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: Systems and methods stabilize corneal tissue after treatment of the corneal tissue. For example, thermokeratoplasty may be applied to the corneal tissue to address disorders associated with abnormal shaping of the cornea. To stabilize the desired structural changes caused by the treatment, embodiments apply ophthalmic formulations that help to inhibit wound healing. Wound healing may occur in response to the application of the treatment and may produce further structural changes that mitigate or alter the desired effects of the treatment.

Abstract: An electrical energy applicator directs electrical energy from the electrical energy source to a distal end, which positionable at a surface of an eye. The energy conducting applicator includes a first conductor and a second conductor separated by a gap. The first conductor has a first contact surface at the distal end, and the second conductor has a second contact surface at the distal end. The first conductor and/or the second conductor has a length that is adjustable by a biasing element. The first contact surface of the first conductor is movable relative to the second contact surface of the second conductor. The first contact surface and the second contact surface are adjustably positionable simultaneously against the surface of the eye to deliver energy to the eye according to a pattern defined by the first contact surface, the second contact surface, and the gap.

Abstract: Embodiments according to aspects of the present invention provide a single convenient and versatile tool that allows an operator to apply energy to the cornea according to different patterns to suit different treatment cases, without requiring multiple applicators or interchangeable components. 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 distal end is positionable at a surface of an eye. The energy conducting applicator includes at least three selectable conductors coupled to the one or more electrical energy sources. The selectable conductors define an outer conductor and an inner conductor being separated by a gap.

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: 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 includes a conducting element that conducts energy from an energy source to apply therapy to an eye. The system includes a covering configured to be removably attached to the conducting element. The covering has an interface surface that is positionable at an eye. At least a portion of the interface surface includes one or more dielectric materials. Energy is deliverable to the eye through the interface surface. In one aspect, the covering provides an electrical insulator to minimize the concentration of electrical current in the area of contact with the eye. In another aspect, the covering allows the eye to be cooled during the application of energy without directly applying coolant to the eye. In another aspect, the covering includes a dielectric layer that may provide varying impedances that allow different patterns for energy delivery. In another aspect, the sheath promotes hygienic use of the conducting element.

Abstract: The cornea is reshaped in multiple steps according to varying amounts of energy in varying patterns and/or at varying locations to achieve a customized reshaping of the cornea to address the specific needs of an individual patient. The varying amounts of energy may be applied via one or more conducting elements, which include an outer conductor and an inner conductor disposed within the outer conductor, a distal end of the outer conductor and the inner conductor defining the varying patterns. For example, one step may form a substantially circular lesion to flatten a first portion of the cornea to treat presbyopia, while another step may form a substantially circular and concentric lesion having a greater diameter to steepen a second portion of the cornea to treat hyperopia. Advantageously, continuous transitional regions are formed relative to the reshaped portions to provide vision for intermediate distances.

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.