Abstract: An ophthalmic surgical device is provided for facilitating a continuous, smooth, curve linear, stress-free, tag-free cut of the anterior capsule which comprises a handle, a blade rotatably mounted to the handle's distal end and a controller on the handle for manually and positively positioning the blade at a desired angular position during movement of the handle.

Abstract: A surgical instrument is provided having a tubular body including a distal portion, a proximal portion and a mid portion. A cutting member having a cutting edge is longitudinally received within the tubular body for guided reciprocal movement therein between a cutting position wherein the cutting edge extends from the distal portion and a non-cutting position wherein the cutting edge is retracted within the tubular body. A urging mechanism is also provided within the mid portion of the tubular body for urging the cutting member to the cutting position. A vacuum source is coupled to the cutting member at a proximal end thereof and provides a vacuum directed to the distal portion to hold tissue to be cut. A method of cutting the tissue is also provided.

Abstract: A keratorefractive surgical blade has opposing sides and first and second edges which intersect each other to form a point. The first edge is shaped to form a sharp cutting edge extending from the point a predetermined distance shorter than the distance from the base of a surgical incision to Bowman's membrane, a portion of the first edge adjacent to the sharp cutting edge being dull relative to the cutting edge.

Abstract: A keratotomy incision is formed in a cornea manipulating an RK knife so that its blade extends a preselected depth into a preselected point on the cornea. Sufficient force is applied by a surgeon's fingers to the knife to advance its blade in a preselected direction. Advancement of the blade is halted when resistance of the cornea against the blade exceeds a certain level. A signal representative of the resistance is produced by a strain gauge or transducer in or on the knife. The level of the resistance is indicated on a display or audibly in response to the signal.

Abstract: A surgical blade and method incorporating the surgical blade which ensure uniform incision depth and angulation, and the creation of self sealing surgical wounds during cataract surgery.

Abstract: Radial keratotomies can be performed by incising centrifugally. A vibrating diamond front cutting blade with a reverse cutting edge incises centrifugally to form a squared-off incision at the optical zone. The incision can be retraced if an enhancement is necessary with the vibrating blade without tearing the collagen or resulting in blade setting variability or variability due to corneal compression.

Abstract: Refractive error of the cornea is corrected by a scraping procedure of rotating or oscillating, about a center axis of the cornea, a sharpened knife edge blade that is tangential to and against that portion of the cornea to be corrected, and microaxially advanced until the refractive error has been corrected.

Abstract: An ophthalmic lance includes a retractable blade and a sheath, the retractable blade can only be exposed when a button is pressed down. The blade is attached to a spring loaded stem so that when the button is released, the blade is automatically retracted back into the sheath. Pressure on the button at the end of the stem or on the locking pin causes the blade to be exposed. As soon as that pressure is released the blade is automatically retracted back up into the sheath. The sheath has an H-shaped cutout in which a locking pin fits in and can slide about. The locking pin is coupled to the stem. The H-shaped cutout has a short-leg, a long-leg and a cross-bar so that when the locking pin is inside of the short-leg, the blade is in the locked position and when the locking pin is inside of the long-leg, the stem can be depressed and the blade exposed.

Abstract: Surgical blades, knives and keratotomy procedures are provided which are capable of severing deep corneal tissue in the optical zone without penetrating the surface of this zone and causing optical glare. The blades of this invention include at least one cutting edge thereon which is shorter than about 0.5 mm and which includes a projecting cutting portion and/or recessed blunt edge to permit primary or secondary incisions beneath the surface of the optical zone.

Abstract: The present invention provides a surgical technique and instrument kit that allows for subtle modification of the corneal curvature by interlamellar injection of a synthetic gel at the corneal periphery while sparing the optical zone. The gel viscosity, volume and disposition within the surgical annular track as well as the diameter of the track, width, depth, and location are all parameters in the refractive change obtained. Following ultrasonic pachymetry performed centrally and at a selected wound entrance located about 2.5 to 3.5 mm from the apex, a one millimeter or so wide, about 75-85% corneal thickness depth radial incision is performed with a micrometric diamond knife adjusted to about 86% corneal thickness. Inserted through the partial-depth incision, a corkscrew-like dissector or helicoidal spatula forms a 360.degree. annular track centered about the apex. A transparent gel is manually injected through the incision, filling the annular channel.

Abstract: A surgical knife blade includes a cutting blade for penetrating tissue of the eye. First indicia is carried on the cutting blade proximally spaced from a tip thereof for being aligned with an external surface of the tissue when the cutting blade is inserted tip first in the tissue to form an initial incision having a depth equal to the distance that the first indicia is spaced proximally from the tip. The cutting edge is configured to form a subsurface tunnel within the thickness of the tissue when the cutting blade is moved from the initial incision along a plane transverse to the plane of the initial incision. Second indicia is carried on the blade proximally spaced from the tip for being aligned relative to the initial incision to gauge the length of the subsurface tunnel.

Abstract: This invention contemplates the use of a surgical laser device characterized by ultra-violet or infrared radiation to achieve controlled trabeculodissection in selected regions of the trabecular meshwork and Schlemm's Canal. The surgical laser is positioned over the corneoscleral bed for non-contact delivery, or, alternatively, it is inserted under a sclera flap with a contact tip and laser radiation is directed toward the trabecular meshwork and canal of Schlemm creating an ultra-thin trabecular meshwork and Canal of Schlemm. The outflow of aqueous humor through the disected trabecular meshwork functions as a self-limiting end point to the surgery when the aqueous humor absorbs the laser energy.

Abstract: Refractive error of the cornea is corrected by a scraping procedure performed within a vacuum chamber formed above the cornea.

Abstract: To control the angle of an incision by a surgical scalpel during microsurgery, a scalpel has a double-beveled thin blade with reflective and light-absorbing matted portions on its surface whereby glare from the reflective portions of the blade indicates the angle of an incision. The matted portions are spaced longitudinally along the blade of the scalpel against a reflective background. A source of light in the microscope is reflected into the eye piece of the microscope from the blade so that the pattern of reflective and matted portions indicates the angle of the blade with respect to the light source.

Abstract: A keratome is machined from a single block of material to form front and back portions that cannot become distorted during use. The blade is held at a reduced angle and a surface defining a chamber for receiving the slice intersects the blade at a tangent. The adjustable plate overlaps the blade a predetermined amount. The lower edge of the plate, adjacent the blade, is shaped for an improved cut, as is the blade itself. The suction ring is laser welded to avoid distortion of the channel for the keratome and an applanator is shaped to prevent relative motion of the applanator along the channel.

Abstract: An instrument and method for performing a capsulotomy where the instrument is in the form of a tubular probe through which irrigation fluid may be passed, the end of the probe carrying a thin blade pivotable about an axis transverse to the axis of the tubular probe, the blade being disposed eccentrically with reference to the axis, with its major trailing cutting edge located toward the rear of the blade and at a greater distance from the axis than the leading end of the blade so that, when the leading end of the blade is applied to cut the anterior wall of the capsule, the cutting is completed by the swiveling of the blade about the axis to follow the movement of the leading end. The method involves the use of this blade to perform a circular cut in the capsule wall through which the cataract may be drawn out.

Abstract: A keratome is disclosed for use in eye surgery. The keratome includes an elongated handle having two ends. A blade is secured to one end of the handle so that the blade has a cutting edge spaced from and facing outwardly from the end of the handle. The blade is curvilinear in shape and has a radius of curvature substantially the same as the radius of curvature of the eye immediately adjacent the outer periphery of the cornea of the eye.

Abstract: A surgical knife and a method for enhancing incisions in radial keratotomy enhancement surgery on an eye having a cornea and a central optical zone, where a generally radial incision previously made in the cornea has a wall adjacent the optical zone and is to be extended centripetally toward the optical zone. The knife comprises a knife blade with an end, and the blade has a sharpened cutting edge facing in a leading direction, a recess extending inwardly from the cutting edge and from the end of the blade, and a stopping edge and a measuring edge at the recess. The stopping edge faces in the leading direction. The measuring edge has a predetermined length and extends from the cutting edge to the stopping edge. The surgical knife is inserted into a previously made incision so that the cutting edge and the stopping edge face centripetally and the end of the blade contacts a bottom portion of the incision.

Abstract: A corneal press is disclosed for accurately trephining corneal tissue. The disclosed press includes a base support member, a modular cutting block, two guide posts, a collet mount, a threaded drive mechanism, and a set of modular collets. The base includes means for securely holding the cutting block in position for holding a corneal specimen to be cut about a defined axis. The guide posts are attached to the base in offset parallel alignment relative to the defined axis. The collet mount is mounted onto the guide posts and is slidable relative thereto toward and away from a corneal specimen positioned on the cutting block mounted onto the base. The threaded drive mechanically links the collet mount to the base such that the operation of the threaded drive causes the collet mount to move along said guide posts toward or away from a specimen positioned on the base.

Abstract: A method of reshaping a cornea to meet the refractive needs of a patient is provided which includes: providing apparatus suitable for conducting keratomileusis in situ, the apparatus including a keratome means to cut across and remove a section of the cornea, and positioning means to maintain shaping means in register with respect to the cornea, the shaping means having a lower surface which can be brought into contact with the cornea, and engaged to downwardly depress the exposed surface of the cornea into a substantially flat configuration across a predefined optical zone; engaging the lower surface with the surface of the cornea, depressing the cornea and then causing the keratome to move across the cornea removing a predetermined section of the cornea thereby creating a revised exposed surface; retaining the section for later reattachment; providing a lenticular member having a predetermined thickness profile, and disposing the lenticular member between the lower surface and the revised surface of the cor

Abstract: Hyperopia (far-sighted) refractive error of the cornea is corrected by a scraping procedure of rotating or oscillating a tool having a central pressure pad with a plurality of curved sharpened knife-edge blades that initially are tangential to and against an outer zone or band of the cornea and micro-axially advanced until the refractive error has been corrected.

Abstract: A host cornea marking device for providing marks on a recipient cornea bed of a corneal transplant patient is disclosed. The present marking device includes: an outer tube having a plurality of marking blades at one of opposite axial ends thereof which is adapted to face the recipient cornea bed, the marking blades being spaced apart from each other in a circumferential direction of said outer tube; and an inner tube which is received in the outer tube, such that the inner tube is axially slidable relative to the outer tube. The inner tube includes a contact portion at one of opposite axial ends thereof which is adapted to be in contact with the cornea bed so as to position the marking device with respect to a cutout section in the recipient cornea bed for receiving a donor cornea. A spring between the inner and outer tubes may be used to hold the inner tube in a first position.

Abstract: A corneal punch for cutting a portion of corneal tissue. The corneal punch includes a support stand including a base portion having a recess formed therein. First and second pins extend upwardly from the base portion and are constructed to receive a cutting block in a single rotational orientation relative to the support stand. A piston assembly having a cutting blade mounted thereon is movably mounted on the support stand. The piston assembly is rotationally locked relative to the support stand in order to prevent rotation of the piston assembly relative to the support stand during the cutting of corneal tissue. The cutting block has at least one mark placed thereon such that the orientation of the corneal tissue relative to the corneal punch can be controlled. A method for transplanting corneal tissue is also provided.

Abstract: Surgical apparatus for inserting a plastic, split end, adjusting ring into the stroma of the cornea of the eye wherein the adjusting ring includes, as a part thereof, a dissecting head to part the stroma and provide a pathway for the adjusting ring as the ring is rotated. The ends of the adjusting ring are moved to change the shape of the cornea to a desired shape in accordance with the desired visual correction after which the ends of the adjusting ring are fixably joined to maintain the desired shape.

Abstract: A method and device for lifting the epithelium from a selected area of the eye using an incision instrument for cutting the epithelium to define an area of the epithelium to be removed, and a fluid jet assembly for separating the selected area of the epithelium from the underlying layer. The incision instrument shown has a series of incision elements distributed about a peripheral pattern, arranged to cut the epithelium in the direction of its thickness without disturbing the underlying layer, to create a tear line. The jet assembly directs through the tear line a fluid jet in the manner that the fluid progresses inwardly from the tear line and effectively wedges the epithelium from the underlying layer. The device shown also has an epithelium support structure for engaging the exterior surface of the delineated area of the epithelium in order to support and maintain the structural integrity of the lifted epithelium.

Abstract: A corneal surgical instrument comprising a surgical knife and ultrasonic probe assembly that measures the corneal thickness, monitors the positioning and perpendicularity of the knife and controls the depth of the knife blade. The ultrasonic probe assembly includes a pair of ultrasonic probes disposed on opposite sides of said cutting plane of the knife blade. Information on monitored parameters is displayed to the surgeon in the display of a surgical instrument used to perform corneal surgery.

Abstract: The intrastromal corneal ring (ICR) is adjustable in thickness and has an elongated, flexible, preferably transparent or translucent body which forms a circle. The ICR is of a size such that it can be inserted into a human eye and is comprised of a material which is compatible with human ocular tissue. The thickness of the ring can be adjusted so that it is not necessary to stock a plurality of different rings of different sizes to be used in connection with a method of adjusting the shape of the cornea of the eye. A plurality of different embodiments of ICRs are disclosed each of which are adjustable in terms of their thickness. The thickness may be adjusted prior to the insertion of the ICR into the cornea and may not be further adjustable after insertion.

Abstract: A cam guided corneal trephine for selectively cutting a portion of an eye is provided herein. The cam-guided corneal trephine comprises a base, a coarse adjusting ring, interchangeable annular ring, interchangeable annular cams operatively supported by the adjusting ring, the annular cams having various inner round diameters or other than round dimensions, and a roller cage assembly adapted to be disposed and rotated within the annular cam, the roller cage assembly having a blade mounting means disposed therein for providing a continuous cut of the corneal tissue corresponding to the inner shape of the selected cam upon rotation of the roller cage assembly.

Abstract: A keratome includes a miniature differential micrometer having a barrel, a middle sleeve, and a inner sleeve connected by a threaded shaft having threads of two different pitches. One end of each of the middle sleeve and inner sleeve is drilled and tapped undersize and is slotted to conform resiliently to the threaded shaft. The middle sleeve is attached to a keratome by set screws drawing the middle sleeve into tight contact with the body of the keratome. The adjustable plate in the keratome is attached to the inner sleeve.

Abstract: A cannula for use in cataract surgery during the phases of hydrodissection and hydrodelamination/hydrodelineation/hydrodemarcation is described. The cannula has a hub for mating with a syringe and a needle originating from the distal end of the hub. The needle comprises a first section, second section, and truncated surface. The first section originates from the distal end of the hub and extends forward in a plane delineating the central longitudinal axis of the cannula. The second section originates from the distal end of the first section and is flattened and curved away from the central longitudinal axis of the hub. The truncated surface of the needle forms a rounded tip with beveled surfaces. The intersection of the bevel and sides of the cannula are sharpened to provide a cutting edge.

Abstract: An apparatus and method for performing an incision in, for example, the wall of the eye, including a suction cup which may be fixed to the wall of the eye, a cutting tool the cutting edge of which is in the shape of a closed curve, in particular a circle, surrounding tightly the rim of the suction cup, and capable of moving along the rim of the suction cup in order to penetrate into the wall of the eye and to incise it along the closed curve, means to create suction in the central zone of the suction cup in order to fix it firmly to the wall of the eye, and means to move the cutting tool along the rim of the suction cup, and to have it penetrate into the wall, at a depth at least equal to the thickness of the wall.

Abstract: A trephine device for removing anterior epithelial cells from a corneal surface, typically prior to laser excimer reshaping of a portion of the corneal surface, comprises a housing having upper and lower end portions, removal means integral to the housing, and means for activating and deactivating the removal means. The removal means may have at least one cutting surface adapted to conform substantially to the shape of the cornea, with the cutting surface contacted with the cornea at a pressure sufficient to remove the anterior epithelial cells without affecting underlying corneal tissue.

Abstract: Surgical apparatus and method for incising an aperture in the anterior capsule of the human eye. The apparatus for capsulorhexis comprises a shaft, a cutting member with a sharp cutting edge, and a fastener connecting the shaft to an ultrasonic power source. After making an initial incision in the eye, the surgeon uses the apparatus to make a smooth, continuous, curvilinear aperture in the anterior capsule of the eye.

Abstract: A surgical instrument adapted to pass through a superior limbal incision and fit behind the cornea for making a continuous circular incision about the anterior pole of the lens capsule in extracapsular cataract extractions and phacoemulsification. The surgical instrument includes a rotating blade disposed at one end and adapted to rotate about 360.degree.. The instrument is fixed with respect to the lens capsule by a peg extending from the rotation axis of the blade. A method for making the circular incision is also disclosed.

Abstract: The instrument comprises a tubular outer support forming a shell around a determined axis and including a circularly symmetrical annular base portion about the axis defining a substantially spherical annular surface enabling the support to be pressed against the cornea; the support includes a cylindrical inside wall that is resiliently deformable in the radial direction to receive the tubular top section of a template having a transverse wall at its bottom which is delimited by a substantially spherical bottom surface and which includes a central orifice and at least one pair of arcuate slots disposed symmetrically about the center of the wall.

Abstract: The instrument comprises:a tubular outer support forming a shell about a determined axis and including an annular bottom portion that is circularly symmetrical about the axis to define a substantially spherical annular surface of the support for application against the cornea; anda tool carrier received inside the outer support and movable relative thereto between a high position and a low position, the tool carrier including a smooth tool-holding socket whose inside wall is resiliently deformable in the radial direction, the socket being axially movable relative to the support, a resilient member disposed between the socket and the support urging the tool carrier towards its high position, and a threaded drive socket screwed into the support above the smooth socket to constitute an adjustable top abutment for the smooth socket and opposing the return effect of the resilient member.

Abstract: A scalpel for eye surgery having a blade member with a plurality of juxtaposed cutting sections arranged successively along the blade member. The cutting sections have respective cutting edges defining respective widths and lengths of incisions. Each cutting section is visually delineated from the other cutting sections by different coloration or other marking indicia, such that each cutting section will visually indicate the depth and width of an incision made by inserting the blade member into a body to the depth of the respective cutting section. The scalpel can include both a keratome type blade member and a scleral dissector blade member on a common support stem.

Abstract: A keratorefractive surgical blade has opposing sides and first and second edges which intersect each other to form a point. The first edge is shaped to form a sharp cutting edge extending from the point a predetermined distance shorter than the distance from the base of a surgical incision to Bowman's membrane, a portion of the first edge adjacent to the sharp cutting edge being dull relative to the cutting edge.

Abstract: A surgical knife having a handle and a blade with a first generally V-shaped portion for cutting an incision having a first width of approximately 3.2 millimeters and a second generally arcuate portion for widening the incision to a second width of approximately 5.2 millimeters.

Abstract: Method and apparatus for surgically altering the cornea of an eye by forming a pocket in the corneal stroma, situated between anterior posterior lamellar portions of the cornea, posteriorly displacing the anterior corneal portion to form a posteriorly protruding mass of corneal stroma, excising a part of the posteriorly protruding mass, and removing the excised part from the pocket. Also, the invention includes inserting into the pocket a die that has an anteriorly facing impression surface whereby posteriorly displacing the anterior lamellar portion forces a portion of the posteriorly protruding mass against a portion of the impression surface, and further includes removing the die from the pocket after the excision.

Abstract: Surgical blades for use in ophthalmic surgery are shown to include a first shaft, a second shaft, connected to the first shaft at a predetermined angle and a tip, connected to the distal end of said second shaft. The tip associated with the micro-paufique blade has a tapered surface extending inwardly forming a continuous cutting edge which includes a front portion and first and second side portions. Rotation and transverse movement of the first shaft in relation to a scleral incision results in a subsurface scleral pocket. In a preferred embodiment the micro-paufique tip portion is generally circular shape around its outer periphery and the tapered surface extends radially inwardly and towards the bottom surface. The tip associated with the micro-keratome blade extends a distance along a central axis and includes first and second side portions substantially symmetrical to the central axis.

Abstract: An improved surgical knife blade particularly suited to eye surgery having a triple edged truncated point. An elongated, flat diamond blade has a primal end adapted to be supported in a handle or the like and a sharp distal end adapted to penetrate and cut tissue, such as the cornea of the eye in radial keratotomy. The blade has a first edge lying generally parallel to the blade axis and a second edge at the distal blade end converging toward the first edge at a selected angle, optimally about 15.degree.. A flat transverse tip is provided at the meeting point of the first and second edges, at an angle of from about 45.degree. to 135.degree. to the first blade edge. Both edges and the tip are faceted to provide uniformly very sharp edges. This blade will penetrate tissue more easily and under greater control than prior blades so that arcuate transverse incisions may be accurately made in astigmatic keratotomy. Incisions of uniform depth to nearly the ends of the incisions can be made more accurately.

Abstract: A corneal stromal puncture needle for ophthalmic surgery having a cutting tip from 0.1 to 0.6 mm in length extending from the needle shaft at an included angle of 75.degree. to 105.degree..

Abstract: Surgical apparatus for inserting a plastic, split end, adjusting ring into the stroma of the cornea of the eye wherein the adjusting ring includes, as a part thereof, a dissecting head to part the stroma and provide a pathway for the adjusting ring as the ring is rotated. The ends of the adjusting ring are moved to change the shape of the cornea to a desired shape in accordance with the desired visual correction after which the ends of the adjusting ring are fixably joined to maintain the desired shape.

Abstract: An ophthalmic instrument for fixating a patient's eye during an ophthalmic procedure. The instrument includes a speculum securable against the patient's bony orbit, and a fixation ring attachable to the patient's eye, the ring including both a mechanism for fixating the ring with respect to the eye, and a mechanism for adjustably attaching the ring to the speculum. The instrument may include one or more bubble-type levels carried on the fixation ring for indicating the orientation of the ring and assisting the surgeon in orienting the eye of the patient before securing the ring to the speculum.

Abstract: A lense for keratometry and a keratotome for making an incision for receiving such a lense. The lense comprises an optical zone and an anchoring zone with a sloping shape such that this zone can be inserted under a strip disengaged from the cornea of the receiving eyeball via a tapering incision diverging from the cornea. The keratotome according to the invention is adapted to perform such an incision. The result is that the lense is anchored in the cornea in a more efficient, less traumatic and more aesthetic manner.

Abstract: Prosthetic devices and methods are described that can be employed in replacing corneal endothelial tissue to allow the diseased or damaged corneal endothelial tissue to be replaced without replacing the outer layers of the patient's cornea and/or to replace the full thickness of the cornea in a manner resulting in less deformation of the outermost surface of the cornea (i.e. less astigmatism) than occurs with current full thickness transplant techniques.

Abstract: The present invention is an anterior capsular incising apparatus having a pair of crisscrossing arms hinged at a crisscross joint and each having a forward portion and a rearward portion and a deformable circular cutting ring having a sharp bottom circular cutting edge detachably mounted onto and between the forward portions of the pair of crisscross arms, such that the deformable circular cutting ring can be compressed into a narrow elliptical shape by squeezing the rearward portions of the pair of crisscrossing arms.

Abstract: The invention relates to a mechanical device for performing automatic lamellar corneal resections, in particular, myopic keratomileusis-in-situ and Hyperopic Lamellar Keratotomy. The device includes three major components, a motor and transmission assembly, a shaper head assembly and an eyeball retaining ring. The motor and transmission assembly includes a flexible shaft with a threaded end which is rotated by an electric or turbine motor. The threaded end of the shaft drives a helicoidal pinion on the shaper head assembly which changes the shaft direction by 90.degree.. The shaper head assembly is moved across the rack of the eyeball retaining ring by a series of pinions. The device provides a means for automatically, precisely and safely performing corneal resections.

Abstract: A method for locating on a cornea an artificial lens fabricated from a collagen-hydrogel for promoting epithelial cell growth and regeneration of the stroma is shown. The method provides for affixing an artificial lens to the Bowman's membrane and the lens, during the healing process, promotes and supports epithelial cell growth enabling corneal epithelium of the cornea of an eye to attach to and cover the anterior surface of the lens implanting the same and to regenerate the stroma which grows over the edge of and attaches to the optical lens. Laid down in the layers of the regenerated stroma are new keratocytes and collagen fibial produced from keratocytes. The collagen-hydrogel is a hydrogel polymer formed by the free radical polymerization of a hydrophilic monomer solution gelled and crosslinked in the presence of an aqueous stock solution of collagen to form a three dimensional polymeric meshwork for anchoring collagen.