Method for laser cutting a corneal pocket

Abstract

A method for using a laser to create a pocket in a patient's cornea is provided. The pocket is created using a femtosecond or a nanosecond laser. The laser ablates tissue within the cornea in a specific shape. The shape of the pocket can be determined by software to custom program a three-dimensional path of the laser. A variety of corneal pocket configurations or computer programmed shapes can be used accommodate various corneal lens shapes and sizes. An intracorneal lens can then be inserted into the pocket, in order to correct the patient's vision.

1 . A method for creating a corneal pocket and an entry channel for inserting and positioning an intracorneal lens in the corneal pocket, the method comprising:
 providing a low-energy femtosecond laser configured to create the corneal pocket;   positioning the laser proximate to a cornea such that it can be used to create the corneal pocket;   receiving an input for a generally curvilinear movement path and a first laser energy output in a range between approximately 0.2 microjoules and 1.5 microjoules for the laser to form the corneal pocket having a specific pocket shape and a thickness conforming to predefined surfaces of an intracorneal lens to be inserted into the corneal pocket;   focusing a laser beam from the laser to a predetermined depth within the cornea between an anterior surface and a posterior surface of the cornea such that the laser beam ablates corneal tissue at a focal point at the predetermined depth;   moving the laser beam in the generally curvilinear movement path in order to create the corneal pocket having the specific pocket shape and a thickness about the size of diameter of the laser beam focal point;   forming the entry channel into the corneal pocket with the laser beam, wherein the entry channel is at an obtuse angle form the conical pocket toward an entry incision on the cornea; and   forming a relaxing incision in a region of the cornea outside of the corneal pocket and the entry channel using a second laser energy output that is less than the determined first laser energy output used to create the corneal pocket in order to ease the insertion of the intracorneal lens into the corneal pocket.   
     
     
         2 . The method of  claim 1 , wherein the relaxing incision is formed at a depth in the cornea that is in the range of about 220 microns and 350 microns. 
     
     
         3 . The method of  claim 1 , further comprising programming the laser to have a spot size in a range of approximately 0.2 to 4.0 microns. 
     
     
         4 . The method of  claim 1 , further comprising making the corneal pocket at a depth in a range between approximately 220 microns to 350 microns. 
     
     
         5 . The method of  claim 1 , further comprising providing a laser with multiple laser beam spots. 
     
     
         6 . The method of  claim 6 , further comprising eliminating space between the laser beam spots. 
     
     
         7 . The method of  claim 1 , wherein the forming of the relaxing incision includes forming at least two generally arc shaped incisions that can reduce a preexisting astigmatism. 
     
     
         8 . A method for creating a corneal pocket and an entry channel for inserting and positioning an intracorneal lens in the corneal pocket, the method comprising:
 using a low-energy nanosecond laser configured to create the corneal pocket;   positioning the laser proximate to a cornea such that it can be used to create the corneal pocket;   determining a generally curvilinear movement path and an energy output in a range between approximately 0.2 microjoules and 1.5 microjoules for the laser in order to form the corneal pocket having a specific shape and a thickness conforming to predefined surfaces of an intracorneal lens to be inserted into the corneal pocket;   configuring the laser to follow the generally curvilinear movement path using a positioning software;   focusing a laser beam from the laser to as focal point at a predetermined depth within the cornea between an anterior surface and a posterior surface of the cornea such that the laser beam cuts and separates conical tissue at the predetermined depth;   operating the laser beam in the generally curvilinear movement path in order to create the corneal pocket having the specific shape and a thickness about the size of a diameter of the laser beam focal point;   forming the entry channel into the corneal pocket with the laser beam, wherein the entry channel is at an obtuse angle from the conical pocket toward an entry incision on the cornea; and   forming at least one arc shaped relaxing incision(s), using an energy output that is less than the determined energy output used to create the corneal pocket, in a region of the cornea at a depth in the range of 220 microns and 350 microns and outside of the conical pocket and the entry channel used to correct a preexisting astigmatism.   
     
     
         9 . The method for  claim 8 , further comprising using a laser with spot size in a range of approximately 0.2 to 4.0 microns. 
     
     
         10 . The method for  claim 8 , further comprising making the corneal pocket at a depth in a range of approximately 220 microns to 350 microns. 
     
     
         11 . The method of  claim 8 , further comprising providing a laser with multiple laser beam spots. 
     
     
         12 . The method of  claim 11 , further comprising eliminating space between the laser beam spots. 
     
     
         13 . A method for creating a corneal pocket and an entry channel for inserting and positioning an intracorneal lens in the corneal pocket using a low energy femtosecond or a nanosecond laser, the method comprising:
 receiving inputs for programming a three-dimensional generally curvilinear movement path and an energy output in a range bets approximately 0.2 microjoules and 1.5 microjoules for the low-energy femtosecond or a nanosecond laser configured to create the conical pocket;   transmitting instructions for a three-dimensional generally curvilinear movement path for the laser in order to form the conical pocket having a specific shape and thickness conforming to a predetermined intracorneal lens to be inserted;   focusing a laser beam from the laser to a focal point at a predetermined depth within the cornea between an anterior surface and a posterior surface of the cornea such that the laser beam ablates corneal tissue at the predetermined depth using the energy output input received;   forming the entry channel into the conical pocket with the laser beam; and   forming a relaxing incision in a region of the cornea outside of the corneal pocket and the entry channel using, an energy output that is less than the energy output input received to create the conical pocket.   
     
     
         14 . The method of  claim 13 , wherein the relaxing incision is formed in order to ease the insertion of the intracorneal lens into the corneal pocket. 
     
     
         15 . The method of  claim 13 , wherein the relaxing incision includes at least one are shaped incision formed in order to correct a pre-existing astigmatism. 
     
     
         16 . The method of  claim 13 , further comprising configuring the laser to have a spot size in a range of approximately 0.2 to 4.0 microns. 
     
     
         17 . The method of  claim 13 , wherein the corneal pocket is formed at a depth in a range of approximately 220 microns to 350 microns in the cornea. 
     
     
         18 . The method of  claim 13 , further comprising configuring the laser to emit multiple laser beam spots. 
     
     
         19 . The method of  claim 18 , wherein space between the multiple laser beam spots can be eliminated before the insertion of the intracorneal lens.