addition, coupling of the radiant energy to the cladding of the fiber is minimized by stripping or at least partially removing the cladding to reduce the amount of cladding in the area that extends to the focal plane of the radiant energy source.

Abstract: A laser handpiece is disclosed, including a fiber optic end having a non-cylindrical shape and further including a reflector surrounding a portion of the fiber optic end. The reflector is shaped to direct laser energy emitted from the fiber optic end in a direction away from the laser handpiece and toward a treatment site.

Abstract: Methods and systems are disclosed for detecting overheating in an optical device before harmful consequences, such as severe local heating, can result. In one embodiment of the invention, a blackbody emitter is disposed in close proximity to a therapeutic optical fiber to absorb therapeutic radiation at a fault and re-emit blackbody (infrared) radiation. The emitter can be coupled to the fiber but, during normal operation, lies outside the optical path between the output of the laser radiation and the site of treatment. Systems and catheters incorporating such emitters are also described for effective monitoring of the laser power transmitted along the optical fiber within the phototherapy device.

Abstract: A laser device for medical treatment system, comprising at least a plurality of laser beam emitting sources, a laser beam multiplexing means for superimposing the laser beams emitted from the laser beam emitting sources, and a beam mixing means where the laser beams from the laser beam multiplexing means enter.

Abstract: A system for treating a selected dermatologic problem and a head for use with such system are provided. The head may include an optical waveguide having a first end to which EM radiation appropriate for treating the condition is applied. The waveguide also has a skin-contacting second end opposite the first end, a temperature sensor being located within a few millimeters, and preferably within 1 to 2 millimeters, of the second end of the waveguide. A temperature sensor may be similarly located in other skin contacting portions of the head. A mechanism is preferably also provided for removing heat from the waveguide and, for preferred embodiments, the second end of the head which is in contact with the skin has a reflection aperture which is substantially as great as the radiation back-scatter aperture from the patient's skin.

Abstract: A light application unit for a combined photodynamic diagnosis and photodynamic therapy of non-malignant diseases of a parodontium and a tooth of a living being having administered a pharmaceutical preparation allowing the photodynamic diagnosis and the photodynamic therapy comprises a light source, a focusing unit for focusing light emitted by the light source, at least one element arrangeable in a light beam path of the light, and at least one wave guide for transmitting the light from the light source to a distal emitting end, the wave guide is configured rigidly in at least a distal handling end section thereof and being curved in a distal end section.

Abstract: The present invention relates to surgical methods which may include excising a sheet of tissue from surrounding tissue, treating the isolated sheet with focused energy thereby ablating at least one layer of said sheet (or a part thereof) and inserting the treated sheet to the location from which the sheet of tissue was excised or to another location. The invention also includes devices for conducting such methods. The method is particularly useful for the treatment of age-related macular degeneration.

Abstract: A device and a method for the photolithographic exposure of biological substances is described, which comprises at least one light source, a bundle of optical fibers and a control unit, whereby each of the optical fibers can be controlled by light independently from one another and/or light can be coupled to each fiber independently. The device is particularly suitable for the exposure of DNA, PNA or peptide chips.

Abstract: An introducer and system and method for using the introducer in endoscopic combined laser assisted DCR for treatment of nasolachrymal drainage obstruction (NLDO) is disclosed. An introducer comprising a hollow outer tube and an atraumatic inner mandril is inserted into the lachrymal sac section. The atraumatic inner mandril is removed and (one or more) optical fibers or fiber bundles are inserted for illumination to determine proper position and for ablating a drainage channel. The fiber or bundle is then removed and a DCR intubation set can then be introduced to maintain the drainage channel. One advantage of this device and method is that all aspects of the procedure can be performed through the introducer, thus only requiring a single insertion point, reducing trauma to the lachrymal duct, and reducing the complexity and risk of complication or infection.

Abstract: A system and method for controllably releasing laser radiation in percutaneous laser treatment is disclosed. In a preferred embodiment, an optical fiber is inserted below the skin or into a vascular lumen to a predetermined point. The fiber is connected to a source of electromagnetic radiation such as a laser. Radiation is then delivered to the treatment site while the fiber is simultaneously drawn out to the entry point. The fiber is manually withdrawn at a predetermined rate and radiation is administered in a constant power or energy level. To maintain a constant proper energy density, the speed of withdrawal is measured and sent to a controlling mechanism. The controlling mechanism modifies the power emitted, pulse length or pulse rate to ensure that the vein or tissue receives a consistent dose of energy. In one preferred embodiment, an imaging device provides the controlling device with speed information based on fiber surface textural properties or based on a series of bar code like markings.

Abstract: A surgical needle for fracturing tissue such as cataracts has a distal operating port which holds tissue to be fractured. An optical fiber that extends down a needle applies laser energy pulses to a target causing optical breakdown and the generation of shockwaves which impinge on the tissue at the operating port, causing the tissue to fracture. Fractured tissue is aspirated through the passageway of the surgical needle. The operating port and target are both positioned at the distal end of the needle to facilitate surgeon observation during the operation. The needle has a wall which is unitary and provides an aspirating channel with a smooth surface so as to minimize flow turbulence and maximize laminar flow and also minimize friction. The close to laminar flow permits greater flow velocity and thus enhanced ability to hold tissue at the port.

Abstract: A surgical needle for fracturing tissue such as cataracts has a distal operating port which holds tissue to be fractured. An optical fiber that extends down a needle applies laser energy pulses to a target causing optical breakdown and the generation of shockwaves which impinge on the tissue at the operating port, causing the tissue to fracture. Fractured tissue is aspirated at the passageway of the surgical needle. The operating port and target are both positioned at the distal end of the needle to facilitate surgeon observation during the operation. The needle has a wall which is unitary and provides an aspirating channel with a smooth surface so as to minimize flow turbulence and maximize laminar flow. The combination of laminar flow results in greater flow velocity and thus enhanced ability to hold tissue at the port.

Abstract: An apparatus for and method of developing laser therapies to eradicate or ablate one or more pathogens in periodontal tissues are disclosed. The apparatus comprises an adjustable laser source, that is preferably a Nd:YAG laser, for directing pulsed laser light to an area of a target comprising the one or more pathogens, such as phorphyromonas gingivalis (Pg) and prevotella intermedia (Pi) and/or a pigment fungi. The apparatus preferably comprises means for measuring the laser power provided to the target from the adjustable laser source and means for determining if exposed pathogens within the target have been eradicated or ablated. By identifying damage thresholds of laser doses, therapeutic protocols for treating periodontal tissues infected with the one or more pathogens are developed.

Abstract: A medical radiation treatment system is disclosed for identifying and monitoring the use of disposable or reusable optical fibers or other optical accessories. The treatment system comprises a radiation source unit connected to a recognition/control unit, and a medical radiation delivery system connected to an identification/recordation unit. This forms a read-write system to ensure that radiation parameters conform to delivery device characteristics, and to prevent the use of overused or incompatible delivery devices. This is achieved by reading previously encoded information in the identification/recordation unit that provides all usage history, including number of uses or total duration of use. The encoded information is updated after use, and preferably frequently or continuously during use, to guarantee a complete usage history even after an incomplete treatment.

Abstract: A stent delivery system includes inner and outer tubular members with the outer tubular member sized to pass through the body lumen to the deployment site and with the inner tubular member sized to be received within the outer tubular member. The inner and outer tubular members are axially slideable relative to one another between a transport position and a deploy position. The inner tubular member has a stent attachment location at its distal end. The stent attachment location is covered by the outer tubular member when the inner and outer tubular members are in the transport position. The stent attachment location is exposed when the inner and outer tubular members are in the deploy position. A first handle is provided rotatably connected to a proximal end of the outer tubular member for the first handle to transmit to the outer tubular member axial forces applied to the handle by an operator and to rotate freely about the axis relative to the outer tubular member.

Abstract: An apparatus for thermally treating intervertebral discs includes an energy application head having an energy application region and a tissue protecting region. A control member operationally connected to the energy application head preferably controls the energy application head during treatment. Significantly, the energy application head is preferably wedge-shaped and has a thin insertion edge sloped to a thick region for lifting vulnerable tissues away from a site of energy application to the at least one intervertebral disc. Preferably, the energy application head has a smooth surface suitable for gliding over surfaces of an annulus fibrosis without snagging other tissues. The present invention also includes a method for thermally treating an intervertebral disc.

Abstract: The present invention provides an apparatus for applying energy to human tissue, which includes an energy generator and a usage-limited, energy delivery device, and ancillary information exchange capability therebetween for the purposes of security, reliability and operational monitoring and control. The invention also provides a usage-limited, energy delivery device for use in such an apparatus, a method for determining the suitability of the delivery device for use in such an apparatus, and a method of using the delivery device in such an apparatus. The present invention provides an efficient medical treatment system having ready data-communication capability between its permanent and non-permanent components, for the security, reliability and operational monitoring and control desired in such medical systems.

Abstract: A probe tip having a surgical tool manufactured from a light transmissive material. Such a construction eliminates the need for a separate fiberoptic and surgical tool. If desired, the probe tip may be used in combination with a surgical probe having an actuation handle made from springy material having a memory. Squeezing the handle causing the actuation device to elongate, thereby causing movement in the probe tip. The probe handle of the present invention may be held and actuated in any position.

Abstract: A laser system is provided that includes a laser unit, an incoupling means for coupling the laser radiation into a light-guide, and an outcoupling means for coupling the laser radiation out from the light-guide. A data transmitting means is coupled to the incoupling means or outcoupling means and produces optical signals which are coupled into the light-guide via the incoupling means or the outcoupling means. These optical signals are received by a data receiving means at the other end of the light-guide. The laser system can be used for realizing a data communication between the hand-piece and the stationary unit of the laser system in the case of which additional cables between the hand-piece and the laser are not necessary for transmitting data.

Abstract: A novel optical fiber, and a method for its production, having a diffuser portion and continuous unitarily-constructed outer sleeve, which is adapted for the transmission of light to a treatment locale. More particularly, a medical instrument has an optical fiber including a diffuser portion at a distal end wherein an alignment sleeve for the optical fiber extends uninterruptedly in a single piece from a connector for a laser light source to at least the distal end of the core of the optical fiber.

Abstract: A laser operating system, comprising treatment laser beam projector for projecting a treatment laser beam to an affected site to be treated, sighting laser beam projector for projecting a sighting laser beam for aligning the treatment laser beam to the affected site, and an adjuster 36 for adjusting a spot diameter of the treatment laser beam, wherein output of the sighting laser beam projector is adjusted in association with adjusting operation of the adjuster.

Abstract: First and second optical-redirectors mounted on a catheter couple radiation to a target along separate first and second paths. Either the first or second optical-redirectors, or both, can include a steering mechanism for selecting the first and/or second path.

Abstract: Surgical ablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. Photoablative instruments are disclosed that can achieve rapid and effective photoablation through the use of distributed (e.g., diffuse or defocused) radiant energy.

Abstract: A laser scalpel includes a ribbon optical waveguide extending therethrough and terminating at a slender optical cutting tip. A laser beam is emitted along the height of the cutting tip for cutting tissue therealong.

Abstract: An apparatus for thermally treating intervertebral discs includes an energy application head having an energy application region and a tissue protecting region. A control member operationally connected to the energy application head preferably controls the energy application head during treatment. The present invention also includes a method for thermally treating an intervertebral disc.

Abstract: An apparatus for the delivery of laser light in a therapeutic environment including: a console; an optical waveguide wherein a first end of the waveguide is configured to expose a biological tissue to energy transmitted through the waveguide; a plurality of laser diodes housed within the console such that the light emitted by each of the diodes will illuminate a second end of the optical wave guide; and a power supply for providing electrical power to each laser diode. Preferably each laser diode is configured to produce a unique wavelength of light. The power supply provides an independently controllable output for each laser such that the exposure, both in terms of intensity and duration, to each wavelength of light may be controlled independently of the exposure to each of the other wavelengths of light.

Abstract: An optical fiber device for ablating a channel through a plaque deposit or a clot in a blood vessel is described. Laser energy is transmitted through one or a bundle of optical fibers to a quartz or fused silica cylinder, whose distal end surface has been made into a desired shape and sandblasted or carbon coated or both. The cylinder is received with a pocket defined in a sheath which surrounds the optical fibers. Moreover, the cylinder includes a circumferential recess and the sheath includes a circumferential rib which engages into the recess for securing the lens in the pocket. In one embodiment, the cylinder has a cavity formed therein and the distal end of the optical fiber extends into the cavity. In a further embodiment, the device is adapted to be guided along a wire extending through the pocket and an aperture defined in the sheath and/or a channel defined in the cylinder.

Abstract: A lighting accessory stem using fiberoptic illumination is provided. In certain embodiments, the lighting accessory system is combinable with a hand tool, for example a forceps, to illuminate the grasping tips of the tool. The lighting accessory system provides an illuminable tool whereby an object may be illuminated and grasped while being illuminated without obstruction by the illumination means. In certain embodiments, the lighting accessory system may be used for medical or surgical tools.

Abstract: A lighting accessory system using fiberoptic illumination is provided. In certain embodiments, the lighting accessory system is combinable with a hand tool, for example a forceps, to illuminate the grasping tips of the tool. The lighting accessory system provides an illuminable tool whereby an object may be illuminated and grasped while being illuminated without obstruction by the illumination means. In certain embodiments, the lighting accessory system may be used for medical or surgical tools.

Abstract: A probe having the ability to deliver cardioplegia solution to the coronary sinus under direct visualization and to provide venous drainage from the right atrium for cardiopulmonary bypass. The probe has an elongate tubular member, including a distal end, a proximal end, and a lumen. A membrane, optionally perforated, mounted within the lumen of the tubular member partitions the lumen and is removable or penetrable by a cardioplegia catheter. The distal end comprises a toroidal balloon or a circumferential recessed vacuum manifold. A vacuum port communicates with the distal end of the tubular member or the vacuum manifold. Methods of using the cardioplegia access view probe for catheterization of the coronary sinus and for venous return as herein described are also disclosed.

Abstract: A handpiece for topical application of electromagnetic radiation is disclosed, consisting of a single monolithic transparent block covered by a semitransparent coating on the faces of the block not directed toward a treatment site. The block and coating are transparent to visible radiation, allowing the user a direct view of the treatment site. At the same time, for the safety of the user and a patient, the monolithic block has a coating of radiation blocking or absorbing material to selectively prevent treatment radiation from harming a user or patient. In a preferred embodiment, an optical fiber or fiber bundle coupled to a suitable power source is directly molded into the monolithic block. This invention is useful for a broad variety of laser applications, including the treatment of dermatological diseases and paint removal. The simple monolithic structure allows the device to be portable and practical in open environments.

Abstract: A medical instrument for phacoemulsification with which the biological tissue of a lens of the eye is comminuted by the introduction of energy, the comminuted product is sucked out through an incision in the cornea, while intraocular pressure is maintained by supplying an irrigating liquid. In an instrument of the type mentioned above, two cannulas are provided for sucking out the ablated lens material and for supplying the irrigating liquid and are connected, via feed lines, with the suction device and with the supply device. A switchable directional valve is provided in the feed lines between the cannulas and the suction device and supply device, by means of which, in a first valve position, a first cannula is connected with the suction device and the second cannula is connected with the supply device and, in a second valve position, the second cannula is connected with the suction device and the first cannula is connected with the supply device.

Abstract: A laser system in which the gain medium is an excited YAP:Nd crystal. The system is configured so that the crystal produces a twin laser beam comprising wavelengths at both 1079 nm and 1340 nm with substantial intensities at each wavelength. Optical components are described which establish the desired ratio of the intensities of the light at each of the two wavelengths. These ratios, I1079 nm/I1340 nm, may vary from about 0.1 to 10. In a preferred embodiment of the invention a kit including a YAP:Nd crystal and a specially coated output coupler is provided for converting an existing Nd:YAG laser system to a twin light laser capable of producing the above described twin laser beam.

Abstract: A laser irradiation apparatus comprising: a long and slender main body 101; an optical fiber 107, which is placed inside the main body 101 and which is equipped with a proximal end through which a laser ray is introduced and an emitting part from which the laser ray is emitted sideways or diagonally; and a reflecting member 151, which is affixed inside said main body 101 and reflects laser ray emitted from the optical fiber 107. The emitting part of the optical fiber 107 is capable of making a reciprocating motion in the lengthwise direction inside the main body 101 within the specified range. The reflecting member 151 has a reflecting surface 152 that changes its reflecting angle as the emitting part of the optical fiber 107 moves along its reciprocating movement range.

Abstract: An energy irradiation apparatus for medical treatment of tissues through irradiation of energy including a long main unit, an emitting part, a power transmission member, a drive mechanism, a first engaging member, and a second engaging is disclosed. The emitting part is disposed moveably inside a distal end of the main unit for emitting energy transmitted to a distal side from a proximal side. The power transmission member is disposed moveable inside the main unit. The emitting part is mounted to a distal end of the power transmission member. The drive mechanism reciprocates the power transmission member in a longitudinal direction of the main unit. The first engaging member is provided inside the power transmission member for receiving a drive force from the drive mechanism. The second engaging member is provided in the drive mechanism for engaging removably with the first engaging member.

Abstract: An ablation system incorporating an enhanced deflectable distal portion, is provided. The system includes an elongated tubular member having a deflectable distal portion adapted to assume a specific predetermined or predefined shape when deployed. The predetermined shape allows for the creation of a desired uniform energy emission pattern with respect to a target tissue, such that energy may be directed toward the target tissue independent of an approach orientation of the ablation system. The energy pattern results in the creation of a desired tissue ablation. The ablation system may further comprise a steering system which aides in directing the distal portion toward a target tissue site. The steering system may alternatively be incorporated into a separate guiding catheter as part of the ablation system.

Abstract: A fiber optic cable to be used with surgical instruments is provided wherein the cable is temporarily attached to the surgical instrument with which it is used, and mounted in an open design to allow illumination to a wider portion of the targeted area such that an entire surgical pocket may be illuminated, and the cables provided can be disposable without requiring permanent attachment to an instrument or development of surgical instruments permanently incorporating a light source by providing a plurality of guide members on the surgical instrument so the cable may be threaded through the guides and preferably engaged by at least one of the guides.

Abstract: Infrared surgical photoablation instruments are disclosed for creating lesions in tissue, including cardiac tissue for treatment of arrhythmias and other diseases. The hand held instruments are especially useful in open chest or port access cardiac surgery for rapid and efficient creation of curvilinear lesions to serve as conduction blocks. Photoablative instruments are disclosed that emit radiation at a wavelength in a range from about 800 nm to about 1000 nm, and preferably emit at a wavelength in a range of about 915 nm to about 980 nm. Radiation at a wavelength of 915 nm or 980 nm is commonly preferred, in some applications, because of the optimal absorption of infrared radiation by cardiac tissue at these wavelengths.

Abstract: A laser apparatus for permanently removing a plurality of hair follicles, veins or capillaries from the skin of a patient. The laser apparatus includes a housing having a single laser for sequentially emitting a series of pulses of coherent light energy having a pulse duration in the range of ½ ms to 10 ms; a fiber optic bundle connected to the laser for transmitting said series of pulses of coherent light energy to the skin of a patient; and a sequence control device for controlling the laser to emit the series of pulses of coherent light energy sequentially, with a time delay of less than 20 milliseconds between the sequential pulses of the single laser. The laser apparatus includes a handpiece assembly for holding a section of the fiber optic bundle for directing the series of pulses of coherent light energy to the same spot of the patient's skin to remove the plurality of hair follicles, veins, or capillaries.

Abstract: A method of manufacturing a medical instrument for diffusing light from an optical fiber is provided. The medical instrument includes an optical fiber having a proximal portion including a cladding layer surrounding the core and a distal portion having a diffuser tip comprising a protective coating made of acrylic or methylpentene surrounding the core, an optical coupling layer, and a sleeve. The protective coating strengthens the distal end of the optical fiber so that it can withstand a higher bending moment at failure than the uncladded core. At the same time, the protective layer has an index of refraction that is between the indices of refraction of the core and the optical coupling layer to direct light out of the core through to the optical coupling layer.

Abstract: The present invention describes a multi-component handpiece that is both economical and practical for surgical laser treatment. A disposable optical fiber is inserted into a reusable handpiece. The distal end of the optical fiber is protected by a micro-walled protective tube to prevent the disposable fiber from chipping before and during insertion into the handpiece. Once the optical fiber is protected, it is inserted into the handpiece by threading the optical fiber through the cap, body, and cannula of the handpiece until the fiber extends slightly beyond the distal end of the needle. The micro-walled protective tube is removed from the end of the optical fiber, the optical fiber is positioned, and the cap is tightened. The cap and body of the handpiece cooperate to produce a tight friction fit that prevents longitudinal movement of the optical fiber during laser therapy.

Abstract: A method of controllably heating the annulus of an intervertebral disc is disclosed. The method comprises the steps of forming an access channel through the annulus of an intervertebral disc while avoiding the nucleus of the intervertebral disc, inserting a light-emitting diffuser into the annulus, and activating the light-emitting diffuser to emit diffuse light while maintaining the light-emitting diffuser within the access channel to raise the temperature of the annulus to a value sufficient to cause a change in the characteristics of the annulus.

Abstract: The present invention is directed to a hand held cardiac ablation instrument and methods for irradiating a target ablation site. The instrument can include at least one light transmitting optical fiber and a light diffusing element to create a circumferential or curvilinear lesion. A handle is provided for manual application. The handle can be substantially coaxial or otherwise aligned with the center of the circumferential housing. Light travelling through the light transmitting optical fiber or fibers is scattered in a circular pattern by the light diffusing element. The light diffusing element can include a scattering medium, a reflective end cap, and a reflective surface diametrically opposed to the target ablation site, that interact to provide a substantially uniform distribution of laser radiation throughout the circular target region.

Abstract: A system for delivering medicaments to tissue including a delivery member and an optical fiber formed together into a unitary structure. The optical fiber has an inlet attached to a laser energy source and an outlet for emitting laser energy. The delivery member has an inlet attached to a medicament source and an outlet for injecting medicament. A handpiece is adapted to receive the ablating and injecting device in a controlled and movable relationship and may include at least one tissue stabilizing member thereon. In use, the distal end of the handpiece is placed against tissue to be ablated. The optical fiber is advanced into the tissue while emitting laser energy thereby ablating the tissue and forming a channel therein. During retraction, medicament may be injected into the channel or into the tissue surrounding the channel.

Abstract: A laser therapy assembly (1) for the revascularization of muscular tissues (t), especially cardiac muscular tissue, with a laser source (2) and an optical coupling unit (9, 11) for transmitting the laser beam (L) into the muscular tissue, with an ultrasound generator (6) connected to the optical coupling unit for a transfer of heat to the muscular tissue, which can be regulated independently from the laser beam with the purpose of producing a thermal effect that can be separately adjusted, especially a marginal thermal necrosis, in a channel generated in the muscular tissue.

Abstract: A probe tip having a surgical tool manufactured from a light transmissive material. Such a construction eliminates the need for a separate fiberoptic and surgical tool. If desired, the probe tip may be used in combination with a surgical probe having an actuation handle made from springy material having a memory. Squeezing the handle causing the actuation device to elongate, thereby causing movement in the probe tip. The probe handle of the present invention may be held and actuated in any position.

Abstract: Apparatus (10) for treatment of an ischemic region of brain cells in a cranium, comprising a skull covering (14) adapted to cover at least part of the cranium, at least one guide (16) attached to the skull covering (14), and a laser source (12) which is operative to direct a laser beam through the at least one guide (16) into the cranium. The at least one guide may include an optic fiber or a waveguide.

Abstract: A medical handpiece is disclosed which is connected with a laser radiation source via a beam guidance device and by which a laser beam is directed to a treatment area. The handpiece is freely movable to the laser beam source. At least one optical element with a surface which is structured in the micrometer range and which is accordingly micro-optically active is provided inside the handpiece following an exit face of the beam guidance device.

Abstract: A method and apparatus are provided for radiation treatment on a patient by use fiber laser and/or a tunable laser, a tunable fiber laser being used for preferred embodiments. Wavelength may be controlled to control depth of penetration and/or radiation absorption and may be scanned to scan depth of penetration.