Methods and Devices for Forming Corneal Channels

Abstract

Instruments for creating a corneal channel and methods of use.

What is claimed is: 
     
         1 . An instrument for creating a channel in a patient's cornea, comprising:
 a handle portion; and   an elongate channel portion extending from the handle portion and adapted to break corneal tags,   wherein the channel portion comprises a window therethrough.   
     
     
         2 . The instrument of  claim 1  wherein the channel portion comprises a distal end with a beveled surface adapted to break corneal tags. 
     
     
         3 . The instrument of  claim 2  wherein the distal end comprises a double-beveled edge adapted to break corneal tags. 
     
     
         4 . The instrument of  claim 2  wherein the distal end is curved. 
     
     
         5 . The instrument of  claim 4  wherein the channel portion comprises substantially straight side edges extending from the curved distal end. 
     
     
         6 . The instrument of  claim 5  wherein the substantially straight side edges are double-beveled. 
     
     
         7 . The instrument of  claim 1  wherein the channel portion comprises a first channel portion with a first width and a second channel portion with a second width, wherein the first width is less than the second width. 
     
     
         8 . The instrument of  claim 7  wherein the first channel portion is disposed distal relative to the second channel portion. 
     
     
         9 . The instrument of  claim 7  wherein channel portion comprises a transition portion between the first channel portion and the second channel portion, wherein the transition portion has a width that transitions from the first width to the second width. 
     
     
         10 . The instrument of  claim 7  wherein the window extends through the second channel portion. 
     
     
         11 . The instrument of  claim 10  wherein the window extends through the second channel portion and the first channel portion. 
     
     
         12 . The instrument of  claim 11  wherein the window has a distal window portion with a first width and a proximal window portion with a second with, wherein the first width is less than the second width, and wherein the distal window portion extends through at least a portion of the first channel portion and the proximal window portion extends through at least a portion of the second channel portion. 
     
     
         13 . The instrument of  claim 1  wherein the channel portion comprises a distal portion with a beveled edge and a proximal portion that does not have a beveled edge. 
     
     
         14 . The instrument of  claim 1  wherein the channel portion has a curved configuration when viewed from the side. 
     
     
         15 . The instrument of  claim 14  wherein the channel portion has a curve that is substantially the same as the curvature of the anterior surface of the cornea. 
     
     
         16 . The instrument of  claim 14  wherein the channel portion has a first bend and a second bend to create a generally S-bend configuration when viewed from the side. 
     
     
         17 . The instrument of  claim 1  wherein the channel portion comprises a marker adapted to indicate the channel portion's position relative to a pupil. 
     
     
         18 . An instrument for creating a channel in a patient's cornea, comprising:
 a handle portion; and   an elongate channel portion extending from the handle portion adapted to break corneal tags,   wherein the channel portion comprises a distal portion with a first width and a proximal portion with a second width, wherein the first width is less than the second width.   
     
     
         19 . The instrument of  claim 17  wherein the distal portion comprises a double-beveled edge adapted to break corneal tags. 
     
     
         20 . The instrument of  claim 18  wherein the distal portion comprises a curved distal end with the double-beveled edge. 
     
     
         21 . The instrument of  claim 19  wherein the distal portion comprises an intermediate region extending from the distal end, wherein the intermediate region has a double-beveled edge. 
     
     
         22 . The instrument of  claim 17  wherein the channel portion comprises an opening therethrough. 
     
     
         23 . The instrument of  claim 21  wherein the opening extends through at least a portion of the proximal portion. 
     
     
         24 . The instrument of  claim 22  wherein the opening also extends through at least a portion of the distal portion. 
     
     
         25 . The instrument of  claim 17  wherein the channel portion comprises a marker adapted to indicate the channel portion's position relative to a pupil. 
     
     
         26 . A method of creating a channel in a patient's cornea, comprising:
 disrupting corneal tissue with a laser to create a first region of the cornea comprising a plurality of corneal tags; and   creating a corneal channel within the first region of the cornea by advancing a channel instrument into the first region from a first side of the first region to break a first portion of the plurality of corneal tags without breaking a second portion of the plurality of corneal tags, wherein the method does not comprise lifting corneal tissue.   
     
     
         27 . The method of  claim 26  wherein the advancing step comprises advancing the channel instrument along a substantially linear path in the first region to create a substantially linear-shaped channel. 
     
     
         28 . The method of  claim 26  wherein the advancing step comprises creating a channel with a first portion with a first width and a second portion with a second width, wherein the first width is different than the second width. 
     
     
         29 . The method of  claim 26  further comprising positioning a corneal implant within the corneal channel. 
     
     
         30 . The method of  claim 26  wherein creating a channel comprises advancing a channel instrument into the first region from a first side of the first region and out a second side of the first region to break a first portion of the plurality of corneal tags without breaking a second portion of the plurality of corneal tags. 
     
     
         31 . The method of  claim 26  further comprising creating a peripheral side cut at a periphery of the first region that subtends an angle less than about 90 degrees. 
     
     
         32 . A method of correcting a subject's corneal refractive error, comprising:
 performing a LASIK procedure on the subject, wherein the LASIK procedure comprises creating a corneal flap, lifting the corneal flap, remodeling corneal tissue, and repositioning the flap; and   advancing a channel instrument under the flap created during the LASIK procedure to create a channel in the cornea, wherein the channel creation step is performed after performing the LASIK procedure.   
     
     
         33 . The method of  claim 32  further comprising implanting a corneal implant within the channel created in the cornea. 
     
     
         34 . The method of  claim 32  wherein the advancing step comprises advancing the channel instrument along a substantially linear path from a first side of the cornea to a second side of the cornea to create a substantially linear channel.