An ophthalmic surgical laser system includes: a laser that produces a pulsed laser beam having a pulse energy and pulse repetition rate; a high frequency fast scanner; an XY-scan device; a Z-scan device; and a controller. The controller controls the high frequency scanner to produce a scan line having a scan width; controls the XY-scan device and the Z-scan device to carry out of first sweep of the scan line in a first sweep direction and to carry out a second sweep of the scan line in a second sweep direction that is not parallel to the first sweep direction thereby defining an overlap region. At least one of the pulse energy, repetition rate, XY-scan speed, and the scan width is varied so as to accelerate the cutting speed and reduce the exposure of ophthalmic tissue in the overlap region to multiple exposures of laser pulses configured to modify ophthalmic tissue.
A method of altering a refractive property of a crosslinked acrylic polymer material by irradiating the material with a high energy pulsed laser beam to change its refractive index. The method is used to alter the refractive property, and hence the optical power, of an implantable intraocular lens after implantation in the patient's eye. In some examples, the wavelength of the laser beam is in the far red and near IR range and the light is absorbed by the crosslinked acrylic polymer via two-photon absorption at high laser pulse energy. The method also includes designing laser beam scan patterns that compensate for effects of multiphone absorption such as a shift in the depth of the laser pulse absorption location, and compensate for effects caused by high laser pulse energy such as thermal lensing. The method can be used to form a Fresnel lens in the optical zone.
A method for treating presbyopia of a crystalline lens using a femtosecond laser system, operated in a parameter regime characterized by extremely short pulse duration (below 100 fs) and low pulse energy (sub-μJ) of the pulses delivered to the lens tissue. The laser beam has a small focal volume in the tissue that is achieved by the short spatial pulse length, rather than defined by the large depth of focus resulting from the low numerical aperture of the laser beam. The laser energy density within the small focal volume (below 50 μm3) is sufficiently high to induce optical breakdown of the tissue, which reduces the Young's modulus of the lens to improve accommodation, thereby reducing presbyopia. Meanwhile, the total pulse energy in the focal volume is sufficiently low, resulting in small cavitation bubbles, which reduce light scattering and other damage or undesirable effects in the treated lens tissue.
An ophthalmic laser system and related method for performing corneal lenticule incision and extraction for treating hyperopia and mixed astigmatism of the eye are described. Various techniques are used to optimize the procedure for concave lenticule incisions. One technique employs a fast-scan-slow-sweep scanning scheme to form the lenticule incisions, where the sweep angle increment is set to ensure at least double-pass cut for the entire lenticule. Another technique allows for desired distribution of refractive powers between the top and bottom lenticule incisions. Other techniques configure the lenticule such that its edge thickness is a constant; or such that the highest point of the top lenticule incision, located near the lenticule periphery, is at a predefined depth below the anterior corneal surface; or to maximize lenticule thickness for refractive treatment while ensuring that minimum anterior depth and minimum residual bed thickness in the peripheral region of the lenticule are maintained.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 17/00 - Surgical instruments, devices or methods
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
5.
FEMTOSECOND LASER SYSTEM AND METHOD FOR PRESBYOPIA CORRECTION
A method for treating presbyopia of a crystalline lens using a femtosecond laser system, operated in a parameter regime characterized by extremely short pulse duration (below 100 fs) and low pulse energy (sub-µJ) of the pulses delivered to the lens tissue. The laser beam has a small focal volume in the tissue that is achieved by the short spatial pulse length, rather than defined by the large depth of focus resulting from the low numerical aperture of the laser beam. The laser energy density within the small focal volume (below 50 µm3) is sufficiently high to induce optical breakdown of the tissue, which reduces the Young's modulus of the lens to improve accommodation, thereby reducing presbyopia. Meanwhile, the total pulse energy in the focal volume is sufficiently low, resulting in small cavitation bubbles, which reduce light scattering and other damage or undesirable effects in the treated lens tissue.
An ophthalmic laser system and related method for performing corneal lenticule incision and extraction for treating hyperopia and mixed astigmatism of the eye are described. Various techniques are used to optimize the procedure for concave lenticule incisions. One technique employs a fast-scan-slow-sweep scanning scheme to form the lenticule incisions, where the sweep angle increment is set to ensure at least double-pass cut for the entire lenticule. Another technique allows for desired distribution of refractive powers between the top and bottom lenticule incisions. Other techniques configure the lenticule such that its edge thickness is a constant; or such that the highest point of the top lenticule incision, located near the lenticule periphery, is at a predefined depth below the anterior corneal surface; or to maximize lenticule thickness for refractive treatment while ensuring that minimum anterior depth and minimum residual bed thickness in the peripheral region of the lenticule are maintained.
Methods and apparatus are configures to measure an eye without contacting the eye with a patient interface, and these measurements are used to determine alignment and placement of the incisions when the patient interface contacts the eye. The pre-contact locations of one or more structures of the eye can be used to determine corresponding post-contact locations of the one or more optical structures of the eye when the patient interface has contacted the eye, such that the laser incisions are placed at locations that promote normal vision of the eye. The incisions are positioned in relation to the pre-contact optical structures of the eye, such as an astigmatic treatment axis, nodal points of the eye, and visual axis of the eye.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
8.
PATIENT INTERFACE DEVICE FOR OPHTHALMIC SURGICAL LASER SYSTEM EMPLOYING A CAP FOR LENS CONE HANDLING
In an ophthalmic surgical laser system, a patient interface device for coupling a patient's eye to the laser system includes a lens cone with a frustoconical shaped shell for coupling to the laser system and a suction ring for coupling to the patient's eye, the lens cone and the suction ring being joined together by clamping. A cap is provided for use with the lens cone as an installation aid. In the configuration supplied to the user, the lens cone is partially embedded in and snapped to the cap. The cap has a portion with a relatively large diameter and multiple ribs for easy handling. The user holds the cap to install the lens cone on the laser system, and pulls the cap to unsnap it from the lens cone. The lens cone is attached to the laser system with a bayonet mount that provides tactile feedback to the user.
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
A61F 9/008 - Methods or devices for eye surgery using laser
9.
STEPPER MOTOR CONTROL METHOD AND APPARATUS WITH REDUCED VIBRATION DURING ACCELERATION AND DECELERATION
A stepper motor control method and related control circuitry (for example, an FPGA) to control the acceleration and/or deceleration of the stepper motor movement to reduce system vibration. Acceleration and deceleration are implemented by adjusting the stepper motor period (the time between consecutive stepper motor position) based on the distance from the start or to the end position. The closer to the start or end position, the longer the period employed. In the middle range of its travel, the motor speed is constant and the stepper motor period is the shortest. The stepper motor period is always a nominal period multiplied by a factor of 2^n, where n is zero or a positive integer. The resulting motor position vs. time curve is an approximated S-curve. The acceleration and deceleration control minimizes mechanically induced vibrations, while reducing implementation complexity and demand on FPGA resources.
A counterbalance mechanism in an ophthalmic laser system balances the weight of the laser beam delivery head and provides small, precise and repeatable variations in the net load exerted by the laser head on the patient's eye over a defined distance of travel. The counterbalance mechanism includes a balance beam pivotably mounted on a support block, with the laser head and a counterweight mounted on its two ends. The counterweight is movable along the balance beam via a linear motion bearing. A mechanical link links the counterweight to the support block; the link has a predefined length and is pivotable around its respective connection points on the support block and the counterweight. When the balance beam pivots, the link causes the counterweight to move along the balance beam, thereby changing the mechanical advantage of the counterweight and varies the counterbalancing force to provide variations in the net load.
A stepper motor control method and related control circuitry (for example, an FPGA) to control the acceleration and/or deceleration of the stepper motor movement to reduce system vibration. Acceleration and deceleration are implemented by adjusting the stepper motor period (the time between consecutive stepper motor position) based on the distance from the start or to the end position. The closer to the start or end position, the longer the period employed. In the middle range of its travel, the motor speed is constant and the stepper motor period is the shortest. The stepper motor period is always a nominal period multiplied by a factor of 2{circumflex over ( )}n, where n is zero or a positive integer. The resulting motor position vs. time curve is an approximated S-curve. The acceleration and deceleration control minimizes mechanically induced vibrations, while reducing implementation complexity and demand on FPGA resources.
A method implemented in an ophthalmic surgical laser system for forming a corneal flap in a patient's eye with improved bubble management. The flap includes a horizontal bed and a vertical or near vertical side cut around the periphery of the bed except for an uncut hinge area. The side cut has a bubble barrier layer that can prevent bubbles formed by the laser-tissue interaction from escaping into an interface between the corneal and the patient interface lens. In some embodiments, the bubble barrier layer is a thin uncut layer, located in the epithelium of the cornea, that separates the side cut into two portions. In other embodiments, the side cut does not reach the anterior corneal surface, leaving an uncut bubble barrier layer located with the epithelium. In other embodiments, an additional side cut portion is formed through the uncut bubble barrier layer as the last step.
A ophthalmic laser-assisted corneal lenticule extraction procedure that uses wavefront measurements to guide the formation of the corneal lenticule. The wavefront map measured from a free eye using a wavefront aberrometer is registered to the cornea of a docked eye based on comparisons of iris images and corneal markings. The docked-eye cornea-registered wavefront map is then corrected to be consistent with the Munnerlyn formula for the spherical power, and adjusted for any physician adjustments and/or myopia error due to a flat add in the lenticule, using Zernike polynomials. The corrected and adjusted wavefront map is then used to calculate the profiles of the bottom and top lenticule incisions in the applanated cornea, where higher-order components in the wavefront map are distributed to the bottom lenticule incision alone and lower-order components in the wavefront map are distributed to both the bottom and the top lenticule incision.
In a femtosecond ophthalmic laser system which employs a high frequency resonant scanner to produce a laser scanline and XY and Z scanners to move the scanline in a patient's eye to perform eye surgery, a beam blocking member is placed near an internal focus plane of the optical system to block some of the beam paths to truncate the laser scanline at the two ends. This eliminates the closely spaced or overlapping laser focus spots near the ends of the scanline. The beam blocking member has a plate shape with one or more apertures of different shapes or sizes, and is movable in the transverse direction to different positions to block different amounts of the scanline.
In a femtosecond ophthalmic laser system which employs a high frequency resonant scanner to produce a laser scanline and XY and Z scanners to move the scanline in a patient's eye to perform eye surgery, a beam blocking member is placed near an internal focus plane of the optical system to block some of the beam paths to truncate the laser scanline at the two ends. This eliminates the closely spaced or overlapping laser focus spots near the ends of the scanline. The beam blocking member has a plate shape with one or more apertures of different shapes or sizes, and is movable in the transverse direction to different positions to block different amounts of the scanline.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
16.
LASER FIDUCIALS FOR AXIS ALIGNMENT IN CATARACT SURGERY
A fiducial is generated on an internal anatomical structure of the eye of a patient with a surgical laser. A toric artificial intraocular lens (IOL) is positioned so that a marker of the toric IOL is in a predetermined positional relationship relative to the fiducial. This positioning aligns the toric IOL with the astigmatic or other axis of the eye. The toric IOL is then implanted in the eye of the patient with high accuracy.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 90/20 - Surgical microscopes characterised by non-optical aspects
Two pupil detection methods implemented in an ophthalmic laser surgery system for detecting the pupil of the patient's eye both before and after the eye is applanated by a patient interface device. In the first method, an infrared image is captured before the eye is coupled to the patient interface. After excluding certain image artifacts, the pixel intensity is clustered into four clusters, and pixels belonging to the cluster with the lowest intensity are deemed pupil pixels, and pupil boundary and pupil center are determined accordingly. In the second method, a color image is captured after the eye is coupled to the patient interface. The color image is converted to the HSV color space, and only the hue channel is used for pupil detection. The hue channel image is filtered by median filtering and edge-preserving filtering (e.g. guided image filtering), then binarized, before pupil detection is performed.
G06V 10/28 - Quantising the image, e.g. histogram thresholding for discrimination between background and foreground patterns
G06V 10/34 - Smoothing or thinning of the patternMorphological operationsSkeletonisation
G06V 10/762 - Arrangements for image or video recognition or understanding using pattern recognition or machine learning using clustering, e.g. of similar faces in social networks
G06V 10/764 - Arrangements for image or video recognition or understanding using pattern recognition or machine learning using classification, e.g. of video objects
G06V 40/18 - Eye characteristics, e.g. of the iris
18.
PUPIL DETECTION METHODS IN OPHTHALMIC LASER SURGERY FOR DETECTING PUPIL IN EYE IMAGES CAPTURED BEFORE AND AFTER EYE APPLANATION
Two pupil detection methods implemented in an ophthalmic laser surgery system for detecting the pupil of the patient's eye both before and after the eye is applanated by a patient interface device. In the first method, an infrared image is captured before the eye is coupled to the patient interface. After excluding certain image artifacts, the pixel intensity is clustered into four clusters, and pixels belonging to the cluster with the lowest intensity are deemed pupil pixels, and pupil boundary and pupil center are determined accordingly. In the second method, a color image is captured after the eye is coupled to the patient interface. The color image is converted to the HSV color space, and only the hue channel is used for pupil detection. The hue channel image is filtered by median filtering and edge-preserving filtering (e.g. guided image filtering), then binarized, before pupil detection is performed.
A method implemented in an ophthalmic laser system to perform iris registration based on two iris images taken with the patient at upright and supine positions, respectively. For each iris image, the iris region is transformed into a rectangular rubbersheet, with the radial and angular coordinates of the iris image respectively mapped to vertical and horizontal coordinates of the rubbersheet. A horizontal one-dimensional log-Gabor transform is applied to the rubbersheet line-by-line. The transformed rubbersheet is binarized line-by-line. The two binary rubbersheets are compared at a series of relative horizontal shifts to determine the horizontal shift value that produces the lowest Hamming distance between the two binary rubbersheets, and the cyclotorsion rotation of the eye between the upright and supine positions is calculated accordingly. Then, while the patient is in the supine position, the laser system treats the eye based on measured astigmatism axis orientation and the calculated cyclotorsion rotation.
A method implemented in an ophthalmic laser system to perform iris registration based on two iris images taken with the patient at upright and supine positions, respectively. For each iris image, the iris region is transformed into a rectangular rubbersheet, with the radial and angular coordinates of the iris image respectively mapped to vertical and horizontal coordinates of the rubbersheet. A horizontal one-dimensional log-Gabor transform is applied to the rubbersheet line-by-line. The transformed rubbersheet is binarized line-by-line. The two binary rubbersheets are compared at a series of relative horizontal shifts to determine the horizontal shift value that produces the lowest Hamming distance between the two binary rubbersheets, and the cyclotorsion rotation of the eye between the upright and supine positions is calculated accordingly. Then, while the patient is in the supine position, the laser system treats the eye based on measured astigmatism axis orientation and the calculated cyclotorsion rotation.
A61B 3/103 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
A61F 9/008 - Methods or devices for eye surgery using laser
G06T 3/14 - Transformations for image registration, e.g. adjusting or mapping for alignment of images
A single-piece patient interface device for coupling a patient's eye to an ophthalmic surgical laser system includes a cone substrate with a rigid frustoconical shaped shell for coupling to the laser system, and a flexible suction ring integrally joined to the lower end of the rigid shell for coupling to the patient's eye. The suction ring has a circular skirt extending downwardly from a base portion, a diaphragm extending from the base portion and disposed inside of the skirt, and a contact lens held by the diaphragm to cover a center opening. When the skirt contacts the eye's surface, the skirt, the diaphragm, the contact lens and the eye surface form a vacuum chamber, where a vacuum may be applied to secure the patient interface device to the eye. The parameters of the suction ring are optimized to fit a large range of eye sizes, including smaller eyes.
A single-piece patient interface device for coupling a patient's eye to an ophthalmic surgical laser system includes a cone substrate with a rigid frustoconical shaped shell for coupling to the laser system, and a flexible suction ring integrally joined to the lower end of the rigid shell for coupling to the patient's eye. The suction ring has a circular skirt extending downwardly from a base portion, a diaphragm extending from the base portion and disposed inside of the skirt, and a contact lens held by the diaphragm to cover a center opening. When the skirt contacts the eye's surface, the skirt, the diaphragm, the contact lens and the eye surface form a vacuum chamber, where a vacuum may be applied to secure the patient interface device to the eye. The parameters of the suction ring are optimized to fit a large range of eye sizes, including smaller eyes.
In a femtosecond laser eye surgery system where beam delivery is accomplished with a moving objective, a dual-channel imaging system allows real-time procedure visualization before and during incision. The first (docking) imaging channel covers a full field of view (FoV) of the eye, e.g., 13 mm; the second (cutting) imaging channel is through the objective and moves with it, and covers a smaller FoV, e.g., 2 mm. During eye docking and undocking, the objective is moved to a parking position out of the visual field of the docking imaging channel, and the latter operates to provide process visualization. During incision, a composite eye image is displayed, composed of a stationary image captured by the docking imaging channel before treatment began overlayed with live cutting images captured by the cutting imaging channel. The live cutting images are compared to the stationary image in real time to detect eye movement.
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using “fast-scan-slow-sweep” scanning scheme. A high frequency scanner forms a fast scan line, which is placed tangential to a parallel of latitude of the surface of the lenticule and then then moved in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, with the orientation of the scan line rotated between successive sweeps. To generate tissue bridge free incisions without leaving laser-induced marks in the eye, a laser pulse energy between 40 nJ to 70 nJ is used, and the sweeping speed is controlled such that the scan line step (the distance between the centers of consecutive scan lines) is between 1.7 μm and 2.3 μm.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
25.
LASER EYE SURGERY SYSTEM EMPLOYING DUAL-CHANNEL VIDEO IMAGING SYSTEM FOR REAL-TIME PROCEDURE VISUALIZATION AND RELATED IMAGING METHODS
In a femtosecond laser eye surgery system where beam delivery is accomplished with a moving objective, a dual-channel imaging system allows real-time procedure visualization before and during incision. The first (docking) imaging channel covers a full field of view (FoV) of the eye, e.g., 13 mm; the second (cutting) imaging channel is through the objective and moves with it, and covers a smaller FoV, e.g., 2 mm. During eye docking and undocking, the objective is moved to a parking position out of the visual field of the docking imaging channel, and the latter operates to provide process visualization. During incision, a composite eye image is displayed, composed of a stationary image captured by the docking imaging channel before treatment began overlayed with live cutting images captured by the cutting imaging channel. The live cutting images are compared to the stationary image in real time to detect eye movement.
Methods and related apparatus for real-time process monitoring during laser-based refractive index modification of an intraocular lens. During in situ laser treatment of the IOL to modify the refractive index of the IOL material, a signal from the IOL is measured to determine the processing effect of the refractive index modification, and based on the determination, to adjust the laser system parameters to achieve intended processing result. The signal measured from the IOL may be a fluorescent signal induced by the treatment laser, a fluorescent signal induced by an external illumination source, a temporary photodarkening effect, a color change, or a refractive index change directly measured by phase stabilized OCT.
A system for ophthalmic surgery on an eye includes: a pulsed laser which produces a treatment beam; an OCT imaging assembly capable of creating a continuous depth profile of the eye; an optical scanning system configured to position a focal zone of the treatment beam to a targeted location in three dimensions in one or more floaters in the posterior pole. The system also includes one or more controllers programmed to automatically scan tissues of the patient's eye with the imaging assembly; identify one or more boundaries of the one or more floaters based at least in part on the image data; iii. identify one or more treatment regions based upon the boundaries; and operate the optical scanning system with the pulsed laser to produce a treatment beam directed in a pattern based on the one or more treatment regions.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
The XYZ beam position of an ophthalmic laser system is calibrated by measuring a fluorescent signal induced by the focused laser beam in a thin glass coverslip via multiphoton absorption. A video camera measures the XY position and intensity of the fluorescent signal as the focused laser beam strikes the coverslip. The Z position of the focus is determined by scanning the targeted z position and identifying the Z scanner position of peak fluorescence. An OCT system measures the real space Z location of the coverslip, which is correlated with the Z scanner position. Other laser system parameters are assessed by repeatedly scanning a lower energy laser beam in a piece of IOL material, and observing damage (scattering voids) formation in the IOL material. Based on the rate of damage formation, laser system parameters such as beam quality, numerical aperture, pulse energy, and pulse duration, etc. can be assessed.
In an ophthalmic surgical laser system, a patient interface device for coupling a patient's eye to the laser system includes a lens cone with a frustoconical shaped shell for coupling to the laser system and a suction ring for coupling to the patient's eye, the lens cone and the suction ring being either joined together by clamping or formed integrally as one piece. A cap is provided for use with the lens cone as an installation aid. In the configuration supplied to the user, the lens cone is partially embedded in and snapped to the cap. The cap has a portion with a relatively large diameter and multiple ribs for easy handling. The user holds the cap to install the lens cone on the laser system, and pulls the cap to unsnap it from the lens cone. The lens cone is attached to the laser system with a bayonet mount.
A laser system calibration method and system are provided. In some methods, a calibration plate may be used to calibrate a video camera of the laser system. The video camera pixel locations may be mapped to the physical space. A xy-scan device of the laser system may be calibrated by defining control parameters for actuating components of the xy-scan device to scan a beam to a series of locations. Optionally, the beam may be scanned to a series of locations on a fluorescent plate. The video camera may be used to capture reflected light from the fluorescent plate. The xy-scan device may then be calibrated by mapping the xy-scan device control parameters to physical locations. A desired z-depth focus may be determined by defining control parameters for focusing a beam to different depths. The video camera or a confocal detector may be used to detect the scanned depths.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
B23K 26/082 - Scanning systems, i.e. devices involving movement of the laser beam relative to the laser head
31.
COMPACT AUTOCYLINDER COMPENSATION MODULE FOR AUTOREFRACTOR AND AUTOREFRACTOR WITH AUTOCYLINDER COMPENSATION MODULE
An instrument includes: an aberrometer; a corneal topographer; an optical coherence tomographer; and a fixation target subsystem. The fixation target subsystem includes a fixation target and a Stokes cell disposed in an optical path between the fixation target and the eye, wherein the Stokes cell includes a first rotation stage having a first cylinder lens and a second rotation stage having a second cylinder lens, wherein; and a controller configured for controlling a rotation of the first rotation stage and the second rotation stage for correcting for an astigmatism of the eye.
A61B 3/103 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
A61B 3/00 - Apparatus for testing the eyesInstruments for examining the eyes
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
32.
MONITORING LASER-TISSUE INTERACTION DURING FEMTOSECOND LASER INCISION IN CORNEA USING BACK-REFLECTED TREATMENT LIGHT
During laser ophthalmic procedures, back-reflected treatment laser light is detected by an auto-Z module and analyzed in real-time to determine various aspects of laser-tissue interaction during the procedure. This method can detect the presence of "black spots" (locations where no laser-tissue interaction occurred), sub-optimal incision quality, etc. in real time, and allows for dynamical adjustment of the laser treatment parameters such as pulse energy, laser spot separation, etc. to correct the detected problems. The auto-Z signal analysis may also depend on which incision segment or region is currently being cut, to optimally control different cutting segments. This method improves corneal incision quality and helps to achieves consistent laser- tissue interaction from patient to patient.
During laser ophthalmic procedures, back-reflected treatment laser light is detected by an auto-Z module and analyzed in real-time to determine various aspects of laser-tissue interaction during the procedure. This method can detect the presence of “black spots” (locations where no laser-tissue interaction occurred), sub-optimal incision quality, etc. in real time, and allows for dynamical adjustment of the laser treatment parameters such as pulse energy, laser spot separation, etc. to correct the detected problems. The auto-Z signal analysis may also depend on which incision segment or region is currently being cut, to optimally control different cutting segments. This method improves corneal incision quality and helps to achieves consistent laser-tissue interaction from patient to patient.
A laser surgery system includes a light source, an eye interface device, a scanning assembly, a confocal detection assembly and preferably a confocal bypass assembly. The light source generates an electromagnetic beam. The scanning assembly scans a focal point of the electromagnetic beam to different locations within the eye. An optical path propagates the electromagnetic beam from a light source to the focal point, and also propagates a portion of the electromagnetic beam reflected from the focal point location back along at least a portion of the optical path. The optical path includes an optical element associated with a confocal detection assembly that diverts a portion of the reflected electromagnetic radiation to a sensor. The sensor generates an intensity signal indicative of intensity the electromagnetic beam reflected from the focal point location. The confocal bypass assembly reversibly diverts the electromagnetic beam along a diversion optical path around the optical element.
A61B 3/117 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
A61B 3/00 - Apparatus for testing the eyesInstruments for examining the eyes
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/14 - Arrangements specially adapted for eye photography
Method and apparatus for performing a laser-assisted posterior capsulotomy and for performing laser eye surgery on an eye having a penetrated cornea are provided. A method for performing a posterior capsulotomy includes injecting fluid between the lens posterior capsule and the anterior hyaloids membrane to separate the lens posterior capsule and the anterior hyaloids membrane. With the lens posterior capsule separated from the anterior hyaloids membrane, a posterior capsulotomy is performed on the lens posterior capsule by using a laser to incise the lens posterior capsule.
In laser-assisted corneal lenticule extraction procedures, the lenticule incision profile includes anterior and posterior lenticule incisions, with one or more of the following features: plano transition zone outside the optical zone, to improve mating of anterior and posterior incision surfaces after lenticule extraction; shallow arcuate incisions above the anterior incision and near the lenticule edge, to improve surface mating; separate ring cut intersecting the anterior and posterior incisions in the transition zone, to reduce tissue bridges and minimize tear at the lenticule edges and facilitate easy lenticule extraction; larger posterior incision, which includes a pocket zone outside the lenticule edge, for better surface mating and bubble management during cutting; and a separate ring shaped pocket cut intersecting the pocket zone of the posterior incision, for bubble management. An entry cut can intersect either the pocket zone of the posterior incision or an entry extension zone of the anterior incision.
A compact system for performing laser ophthalmic surgery is disclosed. An embodiment of the system includes a mode-locked fiber oscillator-based ultra-short pulsed laser capable of producing laser pulses in the range of 1 nJ to 5 μJ at a pulse repetition rate of between 5 MHz and 25 MHz, a resonant optical scanner oscillating at a frequency of 200 Hz and 21000 Hz, a scan-line rotator, a movable XY-scan device, a z-scan device, and a controller configured to coordinate with the other components of the system to produce one or more desired incision patterns. The system also includes compact visualization optics for in-process monitoring using a beam-splitter inside the cone of a patient interface used to fixate the patient's eye during surgery. The system can be configured such that eye surgery is performed while the patient is either sitting upright, or lying on his or her back.
A corneal lenticule extraction procedure provides convenient re-treatment options when treatment interruptions occur. The procedure is executed by an ophthalmic laser system according to a programmed treatment plan, which defines an entry cut, an optional ring cut, a bottom lenticule incision having an optical zone, and a flat top bed incision. If an interruption occurs during the entry cut, the treatment plan is re-aligned with the partially formed entry cut and continued, or with a new entry cut placed at a different angular position. If an interruption occurs during the ring cut, the treatment plan is revised to define a larger ring cut concentric with the partially formed ring cut. If an interruption occurs during the bottom or top incision, the depth of the partially formed bottom or top incision is measured, and the treatment plan is revised to form a deeper bottom incision or a shallower top incision, respectively.
A method used in a corneal lenticule procedure for finding the visual axis location before eye docking, to track the visual axis location displacement during docking, and to center the lenticule incision pattern at the visual axis location after docking, without ink-marking the visual axis location at the center of the cornea with ink or other substance. Two docking illumination beams are illuminated on the eye surface at oblique angles, and a first eye image is taken before docking while the eye looks at the fixation light of the laser system. A second eye image is taken after docking. The pre-docking cornea apex position is obtained based on the two reflected light spots of the docking illumination light. Pupil center is obtained in both images. The post-docking corneal apex is then calculated from the pre-docking cornea apex position and the pre- and post-docking pupil center positions.
A method used in a corneal lenticule procedure for finding the visual axis location before eye docking, to track the visual axis location displacement during docking, and to center the lenticule incision pattern at the visual axis location after docking, without ink-marking the visual axis location at the center of the cornea with ink or other substance. Two docking illumination beams are illuminated on the eye surface at oblique angles, and a first eye image is taken before docking while the eye looks at the fixation light of the laser system. A second eye image is taken after docking. The pre-docking cornea apex position is obtained based on the two reflected light spots of the docking illumination light. Pupil center is obtained in both images. The post-docking corneal apex is then calculated from the pre-docking cornea apex position and the pre- and post-docking pupil center positions.
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using “fast-scan-slow-sweep” scanning scheme. A high frequency scanner forms a fast scanline, which is placed tangential to a parallel of latitude of the surface of the lenticule and then moved in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, with the orientation of the scanline rotated between successive sweeps. To reduce acceleration and jerk in the XY stage motion, especially during transition from one sweep to the next, the sweeping speed profile is a sigmoid function.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 17/00 - Surgical instruments, devices or methods
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
42.
COPY SUBSYSTEM FOR MULTIPLE LEVEL FILE TRANSFER IMPLEMENTED ON THINGWORX PLATFORM
In a cloud system that includes a cloud server and multiple edge devices implementing the ThingWorx platform, an improved file transfer method for transferring multiple files from the edge device to a file repository of the cloud server. The method provides multi-level path traversal and copy from a specified root level, in a file system containing a plurality of nested variably named paths, with the abilities to exclude path(s) in the path traversal and copy, to specify custom date(s) in the past as the earliest date to transfer file(s), to specify and track copy retries, and to track and report file copy metrics.
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using "fast-scan-slow-sweep" scanning scheme. A high frequency scanner forms a fast scanline, which is placed tangential to a parallel of latitude of the surface of the lenticule and then moved in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, with the orientation of the scanline rotated between successive sweeps. To reduce acceleration and jerk in the XY stage motion, especially during transition from one sweep to the next, the sweeping speed profile is a sigmoid function.
The amount of energy to provide optical breakdown can be determined based on mapped optical breakdown thresholds of the treatment volume, and the laser energy can be adjusted in response to the mapped breakdown thresholds. The mapping of threshold energies can be combined with depth and lateral calibration in order to determine the location of optical breakdown along the laser beam path for an amount of energy determined based on the mapping. The mapping can be used with look up tables to determine mapped locations from one reference system to another reference system.
A measurement instrument and method: produce light having a linear shape; direct the light toward an eye and provide returned light, having the linear shape, from the eye to a split-prism; split the returned light into first and second linear segments and image them onto an image sensor; determine a first lateral offset between the first and second linear segments on the image sensor at a first time; determine a second lateral offset between them at a second time; determine a difference between the first and second lateral offsets; determine a distance that the eye moved relative to the first lens between the first time and the second time based on the difference between the first and second lateral offsets; perform optical coherence tomographer (OCT) measurements at the first and second times; and combine the OCT measurements while compensating for eye movement based on the determined eye movement.
A61B 3/113 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining or recording eye movement
A61B 3/00 - Apparatus for testing the eyesInstruments for examining the eyes
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
46.
Method and Apparatus for Creating Ocular Surgical and Relaxing Incisions
A system and method of treating target tissue in a patient's eye, which includes generating a light beam, deflecting the light beam using a scanner to form first and second treatment patterns, delivering the first treatment pattern to the target tissue to form an incision that provides access to an eye chamber of the patient's eye, and delivering the second treatment pattern to the target tissue to form a relaxation incision along or near limbus tissue or along corneal tissue anterior to the limbus tissue of the patient's eye to reduce astigmatism thereof.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A method implemented in an ophthalmic surgical laser system that employs a resonant scanner, scan line rotator, and XY- and Z-scanners, for forming a corneal flap in a patient's eye with improved bubble management during each step of the flap creation process. A pocket cut is formed first below bed level, followed by the bed connected to the pocket cut, then by a side cut extending from the bed to the anterior corneal surface. The pocket cut includes a pocket region located below the bed level and a ramp region connecting the pocket region to the bed. The bed is formed by a bed cut, including multiple overlapping parallel raster scan passes, and a ring cut. The side cut is formed by multiple side-cut layers at different depths which are joined together. All cuts are formed by scanning a laser scan line generated by the resonant scanner.
A method implemented in an ophthalmic surgical laser system that employs a resonant scanner, scan line rotator, and XY- and Z-scanners, for forming a corneal flap in a patient's eye with improved bubble management during each step of the flap creation process. A pocket cut is formed first below bed level, followed by the bed connected to the pocket cut, then by a side cut extending from the bed to the anterior corneal surface. The pocket cut includes a pocket region located below the bed level and a ramp region connecting the pocket region to the bed. The bed is formed by a hinge cut and a first ring cut at lower laser energies, followed by a bed cut and then a second ring cut, which ensures that any location in the flap bed is cut twice to minimize tissue adhesion. The side cut is formed by multiple side-cut layers at different depths which are joined together. All cuts are formed by scanning a laser scan line generated by the resonant scanner.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
49.
SITU DETERMINATION OF REFRACTIVE INDEX OF MATERIALS
A laser eye surgery system focuses light along a beam path to a focal point having a location within a lens of the eye. The refractive index of the lens is determined in response to the location. The lens comprises a surface adjacent a second material having a second refractive index. The beam path extends a distance from the surface to the focal point. The index is determined in response to the distances from the surface to the targeted focal point and from the surface to the actual focal point, which corresponds to a location of a peak intensity of an optical interference signal of the focused light within the lens. The determined refractive index is mapped to a region in the lens, and may be used to generate a gradient index profile of the lens to more accurately place laser beam pulses for incisions.
A61B 3/103 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
A61B 3/00 - Apparatus for testing the eyesInstruments for examining the eyes
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61F 9/008 - Methods or devices for eye surgery using laser
G01N 21/45 - RefractivityPhase-affecting properties, e.g. optical path length using interferometric methodsRefractivityPhase-affecting properties, e.g. optical path length using Schlieren methods
50.
Automatic patient positioning within a laser eye surgery system
A laser eye surgery system produces a treatment beam that includes a plurality of laser pulses. An optical coherence tomography (OCT) subsystem produces a source beam used to locate one or more structures of an eye. The OCT subsystem is used to sense the distance between a camera objective on the underside of the laser eye surgery system and the patient's eye. Control electronics compare the sensed distance with a pre-determined target distance, and reposition a movable patient support toward or away the camera objective until the sensed distance is at the pre-determined target distance. A subsequent measurement dependent upon the spacing between the camera objective and the patient's eye is performed, such as determining the astigmatic axis by observing the reflection of a plurality of point source LEDs arranged in concentric rings off the eye.
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
Methods and apparatus are configures to measure an eye without contacting the eye with a patient interface, and these measurements are used to determine alignment and placement of the incisions when the patient interface contacts the eye. The pre-contact locations of one or more structures of the eye can be used to determine corresponding post-contact locations of the one or more optical structures of the eye when the patient interface has contacted the eye, such that the laser incisions are placed at locations that promote normal vision of the eye. The incisions are positioned in relation to the pre-contact optical structures of the eye, such as an astigmatic treatment axis, nodal points of the eye, and visual axis of the eye.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
52.
Methods and systems for laser ophthalmic surgery that provide for iris exposures below a predetermined exposure limit
A laser surgical method for performing a corneal incision while maintaining iris exposure below a predetermined exposure limit includes: determining an initial iris exposure based on an initial treatment scan, determining whether the initial iris exposure is less than the predetermined exposure limit, generating a revised treatment scan comprising one or more treatment scan modifying elements when the initial iris exposure is greater than the predetermined exposure limit, and scanning the focal zone of a pulsed laser beam according to the revised treatment scan, thereby performing the corneal incision, wherein the one or more treatment scan modifying elements causes the iris exposure to be smaller than the predetermined exposure limit.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/14 - Arrangements specially adapted for eye photography
A61B 17/00 - Surgical instruments, devices or methods
A61B 18/00 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
A61B 34/00 - Computer-aided surgeryManipulators or robots specially adapted for use in surgery
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
53.
Detection of optical surface of patient interface for ophthalmic laser applications using a non-confocal configuration
An ophthalmic laser system uses a non-confocal configuration to determine a laser beam focus position relative to the patient interface (PI) surface. The system includes a light intensity detector with no confocal lens or pinhole between the detector and the objective lens. When the objective focuses the light to a target focus point inside the PI lens at a particular offset from its distal surface, the light signal at the detector peaks. The offset value is determined by fixed system parameters, and can also be empirically determined by directly measuring the PI lens surface by observing the effect of plasma formation at the glass surface. During ophthalmic procedures, the laser focus is first scanned insider the PI lens, and the target focus point location is determined from the peak of the detector signal. The known offset value is then added to obtain the location of the PI lens surface.
G02B 26/08 - Optical devices or arrangements for the control of light using movable or deformable optical elements for controlling the direction of light
A method of treating a lens of a patient's eye includes generating a light beam, deflecting the light beam using a scanner to form a treatment pattern of the light beam, delivering the treatment pattern to the lens of a patient's eye to create a plurality of cuts in the lens in the form of the treatment pattern to break the lens up into a plurality of pieces, and removing the lens pieces from the patient's eye. The lens pieces can then be mechanically removed. The light beam can be used to create larger segmenting cuts into the lens, as well as smaller softening cuts that soften the lens for easier removal.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A method of altering a refractive property of a crosslinked acrylic polymer material by irradiating the material with a high energy pulsed laser beam to change its refractive index. The method is used to alter the refractive property, and hence the optical power, of an implantable intraocular lens after implantation in the patient's eye. In some examples, the wavelength of the laser beam is in the far red and near IR range and the light is absorbed by the crosslinked acrylic polymer via two-photon absorption at high laser pulse energy. The method also includes designing laser beam scan patterns that compensate for effects of multiphone absorption such as a shift in the depth of the laser pulse absorption location, and compensate for effects caused by high laser pulse energy such as thermal lensing. The method can be used to form a Fresnel lens in the optical zone.
In a laser delivery system for an ophthalmic laser surgery system, a laser beam scanner employs a single or two MEMS micromirror arrays. Each micromirror in the array is capable of being independently actuated to rotate to desired angles. In one embodiment, one or two micromirror arrays are controlled to scan a laser beam in two directions. In another embodiment, a micromirror array is controlled to both correct optical aberrations in the laser beam and scan the laser beam in two directions. In yet another embodiment, a micromirror array is controlled to cause the laser beam to be focused to multiple focal spots simultaneously and to scan the multiple focal spot simultaneously. The ophthalmic laser surgery system also includes an ultrashort pulse laser, a laser energy control module, focusing optics and other optics, and a controller for controlling the laser beam scanner and other components of the system.
A61F 9/008 - Methods or devices for eye surgery using laser
G02B 26/08 - Optical devices or arrangements for the control of light using movable or deformable optical elements for controlling the direction of light
G02B 30/50 - Optical systems or apparatus for producing three-dimensional [3D] effects, e.g. stereoscopic images the image being built up from image elements distributed over a 3D volume, e.g. voxels
G02B 27/18 - Optical systems or apparatus not provided for by any of the groups , for optical projection, e.g. combination of mirror and condenser and objective
G02B 27/28 - Optical systems or apparatus not provided for by any of the groups , for polarising
57.
Free floating patient interface for laser surgery system
A patient interface includes an eye interface device, a scanner, a first support assembly, and a beam source. The eye interface device is configured to interface with an eye of a patient. The scanner is configured to be coupled with the eye interface device and operable to scan an electromagnetic radiation beam in at least two dimensions in an eye interfaced with the eye interface device. The scanner and the eye interface device move in conjunction with movement of the eye. The first support assembly supports the scanner so as to accommodate relative movement between the scanner and the first support assembly parallel so as to accommodate movement of the eye. The beam source generates the electromagnetic radiation beam. The electromagnetic radiation beam propagates from the beam source to the scanner along an optical path having an optical path length that varies in response to movement of the eye.
Systems and methods automatically locate optical surfaces of an eye and automatically generate surface models of the optical surfaces. A method includes OCT scanning of an eye. Returning portions of a sample beam are processed to locate a point on the optical surface and first locations on the optical surface within a first radial distance of the point. A first surface model of the optical surface is generated based on the location of the point and the first locations. Returning portions of the sample beam are processed so as to detect second locations on the optical surface beyond the first radial distance and within a second radial distance from the point. A second surface model of the optical surface is generated based on the location of the point on the optical surface and the first and second locations on the optical surface.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/117 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
Apparatus to treat an eye with an ophthalmic laser system comprises a patient interface having an annular retention structure to couple to an anterior surface of the eye. The retention structure is coupled to a suction line to couple the retention structure to the eye with suction. Liquid is added above the eye to act as a transmissive medium. A coupling sensor is coupled to the suction line to determine coupling of the retention structure to the eye. A separate pressure monitoring circuit having a much smaller volume than the suction line is connected to the annular retention structure to measure suction pressure therein. A system processor coupled to the monitoring pressure sensor includes instructions to interrupt firing of a laser when the pressure measured with a monitoring pressure sensor rises above a threshold amount.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61F 9/008 - Methods or devices for eye surgery using laser
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
A61M 1/00 - Suction or pumping devices for medical purposesDevices for carrying-off, for treatment of, or for carrying-over, body-liquidsDrainage systems
60.
Graphical user interface for laser eye surgery system
Methods and systems for planning and forming incisions in a cornea, lens capsule, and/or crystalline lens nucleus are disclosed. A method includes measuring spatial dispositions, relative to a laser surgery system, of at least portions of the corneal anterior and posterior surfaces. A spatial disposition of an incision of the cornea is generated based at least in part on the measured corneal anterior and posterior spatial dispositions and at least one corneal incision parameter. A composite image is displayed that includes an image representative of the measured corneal anterior and posterior surfaces and an image representing the corneal incision.
A61F 9/008 - Methods or devices for eye surgery using laser
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
A61B 34/10 - Computer-aided planning, simulation or modelling of surgical operations
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
61.
OPTICAL IMAGING AND MEASUREMENT SYSTEMS AND METHODS FOR CATARACT SURGERY AND TREATMENT PLANNING
An optical measurement system and apparatus for carrying out cataract diagnostics in an eye of a patient includes a Corneal Topography Subsystem, a wavefront aberrometer subsystem, and an eye structure imaging subsystem, wherein the subsystems have a shared optical axis, and each subsystem is operatively coupled to the others via a controller. The eye structure imaging subsystem is preferably a fourierdomain optical coherence tomographer, and more preferably, a swept source OCT.
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/00 - Apparatus for testing the eyesInstruments for examining the eyes
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/11 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for measuring interpupillary distance or diameter of pupils
A61B 3/117 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
A61B 3/12 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for looking at the eye fundus, e.g. ophthalmoscopes
A61B 3/18 - Arrangement of plural eye-testing or -examining apparatus
In an ophthalmic surgical laser system, a patient interface device for coupling a patient’s eye to the laser system includes a lens cone with a frustoconical shaped shell for coupling to the laser system and a suction ring for coupling to the patient’s eye, the lens cone and the suction ring being either joined together by clamping or formed integrally as one piece. A cap is provided for use with the lens cone as an installation aid. In the configuration supplied to the user, the lens cone is partially embedded in and snapped to the cap. The cap has a portion with a relatively large diameter and multiple ribs for easy handling. The user holds the cap to install the lens cone on the laser system, and pulls the cap to unsnap it from the lens cone. The lens cone is attached to the laser system with a bayonet mount.
In an ophthalmic surgical laser system, a patient interface device for coupling a patient's eye to the laser system includes a lens cone with a frustoconical shaped shell for coupling to the laser system and a suction ring for coupling to the patient's eye, the lens cone and the suction ring being joined together by clamping. A cap is provided for use with the lens cone as an installation aid. In the configuration supplied to the user, the lens cone is partially embedded in and snapped to the cap. The cap has a portion with a relatively large diameter and multiple ribs for easy handling. The user holds the cap to install the lens cone on the laser system, and pulls the cap to unsnap it from the lens cone. The lens cone is attached to the laser system with a bayonet mount that provides tactile feedback to the user.
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
A61F 9/008 - Methods or devices for eye surgery using laser
64.
PATIENT INTERFACE DEVICE FOR OPHTHALMIC SURGICAL LASER SYSTEM EMPLOYING A CAP FOR LENS CONE HANDLING
In an ophthalmic surgical laser system, a patient interface device for coupling a patient's eye to the laser system includes a lens cone with a frustoconical shaped shell for coupling to the laser system and a suction ring for coupling to the patient's eye, the lens cone and the suction ring being joined together by clamping. A cap is provided for use with the lens cone as an installation aid. In the configuration supplied to the user, the lens cone is partially embedded in and snapped to the cap. The cap has a portion with a relatively large diameter and multiple ribs for easy handling. The user holds the cap to install the lens cone on the laser system, and pulls the cap to unsnap it from the lens cone. The lens cone is attached to the laser system with a bayonet mount that provides tactile feedback to the user.
An ophthalmic laser system and related method for forming a lenticular incision in a corneal lenticule extraction procedure. The lenticular incision is formed by multiple sweeps of a laser scan line along meridians of longitude of the lenticular incision, where the end point of each sweep is connected to the start point of the next sweep by a smooth turning trajectory. The trajectory includes a first circular arc tangentially connected to the first sweep at its end point, a second circular arc tangentially connected to the next sweep at its start point, and a straight line segment tangentially connected to both circular arcs. The smooth trajectory is determined with the given limits of velocity, acceleration and jerk of the XY scanning motors, without using high frequency filters to smooth the trajectory, thereby avoiding unknown changes to the original trajectory and achieving high precision lenticule shapes.
An ophthalmic laser system and related method for forming a lenticular incision in a corneal lenticule extraction procedure. The lenticular incision is formed by multiple sweeps of a laser scan line along meridians of longitude of the lenticular incision, where the end point of each sweep is connected to the start point of the next sweep by a smooth turning trajectory. The trajectory includes a first circular arc tangentially connected to the first sweep at its end point, a second circular arc tangentially connected to the next sweep at its start point, and a straight line segment tangentially connected to both circular arcs. The smooth trajectory is determined with the given limits of velocity, acceleration and jerk of the XY scanning motors, without using high frequency filters to smooth the trajectory, thereby avoiding unknown changes to the original trajectory and achieving high precision lenticule shapes.
A ophthalmic laser-assisted corneal lenticule extraction procedure that uses wavefront measurements to guide the formation of the corneal lenticule. The wavefront map measured from a free eye using a wavefront aberrometer is registered to the cornea of a docked eye based on comparisons of iris images and corneal markings. The docked-eye cornea-registered wavefront map is then corrected to be consistent with the Munnerlyn formula for the spherical power, and adjusted for any physician adjustments and/or myopia error due to a flat add in the lenticule, using Zernike polynomials. The corrected and adjusted wavefront map is then used to calculate the profiles of the bottom and top lenticule incisions in the applanated cornea, where higher-order components in the wavefront map are distributed to the bottom lenticule incision alone and lower-order components in the wavefront map are distributed to both the bottom and the top lenticule incision.
A ophthalmic laser-assisted corneal lenticule extraction procedure that uses wavefront measurements to guide the formation of the corneal lenticule. The wavefront map measured from a free eye using a wavefront aberrometer is registered to the cornea of a docked eye based on comparisons of iris images and corneal markings. The docked-eye cornea-registered wavefront map is then corrected to be consistent with the Munnerlyn formula for the spherical power, and adjusted for any physician adjustments and/or myopia error due to a flat add in the lenticule, using Zernike polynomials. The corrected and adjusted wavefront map is then used to calculate the profiles of the bottom and top lenticule incisions in the applanated cornea, where higher-order components in the wavefront map are distributed to the bottom lenticule incision alone and lower-order components in the wavefront map are distributed to both the bottom and the top lenticule incision.
In a cataract procedure, a new geometry of a lens segmentation pattern reduces the required phacoemulsification energy to remove the lens. The lens segmentation process employs a three-dimensional spiral lens segmentation pattern that resembles a spiral staircase or a spiral ramp, to incise a vertical cylindrical volume of the lens into a three-dimensional spiral that can be more easily removed. The segmentation patter is formed by scanning the laser focal spot in a layer by layer manner, each layer including a closed curve corresponding to the outer boundary of the segmentation volume, and a filled area inside the closed curve forming a horizontal step of the spiral staircase. The horizontal steps of vertically adjacent layers are offset by an offset angle, creating the spiral lens segmentation pattern that form a spiral volume.
Apparatus and method for interfacing an ophthalmic surgical laser system with a patient's eye using a single-piece patient interface (PI). The PI includes a hollow shell, with an applanation lens and a flexible skirt at its lower end. Through channels are formed around the applanation lens to connect the spaces above and below the lens. When the PI is coupled to the laser system and the eye, the upper rim of the shell forms a seal with the laser system and the flexible skirt forms a seal with the eye. A vacuum is applied to the interior of the shell via a vacuum port on the laser system, and the vacuum is communicated to the space enclosed by the applanation lens, the skirt and the eye through the channels around the lens. A magnetic mechanism is also provided to hold the PI shell to the laser system.
In a cataract procedure, a new geometry of a lens segmentation pattern reduces the required phacoemulsification energy to remove the lens. The lens segmentation process employs a three-dimensional spiral lens segmentation pattern that resembles a spiral staircase or a spiral ramp, to incise a vertical cylindrical volume of the lens into a three-dimensional spiral that can be more easily removed. The segmentation patter is formed by scanning the laser focal spot in a layer by layer manner, each layer including a closed curve corresponding to the outer boundary of the segmentation volume, and a filled area inside the closed curve forming a horizontal step of the spiral staircase. The horizontal steps of vertically adjacent layers are offset by an offset angle, creating the spiral lens segmentation pattern that form a spiral volume.
Systems and methods automatically locate optical surfaces of an eye and automatically generate surface models of the optical surfaces. A method includes OCT scanning of an eye. Returning portions of a sample beam are processed to locate a point on the optical surface and first locations on the optical surface within a first radial distance of the point. A first surface model of the optical surface is generated based on the location of the point and the first locations. Returning portions of the sample beam are processed so as to detect second locations on the optical surface beyond the first radial distance and within a second radial distance from the point. A second surface model of the optical surface is generated based on the location of the point on the optical surface and the first and second locations on the optical surface.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/117 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for examining the anterior chamber or the anterior chamber angle, e.g. gonioscopes
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
Methods and systems for performing laser-assisted surgery on an eye form one or more small anchoring capsulotomies in the lens capsule of the eye. The one or more anchoring capsulotomies are configured to accommodate corresponding anchoring features of an intraocular lens and/or to accommodate one or more drug-eluting members. A method for performing laser-assisted eye surgery on an eye having a lens capsule includes forming an anchoring capsulotomy in the lens capsule and coupling an anchoring feature of the intraocular lens with the anchoring capsulotomy. The anchoring capsulotomy is formed by using a laser to incise the lens capsule. The anchoring feature can protrude transverse to a surface of the intraocular lens that interfaces with the lens capsule adjacent to the anchoring capsulotomy.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using "fast-scan-slow-sweep" scanning scheme. A high frequency scanner forms a fast scan line, which is placed by the XY and Z scanners at a location tangential to a parallel of latitude of the surface of the lenticule. The XY and Z scanners then move the scan line in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, and a prism is used to change the orientation of the scan line of the high frequency scanner between successive sweeps. In each sweep, within a central area of the lenticule where the sweeps overlap, the laser is periodically blanked (or delivered with significantly reduced pulse energy) to reduce the total energy delivered in that area.
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using “fast-scan-slow-sweep” scanning scheme. A high frequency scanner forms a fast scan line, which is placed by the XY and Z scanners at a location tangential to a parallel of latitude of the surface of the lenticule. The XY and Z scanners then move the scan line in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, and a prism is used to change the orientation of the scan line of the high frequency scanner between successive sweeps. In each sweep, within a central area of the lenticule where the sweeps overlap, the laser is periodically blanked (or delivered with significantly reduced pulse energy) to reduce the total energy delivered in that area.
A measurement apparatus for measuring a laser focus spot size, which includes a two-dimensional image detector and an imaging system which forms a magnified image of a focus spot located an object plane onto the image detector. The imaging system includes at least an objective lens. A sealed liquid container is secured over a part of the objective lens such as the optical surface of the objective lens is immersed in the liquid (e.g. water) within the container. The liquid container has a window through which the laser beam enters. An image processing method is also disclosed which processes the image obtained by the image detector to obtain the focus spot size while implementing an algorithm that corrects for the effect of ambient vibration.
A photo detector is selectively coupled to a first integrator or a second integrator with switching circuitry when the laser pulses. An integration time of the signal from the photo detector can be substantially greater than an amount of time between successive laser beam pulses in order to provide an accurate measurement of each laser beam pulse of a high repetition rate pulsed laser. The laser may comprise a clock coupled to an optical switch of the laser system, and control circuitry can control switching and coupling of the detector to the first integrator or the second integrator in response to the clock signal. The first integrator and the second integrator can be selectively coupled to an output such that the first integrator or the second integrator is coupled to the output of the energy detection circuitry when the other integrator is coupled to the detector.
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using "fast-scan-slow-sweep" scanning scheme. A high frequency scanner forms a fast scan line, which is placed tangential to a parallel of latitude of the surface of the lenticule and then then moved in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, with the orientation of the scan line rotated between successive sweeps. To generate tissue bridge free incisions without leaving laser-induced marks in the eye, a laser pulse energy between 40 nJ to 70 nJ is used, and the sweeping speed is controlled such that the scan line step (the distance between the centers of consecutive scan lines) is between 1.7 µm and 2.3 µm.
An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using “fast-scan-slow-sweep” scanning scheme. A high frequency scanner forms a fast scan line, which is placed tangential to a parallel of latitude of the surface of the lenticule and then then moved in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, with the orientation of the scan line rotated between successive sweeps. To generate tissue bridge free incisions without leaving laser-induced marks in the eye, a laser pulse energy between 40 nJ to 70 nJ is used, and the sweeping speed is controlled such that the scan line step (the distance between the centers of consecutive scan lines) is between 1.7 μm and 2.3 μm.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 18/20 - Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
80.
Liquid optical interface for laser eye surgery system
Apparatus to treat an eye comprises an annular retention structure to couple to an anterior surface of the eye. The retention structure is coupled to a suction line to couple the retention structure to the eye with suction. A coupling sensor is coupled to the retention structure or the suction line to determine coupling of the retention structure to the eye. A fluid collecting container can be coupled to the retention structure to receive and collect liquid or viscous material from the retention structure. A fluid stop comprising a porous structure can be coupled to an outlet of the fluid collecting container to inhibit passage of the liquid or viscous material when the container has received an amount of the liquid or viscous material. The coupling sensor can be coupled upstream of the porous structure to provide a rapid measurement of the coupling of the retention structure to the eye.
A61F 9/008 - Methods or devices for eye surgery using laser
A61F 9/009 - Auxiliary devices for making contact with the eyeball and coupling-in laser light
A61M 1/00 - Suction or pumping devices for medical purposesDevices for carrying-off, for treatment of, or for carrying-over, body-liquidsDrainage systems
81.
PATIENT INTERFACE FOR OPHTHALMIC LASER SURGERY EMPLOYING SCLERAL SUPPORT STRUCTURES TO REDUCE INTRAOCULAR PRESSURE
A patient interface device for an ophthalmic surgical laser system includes a lens cone component for coupling to the laser system and a suction ring component for coupling to the patient's eye. The suction ring includes a gripper with an opening for receiving and retaining the lens cone, and a flexible skirt joined to the gripper for coupling to the eye with a vacuum force. The flexible skirt includes a circular inner edge and a circular outer edge for contacting the eye surface, and a plurality of circumferentially distributed scleral support protrusions protruding from a circumferential side wall. The end surface of the scleral support protrusions are sloped in a side cross-sectional view. The scleral support protrusions have a length to width ratio from 1.1 to 2.1, and an arc-angle ratio of the scleral support protrusions to the gaps between them is from 2.2 to 3.0. The scleral support protrusions contact the surface of the eye when the skirt is docked to the eye, which minimize intraocular pressure increase due to docking and applanation while still achieving a good vacuum seal between the suction ring and the eye. The scleral support protrusions function to prevent major deformation of the sclera when the cornea is applanated.
In a laser cataract procedure that also corrects for astigmatism, an iris registration method compares an iris image of a patient's eye taken when the eye is not docked to a patient interface device with an iris image of the same eye that is docked to the patient interface, to calculate a rotation angle between the two images. The astigmatism axis of the eye is measured when the eye is not docked, and the measured axis is rotated by the calculated rotation angle to obtain a rotated astigmatism axis relative to the iris image of the docked eye. The laser cataract procedure is performed based on the rotated astigmatism axis. The rotation angle is calculated by optimizing a transformation that transforms the undocked iris image to match the docked iris image, where the transformation includes a dilation factor that accounts for different pupil dilation of the two iris images.
A61F 9/008 - Methods or devices for eye surgery using laser
G06T 3/4084 - Scaling of whole images or parts thereof, e.g. expanding or contracting in the transform domain, e.g. fast Fourier transform [FFT] domain scaling
G16H 30/40 - ICT specially adapted for the handling or processing of medical images for processing medical images, e.g. editing
83.
Patient interface for ophthalmic laser surgery employing scleral support structures to reduce intraocular pressure
A patient interface device for an ophthalmic surgical laser system includes a lens cone component for coupling to the laser system and a suction ring component for coupling to the patient's eye. The suction ring includes a gripper with an opening for receiving and retaining the lens cone, and a flexible skirt joined to the gripper for coupling to the eye with a vacuum force. The flexible skirt includes a circular inner edge and a circular outer edge for contacting the eye surface, and a plurality of circumferentially distributed scleral support protrusions protruding from a circumferential side wall. The end surface of the scleral support protrusions are sloped in a side cross-sectional view. The scleral support protrusions have a length to width ratio from 1.1 to 2.1, and an arc-angle ratio of the scleral support protrusions to the gaps between them is from 2.2 to 3.0. The scleral support protrusions contact the surface of the eye when the skirt is docked to the eye, which minimize intraocular pressure increase due to docking and applanation while still achieving a good vacuum seal between the suction ring and the eye. The scleral support protrusions function to prevent major deformation of the sclera when the cornea is applanated.
An ophthalmic surgical laser system includes: a laser that produces a pulsed laser beam having a pulse energy and pulse repetition rate; a high frequency fast scanner; an XY-scan device; a Z-scan device; and a controller. The controller controls the high frequency scanner to produce a scan line having a scan width; controls the XY-scan device and the Z-scan device to carry out of first sweep of the scan line in a first sweep direction and to carry out a second sweep of the scan line in a second sweep direction that is not parallel to the first sweep direction thereby defining an overlap region. At least one of the pulse energy, repetition rate, XY-scan speed, and the scan width is varied so as to accelerate the cutting speed and reduce the exposure of ophthalmic tissue in the overlap region to multiple exposures of laser pulses configured to modify ophthalmic tissue.
Methods and related apparatus for real-time process monitoring during laser-based refractive index modification of an intraocular lens. During in situ laser treatment of the IOL to modify the refractive index of the IOL material, a signal from the IOL is measured to determine the processing effect of the refractive index modification, and based on the determination, to adjust the laser system parameters to achieve intended processing result. The signal measured from the IOL may be a fluorescent signal induced by the treatment laser, a fluorescent signal induced by an external illumination source, a temporary photodarkening effect, a color change, or a refractive index change directly measured by phase stabilized OCT.
During a process of refractive index modification of an intraocular lens (IOL) using an ophthalmic laser system, optical position monitoring of the IOL is performed by a video camera system viewing the top surface of the IOL. Fiducials are incorporated into the IOL at manufacture, or created in-vivo with laser. The monitoring method employs a defined area of interest (AOI) to limit the number of pixels to be analyzed, to achieve adequately high acquisition speed. In one example, the AOI contains 5 camera scan line segments, each line segment having sufficient pixels to create a stable amplitude signature. Successive frames of the AOI are analyzed to detect movement of the fiducial and/or to determine whether the fiducial has been lost.
Embodiments of this invention generally relate to ophthalmic laser procedures and, more particularly, to systems and methods for lenticular laser incision. In an embodiment, an ophthalmic surgical laser system comprises a laser delivery system for delivering a pulsed laser beam to a target in a subject's eye, an XY-scan device to deflect the pulsed laser beam, a Z-scan device to modify a depth of a focus of the pulsed laser beam, and a controller configured to form a top lenticular incision and a bottom lenticular incision of a lens in the subject's eye, or just a bottom lenticular incision.
An imaging system includes an eye interface device, a scanning assembly, a beam source, a free-floating mechanism, and a detection assembly. The eye interface device interfaces with an eye. The scanning assembly supports the eye interface device and scans a focal point of an electromagnetic radiation beam within the eye. The beam source generates the electromagnetic radiation beam. The free-floating mechanism supports the scanning assembly and accommodates movement of the eye and provides a variable optical path for the electronic radiation beam and a portion of the electronic radiation beam reflected from the focal point location. The variable optical path is disposed between the beam source and the scanner and has an optical path length that varies to accommodate movement of the eye. The detection assembly generates a signal indicative of intensity of a portion of the electromagnetic radiation beam reflected from the focal point location.
A full depth ophthalmic surgical system includes a femtosecond laser source and an optical coherence tomographer. The system is capable of performing surgical procedures along the entire length of the eye from the cornea to the retina. The optical system of the ophthalmic surgical system is optimized to focus the laser beam and imaging light in the vitreous humor of the eye. In some embodiments, the system includes a video camera with a tunable lens before it to image the entire length of the eye. For procedures performed posterior to the lens, a method for calibrating the full depth ophthalmic surgical system is also provided. The system can be used to perform treatment in the vitreous humor, including treating floaters and liquification of the vitreous humor.
A counterbalance mechanism in an ophthalmic laser system balances the weight of the laser beam delivery head and provides small, precise and repeatable variations in the net load exerted by the laser head on the patient's eye over a defined distance of travel. The counterbalance mechanism includes a balance beam pivotably mounted on a support block, with the laser head and a counterweight mounted on its two ends. The counterweight is movable along the balance beam via a linear motion bearing. A mechanical link links the counterweight to the support block; the link has a predefined length and is pivotable around its respective connection points on the support block and the counterweight. When the balance beam pivots, the link causes the counterweight to move along the balance beam, thereby changing the mechanical advantage of the counterweight and varies the counterbalancing force to provide variations in the net load.
A fiducial is generated on an internal anatomical structure of the eye of a patient with a surgical laser. A toric artificial intraocular lens (IOL) is positioned so that a marker of the toric IOL is in a predetermined positional relationship relative to the fiducial. This positioning aligns the toric IOL with the astigmatic or other axis of the eye. The toric IOL is then implanted in the eye of the patient with high accuracy.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 90/00 - Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups , e.g. for luxation treatment or for protecting wound edges
A61B 90/20 - Surgical microscopes characterised by non-optical aspects
A counterbalance mechanism in an ophthalmic laser system balances the weight of the laser beam delivery head and provides small, precise and repeatable variations in the net load exerted by the laser head on the patient's eye over a defined distance of travel. The counterbalance mechanism includes a balance beam pivotably mounted on a support block, with the laser head and a counterweight mounted on its two ends. The counterweight is movable along the balance beam via a linear motion bearing. A mechanical link links the counterweight to the support block; the link has a predefined length and is pivotable around its respective connection points on the support block and the counterweight. When the balance beam pivots, the link causes the counterweight to move along the balance beam, thereby changing the mechanical advantage of the counterweight and varies the counterbalancing force to provide variations in the net load.
A laser eye surgery system includes a laser source, a ranging subsystem, an integrated optical subsystem, and a patient interface assembly. The laser source produces a treatment beam that includes a plurality of laser pulses. The ranging subsystem produces a source beam used to locate one or more structures of an eye. The ranging subsystem includes an optical coherence tomography (OCT) pickoff assembly that includes a first optical wedge and a second optical wedge separated from the first optical wedge. The OCT pickoff assembly is configured to divide an OCT source beam into a sample beam and a reference beam. The integrated optical subsystem is used to scan the treatment beam and the sample beam. The patient interface assembly couples the eye with the integrated optical subsystem so as to constrain the eye relative to the integrated optical subsystem.
Methods and apparatus are configures to measure an eye without contacting the eye with a patient interface, and these measurements are used to determine alignment and placement of the incisions when the patient interface contacts the eye. The pre-contact locations of one or more structures of the eye can be used to determine corresponding post-contact locations of the one or more optical structures of the eye when the patient interface has contacted the eye, such that the laser incisions are placed at locations that promote normal vision of the eye. The incisions are positioned in relation to the pre-contact optical structures of the eye, such as an astigmatic treatment axis, nodal points of the eye, and visual axis of the eye.
A61F 9/008 - Methods or devices for eye surgery using laser
A61B 3/107 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions for determining the shape or measuring the curvature of the cornea
A61B 3/10 - Objective types, i.e. instruments for examining the eyes independent of the patients perceptions or reactions
A61B 5/00 - Measuring for diagnostic purposes Identification of persons
95.
Lasik flap cutting patterns including bubble barrier layer in side cut for bubble management
A method implemented in an ophthalmic surgical laser system for forming a corneal flap in a patient's eye with improved bubble management. The flap includes a horizontal bed and a vertical or near vertical side cut around the periphery of the bed except for an uncut hinge area. The side cut has a bubble barrier layer that can prevent bubbles formed by the laser-tissue interaction from escaping into an interface between the corneal and the patient interface lens. In some embodiments, the bubble barrier layer is a thin uncut layer, located in the epithelium of the cornea, that separates the side cut into two portions. In other embodiments, the side cut does not reach the anterior corneal surface, leaving an uncut bubble barrier layer located with the epithelium. In other embodiments, an additional side cut portion is formed through the uncut bubble barrier layer as the last step.
A laser eye surgery system includes a laser to generate a laser beam. A spatial measurement system generates a measurement beam and measure a spatial disposition of an eye. A processor is coupled to the laser and the spatial measurement system, the processor comprising a tangible medium embodying instructions to determine a spatial model of the eye in an eye coordinate reference system based on the measurement beam. The spatial model is mapped from the eye coordinate reference system to a machine coordinate reference system. A laser fragmentation pattern is determined based on a plurality of laser fragmentation parameters. The laser fragmentation pattern and the spatial model is rotated by a first rotation angle such that the spatial model is aligned with the reference axis of the machine coordinate reference system and the rotated laser fragmentation pattern is aligned with the corneal incision.
A patient interface device for an ophthalmic surgical laser system includes a lens cone component for coupling to the laser system and a suction ring component having a flexible skirt for coupling to the patient's eye. The suction ring component includes a gripper integrated with the flexible skirt, formed of hard plastic material and having two jaws that face each other to define a receiving opening between them. During use, a base portion of the lens cone is inserted into the receiving opening of the gripper and retained by the clamping force of the jaws. To ensure that the gripper securely retains the lens cone, a soft thermoplastic elastomer material is provided on the outer surface of the base portion of the lens cone, and the inner surfaces of the jaws of the gripper are provided with teeth to engage the soft thermoplastic elastomer material of the lens cone.
A patient interface device for an ophthalmic surgical laser system includes a lens cone component for coupling to the laser system and a suction ring component having a flexible skirt for coupling to the patient's eye. The suction ring component includes a gripper integrated with the flexible skirt, formed of hard plastic material and having two jaws that face each other to define a receiving opening between them. During use, a base portion of the lens cone is inserted into the receiving opening of the gripper and retained by the clamping force of the jaws. To ensure that the gripper securely retains the lens cone, a soft thermoplastic elastomer material is provided on the outer surface of the base portion of the lens cone, and the inner surfaces of the jaws of the gripper are provided with teeth to engage the soft thermoplastic elastomer material of the lens cone.
A method and apparatus for performing ophthalmic laser surgery using a pulsed laser beam is provided. The method includes establishing an initial cutting pattern comprising a plurality of original photodisruption points, establishing an enhanced cutting pattern comprising a plurality of enhanced photodisruption points selected to decrease potential adverse effects due to patient movement and having increased density over a fixed area as compared with the plurality of original photodisruption points, and performing an ocular surgical procedure according to the enhanced cutting pattern Enhanced cutting patterns may include circular cuts around the periphery of a capsule, vertical side cuts for lens fragmentation, raster lamellar cuts, and grid lamellar cuts. Each photodisruption point in the initial cutting pattern and the enhanced cutting pattern comprises a laser target point.
A61F 9/00 - Methods or devices for treatment of the eyesDevices for putting in contact-lensesDevices to correct squintingApparatus to guide the blindProtective devices for the eyes, carried on the body or in the hand
A61F 9/008 - Methods or devices for eye surgery using laser
