Abstract: A method and device are provided for directing laser radiation to a body cavity site. A hollow, elongate, optical fiber is advanced, usually in a containing device, to the vicinity of the site and coupled to a laser source with a distal end region of the fiber extending along a longitudinal axis. The fiber terminates in an energy delivery surface for emitting laser radiation transmitted by the fiber. The radiation is intercepted at a location axially aligned with the energy delivery surface and is reflected in a beam radiating substantially transversely of, and substantially circumferentially around, the axis. A reflector member or block is provided for reflecting the radiation and is mounted in an open end of the catheter at a selected axial position along the axis. A fluid, such as a flushing fluid, can be directed between the end of the fiber, against the reflector member, and to the body site.

Abstract: An apparatus for performing an ophthalmic operation on an eye by photocoagulation using a laser beam while allowing continuous observation of the eye to be treated, includes a light source for producing the laser beam, an observing system having a first inherent optical path including a slit-lamp microscope, a laser optical system having a second inherent optical path, means for transmitting the laser beam from the light source to the laser optical system, means for introducing the laser beam from the second optical path of the laser optical system to the first optical path of the observing system, a contact lens having predetermined characteristics positioned in front of and contacting the eye to be treated, first optical means provided in the first inherent optical path of the observing system for adjusting an objective plane observable from the slit-lamp microscope, means for shifting the objective plane to a desired position along the optical path while observing the objective plane, and second optical me

Abstract: A decoupled dual-beam control system for a compact micromanipulator unit for a surgical laser system includes a focusing mechanism for focusing a first laser beam of a first wavelength at a predetermined focal point; and a control mechanism for directing a second laser beam of a second wavelength onto the focusing mechanism; the control mechanism includes a device for varying the diameter and wavefront of the second laser beam at the focusing mechanism for enabling the focusing mechanism to focus the second beam in the same focal plane as the first beam. The control mechanism further includes a device for translating the second beam relative to the focusing mechanism for enabling the focusing mechanism to coincidentally position the foci of the surgical and aiming beams in the focal plane.

Abstract: A light diffuser for simultaneous photodynamic therapy and hyperthermic treatment in the oesophagus has an arrangement (14 to 18) which disperses radially the light (10) fed in by way of an optical fiber (6) and has a tube (12) filled with silicone to which are added concentrations, modulated in the axial direction, of quartz grains having a diameter of approximately 40 .mu.m which bring about a refraction having little dependence on the wavelength.

Abstract: An intra-vascular optical radial imaging system comprising an intra-vascular guidewire-compatible catheter, a source of illumination and a synchronous fluorescence detector. The catheter is inserted into a blood vessel until the tip is adjacent to a section of vessel to be imaged. A narrow beam of light emanating radially from an aperture underlying the segment to be imaged repetitively illuminates segments of the wall of the vessel in a scanning or sweeping manner with the light of a wavelength that induces fluorescence in molecules in the tissue. Fluorescence from molecules in the illuminated tissue enters the catheter through the aperture and is conveyed to a spectral analyzer. Properties of the fluorescence signal are characteristic of the particular tissue and may be used to differentiate healthy tissue from atherosclerotic plaque.

Abstract: A laser light irradiation apparatus used for medical treatment of tissues. According to a preferred embodiment, the apparatus comprises a probe, an optical fiber feeding laser light into the probe and a lead wire for detecting a temperature being inserted through and projecting from the probe. Then, the probe contains laser light scattering particles for uniform irradiation of the laser light against the tissues. Further, the probe is fabricated from a laser light tramissive synthetic material, and the fore end of a core of the optical fiber and the inserting part of the lead wire are in the synthetic material of the probe for easy molding for this apparatus.

Abstract: An optical apparatus functions as a laser catheter for removal, penetration or treatment of human tissue or other biotic material. The arrangement of the optical components, including the focal length of the lens and the spacing between the lens and the source of light is selected to yield an output beam having advantageous characteristics which are particularly suitable for medical laser treatment. Such characteristics include a relatively long beam throw, a long focal range, and a small output beam waist. A hollow tip, preferably conical in shape, is utilized to provide a tactile indicator as to the cutting action of the output beam.

Abstract: A method for performing percutaneous diskectomy using a laser applies a laser beam from the laser to vaporize nucleus pulposus in the nucleus of the herniated disc. The wavelength of the laser beam will vary and depend on the laser system used.

Abstract: A cutting tool such as a laser knife comprises a passage for a beam of light, a layer of single crystal diamond located in the passage to intercept the light passing down the passage, the diamond layer presenting a surface for the incoming light and a surface for the outgoing light, and an anti-reflective coating bonded to at least one of the surfaces. The anti-reflective coating is typically a silicon ceramic material for wavelengths not exceeding 2 .mu.m and typically a polycrystalline diamond for wavelengths of at least 2 .mu.m.

Abstract: A method and apparatus are described for cutting, drilling, ablating, fusing or altering dental tissues including enamel, dentine, bone, and cementium among others. Far infrared radiation of wavelengths between 2.5 and 3.2 microns are used to selectively affect dental tissue, where the radiation energy density determines whether cutting, fusing or other effects are produced. Either continuous wave or pulsed radiation can be used, a suitable IR source being an Erbium YSGG laser having an output wavelength of 2.79 microns. The exposed dental tissue is removed, fused, or otherwise affected without damage to the surrounding tissues depending on the duration of the exposure.

Abstract: A submersible lens fiberoptic assembly for PDT treatment includes an optical fiber, a fiber jacket, a ball lens made of zirconia and a housing. This fiberoptic assembly is simple and inexpensive to manufacture, and has a high quality of output light beam. A submersible lens fiberoptic assembly for PDT treatments is also disclosed which uses a hemisphere ball lens for treatment of areas inaccessible to a normal "forward looking" lens.

Abstract: A method and device are provided for directing laser radiation to a body cavity site. A hollow, elongate, optical fiber is advanced to the vicinity of the site and coupled to a laser source with a distal end region of the fiber extending along a longitudinal axis. The fiber terminates in a transverse, substantially flat, annular, energy delivery surface for emitting laser radiation transmitted by the fiber generally parallel to the axis. The radiation is intercepted axially adjacent the energy delivery surface and is reflected in a beam radiating substantially transversely of, and substantially around, the axis. A reflector block is provided for reflecting the radiation and is connected to an actuator for locating the reflector block at selected axial positions along the axis whereby the beam irradiates the body site along the axis.

Abstract: A fiber-optic waveguide, used for ablating lesions in blood vessels, is mounted within and guided by a catheter having multiple lumens extending therethrough and parallel to each other. The waveguide fits within at least one lumen and a guidewire, previously inserted in a blood vessel, extends through another lumen. The distal end of the waveguide can have a short section of larger diameter fiber fused to it to cause a laser beam transmitted through said fiber to expand as it emerges from the waveguide to provide a larger ablation area. The waveguide may also be connected to an energy source by means of an energy coupler. One or more balloons may be mounted to the distal end of the catheter in order to facilitate positioning the waveguide.

Abstract: A catheter for ablating obstructing material within a corporal lumen includes a fiber optic member through which radiant energy can be transmitted to a distal end adjacent the site of the obstructing material. Beveled surfaces carried on the distal end of the fiber optic member provide output beams of radiant energy oriented in a direction on the order of 45.degree. with respect to an axis of the member. The laterally deflected radiant energy beams impinge upon regions of plaque or obstructing material in the lumen and have an effective radius greater than the radius of the fiber optic member. By rotating the fiber optic member, a circular locus within the lumen can be ablated or vaporized to create a channel in the lumen with a diameter greater than the diameter of the fiber optic member.

Abstract: The invention contemplates controlled ablation of the cornea, using ultraviolet laser radiation, wherein irradiated flux density and exposure time are so controlled as to achieve desired depth of the ablation. Sculpturing action results from precharacterized distribution of flux density across the cross-section of laser-beam projection, in the context of beam size, at cornea incidence, to match the area to be ablated, and the duration of exposure determines the extent of curvature change. Illustrative techniques and situations are disclosed, for myopia correction, for hyperopia correction, and for astigmatism correction.

Abstract: A mechanism for distributing the output beam from a laser system in a treatment pattern that comprises a plurality of optical fibers, having input ends and output ends. At the input ends, the fibers are secured in a scan configuration for receiving an output beam from a laser. At the output ends, the fibers are configured in a treatment configuration for distributing the output beam in a treatment pattern. A scanner coupled with the laser system directs the beam in a scan pattern at the input ends of the fibers which matches the scan configuration. The treatment configuration secures the output ends of the optical fibers so that the output end of one optical fiber sequentially receiving the beam from the scanner is non-adjacent the output end of a next optical fiber sequentially receiving the beam from the scanner.

Abstract: A novel retinal photocoagulator is described, having a laser for generating a beam of laser radiation and a beam delivery system for delivering the laser beam to the surface of the retina. The delivery system includes a lens system for varying the spot size of the beam at the surface of the retina which is operable in two alternate modes over a given range of spot sizes, wherein one of the modes varies the size of the spot while maintaining the beam in a focused condition at the retina, and wherein the other mode varies the size of the spot at the retina by altering it focal point.

Abstract: A surgical laser endoscopic focusing guide for a laser fiber optical link comprises a disposable unit (14) which is connected to the end of an optical fiber link (10). The unit consists of an endoscopic tube (16), the front end of which contains a mirror lens (22) for directing a laser beam emitted from the unit onto the operation area. The lens (22) bends the beam in a lateral direction onto a tissue to be treated. In an embodiment for laser angioplasty, the unit has a firm and reliable attachment directly to a buffer layer (80) of the optical fiber link. This ensures flexibility required for operaton in narrow and curved vessels and provides firm attachment of the mirror lens to the tube.

Abstract: A noncontact laser microsurgical apparatus and method for marking a cornea of a patient's or donor's eye in transplanting surgery or keratoplasty, and in incising or excising the corneal tissue in keratotomy, and for tissue welding and for thermokeratoplasty. The noncontact laser microsurgical apparatus comprises a laser source and a projection optical system for converting laser beams emitted from the laser source into coaxially distributed beam spots on the cornea. The apparatus further includes a multiple-facet prismatic axicon lens system movably mounted for varying the distribution of the beam spots on the cornea. In a further embodiment of the method of the present invention, an adjustable mask pattern is inserted in the optical path of the laser source to selectively block certain portions of the laser beams to thereby impinge only selected areas of the cornea.

Abstract: A laser therapeutic apparatus for treating a patient by irradiating selected body parts by laser beams generated by a plurality of laser probes. The laser probes are supported by a common support table and a lock mechanism is provided to selectively lock and release the laser probes to maintain and release the orientation thereof. Each laser probe includes an inner cylinder and an outer cylinder and a spring for biasing the inner cylinder axially within the outer cylinder. The end of the inner cylinder is provided with one or more lights that are energized when the associated probe is emitting a laser beam. The end of each laser probe further includes indicating rings for visually indicating the extent of the axial movement of the inner cylinder with respect to the outer cylinder.

Abstract: A laser light emitter is provided for use in a medical treatment, particularly excision of a prominence of an animal organism. The laser light emitter has an excision portion, wherein a part of said excision portion includes a laser light emitting portion which is capable of emitting laser light in the direction for excision of the prominence. The emitter also includes a light emission-intercepting member on the side opposite to the direction for excision of the prominence in order to prevent laser light emission. The laser light emitting portion is optically connected with a laser light generator. By using such a laser light emitter, safe excision of the prominence can be made without giving a shock to the human body or a burn, if laser light is emitted under the presence of a physiological salt solution. In addition, it is possible to remove the prominence while controlling bleeding by regulating the quantity of laser light emission and the ability of hemostasis by laser light.

Abstract: A light transmitting and diffusing apparatus is disclosed for activating photodynamic therapy in soft cancerous tumors. In the preferred embodiment, the apparatus is affixed to a standard medical laser that transmits light through an optical fiber to a point adjacent to or within a cancerous tumor. The apparatus includes an unclad fiber-optic core with a reflective cap at a terminal end of the core. A diffuser matrix coats the unclad fiber-optic core and a transparent tubular sleeve encases the matrix and core. The transparent tubular sleeve includes a conical tip adjacent to the terminal end of the core for easy penetration of the cancerous tumors. In use, light leaves the medical laser, travels along the optical fiber into the unclad fiber-optic core. There, some light passes directly out of the core through the diffuser matrix, and the remaining light is reflected, by this reflective cap, back into and around the core, away from its terminal end.

Abstract: A bronchoscope has a fibre-optic apparatus for the photodynamic treatment of tumors in the region of the furcate branches of the bronchi, the divergent pencil of rays (13), which emerges from the end face (9) of an optical fibre, striking a lens arrangement consisting of two microlenses (14,15) which, owing to the spherical aberration, deflect edge rays (23) in the divergent pencil of rays (13) of the optical fibre (8) in such a manner that a homogeneous sharp-edged emerging pencil of rays is formed.

Abstract: This invention relates to an optical system, adapted to be disposed between a source capable of emitting a beam of light and a target. Near the upstream focal point of the first optics for focussing the beam, the beam provides an image which is at least substantially in section, but which, due to characteristics inherent in the beam of light, produces an image which is oblong in shape at the downstream focal point of the first optics for focusing the beam. The optical system successively comprises, in the direction of propagation of the beam, downstream of the first optics, first diaphragm disposed near the focal point of the first focussing optics, capable of removing a variable part of the area of the section of the beam at the focal point, and second focussing optics. The optical system may further include a second diaphragm disposed upstream from the first optics for focusing the beam for further limiting the ellipticity of the beam.

Abstract: A diode laser device and method of use for achieving transcutaneous laser photocoagulation of the retina is described. A diode laser is used since it is much more efficient than the ion or dye lasers presently used for laser photocoagulation, and therefore will not require forced air of water cooling and can be made for compact. In addition, the diode laser can be used with standard 110 v wall sockets, and does not require the high power, three phase sockets required for the ion lasers. The end result is that compared to the ion laser device, the diode laser device can be brought directly into the operating room, which makes it ideal for transcutaneous delivery.A characteristic of diode lasers is that the emitted light diverges rapidly. In addition, the diode laser beam is emitted from a rectangular edge of a diode, and the light emitted along the longer sides of the rectangular edge will diverge more rapidly than that light emitted along the shorter sides of the rectangular edge.

Abstract: A laser light emitting probe used in a medical treatment. It has longitudinally a base end to impinge on, a body to penetrate through and a tip end to emit from for laser light, comprising the tip end being covered with a light scattering surface and bending at a certain angle on a longitudinal cross section. Preferably, the tip end is covered with a surface layer containing laser light absorbing particles and laser light scattering particles having a larger refractive index than that of the material of the probe on the surface of at least from the bending part to the end part of the tip end.

Abstract: A coupler 30 for use with medical laser delivery systems is disclosed. The delivery system includes an articulated arm and an endoscope 42. The coupler 30 connects the arm to the endoscope. The coupler includes an axially extending tube 46 receivable in the bore 48 of the endoscope. The tube facilitates alignment of the coupler with the endoscope. The coupler is also provided with a telescope optical system (50, 52) for adjusting the diameter of the beam at the entrance to the endoscope to reduce clipping of the beam thereby enhancing transmission.

Abstract: A method for effecting controlled refractive correction of the cornea comprising a contact lens whose concave surface is wetted with an inert ultraviolet absorbent liquid. An excimer laser feeds a cylindrical bundle of quartz fibers terminating angularly in a decollimating matrix at the contact lens in such manner as to attenuate the ultraviolet flux in said liquid proportional to the depth thereof at the cornea so as to effect greatest corneal ablation at the thinnest depth of the liquid.

Abstract: An apparatus for delivery of high intensity laser radiation of large spot size into arteries and a method for making same are disclosed. An optical radiating apparatus is formed on one end of a light-conducting optical fiber such that high intensity laser radiation leaves the optical radiation apparatus with a spot size that is expanded to a diameter significantly larger than the optical fiber diameter. The apparatus comprises a small diameter, flexible fiber which tapers to a large diameter, smooth, rounded ball tip. The taper allows the beam to expand to several millimeters in diameter and thereby ablate a large channel through an occluded artery. The smooth ball tip minimizes the chance of mechanical dissection or perforation. The fiber material is continuous such that there are no optical interfaces.

Abstract: An instrument of the type having a casing with a leading edge to be engaged with tissue that is to be laser treated, a laser fiber with a body having an emitting end, and structure for mounting the laser fiber to the casing so that the emitting end of the laser fiber is in a fixed position with respect to the casing and thereby a tissue that is to be treated and engaged by the leading end of the casing.

Abstract: A fiber optic probe and its use in performing a sclerostomy (forming a small hole in the sclera of an eye) as a treatment of glaucoma. The minimally dimensioned probe is designed to direct laser light out of its side and, as a result, allows a sclerostomy procedure to be performed with minimal trauma to the conjunctiva and other surrounding ocular tissues of the patient. A series of pulses of infrared laser radiation delivered through the side of the probe forms the hole in the sclera.

Abstract: Method and apparatus for tissue cutting and cauterizing using a YAG laser and an optical fiber. YAG laser outputs at wavelengths of 1.06 and 1.3 microns are used for tissue cauterizing and cutting, respectively. In one embodiment, a multimode laser with means for switching the laser output between the two wavelengths is utilized; in another embodiment, individual lasers operating at the respective wavelengths are utilized.

Abstract: Surgical procedures on biological tissue are carried out with the aid of a laser with substances being applied to the tissue before or during the treatment and these substances are absorbent in the range of the wavelength of the laser beam. A surgical manipulator can be provided and equipped with suction and irrigation channels and the substances can be directed to one of these channels via a metering unit. The application of substances such as sulfisomidine or sulfacetamide increases the ablation rate and reduces the threshold of the ablation process. At the same time, sensitive structures are protected from the damaging effects of the laser radiation as well as from the stray radiation and fluorescence radiation triggered by the laser radiation during the application of microsurgery to the eye.

Abstract: Apparatus and method for laser surgery in which laser energy, pulsed or continuous, is focussed to a focus spot of ten to thirty microns which is located within tissue, or the like to cause highly localized heating. The pulsed radiation is in the TEM(oo) mode, has a wavelength of approximately 1064 nanometer, the pulses being not in excess of 100 nanoseconds and the pulse rate being approximately 2000 per second. Where the laser beam is continuous or pulsed, it has a wavelength of approximately 1400 to 1800 nanometer, or in photoablative modes, having a wavelength of 190 to about 300 nanometers. The focus spot may be caused to move relative to the axis of a handpiece; and to liquid may flow across the exposure site to remove debris.

Abstract: A laser soft tissue aspiration device comprises an aspiration cannula housing a laser energy transmitting means for conducting laser energy to the site within a patient's body for aspiration of soft tissue. The cannula is provided with an aspiration inlet port adjacent the cannula distal end. The proximal end of the cannula is provided with fluid flow connection to an aspiration source. A laser guide tube is additionally provided housing the laser energy transmitting means extending longitudinally within the cannula lumen from a laser energy source at the cannula proximal end and terminating at a point immediately prior to the aspiration inlet port. The tube also provides a conduit for transmitting cooling and cleaning fluid flow for the laser energy transmitting means.A surgical method of aspirating soft tissue from a patient in vivo using this device is also provided transmitting means.

Abstract: An improved laser apparatus for periodontal treatment comprising a surgical laser and a handpiece for focussing the beam of laser light and directing it on to tissue within a periodontal pocket. The improvement comprises a protective shield at the end of the handpiece displaceable from a first position preventing the passage of the laser beam to a second position allowing the laser beam to pass. Preferably, the protective shield includes two prongs located at the end of the handpiece and capable of relative lateral displacement thereby providing the effect of an improved laser scalpel.

Abstract: An apparatus and method for delivering radiant energy beams onto the cornea of an eye to ablate the cornea in a radial slot or lenticular pattern and thereby modify its curvature and refractive power. The apparatus includes an array of central reflectors and an assembly of peripheral reflectors. Each central reflector is associated with a respective peripheral reflector so that a beam reflected by the central reflector is intercepted by its associated peripheral reflector and is again reflected to precisely incise the cornea. In a modified embodiment, the assembly of peripheral reflectors and the array of central reflectors rotate to permit lathing of the cornea. Each peripheral reflector has a curved reflective surface to provide a line focus on the cornea.

Abstract: An apparatus and method for conducting laser emulsification surgery are disclosed. Laser energy is generated within the hand held member (10) and is transmitted to the probe cylinder (15) at the distal end of the device (2). The apparatus is a hand held device which contains a laser light source and flashlamp (12) for generating and emitting the laser radiation. Preferably, an Erbium YAG laser is utilized. A light horn arrangement (18) or mirror arrangement (51) transmits the light energy from the source (12) to the proximal end of a probe extension member (15). The distal tip (31) of the probe extension member (15) is directed to the cataract or other target to be emulsified.

Abstract: A tunable dye laser has been found particularly suited to selective photothermolysis. A longer pulse duration which makes the system suitable for a wider range of applications is obtained by modifying the laser to generate a spatially noncoherent beam. The optical system at each end of the laser cell, which may include a lens or spherical mirror, refocuses the aperture of the dye cell near to itself so that substantially all light emanating from the dye cell is returned to the dye cell until the light passes through one of the optic systems as a noncoherent laser beam. A tunable intracavity element tunes the laser across the gain curve of the dye solution. The pulse duration of the laser beam can be selected from a range of durations up to about one millisecond.

Abstract: A microscope attachment assembly is provided for pivotably mounting a surgical laser to a microscope. A micromanipulator housing is adapted to swing away to an off-axis position to facilitate exchanging the objective lens of the microscope. The spot size of the laser is controlled by shifting the position of a field lens included in a field lens assembly which is shifted along the laser beam by a stepper motor. By toggling a cut/coagulate switch, the field lens is moved between a presetable cut-mode position and a presetable coagulate-mode position.

Abstract: The arrangement of this invention concerns a surgical apparatus, in particular for ophthalmological use. In addition to a power beam it includes a beam of coherent visible light (29) which is transformed into at least one elementary beam (30) by means of a homogeneous light guide (21). The guide, which may be an optical fiber, is fixed to a rotating element (33) rotating about an axis (2). When the element rotates the elementary beam generates a luminous tubular beam intended to surround the power beam, the whole then being focussed by a lens to a point terminating a treatment cone with a predetermined vertex angle. The rotating element may include means for varying the diameter of the luminous tubular beam such as a transporter (39) bearing one end of the optical fiber and responding to the operation of a screw (45). The arrangement permits, on one hand to localize a point of treatment in the eye and, if necessary, modification of the vertex angle of the treatment cone.

Abstract: A hot tip device, typically used for melting and plowing through stenotic deposits in a coronary artery, is provided with optical diagnostic capabilities. The device includes an elongated, flexible member, a filter glass heating element attached to the distal end of the flexible member and an optical fiber extending through the flexible member and optically coupled to the heating element. The filter glass heating element absorbs a first range of wavelengths for heating and passes a second range of wavelengths for irradiating the artery through the filter glass heating element. In a preferred embodiment, the flexible member is a steerable guidewire, and the filter glass heating element is heated by infrared radiation. Ultraviolet or visible radiation is used to stimulate fluorescence from deposits in the artery.

Abstract: Port wine stain treatment apparatus includes a pad supporting a plurality of diamond tipped needles. The tip of each needle is supplied with laser radiation and the tip acts to scatter laser radiation sideways. Thus, when the pad is applied to the skin, the tips penetrate the skin and when laser radiation is supplied the tips create a laminar radiation profile located below and spaced from the skin surface. In this manner, the cause of the port wine stain can be treated without the danger of disfiguring or scarring the skin surface above the stain.

Abstract: A surgical apparatus for partially modifying the curvature of the cornea of an eye while the eye is within the patient is disclosed. The device is able to ablate a zone of corneal material in the form of a lenticular lamina. The thickness of the lamina at any particular point on the cornea surface varies as a function of the radial distance between that point and the central optical axis of the eye. The surgical apparatus comprises: a source of light (31) capable of emitting a beam of light (4) having a wavelength which is about 200 nanometers; an optical system (32) for directing and focusing the beam of light onto the desired zone of the cornea in order to ablate a lamina of material of the desired dimensions; and, a series of diaphragms and screens for obscuring varying portions of the zone of the cornea undergoing ablation in order to effect differential irradiation of the corneal surface.

Abstract: A method and apparatus for performing laser surgery by directing infrared and ultraviolet radiant energy from a surgical laser inside a patient's body using a lensguide is disclosed. The lensguide is comprised of a plurality of spaced convex lenses which are disposed within a plurality of rigid tubular segments connected end to end. The lensguide is flexible, allowing it to replace optical fibers in redirecting the radiant energy around bends encountered in surgical applications.

Abstract: The invention contemplates laser-aseptic phototherapy, for enhanced sterilization of an area of prospective surgical invasion of living tissue, by first administering, intravenously, orally or otherwise as appropriate, a photosensitizing agent having the property, in the course of an acceptable period of time, of selective concentrated absorption in bacteria and other microorganisms such as those which exist at depth in hair follicles, and then, following lapse of the time period, applying laser irradiation to the area of prospective surgery, using a wavelength and power density selected for absorptive response by the photosensitive agent, whereby microorganisms are destroyed at and beneath the irradiated area.

Abstract: A hand held myringotomy instrument comprises an otoscope and an attached laser beam generator section. The laser beam generator section comprises a portion for moving the laser beam generator of the section along the laser beam axis, in order to adjust the position of the focus of the laser beam nearer, or father from the instrument. Preferably, the moving portion includes an inner sleeve carrying the generator and an outer sleeve respectively inside and outside of a tube connected to the otoscope. A pair of elements diametrically opposed attached to the inner tube project through longitudinal slots diametrically opposed in the tube and are externally threaded to mesh with internal threads on the outer sleeve. The slots restrict the motion of the elements to axial motion. Collars restrict the motion of the outer sleeve to rotational motion.