Abstract: Systems and methods are provided for ablating a lens of an eye. An access incision is made through outer eye tissue to access the lens. A laser tool is inserted through the access incision. Electromagnetic energy is focused using the inserted laser tool to ablate a portion of the lens, where said ablation breaks the lens into a plurality of pieces for removal from the eye.

Abstract: A steerable laser probe may include a handle, and inner bore of the handle, an actuation structure of the handle, a housing tube, and an optic fiber disposed within the inner bore of the handle and the housing tube. The housing tube may include a first housing tube portion having a first stiffness and a second housing tube portion having a second stiffness. The second stiffness may be greater than the first stiffness. A surgeon may aim the steerable laser probe by varying a rotational position of the handle and an amount of compression of the actuation structure.

Abstract: System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye tissue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Abstract: An ophthalmic laser system generating a first beam at a wavelength suitable for performing selective laser trabeculoplasty and selectively generating a second beam at a wavelength suitable for performing secondary cataract surgery procedures. The laser system is able to select between directing the first beam or the second beam to the eye of a patient. The first beam is suitably generated at 1064 nm from a Nd:YAG laser and the second beam is frequency doubled to 532 nm in a KTP doubling crystal.

Abstract: A steerable laser probe may include a handle, an actuation structure of the handle, a housing tube, an optic fiber, and an optic fiber sleeve. The housing tube may have a first housing tube portion having a first stiffness and a second housing tube portion having a second stiffness. The second stiffness may be greater that the first stiffness. The optic fiber may be disposed within an inner bore of the handle, the optic fiber sleeve, the actuation structure, and the housing tube. The optic fiber sleeve may enclose at least a portion of the optic fiber and the optic fiber sleeve may be disposed within the actuation structure and the housing tube. A compression of the actuation structure may be configured to curve the housing tube and the optic fiber.

Abstract: An ophthalmic laser treatment apparatus comprises: a laser source that emits a laser beam for treatment of an affected part of a patient's eye; an optical fiber that transmits the laser beam emitted from the laser source; and a delivery optical system that irradiates the laser beam emitted from the optical fiber to the affected part of the patient's eye, the delivery optical system including: a plurality of diffraction optical elements each being configured to shape a beam profile of the laser beam at an emission end face of the optical fiber into a beam profile having one of a uniform intensity and a lower intensity in the center than on the periphery on the affected part and also to shape the laser beam to have a different spot size on the affected part of the patient's eye; and a changing unit which selectively disposing one of the diffraction optical elements on an optical path.

Abstract: A system for treating a cataractous lens of a patient's eye includes a laser source for generating a light beam, a scanning system for deflecting the light beam to form a treatment pattern of the light beam, and a controller operably coupled to the laser source and scanning system and configured to operate the scanner to form the treatment pattern. The treatment pattern is a plurality of cuts in the form two or more different incision patterns for segmenting the lens tissue into a plurality of patterned pieces. The incision pattern includes: a first incision pattern including two or more crossing cut incision planes; and a second incision pattern comprising one or more laser incision each extending along a first length between a posterior and an anterior surface of the lens capsule.

Abstract: A method of treating a cataractous lens of a patient's eye includes generating a light beam, deflecting the light beam using a scanner to form a treatment pattern, delivering the treatment pattern to the lens of the patient's eye to create a plurality of cuts in the form two or more different incisions patterns within the lens to segment the lens tissue into a plurality of patterned pieces, and mechanically breaking the lens into a plurality of pieces along the cuts. A first incision pattern includes two or more crossing cut incision planes. A second incision pattern includes a plurality of laser incision each extending along a first length between a posterior and an anterior surface of the lens capsule.

Abstract: An apparatus and method for treating opacity in the posterior eye capsule includes using an illumination device to identify and analyze tension lines in the posterior eye capsule and then using a laser to perforate at least a portion of the posterior eye capsule along the tension lines.

Abstract: The present invention generally relates to an apparatus and processes for preventing or delaying presbyopia. More particularly, the present invention relates to processes and apparatus for ablating epithelial cells in the germinative zone or the pregerminative zone of the crystalline lens of the eye so that onset or progression of presbyopia or one or more symptoms is delayed or prevented. The present invention also relates to processes and apparatus for promoting formation of suture lines in the crystalline lens of the eye so that onset or progression of presbyopia or one or more symptoms is delayed or prevented. The present invention also relates to processes and apparatus for creating disruptions in the vitreous humor of the eye.

Abstract: Devices to perform femtolaser ablation and phacoemulsification are physically and/or operationally combined. In some embodiments the femtolaser ablation and phacoemulsification are housed together, and in other embodiments they are housed separately, but operated through a common display screen. At least some software can be shared by the femtolaser ablation and phacoemulsification functionalities. A non-transitory computer-readable memory can provide data that can be used to operate each of at least one femtolaser ablation functionality and at least one phacoemulsification functionality.

Abstract: Devices and methods for use in laser-assisted surgery, particularly cataract surgery. Specifically, the use of an optical fiber with a proximal and distal end, wherein the distal end has a non-orthogonal angle with the diameter of the optical fiber, to create an off-axis steam bubble for cutting and removing tissue in an operative region. Where the optical fiber is bent, rotating the fiber creates a circular cutting path for the steam bubble, allowing access to tissues that may normally be blocked by obstructions and obstacles.

Abstract: An apparatus for generating cut surfaces in the cornea of an eye in order to correct ametropia is provided, said apparatus comprising a laser unit, which can focus pulsed laser radiation into the cornea and move it therein in order to generate cut surfaces, and a control unit, which controls the laser unit for generating cut surfaces such that a predetermined lenticle to be removed is separated from the surrounding corneal material in the cornea by at least one cut surface, and that at least two mutually spaced apart cut surfaces are formed as opening cuts, each extending from the lenticle to the anterior corneal surface, the position and shape of the opening cuts being selected such that the opening cuts contribute to the correction of the ametropia of the eye or do not counteract the correction of the ametropia of the eye.

Abstract: A laser surgical system for making incisions in ocular tissues during cataract surgery includes a laser system, an imaging device and a control system. The laser system includes a scanning assembly and a laser to generate a laser beam that incises ocular tissue. The imaging device acquires image data of a crystalline lens and constructs an image from the image data. The control system operates the imaging device to generate image data for the patient's crystalline lens, processes the image data to determine an anterior capsule incision scanning pattern for scanning a focal zone of the laser beam to perform an anterior capsule incision and operates the laser and the scanning assembly to scan the focal zone of the laser beam in the anterior capsule incision scanning pattern, wherein the focal zone is guided by the control system based on the image data.

Abstract: System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye tissue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Abstract: Systems, devices, and methods for treating a glaucomatous eye are provided. An amount of pulsed laser energy is delivered to the pars plana of the eye by a hand-holdable device which comprises a hand-holdable elongate member and a contact member disposed on an end of the elongate member. A contact surface of the contact member is placed in direct contact with the eye so that a reference edge of the contact member aligns with the limbus and a treatment axis defined by the elongate member is angularly offset from the optical axis of the eye. The amount of pulsed laser energy delivered is insufficient to effect therapeutic photocoagulation but is sufficient to increase uveoscleral outflow so as to maintain a reduction from pre-laser treatment intraocular pressure. Amounts of pulsed laser energy will be transmitted to a circumferential series of tissue regions of the eye.

Abstract: An assembly for a phacoemulsification surgical system includes an aspiration system arranged to aspirate fluid from a surgical site. The aspiration system includes an aspiration path within the phacoemulsification hand piece and includes a flexible small bore aspiration tubing in fluid communication with the aspiration path. The small bore aspiration tubing has a nominal inner diameter smaller than about 0.050 inch to reduce levels of occlusion surge within the surgical system. A high-output, peristaltic pump communicates with the small bore aspiration tubing and is operable to create a flow through the small bore aspiration tubing.

Abstract: A patient interface assembly for interfacing an ophthalmic intervention system with an eye of a patient includes a housing, an optical lens coupled to the housing, an eye engagement assembly coupled to the housing, the eye engagement assembly including an inner seal and an outer seal, and a tissue migration bolster structure positioned between the inner seal and outer seal and configured to apply a resisting load against portions of the eye in a vacuum zone which are capable of distending upon application of the vacuum load. The eye engagement assembly is adapted to be placed into contact with the eye of the patient by sealably engaging the eye with the inner and outer seals, thereby defining the vacuum zone as being between the inner and outer seals when placed into contact with the eye.

Abstract: Devices and methods for cataract surgery include a tip with reciprocating door to chop, fragment or reduce size of large nuclear lens fragments and/or cortex fragments in a capsule bag to facilitate aspiration.

Abstract: A polarization beam splitter selectively decouples detection light onto a detector such that it has a polarization direction that differs from the emitted illumination light. This enables the detection of the light scattered back in the eye lens at a high level of accuracy, since stray light from reflections at optical components of the light path is suppressed. In the generating of photo disruptions or other incisions, the ray exposure of the retina may be reduced in that the incisions being furthest away from the laser are induced first such that laminar gas inclusions with an existence duration time of at least 5 seconds result. In this manner the laser radiation propagated in the direction of the retina in further incisions are scattered and partially reflected such that the influence impinging upon the retina is reduced.

Abstract: Image processing for computer-aided eye-surgery includes acquiring a reference image of the eye and enriching said reference image by inserting additional context information which are helpful for a surgeon when performing the eye surgery. The reference image is registered with a real time image of the eye. The context information is overlayed over the real time image of the eye based on a tracking of the eye movement such that the context information is displayed at the same position despite a movement of the eye.

Abstract: Method, apparatus and systems for laser surgery as part of cataract surgery. The implementation thereof includes: A means to perform incisions in the cornea and inside the eye. In particular Limbal Relaxating Incisions and an anterior or posterior capsulotomy/capsulorhexis using a rapid fire sequence of photodisruptive laser pulses, placed to open the capsule for cataract surgery. The system and methods provides the means to target and direct the laser pulse sequence into the desired region of the eye without the need of a patient interface that is locked to the laser delivery system and holds the eye in a fixed position relative to the delivery system.

Abstract: An ophthalmic laser system generating a first beam at a wavelength suitable for performing selective laser trabeculoplasty and selectively generating a second beam at a wavelength suitable for performing secondary cataract surgery procedures. The laser system is able to select between directing the first beam or the second beam to the eye of a patient. The first beam is suitably generated at 1064 nm from a Nd:YAG laser and the second beam is frequency doubled to 532 nm in a KTP doubling crystal.

Abstract: System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye issue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Abstract: A fluid or laser jet instrument may be used for manually performing eye surgery or any emulsification technique.

Abstract: An evaluating unit which is adapted to determine a degree of an instantaneous overlap between an optical zone of the eye and the structure, or at least a part of the structure effecting refractive correction, based on a recorded image. By determining the degree of overlap between the instantaneous optical zone and the structure to be introduced, it is possible to control the superposition of the optical zone with the tissue volume which is specifically altered by means of the laser cutting and, accordingly, to enable a maximum coverage.

Abstract: A surgical laser system can include a laser engine to generate a laser beam of laser pulses; a scanning delivery system to direct the laser beam to a target region and to scan the laser beam along a scan-pattern in the target region; and a spatio-temporal modulator to perform a space- and time dependent modulation of the laser beam. The spatio-temporal modulation of the phases or amplitudes of the beam components can reduce or even eliminate uncut regions in the target region, caused by the destructive interference of the beam components brought about by a wrinkling of a portion of the target or by other beam distorting factors.

Abstract: Systems and methods are described for cataract intervention. In one embodiment a system comprises a laser source configured to produce a treatment beam comprising a plurality of laser pulses; an integrated optical system comprising an imaging assembly operatively coupled to a treatment laser delivery assembly such that they share at least one common optical element, the integrated optical system being configured to acquire image information pertinent to one or more targeted tissue structures and direct the treatment beam in a 3-dimensional pattern to cause breakdown in at least one of the targeted tissue structures; and a controller operatively coupled to the laser source and integrated optical system, and configured to adjust the laser beam and treatment pattern based upon the image information, and distinguish two or more anatomical structures of the eye based at least in part upon a robust least squares fit analysis of the image information.

Abstract: The invention relates to a method and a device for treatment of glaucoma, wherein by means of an elongated catheter provided with a distal portion and a proximal portion, a tube-shaped implant is inserted and released in a Schlemm's canal with two opposite openings exposed by an incision and a folded up scleral flap. In a first phase, the distal portion inserted into the Schlemm's canal through the first opening, while a fluid or gaseous medium is injected at the same time, and exited through the second opening, which is, in circumferential direction, oppositely located. The implant detachably disposed at the protruding distal portion and, in a second phase, inserted, in circumferential direction, into the expanded Schlemm's canal up to the first opening. Subsequently, the distal portion, which protrudes from the first opening, is detached from the implant and, together with the catheter, removed.

Abstract: A patient interface for an ophthalmic system can include an attachment module, attachable to the ophthalmic system, and a contact module, configured to accommodate a viscoelastic substance between the patient interface and a procedure eye. The viscoelastic substance can include a fluid, a liquid, a gel, a cream, an artificial tear, a film, an elastic material, or a viscous material. The refractive index of the viscoelastic substance can be within a range of approximately 1.24-1.52 at an operating wavelength of the ophthalmic system. The patient interface can further include input ports, output ports, and a suction system. It can be an integrated design or a multi-piece patient interface. The viscoelastic substance can be provided by injection, on the cornea, at the contact module, or in a space bounded by soft elastic films or membranes, such as in a bag.

Abstract: Methods and systems are disclosed for creating an aqueous flow pathway in the trabecular meshwork, juxtacanalicular trabecular meshwork and Schlemm's canal of an eye for reducing elevated intraocular pressure. Some embodiments described apparatus and methods useful in photoablation of tissues. In some embodiments, a photoablation apparatus is used to perforate a tissue, forming an aperture into a space behind the tissue. Gases formed during a photoablation process can be used to pressurize the space behind the tissue to enhance patency of the space. In some embodiments the tissue is the trabecular meshwork of the eye and a wall of Schlemm's canal, and the space behind the tissue is a portion of the lumen of Schlemm's canal. In some embodiments, the method is useful in the treatment of glaucoma by improving outflow from the anterior chamber of the eye into Schlemm's canal, reducing intraocular pressure.

Abstract: Embodiments of this invention relate to a system and method for performing laser ophthalmic surgery. The surgical laser system configured to deliver a laser pulse to a patient's eye comprises a laser engine that includes a compressor configured to compress laser light energy received, the compressor comprising a dispersion or spectrum altering component provided on a computer controlled stage connected to a computing device. A user providing an indication of a desired pulse width received by the computing device causes the computing device to reposition the stage and the component provided thereon, resulting in a different pulse length being transmitted by the laser engine.

Abstract: Some embodiments disclosed here provide for a method fragmenting a cataractous lens of a patient's eye using an ultra-short pulsed laser. The method can include determining, within a lens of a patient's eye, a high NA zone where a cone angle of a laser beam with a high numerical aperture is not shadowed by the iris, and a low NA zone radially closer to the iris where the cone angle of the laser beam with a low numerical aperture is not shadowed by the iris. Laser lens fragmentation is accomplished by delivering the laser beam with the high numerical aperture to the high NA zone, and the laser beam with the low numerical aperture to the low NA zone. This can result in a more effective fragmentation of a nucleus of the lens without exposing the retina to radiation above safety standards.

Abstract: Embodiments of this invention relate to systems and methods for automatic depth (or Z) detection before, during, or after laser-assisted ophthalmic surgery. When performing ophthalmic laser surgery, the operator (or surgeon) needs to make accurate and precise incisions using the laser beam. With the automatic depth detection systems and methods, the same laser used for the surgical procedure may be used for depth measurement of the surgical incisions. The surgical laser system may include a laser delivery system for delivering a pulsed laser beam to photoalter an eye, a mirror to transmit at least a portion of reflected light of the pulsed laser beam, a lens positioned to focus the transmitted reflected lighted on to a detector, (such as a CCD), and a depth encoder configured to automatically detect depth according to one or more of color, intensity, or shape of the focused spot on the CCD.

Abstract: Methods and systems for performing laser-assisted surgery on an eye form one or more small anchoring capsulotomies in the lens capsule of the eye. The one or more anchoring capsulotomies are configured to accommodate corresponding anchoring features of an intraocular lens and/or to accommodate one or more drug-eluting members. A method for performing laser-assisted eye surgery on an eye having a lens capsule includes forming an anchoring capsulotomy in the lens capsule and coupling an anchoring feature of the intraocular lens with the anchoring capsulotomy. The anchoring capsulotomy is formed by using a laser to incise the lens capsule. The anchoring feature can protrude transverse to a surface of the intraocular lens that interfaces with the lens capsule adjacent to the anchoring capsulotomy.

Abstract: Systems and methods are provided for reducing intraocular pressure in an eye. A perpendicular incision is made through a conjunctiva of the eye to access a trabecular meshwork of the eye. Electromagnetic energy is focused through the perpendicular incision to ablate a portion of the trabecular network, where said ablation creates a channel for outflow flow of fluid through a sclera venous sinus to reduce pressure within the eye.

Abstract: An ocular disorder treatment implant includes an anchor and a therapeutic agent. The implant has a body with first and second end portions. The implant is configured to transport fluid from the anterior chamber of an eye to a physiological outflow pathway of the eye. The body has at least one inlet opening at the first end portion and at least one outlet opening at the second end portion such that the inlet and outlet openings are in fluid communication and define an axis therebetween. The anchor extends substantially perpendicularly to a part of the axis between the openings, and at least one outlet opening is configured to be positioned in the physiological outflow pathway. One implant has two outlet openings, and the anchor is disposed closer to one of the outlet openings.

Abstract: System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye tissue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Abstract: System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye tissue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Abstract: Disclosed is a system and method for making a first incision in an anterior capsule of a capsular bag, the first incision being less than or equal to approximately 3.5 mm in diameter and making a second incision in the anterior capsule, the second incision being less than or equal to approximately 3.0 mm in diameter. The first incision and the second incision are positioned off-center from a center portion of the anterior capsule. The method includes performing lens fragmentation of a lens in the capsular bag to yield lens material, inserting a first instrument into the first incision, inserting a second first instrument into the second incision and removing the lens material via one of the first instrument and the second instrument and through one of the first incision and the second incision. The tensile structure of the anterior portion of the capsular bag is maintained such that accommodation exists within the eye after insertion of the intraocular lens.

Abstract: An ophthalmologic laser device includes a pulsed laser configured to produce radiation focused along at treatment beam path. A variably adjustable beam deflector unit and a focusing lens system are disposed in the treatment beam path. The deflector unit is configured to focus the radiation in different target volumes. Measuring equipment is configured to determine a shape and position of optical interfaces along a detection beam path. A control unit is configured to control the laser and the deflector unit and to implement steps including determining a shape and position of an interface of a membrane of a capsular bag of an eye located in a treatment area using the measuring equipment, determining coordinates of a target volume such that, on irradiation of the target volume, a pressure wave runs from the target volume to the anterior or posterior membrane, and adjusting the deflector unit to the target determined volume.

Abstract: There is provided a system, apparatus and methods for developing laser systems that can create precise predetermined self-sealing incisions in the cornea. The systems, apparatus and methods further provide laser systems that can provide these incisions in conjunction with the removal and replacement of the natural human crystalline lens.

Abstract: An apparatus and a method are described for setting up a medical laser machine configured to be used in eye surgery for making a multi-planar incision. In various embodiments, a software interface is provided to receive, from a user, one or more dimensional measurements of an eye of a patient as input, automatically calculate precise geometric and other setup parameters, based on a set of equations, of a multi-planar incision for the patient's eye, and provide the calculated parameters to the user for setting up the medical laser machine to make the incision.

Abstract: A system and method for inserting an intraocular lens in a patient's eye includes a light source for generating a light beam, a scanner for deflecting the light beam to form an enclosed treatment pattern that includes a registration feature, and a delivery system for delivering the enclosed treatment pattern to target tissue in the patient's eye to form an enclosed incision therein having the registration feature. An intraocular lens is placed within the enclosed incision, wherein the intraocular lens has a registration feature that engages with the registration feature of the enclosed incision. Alternately, the scanner can make a separate registration incision for a post that is connected to the intraocular lens via a strut member.

Abstract: A system and method for performing a femto-fragmentation procedure on tissue in the crystalline lens of an eye requires that a laser beam be directed and focused to a focal point in the crystalline lens of the eye. The focal point is then guided, relative to an axis defined by the eye, to create a segment cluster by causing Laser Induced Optical Breakdown (LIOB) of tissue in the crystalline lens. The resultant segment cluster includes a plurality of contiguous, elongated segments in the crystalline lens that are individually tapered from an anterior end-area to a posterior end-area. Specifically, this is done to facilitate the removal of individual segments from the segment cluster in the crystalline lens.

Abstract: A system and method are provided for fragmenting a crystalline lens inside an operational volume in the lens. A reference axis that is based on the crystalline lens is established, and various pluralities of parallel planes are defined relative to the reference axis. A pulsed laser beam is then used to cut tissue in selected planes, to thereby fragment the lens by performing Laser Induced Optical Breakdown (LIOB) on the tissue. In accordance with the present invention each plurality of parallel planes is characterized by a particular inclination angle “?” relative to the reference axis, a particular azimuthal angle “?” relative to the reference axis, and an intersection angle “?” relative to each other.

Abstract: A system and method are disclosed for using a laser unit to treat a crystalline lens (or lens capsule) to compensate for any tilt angle “?” there may be between a lens axis and an operational axis of the laser unit (i.e. “z” axis). To begin, a contiguous sequence of procedure paths that collectively define the boundary surface of a lens volume are identified, with each procedure path inclined by the tilt angle “?”. A slice occurs in an x-y plane that is on the boundary surface of the volume of lens and includes portions of several procedure paths. The slices are projected into the x-y plane where they are sequenced for use as trace paths for the laser unit. The trace paths are used to guide a laser beam to perform LIOB along the slice for the different values of “z” to incise the boundary surface.

Abstract: Systems and methods are described for stabilizing an eye for an ocular laser procedure while minimizing corneal distortions which can adversely affect a surgical laser beam. For the systems, a patient interface includes a contact element for stabilizing the eye and establishing a conformal interface with the anterior surface of the cornea. More specifically, devices are disclosed which overlay both a central corneal region and a peripheral corneal region. In some embodiments, a first material is used in the contact element to overlay the central corneal region and a second material is used in the contact element to overlay the peripheral corneal region. Typically, the first and second materials differ in terms of hardness and deformability. In another embodiment disclosed herein, a contact element having a viscoelastic material for stabilizing an eye for a laser procedure is described.

Abstract: An ophthalmic laser system generating a first beam at a wavelength suitable for performing selective laser trabeculoplasty and selectively generating a second beam at a wavelength suitable for performing secondary cataract surgery procedures. The laser system is able to select between directing the first beam or the second beam to the eye of a patient. The first beam is suitably generated at 1064 nm from a Nd:YAG laser and the second beam is frequency doubled to 532 nm in a KTP doubling crystal.

Abstract: One exemplary method for removing and/or inhibiting unwanted molecular structures and/or cells from or at human or animal tissue, can include the steps of a) supplying fluid medium so that the fluid medium is adjacent to or covers the molecular structures and/or cells that are to be removed and/or inhibited, b) generating pressure pulses in the fluid medium, wherein preferably each pressure pulse comprises a pressure current and/or a pressure wave and/or a shock wave and/or wherein preferably the pressure pulses have the form of a pressure jet of the fluid medium that is or can be directed onto the molecular structures and/or cells, and/or exhibit at least one preferential direction or main propagation direction, c) removing the molecular structures and/or cells from the tissue by the impacting pressure pulses and/or inhibiting molecular structures and/or cells which remain at the tissue by the impacting pressure pulses, d) wherein the pressure pulses are so formed or selected that during removing and/or inh