A surgical device and procedure are provided for performing microsurgery, including a capsulotomy of a lens capsule of an eye. The device has an elastically deformable cutting element mounted within an elastomeric suction cup. The suction cup is attached to an arm for manipulating the device. The device can be inserted into the anterior chamber of the eye, through a corneal incision, to cut a piece from the anterior portion of the lens capsule of the eye. The device is secured against the lens capsule using suction applied by one or more suction elements. The device is then removed from the eye, with the cut piece of membrane retained within the device by suction.

A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.

A device for applying a bubble of a substance to a tissue surface, the device comprising a cannula, a distal tip at the distal end portion of the cannula, the distal tip having a bubble support surface and an exit port extending through the bubble support surface, an expansion fluid passageway extending through the cannula to the exit port, a source of an expansion fluid and an actuator therefor. In some arrangements, the distal tip can be configured to support a layer of the substance thereon over the distal port and the device can be configured such that the advancement of the expansion fluid from the fluid source through the exit port causes at least one bubble of the substance to form on the distal tip, wherein the at least a portion of the bubble can be transferred to the tissue surface to treat a defect on the tissue surface.

To treat corneal ectatic disorders, systems and methods can precisely apply photoactivating light to specified areas of a cornea treated with a cross-linking agent. An example system includes a light source that provides a photoactivating light to photoactivate a cross-linking agent applied to an eye. The system includes optical element(s) that transmit the photoactivating light to the eye according to a pattern defined by a plurality of treatment zones. The treatment zones are delivered to different respective areas on the eye. The plurality of treatment zones includes at least a first treatment zone and a second treatment zone. The first treatment zone provides a first dose of the photoactivating light. The second treatment zone provides a second dose of the photoactivating light. The first dose is greater than the second dose. The first treatment zone is disposed within an inner boundary of the second treatment zone.

An instrument to facilitate hands-free illumination of an eye for a surgical procedure. The instrument includes an optical end of unique architecture and surfacing such that the instrument may be left immobile while sufficiently illuminating an eye interior with greater than 100 of wide beam spread angle provided. Further, the grind surfacing provided to the end cone of the optical end provides enhanced light distribution.

An apparatus to treat refractive error of the eye comprises one or more optics configured to project stimuli comprising out of focus images onto the peripheral retina outside the macula. While the stimuli can be configured in many ways, in some embodiments the stimuli are arranged to decrease interference with central vison such as macular vision. The stimuli can be out of focus images may comprise an amount of defocus within a range from about 3 Diopters (D) to about 6 D. In some embodiments, the brightness of the stimuli is greater than a brightness of background illumination by an appropriate amount such as at least 3 times the background brightness. In some embodiments, each of a plurality of stimuli comprises a spatial frequency distribution with an amplitude profile having spatial frequencies within a range from about range of 110.sup.1 to 2.510.sup.1 cycles per degree.

Embodiments of a modulable absorption light adjustable lens (MALAL) comprise a light adjustable lens that is capable of changing its optical properties upon an adjusting irradiation, including a photo-modifiable material; and a modulable absorption front protection layer, including a modulable absorption compound whose absorption properties can be modulated with a modulating stimulus. Other embodiments include a method of adjusting an optical property of a modulable absorption light adjustable lens, the method comprising: reducing an absorption of a modulable absorption compound of a modulable absorption front protection layer of the MALAL by a modulating stimulus, the MALAL having been previously implanted into an eye; and changing an optical property of a light adjustable lens of the MALAL by applying an adjusting irradiation.

An ophthalmic surgical system comprises a surgical microscope that provides a field of view of a surgical site to a user. A microscope display device displays a graphical overlay and the field of view. The graphical overlay displays fields to adjust configurable settings that modify operation of a surgical instrument. A footswitch receives user input from the user to adjust the configurable settings by: detecting a first movement of a joystick by the user, the first movement representing movement of a cursor relative to the fields; and detecting a second movement of the joystick or a button by the user, the second movement representing a selection of a field. The computer: generates a control signal to adjust the configurable settings in the response to the user input; and outputs the control signal to the surgical instrument to adjust the configurable settings according to the user input.

This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt and/or hydrate and/or prodrug of the compound) that that generates cross-linking in the cornea in response to exposure to an electromagnetic irradiation. This disclosure also features compositions containing the same as well as other methods of using and making the same. The chemical entities are useful, e.g., for treating a subject (e.g., a human) having a disease, disorder, or condition in which in which abnormal shaping of the cornea (e.g., thinning of the cornea, e.g., bilateral thinning of the cornea, e.g., bilateral thinning of the central, paracentral, or peripheral cornea; or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms and/or progression of the disease, disorder, or condition. Non-limiting examples of such diseases, disorders, or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular non-limiting examples of such diseases, disorders, or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g., post-operative ectasia, e.g., post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism, and presbyopia.

A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.