System and Method for Performing Lens Fragmentation

• US 20120259320A1
• Filed: 03/30/2012
• Published: 10/11/2012
• Est. Priority Date: 04/07/2011
• Status: Active Grant

• Current Assignee: Bausch & Lomb Incorporated (Bausch Health Cos., Inc.), Technolas Perfect Vision GMBH (Bausch Health Cos., Inc.)
• Original Assignee: Bausch & Lomb Incorporated (Bausch Health Cos., Inc.)
• Inventors: Loesel, Frieder, Kandulla, Jochen, Moritz, Friedrich, Youssefi, Gerhard, Mordaunt, David Haydn, Mosedale, Gwillem, Schlueter, Holger, Toennies, Roland
• Granted Patent: US 10,716,706 B2
• Time in Patent Office: Days
• US Class Current: 606/5
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 9/00825 for photodisruption

Abstract

A system and method are provided for fragmenting a crystalline lens, to facilitate its removal from the lens bag during an ophthalmic laser surgery. First, a predetermined pattern is used to make Laser Induced Optical Breakdown (LIOB) cuts that section the lens into asymmetrical, operational segments. At least one operational segment is then selected and softened with a plurality of compact LIOB cuts. Once softened, the selected segment is aspirated. The remaining operational segments are then subsequently removed. During a procedure, an imaging unit can monitor movements of the lens bag to ensure proper placement of the LIOB cuts on the lens.

Claims

1. A method for preparing the lens of an eye for removal from a lens bag during ophthalmic surgery, the method comprising the steps of:

sectioning the lens into a plurality of operational segments with Laser Induced Optical Breakdown (LIOB) cuts into the lens;

selecting at least one operational segment; and

creating compact LIOB cuts on tissue in the selected segment to soften lens tissue in the selected segment.

2. A method as recited in claim 1 wherein the selected segment is less than one third of the lens, by volume, and extends from a center of the lens to an edge of the lens between an anterior surface and a posterior surface of the lens.

3. A method as recited in claim 1 further comprising the steps of:

providing a computer for guiding a focal point of a laser beam in a predetermined pattern during the sectioning step, and for guiding the focal point in a defined pattern during the creating step;

imaging the lens of the eye prior to the creating step to establish an initial image of the lens;

producing an actual image of the lens in real-time during the creating step; and

using the computer to compare the initial image of the lens with the actual image of the lens to identify a difference therebetween, wherein the computer uses the difference to guide the focal point of the laser beam to compensate for the difference.

4. A method as recited in claim 3 wherein the imaging step is accomplished with a device having an imaging capability selected from a group comprising confocal microscopy, Optical Coherence Tomography (OCT) imaging, second-harmonic imaging, video imaging, still photo imaging and Scheimpflug imaging.

5. A method as recited in claim 1 further comprising the steps of:

aspirating, in sequence, softened lens tissue in the selected segment, and un-softened tissue in the operational segments outside the selected segment;

moving the lens in the lens bag during the aspirating step to facilitate the aspiration of tissue from the lens bag; and

irrigating the lens bag during the aspirating step.

6. A method as recited in claim 5 wherein the aspirating step, the irrigating step, and the moving step are accomplished robotically with input commands entered into a robotic interface device connected to the computer.

7. A method as recited in claim 6 wherein the aspirating step is accomplished using an aspirator, the irrigating step is accomplished by an irrigator, and the moving step is accomplished by a probe, wherein the aspirator, the irrigator, and the probe are electronically connected to the computer and are responsive to input commands entered into the robotic interface device.

8. A method as recited in claim 6 wherein the moving step comprises the steps of:

inserting the probe into the lens bag; and

turning the lens inside the lens bag with the probe to reposition the lens therein for aspiration of lens tissue therefrom.

9. A method as recited in claim 1 wherein each operational segment is a quadrant of the lens.

10. A method as recited in claim 1 wherein the lens defines an axis, and the LIOB cuts from the sectioning step are selected from a group comprising radial cuts extending outwardly from the axis and ring cuts substantially centered on the axis.

11. A method as recited in claim 10 wherein the compact LIOB cuts are performed in the selected segment and are selected from a group consisting of line cuts, cube cuts, statistically arbitrary cuts, sphere-like cuts, wave cuts, polygonal cuts, radial cuts, arc cuts and combinations thereof.

12. A method as recited in claim 11 wherein selection of compact LIOB cuts is accomplished based on size, shape and optical characteristics of the lens.

13. A method as recited in claim 10 further comprising the step of creating at least one disk layer cut into the lens tissue, wherein the disk layer cut is substantially perpendicular to the axis.

14. A method for preparing the lens of an eye for removal from a lens bag during ophthalmic surgery, the method comprising the steps of:

sectioning the lens into a plurality of operational segments using a predetermined pattern of Laser Induced Optical Breakdown (LIOB) cuts wherein each operational segment is greater than 5% and less than 40% of the lens, by volume; and

creating compact LIOB cuts in a defined pattern on tissue within a selected segment of the lens to soften lens tissue in the selected segment for removal from the lens bag, wherein the selected segment includes at least one operational segment.

15. A method as recited in claim 14 wherein the lens defines an axis and the predetermined pattern of LIOB cuts is selected from a group comprising perforations, radial cuts extending outwardly from the axis, and ring cuts substantially centered on the axis, and the defined pattern of compact LIOB cuts is selected from a group consisting of line cuts, cube cuts, statistically arbitrary cuts, sphere-like cuts, wave cuts, polygonal cuts, radial cuts, arc cuts and combinations thereof.

16. A system for preparing a lens of an eye for removal from a lens bag during ophthalmic surgery, the system comprising:

a laser unit for generating a pulsed laser beam; and

a computer electronically connected to the laser unit, wherein the computer guides a focal point of the laser beam in a predetermined pattern to section the lens into a plurality of operational segments with a plurality of Laser Induced Optical Breakdown (LIOB) cuts, and in a defined pattern to create compact LIOB cuts on tissue in a selected segment of the lens to soften lens tissue in the selected segment.

17. A system as recited in claim 16 further comprising:

an imaging unit connected to the computer for creating an initial image of the lens prior to sectioning the lens and an actual image of the lens in real-time during the creation of compact LIOB cuts in the lens; and

a data transfer line connecting the imaging unit to the computer for sending the initial image to the computer for use in selecting an appropriate predetermined pattern and an appropriate defined pattern and for sending the actual image of the eye to the computer for use in identifying a difference between the initial image and the actual image, wherein the difference is used by the computer to guide the focal point to minimize the difference.

18. A system as recited in claim 16 wherein selection of the predetermined pattern and selection of the defined pattern are accomplished according to size, shape and optical characteristics of the lens, and wherein the lens defines an axis and the predetermined pattern of base-level LIOB cuts is selected from a group comprising perforations, radial cuts extending outwardly from the axis, and ring cuts substantially centered on the axis, and the defined pattern of compact LIOB cuts is selected from a group consisting of line cuts, cube cuts, statistically arbitrary cuts, sphere-like cuts, wave cuts, polygonal cuts, radial cuts, arc cuts and combinations thereof.

19. A system as recited in claim 16 further comprising:

an aspirator for aspirating lens tissue from the lens bag; and

an irrigator for irrigating the lens bag during the aspiration of lens tissue therefrom.

20. A system as recited in claim 19 further comprising a probe for moving the lens in the lens bag during the aspiration of lens tissue from the lens bag, wherein the aspirator, the irrigator and the probe are selectively operated robotically in response to input commands entered into a robotic interface device connected to the computer.

21. A computer program product for using a laser beam to prepare a transparent material for removal from a bag, wherein the computer program product comprises program sections for respectively:

using the laser beam to create an opening in the bag;

sectioning the transparent material, in situ, into a plurality of operational segments, with Laser Induced Optical Breakdown (LIOB) cuts into the transparent material;

selecting at least one asymmetrically oriented operational segment of the transparent material;

creating compact LIOB cuts into the selected segment to soften transparent material in the selected segment;

removing the softened selected segment from the bag; and

removing any remaining operational segments from the bag.