Combination of excimer laser ablation and femtosecond laser technology

• US 20110202045A1
• Filed: 01/28/2011
• Published: 08/18/2011
• Est. Priority Date: 08/01/2008
• Status: Active Grant

• Current Assignee: Gerhard Youssefi
• Original Assignee: Gerhard Youssefi
• Inventors: Youssefi, Gerhard
• Granted Patent: US 8,556,886 B2
• Time in Patent Office: Days
• US Class Current: 606/4
• CPC Class Codes: A61F 2009/00857 considering biodynamics
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/0088 based on wavefront
• CPC Class Codes: A61F 2009/00882 based on topography
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00804 Refractive treatments
• CPC Class Codes: A61F 9/00829 Correction of higher orders

Abstract

The invention relates to an apparatus and a method for providing data for vision correction utilizing a volumetric ablation and an intrastromal manipulation. The provided data may be used by a laser ablating the surface of the cornea in combination with a laser which operates intrastromal to optimize a corneal re-shaping procedure. One aspects of the invention relates to the minimization of the amount of corneal tissue to be removed.

Claims

1. A method for providing data for vision correction utilizing a volumetric ablation and an intrastromal manipulation, comprising:

providing diagnostic data representing a refractive error of a cornea of an eye;

calculating at least one volumetric ablation profile based on the diagnostic data;

calculating of at least one intrastromal manipulation based on the diagnostic data; and

selecting at least one volumetric ablation profile and at least one intrastromal manipulation to optimize a combined treatment of a volumetric ablation and an intrastromal manipulation to correct said refractive error.

2. The method of claim 1, wherein the combined treatment is optimized by selecting a specific ablation profile and a corresponding intrastromal manipulation such that the amount of corneal tissue to be ablated by volumetric ablation is minimized.

3. The method of claim 1, wherein the combined treatment is optimized such that the intrastromal manipulation is selected based on a given set of desired corrections.

4. The method of claim 1, wherein the intrastromal manipulation causes a bio-dynamic shape change of at least a portion of the cornea.

5. The method of claim 1, wherein the intrastromal manipulations at least partially flatten the cornea.

6. The method of claim 1, wherein the volumetric ablation compensates for low order aberrations, preferably up to the second order.

7. The method of claim 1, wherein the intrastromal manipulations compensate for high order aberrations, preferably from the third order.

8. The method of claim 1, wherein the intrastromal manipulation is a disruption.

9. The method of claim 1, wherein the intrastromal manipulation is formed with a femtosecond laser.

10. The method of claim 1, wherein calculating said at least one intrastromal manipulation comprises determining the location and/or length, width and depth of the manipulation.

11. The method of claim 1, wherein at least one of the intrastromal manipulations is located outside the dark adapted pupil.

12. The method of claim 1, wherein the volumetric ablation is located at least partially within the dark adapted pupil.

13. The method of claim 1, wherein the at least one intrastromal manipulation at least compensates for induced refractive errors caused by the volumetric ablation.

14. The method of claim 1, wherein the diagnostic data comprises a refractive error obtained by subjective patient information and/or a wavefront measurement and/or a topographic measurement.

15. The method of claim 1, wherein the volumetric ablation is an excimer laser ablation.

16. The method of claim 1, further comprising the step of controlling a laser apparatus responsive to the provided data for vision correction.

17. The method of claim 1, further comprising the step of controlling an excimer laser responsive to the calculated volumetric ablation profile and controlling a femtosecond laser responsive to the at least one calculated intrastromal manipulation.

18. A system for providing data for vision correction utilizing a volumetric ablation and an intrastromal manipulation, comprising:

first computer software receiving diagnostic data representing a refractive error of a cornea of an eye;

second computer software calculating at least one volumetric ablation profile based on said diagnostic data;

third computer software calculating at least one intrastromal manipulation based on said diagnostic data; and

fourth computer software selecting at least one volumetric ablation profile and at least one intrastromal manipulation to optimize a combined treatment of a volumetric ablation and an intrastromal manipulation to correct said refractive error.

19. The system of claim 18, wherein the combined treatment is optimized by selecting a specific ablation profile and a corresponding intrastromal manipulation such that the amount of corneal tissue to be ablated by volumetric ablation is minimized.

20. The system of claim 18, wherein the combined treatment is optimized such that the intrastromal manipulation is selected based on a given set of desired corrections.

21. The system of claim 18, wherein the intrastromal manipulation causes a bio-dynamic shape change of at least a portion of the cornea.

22. The system of claim 18, wherein the intrastromal manipulations at least partially flatten the cornea.

23. The system of claim 18, wherein the volumetric ablation compensates for low order aberrations, preferably up to the second order.

24. The system of claim 18, wherein the intrastromal manipulations compensate for high order aberrations, preferably from the third order.

25. The system of claim 18, wherein the intrastromal manipulation is a disruption.

26. The system of claim 18, wherein the intrastromal manipulation is formed with a femtosecond laser.

27. The system of claim 18, wherein calculating said at least one intrastromal manipulation comprises determining the location and/or length, width and depth of the manipulation.

28. The system of claim 18, wherein at least one of the intrastromal manipulations is located outside the dark adapted pupil.

29. The system of claim 18, wherein the volumetric ablation is located at least partially within the dark adapted pupil.

30. The system of claim 18, wherein the at least one intrastromal manipulation at least compensates for induced refractive errors caused by the volumetric ablation.

31. The system of claim 18, wherein the diagnostic data comprises a refractive error obtained by subjective patient information and/or a wavefront measurement and/or a topographic measurement.

32. The system of claim 18, wherein the volumetric ablation is an excimer laser ablation.

33. The system of claim 18, further comprising the step of controlling a laser apparatus responsive to the provided data for vision correction.

34. The system of claim 18, further comprising the step of controlling an excimer laser responsive to the calculated volumetric ablation profile and controlling a femtosecond laser responsive to the at least one calculated intrastromal manipulation.

35. The system of claim 18, further comprising a laser treatment system with an excimer laser, and a femtosecond laser.

36. One or more processor readable storage devices having processor readable code embodied on said processor readable storage devices, said processor readable code for programming one or more processors to execute a method for providing data for vision correction utilizing a volumetric ablation and an intrastromal manipulation, comprising:

providing diagnostic data representing a refractive error of a cornea of an eye;

calculating at least one volumetric ablation profile based on the diagnostic data;

calculating of at least one intrastromal manipulation based on the diagnostic data; and

selecting at least one volumetric ablation profile and at least one intrastromal manipulation to optimize a combined treatment of a volumetric ablation and an intrastromal manipulation to correct said refractive error.

37. The processor readable storage device of claim 36, wherein the combined treatment is optimized by selecting a specific ablation profile and a corresponding intrastromal manipulation such that the amount of corneal tissue to be ablated by volumetric ablation is minimized.

38. The processor readable storage device of claim 36, wherein the combined treatment is optimized such that the intrastromal manipulation is selected based on a given set of desired corrections.

39. The processor readable storage device of claim 36, wherein the intrastromal manipulation causes a bio-dynamic shape change of at least a portion of the cornea.

40. The processor readable storage device of claim 36, wherein the intrastromal manipulations at least partially flatten the cornea.

41. The processor readable storage device of claim 36, wherein the volumetric ablation compensates for low order aberrations, preferably up to the second order.

42. The processor readable storage device of claim 36, wherein the intrastromal manipulations compensate for high order aberrations, preferably from the third order.

43. The processor readable storage device of claim 36, wherein the intrastromal manipulation is a disruption.

44. The processor readable storage device of claim 36, wherein the intrastromal manipulation is formed with a femtosecond laser.

45. The processor readable storage device of claim 36, wherein calculating said at least one intrastromal manipulation comprises determining the location and/or length, width and depth of the manipulation.

46. The processor readable storage device of claim 36, wherein at least one of the intrastromal manipulations is located outside the dark adapted pupil.

47. The processor readable storage device of claim 36, wherein the volumetric ablation is located at least partially within the dark adapted pupil.

48. The processor readable storage device of claim 36, wherein the at least one intrastromal manipulation at least compensates for induced refractive errors caused by the volumetric ablation.

49. The processor readable storage device of claim 36, wherein the diagnostic data comprises a refractive error obtained by subjective patient information and/or a wavefront measurement and/or a topographic measurement.

50. The processor readable storage device of claim 36, wherein the volumetric ablation is an excimer laser ablation.

51. The processor readable storage device of claim 36, further comprising the step of controlling a laser apparatus responsive to the provided data for vision correction.

52. The processor readable storage device of claim 36, further comprising the step of controlling an excimer laser responsive to the calculated volumetric ablation profile and controlling a femtosecond laser responsive to the at least one calculated intrastromal manipulation.