Hydrokeratome for refractive surgery

An apparatus for ophthalmic surgery, including:

• a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue;
• jet carrier means for supporting said jet nozzle;
• an instrument body;
• means for releasably securing said instrument body to the corneal portion of an eye;
• means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction;
• means for translating said jet carrier selectively with precise positional control along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue;
• said means for translating said jet carrier including a micro-motor assembly secured in said instrument body, and a pinion gear connected to the output of said micro-motor assembly and protruding from said instrument body.

An apparatus for ophthalmic surgery, including:

• a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue;
• jet carrier means for supporting said jet nozzle;
• an instrument body;
• means for releasably securing said instrument body to the corneal portion of an eye;
• means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction;
• means for translating said jet carrier selectively with precise positional control along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue;
• and,
• a guide member for controlling placement and conformation of incisions in the corneal tissue formed by said high velocity liquid jet;
• said guide member including adaptive applanator means defining a selectively variable curved surface for impinging on the apex of the cornea.

An apparatus for ophthalmic surgery, including:

• cutting means capable of cutting corneal tissue;
• an instrument body, and means for releasably securing said instrument body to the corneal portion of an eye;
• translating means supported on said instrument body for moving said cutting means through a portion of the cornea secured to said instrument body to form an incision in the cornea;
• adaptive applanator means for impinging on the corneal portion of the eye, said adaptive applanator means including a selectively variable curved surface impinging on the corneal portion to temporarily alter the curvature of the outer surface of the corneal portion in a predetermined manner.

An apparatus for ophthalmic surgery, including:

• a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue;
• jet carrier means for supporting said jet nozzle;
• an instrument body;
• means for releasably securing said instrument body to the corneal portion of an eye;
• means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction;
• means for translating said jet carrier selectively along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue;
• and,
• safety shutter means for selectively blocking said high velocity liquid jet.

An apparatus for ophthalmic surgery, including:

• a jet nozzle for emitting a fine diameter, high velocity liquid jet in a longitudinal direction, said jet being capable of cutting corneal tissue;
• jet carrier means for supporting said jet nozzle;
• an instrument body;
• means for releasably securing said instrument body to the corneal portion of an eye;
• means for securing said jet carrier means to said instrument body in translatable fashion along a translation axis intersecting said longitudinal direction;
• means for translating said jet carrier selectively along said translation axis to sweep said liquid jet through a portion of the corneal tissue of an eye secured to said instrument body and effect an incision in said corneal tissue;
• and,
• aiming beam means for permitting direct visualization of said high velocity liquid jet.

A method for resection of the cornea, including the steps of:

• providing an adaptive applanator having a applanation surface of selectively variable conformation;
• securing said adaptive applanator to the corneal portion of an eye while said applanation surface is disposed in a first selected curvature and impinged on the corneal portion;
• forming a first lateral surgical incision in the corneal portion to create an apical flap;
• reconfiguring said adaptive applanator to cause said applanation surface to adopt a second selected curvature impinging on said corneal portion;
• forming a second lateral surgical incision in the corneal portion, said first and second lateral surgical incsions defining a lenticular wafer of corneal tissue;
• removing said lenticular wafer;
• and,
• replacing said apical flap on the stromal bed of the removed lenticular wafer.

A method for resection of the cornea, including the steps of:

• providing a plurality of guide members, said guide members having applanator plates of various thicknesses and applanation surface curvatures;
• providing a surgical instrument having linear cutting means tranversing a planar path;
• said planar path being closely spaced apart from the applanation surface of a guide member;
• securing one of said guide members in the surgical instrument, said one guide member having a predetermined spacing of said applanation surface from said planar path;
• operating said linear cutting means to form a first lateral incision in the cornea and create an apical flap;
• removing said one guide member from said instrument body and securing a second guide member in said instrument body, said second guide member having a second predetermined spacing of said applanation surface from said planar path;
• operating said linear cutting means to form a second lateral incision in the cornea and create an lenticular wafer of corneal tissue;
• removing said lenticular wafer;
• and,
• replacing said apical flap on the stromal bed of the removed lenticular wafer.