U.S. patent application number 12/958037 was filed with the patent office on 2011-08-04 for system and method for treating connective tissue.
Invention is credited to AnnMarie Hipsley.
Application Number | 20110190798 12/958037 |
Document ID | / |
Family ID | 36992461 |
Filed Date | 2011-08-04 |
United States Patent
Application |
20110190798 |
Kind Code |
A1 |
Hipsley; AnnMarie |
August 4, 2011 |
System and Method for Treating Connective Tissue
Abstract
A method and system of treating connective tissue to increase
flexibility of the connective tissue or decrease tension in the
connective tissue includes forming perforations in the connective
tissue to at least 90% of the depth or thickness of the connective
tissue and maintaining the perforations in the connective tissue.
The method alters the tissue to enhance the . fundamental
mechanisms involved the immunology, biochemistry, and molecular
genetics of the metabolism of the connective tissue. The connective
tissue may be any desired connective tissue, such as scleral tissue
of the eye. The connective tissue of the eye may be removed to form
a first desired pattern of perforations in the connective tissue of
the eye at a first distance from the corneal center of the eye. The
first desired pattern of perforations may have a plurality of
perforations. Connective tissue is removed from the eye to form a
second desired pattern of perforations in the tissue of the eye at
a second distance from the corneal center of the eye. The second
desired pattern of perforations may have a plurality of
perforations.
Inventors: |
Hipsley; AnnMarie; (Silver
Lake, OH) |
Family ID: |
36992461 |
Appl. No.: |
12/958037 |
Filed: |
December 1, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11376969 |
Mar 15, 2006 |
7871404 |
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12958037 |
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Current U.S.
Class: |
606/167 |
Current CPC
Class: |
A61F 9/00821 20130101;
A61F 9/00825 20130101; A61F 9/008 20130101; A61F 9/00808 20130101;
A61F 9/00802 20130101; A61F 2009/00865 20130101; A61F 9/00838
20130101 |
Class at
Publication: |
606/167 |
International
Class: |
A61B 17/00 20060101
A61B017/00 |
Claims
1. A method of treating connective tissue comprising: forming
perforations in the connective tissue to at least 90% of the depth
of the connective tissue; and at least partially affecting normal
healing of the perforations.
2-30. (canceled)
Description
RELATED APPLICATION
[0001] The present application claims priority from U.S.
Provisional Application No. 60/662,026, filed Mar. 15, 2005 herein
incorporated by reference in its entirety.
TECHNICAL FIELD
[0002] The present invention relates to a system and method for
treating connective tissue, and more specifically, to a system and
method for treating connective tissue to improve flexibility of the
connective tissue or decrease tension in the connective tissue.
BACKGROUND OF THE INVENTION
[0003] Connective tissue is tissue that supports and connects other
tissues and parts of the body. Connective tissue, such as scleral
tissue of the eye, may become less flexible or elastic as it ages.
Many fundamental properties of connective tissue are affected by
age. These properties include, but are not limited to, the
structure, function, immunology, biochemistry and molecular
genetics of connective tissue proper and newly metabolized
connective tissue. The loss of flexibility or alterations of the
fundamental properties may result in an accumulation of low grade
stress/strain of the connective tissue. This can occur by acute
injury or as a normal gradual process of aging. The loss of
flexibility or alterations of fundamental properties of connective
tissue may change the overall desired properties of the connective
tissue and may also undesirably affect the surrounding tissues,
structures, organs, or systems related to the connective tissue.
Examples of such undesirable affects are increased tension, loss of
flexibility, contracture, fibrosis, or sclerosis, which can prevent
the connective tissue or structures that are related to the
connective tissue from performing their desired function.
[0004] The loss of flexibility of the scleral tissue of the eye may
affect the ability of the eye to focus. The loss of flexibility of
the scleral tissue may also contribute to an increase in the
intraocular pressure in the eye. The loss of flexibility of the
scleral tissue may also contribute to the loss of the contrast
sensitivity of the eye or visual field of the eye. The loss of
flexibility of the sclera may affect the refractive ability of the
eye. The loss of flexibility of the sclera may affect the
efficiency of the homeostatic functions of the eye such as
intraocular pressure, aqueous production, pH balance, vascular
dynamics, metabolism and eye organ function. The loss of
flexibility of the scleral tissue may contribute to damage to the
mechanoreceptors, photoreceptors, or sensory receptors in tissue
layers and structures that are directly or indirectly related to
the scleral tissue. The loss of flexibility of the scleral tissue
may also contribute to the ability of the cerebral cortex to
process accurate visual stimulus necessary for processing visual
signals into accurate visual perception.
[0005] It is known to ablate the surface of scleral tissue of an
eye. The surface of the scleral tissue may be ablated to form
radially extending incisions or excisions. It is also known to form
spots along a ring on the surface of scleral tissue by ablation. A
plurality of bands, inserts, or plugs may be inserted into the
scleral tissue of an eye to expand the sclera.
SUMMARY OF THE INVENTION
[0006] The present invention relates to a method of treating
connective tissue includes forming pores or perforations in the
connective tissue to at least 90% of the depth or thickness of the
connective tissue and maintaining the perforations in the
connective tissue. The connective tissue may be any desired
connective tissue, such as scleral tissue of the eye. The
connective tissue of the eye may be removed to form a first desired
pattern of perforations in the connective tissue of the eye at a
first distance from the outer diameter of the posterior surgical
limbus of the eye. The first desired pattern of perforations may
have a plurality of perforations. Connective tissue is removed from
the eye to form a second desired pattern of perforations in the
tissue of the eye at a second distance from the outer diameter of
the posterior surgical limbus of the eye. The second desired
pattern of perforations may have a plurality of perforations.
[0007] The present invention also relates to a method of treating
connective tissue. The method includes forming perforations in the
connective tissue to at least 90% of the depth of the connective
tissue. The method also includes at least partially affecting
normal healing of the perforations.
[0008] The present invention also relates to a method of treating
connective tissue to increase elasticity of the tissue comprising.
The method includes removing connective tissue of an eye to form a
first desired pattern of perforations in the connective tissue of
the eye at a first distance from the outer diameter of the
posterior surgical limbus of the eye, the first desired pattern of
perforations having a plurality of perforations. The method also
includes removing tissue from the eye to form a second desired
pattern of perforations in the tissue of the eye at a second
distance from the outer diameter of the posterior surgical limbus
of the eye, the second desired pattern of perforations having a
plurality of perforations.
[0009] The present invention also relates to a system for treating
connective tissue. The system include means for forming
perforations in the connective tissue to at least 90% of the depth
of the connective tissue. The system also includes means for at
least partially affecting normal healing of the perforations.
[0010] The present invention further relates to a system for
treating connective tissue to increase elasticity of the tissue
comprising. The system includes means for removing connective
tissue of an eye to form a first desired pattern of perforations in
the connective tissue of the eye at a first distance from the outer
diameter of the posterior surgical limbus of the eye, the first
desired pattern of perforations having a plurality of perforations.
The system also includes means for removing tissue from the eye to
form a second desired pattern of perforations in the tissue of the
eye at a second distance from the outer diameter of the posterior
surgical limbus of the eye, the second desired pattern of
perforations having a plurality of perforations.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] The foregoing and other features of the present invention
will become apparent to one skilled in the art to which the present
invention relates upon consideration of the following description
of the invention with reference to the accompanying drawings, in
which:
[0012] FIG. 1 is a schematic drawing of a system of the present
invention for use in treating connective tissue;
[0013] FIG. 2 is a schematic pictorial view of an eye showing
perforation patterns formed in connective tissue of the eye;
[0014] FIG. 2a is a schematic pictorial view of an eye showing
perforation patterns formed in connective tissue of the eye;
[0015] FIG. 3 is a schematic plan view of the eye of FIG. 2 showing
the perforation patterns formed in the connective tissue of the
eye; and
[0016] FIG. 4 is a schematic plan view of the eye of FIG. 2 showing
alternative perforation patterns formed in the connective tissue of
the eye.
DESCRIPTION OF EMBODIMENTS
[0017] A surgical laser system 10 for treating connective tissue is
illustrated in FIG. 1. To treat the connective tissue, the system
10 accesses desired connective tissue. Access to the desired
connective tissue can be done directly, such as by ablation. Also,
access to the desired connective tissue can be done indirectly,
such as by creating a flap, incision, excision, vaporization, or
gap in overlying tissue or structure.
[0018] The surgical laser system 10 may be used to treat any
desired connective tissue of the body. For example, in the eye, the
surgical laser system may be used to treat the conjunctiva; the
cornea (including all its layers and membranes); the iris; the
ciliary body; the ciliary muscles; the anterior chamber; the zonula
ciliaris; the subchoroidal lamina; the extraocular muscles and
their associated connective tissues, membranes, and fascia; the
posterior chamber; the lens and all of its associated layers,
tissues, capsules, and membranes; the canal of schlemm and all of
its associated layers, tissues, capsules, and membranes; the ora
seratta; the vitreous body; the papilla nervi optici; the optic
nerve; the lamina cribrosa; the choroid; the sclera; the retina;
all epithelial cell layers in the eye; the vascular structures in
the eye; the accessory organs of the eye; and the lymph vessels of
the eye.
[0019] As another example, in the ear, the surgical laser system 10
may be used to treat the tympanic membrane, the crista ampullaris,
the cochlear, the cochlear duct, and hair cells. As another
example, the surgical laser system 10 may be used to treat tissue
of the kidneys or tissue of the ovaries. As another example, the
surgical laser system 10 may be used to treat large aponeuroses,
such as lumbosacral fascia, abdominal raphe, and neural sheath in
the spinal cord. As yet another example, the surgical laser system
10 may be used to treat bones, cartilage, ligaments, and tendons.
As still another example, the surgical laser system 10 may be used
to treat the brain, such as dura matter of the brain. As another
example, the surgical laser system 10 may be used to treat lymph
node CT or spleen CT. As another example, the surgical laser system
10 may be used to treat vascular vessels and the heart. As a
further example, the surgical laser system 10 may be used to treat
muscles.
[0020] The surgical laser system 10 includes a laser 12 coupled to
one end of a connector assembly 14. An opposite end of the
connector assembly 14 is connected to a hand-piece 16 having a tip
18. The connector assembly 14 delivers laser energy from the laser
12 to the hand-piece 16. The connector assembly 14 may be any
desired assembly that delivers laser energy from the laser 12 to
the hand-piece 16, such as a fiber optic assembly, a collimated arm
system, or an atomozied particle beam.
[0021] The laser 12 may be any desired laser. For example, the
laser 12 may be an Er:YAG laser having a wavelength of about 2.94
.mu.m. The laser 12 may also be a free electron laser (FEL). The
laser 12 may be any desired diode-pumped solid state laser, an
infrared laser, an ultraviolet laser, or a semiconductor diode
laser, an electromagnetic gas laser, or a femtosecond laser.
[0022] The hand-piece 16 may include a laser head, such as an
Er:YAG laser head, that is pumped by the laser 12 to generate and
deliver laser radiation through the tip 18. It is contemplated that
the hand-piece 16 may be remotely connected with the laser 12. The
tip 18 may be a contact tip or a non-contact tip. It is
contemplated that the tip 18 may be made of any desired material,
such as quartz, sapphire, or any other rare or basic earth
elements.
[0023] The system 10 may also include a 2D or 3D scanning laser
(not shown) for moving the laser radiation produced by the laser 12
in a desired pattern over the tissue. The system 10 may also
incorporate a display, such as a holographic display or an LCD
display. The system 10 may also incorporate robotic devices and/or
components (not shown) for producing or controlling the radiation
produced by the laser 12 or other device (not shown) in a desired
pattern over the tissue. The system 10 may further incorporate
operation via local or remote device. It is contemplated that the
laser system 10 may include a scanning mechanism having a slit lamp
and a gonioscope with or without the tip 18.
[0024] The system 10 may be used to remove any desired connective
tissue by ablating the tissue. The desired connective tissue may be
ablated to form perforations or pores in the connective tissue.
Normal tissue healing is at least partially affected to maintain
the perforations or pores in the connective tissue. By this, it is
meant that the system 10 inhibits, disrupts, restricts, or
otherwise causes the tissue to deviate from healing, repairing, or
regenerating in a manner conforming to the usual or ordinary course
of nature, producing observable deficiencies therein.
[0025] The flexibility of the connective tissue may be increased by
formation of the perforations. The formation of perforations
interact with and affect the fundamental mechanisms involved in the
immunology, biochemistry and molecular genetics of connective
tissue metabolism. Furthermore, tension or contracture in the
connective tissue may be reduced. The connective tissue may be
ablated to at least 90% of the depth or thickness of the connective
tissue. Accordingly, the tissue may be ablated through an infinite
number of planes of the tissue.
[0026] The system 10 may ablate, excise, incise, vaporize, or
puncture the tissue. This may be done along any axis, such as a
transverse axis, sagital axis, frontal axis, or coronal axis with a
single or plural repetitions (e.g., single or multiple ablations,
excisions, incisions, vaporizations, or punctures). Alternatively,
tension or contracture may be reduced by a shaving technique, with
single or plural repetitions (e.g., single or multiple shavings)
using various tips, to remove contiguous layers of tissue in
desired areas. It is contemplated that the perforations may extend
entirely through the depth or thickness of the tissue. If the
perforations extend through the entire depth or thickness of the
tissue, the perforated connective tissue may act as a flexible
diaphragm pump.
[0027] The system 10 may be used to ablate or remove connective
tissue, such as scleral tissue, of an eye 20 (FIGS. 2 and 3). A
first desired pattern or matrix 22 of pores or perforations 24 is
formed in the scleral tissue 26 of the eye 20. The first pattern 22
of perforations 24 is formed at a first distance from the outer
diameter of the posterior surgical limbus 28 of the eye 20. The
first distance is less than or equal to 1 mm from the outer
diameter of the posterior surgical limbus of the eye 20. The first
pattern or matrix 22 of perforations 24 may have any desired number
of perforations 24.
[0028] As shown in the embodiment of FIGS. 2 and 3, the first
pattern or matrix 22 of pores or perforations 24 may be a single,
generally circular shaped pattern. It is contemplated that the
first pattern 22 may have any desired shape. For example, the first
pattern 22 may have a plurality of perforations 24 that form a
cross-shaped pattern, a Z-shaped pattern, a U-shaped pattern, a
V-shaped pattern, or an E-shaped pattern. It is also contemplated
that the first pattern 22 may have perforations that form an oval,
triangular, diamond, or rectangular shaped pattern or matrix.
[0029] A second pattern or matrix 32 of pores or perforations 34 is
formed in the scleral tissue 26 of the eye 20. The second pattern
32 of perforations 34 is formed at a second distance from the outer
diameter of the posterior surgical limbus 28 of the eye 20. The
second distance is greater than or equal to 1 mm and less than or
equal to 4.5 mm from the outer diameter of the posterior surgical
limbus of the eye 20. The second pattern 32 of perforations 34 may
have any desired number of perforations 34.
[0030] As shown in the embodiment of FIGS. 2 and 3, the second
pattern or matrix 32 of pores or perforations 34 include a
plurality of generally circular patterns. The second pattern 32
includes seven such perforations 34 arranged in three parallel
rows. The outer rows of perforations 34 include two perforations
each and the middle row of perforations includes three
perforations. As shown in FIGS. 2 and 3, the perforations 34 of the
middle row are offset from the perforations of the outer rows. It
is contemplated that the second pattern or matrix 32 may have any
desired shape. For example, the second pattern 32 may have a
plurality of perforations 34 that form a cross-shaped pattern, a
Z-shaped pattern, a U-shaped pattern, a V-shaped pattern, or an
E-shaped pattern. It is also contemplated that the second pattern
32 may have perforations that form an oval, triangular, diamond, or
rectangular shaped pattern or matrix.
[0031] A third pattern or matrix 42 of pores or perforations 44 is
formed in the scleral tissue 26 of the eye 20. The third pattern or
matrix 42 is substantially similar to the first and second patterns
22 and 32. The third pattern 42 of perforations 44 is formed at a
third distance from the outer diameter of the posterior surgical
limbus 28 of the eye 20. The third distance is greater than or
equal to 4.5 mm from the outer diameter of the posterior surgical
limbus of the eye 20. The third pattern or matrix 42 of
perforations 44 may have any desired number of perforations 44.
[0032] As shown in the embodiment of FIGS. 2 and 3, the third
pattern or matrix 42 of pores or perforations 44 may be a single
circular shaped shaped pattern. It is contemplated that the third
pattern 42 may have any desired shape. For example, the third
pattern 42 may have a plurality of perforations 44 that form a
cross-shaped pattern, a Z-shaped pattern, a U-shaped pattern, a
V-shaped pattern, or an E-shaped pattern. It is also contemplated
that the third pattern 42 may have perforations that form an oval,
triangular, diamond, or rectangular shaped pattern.
[0033] The first, second, and third patterns or matrices 22, 32,
and 42 may have the same shape of have different shapes. The first,
second, and third patterns 22, 32, and 42 (FIG. 3) are formed along
the same radial line extending from the outer diameter of the
posterior surgical limbus 28 of the eye 20.
[0034] The first, second and third patterns or matrices 22, 32, and
42 define a first set 52 of patterns or matrices. The first set 52
of patterns or matrices is formed in a first quadrant of the eye
20. Second, third and fourth sets 54, 56, and 58 of patterns or
matrices are formed in second, third, and fourth quadrants of the
eye. The first, second, third, and fourth sets 52, 54, 56, and 58
of patterns may be identical. The four sets 52, 54, 56, and 58 of
patterns each are arranged to have an overall diamond shape. It is
contemplated that the first, second, third and fourth sets 54, 54,
56 and 58 may have a different number of patterns, differently
shaped patterns, or a different number of perforations. It is
contemplated that any desired number of sets of patterns of
perforations may be formed in the scleral tissue 26 of the eye
20.
[0035] In FIGS. 2 and 3, the first, second, third and fourth sets
54, 54, 56 and 58 are located on the anterior portion 70 of the eye
20. The sets 54, 54, 56 and 58 could, however, be located on the
posterior of the eye 20. This is shown in FIG. 2A. As shown in FIG.
2A, the first, second, third and fourth sets 54, 54, 56 and 58 are
arranged on the posterior 72 of the eye 20. As with the sets 54,
54, 56 and 58 on the anterior 70, the sets on the posterior 70 of
the eye 20 may have a different number of patterns or matrices,
differently shaped patterns, or a different number of
perforations.
[0036] The pores or perforations 24, 34, and 44 may have any
desired shape, such as cylindrical, pyramidal or tetrahedral. The
perforations 24, 34, and 44 are formed to at least 90% of the depth
or thickness of the scleral tissue 26. The perforations 24, 34, and
44 may be formed entirely through the scleral tissue 26 to the
subchoroidal lamina so that the scleral tissue may act as a
diaphragm pump. The perforations 24, 34, and 44 are formed by
moving the hand-piece 16 or any surgical tool in a direction toward
the tissue without moving in a direction extending along the
surface of the tissue. The movement is repeated until the desired
depth of the perforation is achieved. The perforations 24, 34, and
44 may improve uveal-scleral aqueous flow to decrease the
intraocular pressure of the eye 20.
[0037] The pores or perforations 24, 34, and 44 may have inner
walls that are spaced from each other a distance that alters the
fundamental mechanisms involved in the immunology, biochemistry and
molecular genetics of connective tissue metabolism in such a way as
to inhibit normal tissue healing, repair, or regeneration to
prevent total healing of the perforations 24, 34, and 44 in the
connective tissue. The inner walls of the perforations 24, 34, and
44 may be spaced from each other by a distance greater than 400
.mu.m. It is also contemplated that the inner walls of the
perforations 24, 34, and 44 may be spaced from each other by a
distance greater than 600 .mu.n.
[0038] The perforations may be filled with a scarring inhibitor
substance such as a porous collagen-glycosaminoglican scaffold. An
example of such a porous collagen-glycosaminoglican scaffold is
made by Mediking under the tradename OcculusGen. Alternatively, the
perforations may be filled with a biological glycoprotein or a
synthetic glycoprotein. As another alternative, the perforations
may be filled via the application of a biologically compatible
product, which can be in the form of a liquid, a gel, or a porous
solid. The perforations may also be treated with a sealant. An
examples of such a sealant is made by Johnson and Johnson under the
tradename Band-Aid.RTM. brand liquid bandage; and a similar product
is made by Spenco under the tradename 2.sup.nd Skin.RTM.. As a
further alternative, the perforations may be filled via application
or treatment to facilitate an ionic reaction, chemical reaction,
photonic reaction, organic reaction, inorganic reaction, electronic
reaction, or a combination of these reactions to disrupt normal
tissue healing.
[0039] Although the pores or perforations in the connective tissue
have been described as being formed by ablating the tissue using
laser energy, it is contemplated that the perforations could be
formed using any desired surgical tool, such as a diamond knife,
ruby knife, or a radio frequency device.
[0040] An example of an alternative perforation patterns is
illustrated in the embodiment shown in FIG. 4. The embodiment of
FIG. 4 is similar to the embodiment of FIGS. 1 and 2. Therefore, in
FIG. 4, similar reference numbers are used, with the suffix "a"
being used in FIG. 4 for clarity.
[0041] As shown in FIG. 4, the first pattern or matrix 22a includes
perforations 24a that are arranged in a generally rectangular
configuration. The first pattern 22a extends generally radially
from the from the outer diameter of the posterior surgical limbus
28a of the eye 20a. The second pattern or matrix 32a includes three
perforations 34a, each of which are arranged in a generally
rectangular configuration. Two of the perforations 34a are
positioned on opposite sides of the first pattern 22a, extend
parallel to the first pattern, and are offset longitudinally from
the first pattern. A third perforation 34a of the second pattern
32a extends transverse (perpendicular) to the remaining two
perforations and is positioned, and is positioned adjacent ends of
the perforations of the other two perforations of the second
pattern distal to the outer diameter of the posterior surgical
limbus 28a of the eye 20a.
[0042] The first and second patterns or matrices 22a and 32a define
a first set 52a of patterns or matrices. The first set 52a of
patterns is formed in a first quadrant of the eye 20a. Second,
third and fourth sets 54a, 56a, and 58a of patterns or matrices are
formed in second, third, and fourth quadrants of the eye 20a. The
first, second, third, and fourth sets 52a, 54a, 56a, and 58a of
patterns may be identical. The four sets 52a, 54a, 56a, and 58a may
have a different number of patterns, differently shaped patterns,
or a different number of perforations. It is contemplated that any
desired number of sets of patterns of perforations may be formed in
the scleral tissue 26a of the eye 20a. Like the embodiment of FIGS.
2-3, the four sets 52a, 54a, 56a, and 58a of FIG. 4 may be located
on the anterior of the eye (shown), the posterior of the eye (not
shown), or both.
[0043] From the above, it will be appreciated that the present
invention relates to a system for treating connective tissue. The
system include means for forming perforations in the connective
tissue to at least 90% of the depth of the connective tissue. The
system also includes means for at least partially affecting normal
healing of the perforations.
[0044] It will also be appreciated that the present invention
relates to a system for treating connective tissue to increase
elasticity of the tissue comprising. The system includes means for
removing connective tissue of an eye to form a first desired
pattern of perforations in the connective tissue of the eye at a
first distance from the outer diameter of the posterior surgical
limbus of the eye, the first desired pattern of perforations having
a plurality of perforations. The system also includes means for
removing tissue from the eye to form a second desired pattern of
perforations in the tissue of the eye at a second distance from the
outer diameter of the posterior surgical limbus of the eye, the
second desired pattern of perforations having a plurality of
perforations.
[0045] It will be understood that the above description of the
present invention is susceptible to various modifications, changes
and adaptations, and the same are intended to be comprehended
within the meaning and range of equivalents of the appended claims.
The presently disclosed embodiments are considered in all respects
to be illustrative, and not restrictive. The scope of the invention
is indicated by the appended claims, rather than the foregoing
description, and all changes that come within the meaning and range
of equivalence thereof are intended to be embraced therein.
* * * * *