Abstract: A method is provided for treating a targeted area of ocular tissue in a tissue-sparing manner comprising use of two or more therapeutic modalities, including thermal radiation source (such as an CW infrared fiber laser), operative in a wavelength range that has a high absorption in water, and photochemical collagen cross-linking (CXL), together with one or more specific system improvements, such as pen-operative feedback measurements for tailoring of the therapeutic modalities, an ocular tissue surface thermal control/cooling mechanism and a source of deuterated water/riboflavin solution in a delivery system targeting ocular tissue in the presence of the ultraviolet radiation. Additional methods of rapid cross-linking (RXL), are provided that enables cross-linking (CXL) therapy to be combined with thermal therapy.

Abstract: Methods, systems, and apparatus to treat glaucoma of the eye are disclosed. They apply energy to the tissue adjacent collector channels and/or Schlemm's Canal. Applying energy to the surface of the eye, such as the sclera, adjacent the collector channels and/or their ostia can dilate the collector channels and/or their ostia to improve uveoscleral outflow to reduce intraocular pressure. In some examples energy is applied to the eye with a laser at a sufficient energy to shrink the tissue on opposing sides of the collector channels to induce channel dilation.

Abstract: An iridocorneal angle of the eye can be opened with a plurality of treatment locations at least about 2 mm radially outward from a limbus of the eye. The opening on the angle can be beneficial for treating both narrow angle glaucoma and open angle glaucoma. The plurality of treatment locations located away from the limbus can decrease invasiveness and complexity of the procedure. The plurality of treatment locations at least about 2 mm away from the limbus can provide tensioning to zonules coupled to the lens of the eye to flatten the lens of the eye, which can allow the iris to move posteriorly so as to open the iridocorneal angle. The plurality of treatment locations may comprise scleral locations, in which shrinkage of scleral tissue at the plurality of treatment locations provides tensioning to the zonules.

Abstract: A method is provided for treating a targeted area of ocular tissue in a tissue-sparing manner comprising use of two or more therapeutic modalities, including thermal radiation source (such as an CW infrared fiber laser), operative in a wavelength range that has a high absorption in water, and photochemical collagen cross-linking (CXL), together with one or more specific system improvements, such as pen-operative feedback measurements for tailoring of the therapeutic modalities, an ocular tissue surface thermal control/cooling mechanism and a source of deuterated water/riboflavin solution in a delivery system targeting ocular tissue in the presence of the ultraviolet radiation. Additional methods of rapid cross-linking (RXL), are provided that enables cross-linking (CXL) therapy to be combined with thermal therapy.

Abstract: The methods and apparatus disclosed herein can be used to adjust the effective lens position (“ELP”) of the eye in order to correct refractive error of the eye. The methods and apparatus can be configured to apply energy to the sclera and other regions of the eye in order to adjust the effective lens position of the eye for far vision. The sclera can be treated in order to shrink or relax the sclera, and combinations thereof in order to adjust the position of the lens of the eye in order to correct vision related to refractive error of the eye. A target location of the lens can be determined to correct the refractive error of the eye, and the energy applied in order to move the lens toward the target location.

Abstract: Delivery systems and methods for delivering riboflavin (R/F) and UVA irradiation to the sclera are disclosed. The R/F is delivered and then activated with UVA irradiation through the use of LEDs or optical fibers, thereby causing cross-linking of the collagen tissue. Delivery systems include implantable structures which provide surfaces that conform to the sclera. The delivery systems include various types of structures for delivery of R/F onto the sclera surface. Additionally, the delivery systems include UVA sources which provide irradiation of R/F in sclera collagen tissue.

Abstract: Delivery systems and methods for delivering riboflavin (R/F) and UVA irradiation to the sclera are disclosed. The R/F is delivered and then activated with UVA irradiation through the use of LEDs or optical fibers, thereby causing cross-linking of the collagen tissue. Delivery systems include implantable structures which provide surfaces that conform to the sclera. The delivery systems include various types of structures for delivery of R/F onto the sclera surface. Additionally, the delivery systems include UVA sources which provide irradiation of R/F in sclera collagen tissue.

Abstract: A method is provided for treating a targeted area of ocular tissue in a tissue-sparing manner comprising use of two or more therapeutic modalities, including thermal radiation source (such as an CW infrared fiber laser), operative in a wavelength range that has a high absorption in water, and photochemical collagen cross-linking (CXL), together with one or more specific system improvements, such as peri-operative feedback measurements for tailoring of the therapeutic modalities, an ocular tissue surface thermal control/cooling mechanism and a source of deuterated water/riboflavin solution in a delivery system targeting ocular tissue in the presence of the ultraviolet radiation. Additional methods of rapid cross-linking (RXL), are provided that enables cross-linking (CXL) therapy to be combined with thermal therapy.

Abstract: Delivery systems and methods for delivering riboflavin (R/F) and UVA irradiation to the sclera are disclosed. The R/F is delivered and then activated with UVA irradiation through the use of LEDs or optical fibers, thereby causing cross-linking of the collagen tissue. Delivery systems include implantable structures which provide surfaces that conform to the sclera. The delivery systems include various types of structures for delivery of R/F onto the sclera surface. Additionally, the delivery systems include UVA sources which provide irradiation of R/F in sclera collagen tissue.

Abstract: An apparatus and a method are provided for treating a targeted area of ocular tissue in a tissue-sparing manner comprising use of two or more therapeutic modalities, including thermal radiation source (such as an CW infrared fiber laser), operative in a wavelength range that has a high absorption in water, and photochemical collagen cross-linking (CXL), together with one or more specific system improvements, such as peri-operative feedback measurements for tailoring of the therapeutic modalities, an ocular tissue surface thermal control/cooling mechanism and a source of deuterated water/riboflavin solution in a delivery system targeting ocular tissue in the presence of the ultraviolet radiation. Additional methods of rapid cross-linking (RXL), are provided that further enables cross-linking (CXL) therapy to be combined with thermal therapy.

Abstract: Systems and methods for delivering and infusing formulations containing riboflavin or its analogues, or other ophthalmic formulations, into corneal tissue are disclosed. Systems and methods are further disclosed to cross-link the corneal tissue through exposure to UVA irradiation. The systems and methods for formulation delivery employ micro-needle array delivery devices.

Abstract: Delivery systems and methods for delivering riboflavin (R/F) and UVA irradiation to the sclera are disclosed. The R/F is delivered and then activated with UVA irradiation through the use of LEDs or optical fibers, thereby causing cross-linking of the collagen tissue. Delivery systems include implantable structures which provide surfaces that conform to the sclera. The delivery systems include various types of structures for delivery of R/F onto the sclera surface. Additionally, the delivery systems include UVA sources which provide irradiation of R/F in sclera collagen tissue.

Abstract: A solution of deuterated water containing a riboflavin-based photosensitizer is provided in order to extend life-times of UVA/Rf photo-generated intra-stromal singlet oxygen, in combination with UVA delivery profiles of pulsing, fractionation, and optionally auxiliary stromal/Rf hyper-oxygenation in order to accelerate protein cross-linking density rates in ocular tissue. A 100% deuterated water solution with 0.1% riboflavin in solution increases singlet oxygen lifetimes by at least an order of magnitude without inducing endothelial cell apoptosis, thereby also permitting use of some combination of lower percentages of deuterated water, lower concentrations of riboflavin or lower dosages of UVA on intact (un-debrided) epithelium for equivalent cross-link densities compared to current acceptable corneal cross-linking procedures.

Abstract: An apparatus and a method are provided for treating a targeted area of ocular tissue in a tissue-sparing manner comprising use of two or more therapeutic modalities, including thermal radiation source (such as an CW infrared fiber laser), operative in a wavelength range that has a high absorption in water, and photochemical collagen cross-linking (CXL), together with one or more specific system improvements, such as peri-operative feedback measurements for tailoring of the therapeutic modalities, an ocular tissue surface thermal control/cooling mechanism and a source of deuterated water/riboflavin solution in a delivery system targeting ocular tissue in the presence of the ultraviolet radiation. Additional methods of rapid cross-linking (RXL), are provided that further enables cross-linking (CXL) therapy to be combined with thermal therapy.

Abstract: A system for accurately delivering bilateral simultaneous equi-dosed time-fractionated pulsed UVA to irradiate a class of riboflavin/collagen mixture in the presence of oxygen for treatment of ocular tissue such as scleral and corneal tissue. The system employs ocular trial frames for mounting on the face that are fitted with 1) a nozzle for introducing Riboflavin in solution to collagen on the surface of the ocular tissue, 2) a port for introducing oxygen-rich gas to the ocular tissue, and 3) a pair of optical collimator inserts mounted in the lens holders, wherein the collimator inserts have a mask in the optical path at an aperture on focal point to control the pattern of UVA radiation at the ocular target, the collimator inserts further having optical input ports coupled to a controlled source of UVA radiation that is operative in accordance with the related inventive method.

Abstract: Equi-dosed time-fractionated pulsed UVA is employed to irradiate a class of riboflavin/collagen mixture in the presence of copious oxygen to cause rapid crosslinking causing gelation of the riboflavin/collagen mixture in situ and to effect adhesion to underlying structure specifically ocular tissue such as scleral and corneal tissue. Irradiation according to an embodiment of the invention results in depletion of dissolved oxygen at a rate inversely related to irradiance and more particularly depletion of dissolved oxygen occurs rapidly during the process of generation/cross-linking of reactive oxygen species (ROS), specifically singlet oxygen, such that the pulsed fractionation of UVA radiation exposure increases cross-linking efficiency by allowing the re-diffusion of oxygen during pauses in exposure.

Abstract: Method and apparatus for performing oculoplasty including applying a photosensitizer solution to a human eye surface includes defining a treatment region within the human eye surface. The treatment region is associated with a predetermined spatial pattern. The method further includes irradiating the treatment region with controlled photoactivating radiation. In relation to presbyopia treatments, shrinkage of the paralimbal scleral region near the scleral spur results in improved near focus with no loss in far acuities.

Abstract: The present invention provides a system and associated method for advantageously treating bodily tissue containing collagen, such as ophthalmic tissue. The treatment includes providing a pattern of heating to which the tissue is to be exposed and the exposure of that tissue to shrink collagen therein. In ophthalmic applications, the pattern includes at least one region that corresponds to an ocular region of from about 4 mm to about 20 mm radially from the optical axis. The shrinkage of collagen within this ocular region improves accommodation for near vision. The present invention thus provides an effective treatment for the ocular condition of presbyopia.

Abstract: An automated method is described for advantageously preparing and treating an eye of the patient. The method further provides a vision-corrective procedure, such as photothermal keratoplasty. The automated method is useful to dry the cornea to reduce or eliminate a tear film on the corneal surface that might otherwise interfere with or reduce the efficacy of a vision-corrective procedure and thereafter to treat the cornea according to a vision-corrective procedure. The automated method is user-friendly, allowing the treatment provider to develop or to select an appropriate pre-treatment and treatment plan and to activate sane using a familiar "Windows" environment. The method has particular application in the area of automated corneal preparation and treatment, it may be used in the automated preparation and treatment of other tissues or substrates.