Abstract: Embodiments apply a cross-linking agent to a region of corneal tissue. The cross-linking agent improves the ability of the corneal tissue to resist undesired structural changes. For example, the cross-linking agent may be Riboflavin or Rose Bengal, and the initiating element may be photoactivating light, such as ultraviolet (UV) light. In these embodiments, the photoactivating light initiates cross-linking activity by irradiating the applied cross-linking agent to release reactive oxygen radicals in the corneal tissue. The cross-linking agent acts as a sensitizer to convert O2 into singlet oxygen which causes cross-linking within the corneal tissue. The rate of cross-linking in the cornea is related to the concentration of O2 present when the cross-linking agent is irradiated with photoactivating light. Accordingly, the embodiments control the concentration of O2 during irradiation to increase or decrease the rate of cross-linking and achieve a desired amount of cross-linking.

Abstract: A system for determining biomechanical properties of corneal tissue includes a light source configured to provide an incident light and a confocal microscopy system configured to scan the incident light across a plurality of cross-sections of corneal tissue. The incident light is reflected by the corneal tissue as scattered light. The system also includes a filter or attenuating device configured to block or attenuate the Rayleigh peak frequency of the scattered light, a spectrometer configured to receive the scattered light and process frequency characteristics of the received scattered light to determine a Brillouin frequency shift in response to the Rayleigh peak frequency being blocked or attenuated by the filter or attenuating device, and a processor configured to generate a three-dimensional profile of the corneal tissue according to the determined Brillouin frequency shift. The three-dimensional profile provides an indicator of one or more biomechanical properties of the corneal tissue.

Abstract: A system for determining biomechanical properties of corneal tissue includes a light source configured to provide an incident light and a confocal microscopy system configured to scan the incident light across a plurality of cross-sections of corneal tissue. The incident light is reflected by the corneal tissue as scattered light. The system also includes a filter or attenuating device configured to block or attenuate the Rayleigh peak frequency of the scattered light, a spectrometer configured to receive the scattered light and process frequency characteristics of the received scattered light to determine a Brillouin frequency shift in response to the Rayleigh peak frequency being blocked or attenuated by the filter or attenuating device, and a processor configured to determine a three-dimensional profile of the corneal tissue according to the determined Brillouin frequency shift. The three-dimensional profile provides an indicator of one or more biomechanical properties of the corneal tissue.

Abstract: Systems and methods include a cutting instrument that creates incisions in selected areas of the cornea; an eye therapy system that applies reshaping forces to the cornea; and a controller that determines the selected areas of the cornea for the incisions and the reshaping forces from the eye therapy system, such that the reshaping forces and the incisions combine to achieve corrective reshaping of the cornea. Other systems and methods include measuring an eye to determine a required amount of reshaping of a cornea; determining one or more doses of cross-linking agent and one or more corresponding doses of photoactivating light according to the required amount of reshaping; applying the cross-linking agent to the cornea; and delivering, from a light source, the photoactivating light to the area of the eye, the photoactivating light combining with the cross-linking agent to induce the corrective reshaping of the cornea.

Abstract: Devices and approaches for monitoring time based photo active agent delivery or photo active marker presence in an eye. A monitoring system is provided for measuring the presence of a photo active marker by illuminating the eye so as to excite the photo-active marker and then observing characteristic emission from the photo active marker. Example systems incorporate Scheimpflug optical systems or slit lamp optical systems to observe cross sectional images of an eye to monitor instantaneous distribution, diffusion pattern, and rate of uptake of a photo active agent applied to an eye. Systems and methods further allow for utilizing the monitored distribution of photo active agent in the eye as feedback for a cross-linking system.

Abstract: A system for applying therapy to an eye selectively applies coolant to the corneal surface to minimize heat-related damage to the corneal surface during thermokeratoplasty. Embodiments may include an energy source, a conducting element, a coolant supply, and at least one coolant delivery element. The conducting element is operably connected to the energy source and extends from a proximal end to a distal end. The conducting element directs energy from the energy source to the distal end, which is positionable at the eye. The coolant delivery elements are in communication with the coolant supply and are operable to deliver a micro-controlled pulse of coolant to the distal end.

Abstract: Various agents and additives for cross-linking treatments are identified in disclosed studies. The characteristics of the various agents and additives may be advantageously employed in formulations applied in cross-linking treatments of the eye. In some embodiments, riboflavin is combined with Iron(II) to enhance the cross-linking activity generated by the riboflavin. In other embodiments, cross-linking treatments employ an Iron(II) solution in combination with a hydrogen peroxide pre-soak. In yet other embodiments, 2,3-butanedione is employed to increase the efficacy of corneal cross-linking with a photosensitizer, such as riboflavin. In further embodiments, folic acid is employed in combination with a photosensitizer, such as riboflavin, to enhance cross-linking activity. In yet further embodiments, 2,3-butanedione, folic acid, a quinoxaline, a quinoline, dibucaine, Methotrexate, menadione, or a derivative thereof is applied as a cross-linking agent.

Abstract: Systems and methods improve operation of an applicator that delivers heat-generating energy to an eye as a part of an eye therapy. For example, reflected power may be measured to determine whether sufficient contact has been established between the applicator and the eye for accurate and precise delivery of energy to the eye. In addition, at least one of forward and reflected power may be measured to monitor the application of coolant pulses that control the generation of heat in the eye when the applicator delivers energy to the eye. Further, the forward and reflected power may be measured to determine an efficiency of energy transfer or an impedance mismatch. Based on the efficiency of energy transfer or the impedance mismatch, an adjustable parameter of a tuning element may be modified.

Abstract: A system for applying a treatment to an eye includes a housing having a first end and a second end, a contact element having an open end and a closed end, and a light source disposed within the housing and configured to direct light toward the open end. The contact element is coupled to the first end of the housing at the closed end. The open end is configured to be positioned at an eye.

Abstract: Embodiments apply a cross-linking agent to a region of corneal tissue. The cross-linking agent improves the ability of the corneal tissue to resist undesired structural changes. For example, the cross-linking agent may be Riboflavin or Rose Bengal, and the initiating element may be photoactivating light, such as ultraviolet (UV) light. In these embodiments, the photoactivating light initiates cross-linking activity by irradiating the applied cross-linking agent to release reactive oxygen radicals in the corneal tissue. The cross-linking agent acts as a sensitizer to convert O2 into singlet oxygen which causes cross-linking within the corneal tissue. The rate of cross-linking in the cornea is related to the concentration of O2 present when the cross-linking agent is irradiated with photoactivating light. Accordingly, the embodiments control the concentration of O2 during irradiation to increase or decrease the rate of cross-linking and achieve a desired amount of cross-linking.

Abstract: A glaucoma treatment system includes: a cannula body configured to be positioned in an area of Schlemm's canal; an illumination guide extending along the cannula body; at least one drug source coupled to the cannula body; a cross-linking agent source coupled to the cannula body; and an illumination source coupled to the illumination guide. The at least one drug source includes a drug that promotes outflow of aqueous humor through the trabecular meshwork and into Schlemm's canal. The cannula body delivers the drug from the at least one drug source to the area of Schlemm's canal, and in response to changes in the outflow of aqueous humor, delivers the cross-linking agent to the area of Schlemm's canal. The illumination guide delivers photo-activating light from the illumination source to the area of Schlemm's canal. The photo-activating light activates the cross-linking agent, thereby stabilizing changes in the area of Schlemm's canal.

Abstract: System and methods for a corrective eye procedure include at least one application device configured to be positioned at a selected area of an eye (e.g., equatorial sclera, posterior sclera, cornea, etc.). The at least one device includes at least one channel and at least one illumination guide. A cross-linking agent source is coupled to the at least one channel. An illumination source is coupled to the at least one illumination guide. The at least one device delivers the cross-linking agent to the selected area of the eye. The at least one device delivers photo-activating light from the illumination source to the selected area of the eye after the cross-linking agent has been delivered. The photo-activating light includes one or more doses necessary for activating the cross-linking agent and for activating TGF-? isoforms to improve health of extracellular matrices in the selected area of the eye.

Abstract: An electrical energy applicator in one embodiment extends from a proximal end to a distal end. The energy conducting applicator includes, at the proximal end, a connection to one or more electrical energy sources. The energy conducting applicator directs electrical energy from the one or more electrical energy sources to the distal end. The energy conducting applicator includes an outer conductor and an inner conductor extending to the distal end. The outer conductor and the inner conductor are separated by a gap. The outer conductor includes a plurality of moveable outer segments and the inner conductor includes a plurality of moveable inner segments. The plurality of outer segments and the plurality of inner segments form a total contact surface at the distal end. The total contact surface is positionable at a surface of an eye. The electrical energy is applied to the eye according to the total contact surface.

Abstract: According to aspects of the present disclosure, a kit for transepithelial delivery of a cross-linking agent to a cornea includes a first vessel containing an initial formulation that includes a cross-linking agent and a first active ingredient configured to open corneal epithelial tight junctions when applied to a cornea and one or more second vessels each containing a respective secondary formulation that includes the cross-linking agent for application to the cornea after the initial formulation is applied to the cornea.

Abstract: Systems and methods for treating an eye select locations for making incisions in areas of the cornea according to astigmatic keratotomy or radial keratotomy, make incisions in the selected areas of the cornea, apply a cross-linking agent to the selected areas of the cornea, and deliver photoactivating light from a light source to the selected areas of the cornea to initiate cross-linking activity in the selected areas of the cornea.

Abstract: A system for applying therapy to an eye selectively applies coolant to the corneal surface to minimize heat-related damage to the corneal surface during thermokeratoplasty. Embodiments may include an energy source, a conducting element, a coolant supply, and a coolant delivery system. The conducting element is operably connected to the energy source and extends from a proximal end to a distal end. The conducting element directs energy from the energy source to the distal end, which is positionable at the eye. The coolant delivery system is in communication with the coolant supply and is operable to deliver a micro-controlled pulse of coolant to the distal end.

Abstract: Heat is generated in corneal fibrils in a cornea of an eye according to a selected pattern. The heat causes the corneal fibrils corresponding to the selected pattern to transition from a first structure to a second structure. The second structure provides a desired reshaping of the cornea. A cross-linking agent is then activated in the region of corneal fibrils according to the selected pattern. The cross-linking agent prevents the corneal fibrils from changing from the second structure. Thus, embodiments stabilize corneal tissue and improve its biomechanical strength after desired structural changes have been achieved in the corneal tissue. Accordingly, the embodiments help to preserve the desired reshaping of the cornea.

Abstract: Embodiments apply a cross-linking agent to a region of corneal tissue. The cross-linking agent improves the ability of the corneal tissue to resist undesired structural changes. For example, the cross-linking agent may be Riboflavin or Rose Bengal, and the initiating element may be photoactivating light, such as ultraviolet (UV) light. In these embodiments, the photoactivating light initiates cross-linking activity by irradiating the applied cross-linking agent to release reactive oxygen radicals in the corneal tissue. The cross-linking agent acts as a sensitizer to convert O2 into singlet oxygen which causes cross-linking within the corneal tissue. The rate of cross-linking in the cornea is related to the concentration of O2 present when the cross-linking agent is irradiated with photoactivating light. Accordingly, the embodiments control the concentration of O2 during irradiation to increase or decrease the rate of cross-linking and achieve a desired amount of cross-linking.

Abstract: Embodiments apply a cross-linking agent to a region of corneal tissue. The cross-linking agent improves the ability of the corneal tissue to resist undesired structural changes. For example, the cross-linking agent may be Riboflavin or Rose Bengal, and the initiating element may be photoactivating light, such as ultraviolet (UV) light. In these embodiments, the photoactivating light initiates cross-linking activity by irradiating the applied cross-linking agent to release reactive oxygen radicals in the corneal tissue. The cross-linking agent acts as a sensitizer to convert O2 into singlet oxygen which causes cross-linking within the corneal tissue. The rate of cross-linking in the cornea is related to the concentration of O2 present when the cross-linking agent is irradiated with photoactivating light. Accordingly, the embodiments control the concentration of O2 during irradiation to increase or decrease the rate of cross-linking and achieve a desired amount of cross-linking.

Abstract: Trans-epithelial osmotic collyrium for the treatment of keratoconus by corneal cross-linking with UV rays, of the type consisting of a riboflavin-based solution and an absorption enhancement adjuvant consisting of benzalkonium chloryde (BAC). The solution has a hypoosmolarity degree ranging between ?70% and ?30% over an isotonic solution and contains a BAC concentration accordingly ranging between 0.005% and 0.035%.