Laser cataract removal

Earliest patents: 1976

Krasnov patent

Method of non-surgical treatment of cataracts
Abstract:
A method of non-surgical treatment of soft and membraneous cataracts, including congenital cataracts, said method comprising the step of cutting the anterior capsule of the lens and/or pupillary membrane without perforating injury to the eye wall with a laser beam, caused to pass through the cornea, the anterior chamber of the eye and pupil, and then be focused onto the anterior capsule of the lens and/or pupillary membrane to thus form at least one hole through which the cataract substance is thus let out of the lens capsule/soft cataract/into the anterior chamber of the eye where the substance is gradually dissolved.

United States Patent 3,971,382 (July 27, 1976)
Mikhail Mikhailovich Krasnov
Filed: November 22, 1974

L'Esperance patent

Eye surgical instrument
Abstract:
Method and apparatus are disclosed for surgically removing surface portions of an eye such as cataract tissue. The eye surface portions to be removed are vaporized by a carbon dioxide laser beam. Smoke and vaporized portions are withdrawn by a vacuum pump.

United States Patent 3,982,541 (September 28, 1976)
Francis L'Esperance, Jr.
Filed: July 29, 1974

Pioneers

In 1975 Krasnov reported the technique of laser phacopuncture, the first laser procedure for cataract removal.

In: Coombes A, Gartry D, eds. Cataract surgery (London : BMJ Books, 2003), p.200

Four top ophthalmologists have been working independently on the system of developing a laser to help in cataract removal. The first has been Dr. Daniel Eichenbaum from the USA. It has been basically due to Dr. Daniel Eichenbaum and Paradigm that the laser cataract removal could be started. [...] The second ophthalmologist Dr. Jack Dodick introduced the use of the YAG laser for surgical cataract removal. [...] The third ophthalmologist is Dr. Michael Colvard. The Erbium laser is being used by Michael Colvard to ablate ocular tissue [...] The fourth ophthalmologist is Dr. Sunita Agarwal who has designed a new probe....

Agarwal S, et al. Laser phaco cataract surgery. In: Agarwal S, et al, eds. Phacoemulsification, Laser Cataract Surgery and Foldable IOLs. New Delhi: Jaypee Brothers Medical Publishers; Thorofare, N.J.: Slack [distributor], 2000. p.237

Eichenbaum patent

SUMMARY OF THE INVENTION

Accordingly, it is an object of this invention to provide a laser surgical device which is capable of operating through a small incision.

A second object of this invention is to provide a laser surgical device able to direct the fragmenting laser energy directly and accurately to a very small area.

Another object of this invention is to provide a laser surgical device capable of preventing random laser or heat energy from damaging adjacent areas of the eye during surgery.

Another object of this invention is to provide a laser surgical device configured to provide a sufficiently large opening to accommodate large, hard pieces of lens, while at the same time preventing unacceptably high levels of aspiration.

Yet another object of this invention is to provide a laser surgical system which can facilitate not only cataract surgery, but other types of laser surgery as well.

United States Patent 4,694,828
Issued: September 22, 1987
Inventor: Eichenbaum; Daniel M.
Application Filed: April 21, 1986

(Patricia Bath's U.S. Patent 4,744,360 was filed December 18, 1986 and issued May 17, 1988.)

1st FDA approval for a laser cataract removal device

SALT LAKE CITY--(BW HealthWire)--July 3, 2000

Laser Corp. (OTC BB:LSER) Monday announced that it has received FDA 510 (K) clearance to market the Dodick Laser PhotoLysis System in the United States.

This clearance brings to the market and the medical profession the first laser device to be approved in the United States for the removal of cataracts.

"Laser Corp. Announces FDA Clearance of Its Dodick Laser PhotoLysis System." Business Wire, July 3, 2000

Ultrasonic phacoemulsification

Most cataract surgeries are performed using ultrasound, not laser.

Many people believe that cataract surgery is typically performed with a laser. In fact, this is one of the most common misperceptions in medicine.

The phaco probe that is most commonly used in modern cataract surgery vibrates rapidly at ultrasonic frequency to break up the cataract and allow it to be removed through a small opening in the phaco probe. A recently developed instrument now uses a laser to break up the cataract, but the laser is not as powerful as ultrasound, and it cannot be used to remove advanced cataracts. Other methods of breaking up the lens are under investigation, like the use of tiny, powerful jets of water. Currently, there is no evidence that laser phaco machines produce better outcomes than ultrasound phaco machines.

http://www.lasikinstitute.org/Phacoemulsification.html (accessed Mar. 1, 2004)

Bibliography

Agarwal S, Agarwal J, Agarwal T. Laser phaco cataract surgery. In: Agarwal S, Sachdev MS, Agarwal A, et al, eds. Phacoemulsification, Laser Cataract Surgery and Foldable IOLs. New Delhi: Jaypee Brothers Medical Publishers; Thorofare, N.J.: Slack [distributor], 2000:237-246.

Coombes A, Gartry D, eds. Cataract surgery. London: BMJ Books, 2003

Dodick JM, Katz JD. Lasers in Cataract Surgery. In: Steinert, ed. Cataract Surgery: Technique, Complications, and Management. Philadelphia Pa.: Saunders, 2004:605-610.

Gardiner MF, Pineda R, Dana MR. Laser cataract surgery: past, present, and evolving technologies. International Ophthalmology Clinics. 2004 Winter;44(1):113-21.