Abstract: An energy delivery system for performing myocardial revascularization on a heart of a patient including an energy pulse source that produces energy pulses sufficient to create channels in a wall of a heart, and an energy pulse delivery system connected to receive the energy pulses and deliver the energy pulses to desired locations for channels in the wall of the heart. Also disclosed are a sensor that senses a cyclical event related to the contraction and expansion of the beating heart; a controller responsive to the sensor for automatically firing the energy pulse system to provide energy to strike the beating heart only within a safe time period during a heart beat cycle; RF electrical or laser energy pulses; a temperature sensor to avoid damage caused by overheating adjacent heart tissue; a thermal conductivity cooling system; and programmably adjusting duty cycle, duration and amplitude of energy pulses.

Abstract: An ab interno method for transscleral photodisruption of tissue on the interior surface of the sclera includes selecting a wavelength for a laser beam. The selected wavelength may be either from a first range of wavelengths (0.4-1.4 .mu.m) which is normally strongly scattered as it is transmitted through the sclera, or from a second range of longer wavelengths (1.5-2.5 .mu.m) which is less scattered as it is transmitted through the sclera. If the first range of wavelengths is selected, a chemical agent may be applied to the sclera to make it effectively transparent, but this may not be necessary. In either case, the laser beam is focused directly through the sclera to a focal point on the interior surface of the sclera. Once focused, the laser beam is activated to photodisrupt scleral tissue at the focal point. The laser beam is then moved in a pattern and refocused at successive focal points to photodisrupt scleral tissue at each of the focal points.