Abstract: A laser perforator is disclosed for perforating skin with a perforation to permit blood under a surface of the skin to flow out, the perforator in one embodiment having a laser light source for producing an output laser beam, and a mode distribution means for intercepting the output laser beam to control distribution of laser energy of the output laser beam across the perforation of the skin. A laser perforator is disclosed for perforating skin with a perforation to permit blood under a surface of the skin to flow out, the perforator in one embodiment having a laser light source for producing an output laser beam having an energy level between about 0.1 to about 2.

Abstract: A laser apparatus for medical treatment use in which a laser beam is irradiated on a portion of a human body to be treated comprises a laser beam generation unit for generating a laser beam of giant pulse, a laser beam guide member having one end through which the laser beam from the laser beam generation-unit is guided, and a hand piece attached to another end of the laser beam guide member and irradiating the laser beam to the portion to be treated. A beam converging point is formed within a laser beam propagating path formed in at least one of the light guiding means and the hand piece and a stay of air is prevented from a predetermined region in the laser beam propagating path including at least the beam converging point at which the air stays. The predetermined region is positioned within the hand piece or the laser beam guide member. The air stay is prevented by means of producing a vacuum state, gas seal state or air flow state in the predetermined region.

Abstract: A method and apparatus for precisely controlling and determining the location of the interaction point of a surgical laser beam, and for controlling the shape of the cornea during ophthalmic surgery. A transparent applanator plate is placed in contact with the cornea of a patient's eye. The applanator plate creates a fixed positional frame of reference from which a laser beam control system can determine the desired point or points at which to focus the surgical laser beam. A surgical tip at the distal end of an articulated arm having flexible joints is placed in contact with the applanator plate and follows any motion of the patient's eye and directs the laser beam to the surgical tip. The applanator plate also provides a means to control the contour of the index of refraction boundary between the corneal epithelium of the patient's eye and the air.

Abstract: A method of damaging pigmented intraocular cells, a patient with a disease, which involves selectively damaging pigmented cells in an intraocular area by irradiating the area with laser radiation of radiant exposure between about 0.01 and about 5 Joules/cm.sup.2, while sparing nonpigmented cells and collagenous structures within the irradiated area. The method is useful for the treatment of glaucoma, intraocular melanoma, and macular edema.

Abstract: An alignment module for determining the astigmatic axis of a patient and for aligning the cylindrical axis of a laser ablation system for ophthalmological surgery. A rotatable image element, such as target, is illuminated through a diffuser plate and an image of the target is presented along an optical path comprising a fixed collimating lens, a plurality of turning mirrors and a slidably adjustable imaging lens. The light source, diffuser plate, lenses and mirrors are all mounted on a platform which is attachable to a camera port of a surgical microscope normally installed in the delivery system optics of the laser surgery system. The movable lens is adjusted to a position corresponding to the required sphere correction, and the target is rotated until the patient sees the clearest target image, signifying alignment of the target with the astigmatic axis of the patient's eye. The alignment angle information is used to align the cylinder axis of the laser surgery system to the proper angle.

Abstract: A light diffuser for the radial emission of light, which has been fed into the diffuser in axial direction, comprises an optical waveguide, which itself comprises a core and a cladding. The core of the waveguide is exposed at an active region at the distal end. The exposed active region of the core is optically separated from a substance containing scattering particles. In a preferred embodiment, the core is roughened and is embedded in a first layer of an elastic substance, which has a refractive index similar to the refractive index of the cladding and which does not contain any scattering particles. This first layer is embedded in at least one further, second layer of an elastic substance comprising the scattering particles. This substance is surrounded by the outer tube.

Abstract: An improved laser fiber assembly is provided which is capable of both effecting direct ablation of tissue or of effecting deep tissue coagulation. The fiber assembly is preferably provided with an orbicular tip for effecting direct ablation in a contact mode. Adjacent the orbicular tip is a cylindrical diffuser element which effects a cylindrical shaped emission pattern when the .orbicular tip is not in contact with tissue. The diffuser element is preferably protected with a covering, such as a teflon tubing element. Alternative embodiments use one or more cylindrical-segment diffuser elements in place of the cylindrical element. The fiber assembly is useful in a wide variety of surgical situations, and is particularly useful for treatment of benign prostatitis hyperplasia. The method of the invention includes the steps of bringing the tip of the dual action fiber assembly into contact with tissue to be ablated or adjacent tissue to be treated for deep tissue coagulation.

Abstract: A laser cyclo-photocoagulation in the eye is monitored on-line by means of an ultrasonic biomicroscope, i.e., visual representations of the treated field, inclusive of the effects obtained in the tissue, are provided continuously on a display placed at the disposal of the attending doctor. The doctor decides, by means of the generated ultrasonic images, on the course of the further treatment. The choice is possible between different operating modes of the ultrasonic biomicroscope.

Abstract: A method for threading a suture through a suture anchor after the anchor has been driven into a bone comprises the steps of (1) providing a suture anchor having an eyelet, with at least a portion of a pre-installed suture engaging implement passed through the eyelet; (2) driving the suture anchor into a bone, leaving the eyelet and the suture engaging implement exposed; (3) engaging a suture with the suture engaging implement; (4) removing the suture engaging implement from the eyelet so as to pull the suture through the eyelet; and (5) disengaging the suture engaging implement from the suture. In one embodiment, the suture engaging implement comprises a thin, flexible tube having an open end. The tube is pre-installed in the anchor by passing it through the eyelet. One end of the suture is pushed into the open end of the tube. The tube is pulled out of the eyelet so as to pull the suture through the eyelet. The end of the suture is then removed from the open end of the tube.

Abstract: A process for surgically correcting presbyopia includes anesthetizing a patient and marking a portion of an eye of the patient which is to be ablated. At least a portion of the cornea is resected to expose the corneal stroma. An annular portion of the corneal stroma is then ablated using radiation from a laser beam. After ablation, the cornea is repositioned onto the eye. The cornea may be resected such that a portion of the cornea remains intact, and is folded back to expose the corneal stroma. Alternatively, a complete disk of the cornea may be removed from the eye, to thereby expose the corneal stroma. After exposure but before ablating, the corneal stroma should be dried to prevent uneven ablation which may occur if fluids are present on the stroma. The laser beam may be directed in a circular fashion until an annular ablation is formed, or a mask may be provided over a central area of the corneal stroma. To prevent edema, the ablated portion should be cleaned by brushing and irrigating.

Abstract: A thermokeratoplastic electrode which has a tip that is placed in direct contact with the epithelium layer of the cornea. The electrode is capable of creating very small localized denatured areas that shrink the corneal membrane to correct hyperopic and astigmatic conditions.

Abstract: An improved radial light emitting ureteral stent is disclosed having an elongated tubular member of substantially uniform outside diameter throughout its length and having a proximal and a distal end, the stent having a central lumen and at least one drainage opening extending through a wall connecting the lumen to the outside, the improvement being the inclusion of at least one fiber optic strand along a length of the tubular member, the strand capable of radially emitting light. The fiber optic strand is connected to a variable voltage source, the strand either being embedded within a wall of the stent or in associative contact with an exterior periphery of the tubular member.

Abstract: A method and apparatus are disclosed for automatically delivering a laser beam [30] to an intricate colored region [23] of a treatment area [32], e.g. for laser photocoagulation treatment of venular malformations and other dermatological conditions. Reflected light from the treatment area [32] travels into the delivery console [28] to a color-sensitive detector which signals a control system to permit the laser beam [30] to be delivered to the treatment area [32] only when the beam is focused on a spot having a predetermined color. By scanning over the treatment region, the laser automatically treats only the area having a specified color. Since reflective optics are employed, the reflected light precisely indicates the color of the region where the treatment beam is focused. Reflective optics also provide a smaller and more precise spot size for the treatment beam.

Abstract: A method is disclosed for treating veins. In the subject method, the skin is pierced with the sharpened tip of a fiber optic probe. The probe is advanced to a location underneath the vessel to be treated. Once in position, the vessel is irradiated with a treatment beam having a fluence sufficient to coagulate and collapse the vessel at that location. The procedure is then repeated at multiple sites along the length of the vessel so that it will collapse along its length and no longer carry any blood. In the preferred embodiment, a curved probe is used to facilitate the insertion of the tip under the vessel.

Abstract: For an interstitial thermotherapeutic treatment of biological tissue in which, for generating a coagulation necrosis, the radiation of the laser within a radiation period is guided into the tissue by way of a fiber optic waveguide, the laser power is reduced continuously or in steps during the radiation period.

Abstract: An illuminator including a differential optical radiator and a laser fiber disposed within the differential optical radiator. The differential optical radiator includes a first region that has a first level of reflectivity and a first level of transmissivity and a second region that has a second, higher level of reflectivity and a second, lower level of transmissivity. The first and second regions are positioned such and their reflectivities and transmissivities are chosen such that the radiator produces a substantially uniform pattern of illumination from the first and second regions.In another embodiment, the illuminator includes an expandable radiator and a laser fiber disposed within the expandable radiator. The reflectivity of the expandable radiator is such that the illumination at the outer surface of the expandable radiator is substantially uniform.

Abstract: A method of treating vascular lesions is disclosed which includes using a focused beam from a high energy, carbon dioxide laser to irradiate a spot on the surface of the skin over the vessel to be treated. The carbon dioxide output wavelength is highly absorbed by the tissue. By using short, high energy pulses, a small volume of skin can be vaporized or ablated with each pulse with little thermal damage beyond the ablated region. Using multiple pulses, a small channel is drilled in the skin until the vessel is reached. The laser energy absorbed by the blood in the vessel will cause it to coagulate and collapse. This procedure is then repeated at multiple sites along the length of the vessel so that it will collapse and no longer carry any blood.

Abstract: Apparatus for irradiating an area with a controllable pattern of light comprises a laser (2), which illuminates a spatial light modulator (6). The resulting spatially modulated light then passes to a cholesteric liquid crystal polymer beam-splitter (10) which reflects it to an image surface (13) of an endoscope (12). The endoscope relays it to another image surface (40) whence it is focussed on the area to be irradiated. This light may be used for photodynamic therapy.

Abstract: A laser treatment system includes a fiber optic assembly for conducting laser beam from a laser beam source to a patient's body. The fiber optic assembly is disposable, sterilized and includes a safety switch to prevent inadvertent application of power to the laser beam generation circuit, thereby preventing accidental generation of a laser beam without a fiber optic assembly in place to guide the laser beam.

Abstract: An applicator for treatment of an elevated internal ocular pressure by means of laser radiation has a handpiece, which releasably surrounds a fiber optic light guide on its exit side end. A sleeve portion is releasably connected to the exit side end of the light guide, a condensing optical element being provided in the sleeve portion, optically dimensioned and arranged in the sleeve portion at a distance from the exit side end of the light guide such that the applied laser radiation can be focused in the ciliary body of the eye on contact of the sleeve portion with the surface of the eye.