METHODS AND SYSTEMS FOR PERFORMING A POSTERIOR CAPSULOTOMY AND FOR LASER EYE SURGERY WITH A PENETRATED CORNEA

• US 20140074074A1
• Filed: 09/06/2013
• Published: 03/13/2014
• Est. Priority Date: 09/07/2012
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Scott, David, Dick, H. Burkhard
• Granted Patent: US 10,143,590 B2
• Time in Patent Office: Days
• US Class Current: 606/6
• CPC Class Codes: A61F 2009/00844 Feedback systems
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00889 Capsulotomy
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/009 Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses apparatus for eye examination A61B3/0008

Abstract

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.

Claims

1. A method for performing laser-assisted cataract surgery on an eye having a lens posterior capsule and an anterior hyaloid membrane, the method comprising:

injecting fluid between the lens posterior capsule and the anterior hyaloid membrane to separate the lens posterior capsule and the anterior hyaloid membrane; and

with the lens posterior capsule separated from the anterior hyaloid membrane, performing a posterior capsulotomy on the lens posterior capsule by using a laser to incise the lens posterior capsule.

2. The method of claim 1, wherein the fluid is injected into the Berger'"'"'s space.

3. The method of claim 1, wherein the fluid is an ophthalmic viscosurgical device (OVD).

4. The method of claim 1, wherein the posterior capsulotomy leaves the anterior hyaloid membrane completely intact.

5. The method of claim 1, wherein the posterior capsulotomy is performed using an incision depth between 400 μ

m and 800 μ

m.

6. The method of claim 1, wherein the posterior capsulotomy is performed using a pulse energy between 7 μ

J and 10 μ

J.

7. The method of claim 1, wherein the posterior capsulotomy is performed using a capsulotomy diameter of at least 3.5 mm.

8. The method of claim 1, further comprising installing a replacement lens so that the replacement lens is at least partially constrained by the lens capsule.

9. The method of claim 8, wherein the replacement lens is installed using a posterior optic buttonholing technique.

10. The method of claim 8, wherein the replacement lens is installed using a bag-in-lens technique.

11. The method of claim 1, further comprising:

performing an anterior capsulotomy on the lens capsule by using a laser to incise the lens capsule; and

removing at least a portion of the lens nucleus.

12. A method for performing laser eye surgery on an eye having a cornea, the method comprising:

coupling an eye having a penetration through the cornea to a laser surgery system by using a liquid interface disposed between the cornea and the laser surgery system; and

forming one or more incisions in the eye by using the laser surgery system to transmit light through the liquid interface.

13. The method of claim 12, further comprising forming the penetration through the cornea.

14. The method of claim 12, further comprising inserting an iris expanding device through the penetration in the cornea.

15. A system for performing laser-assisted cataract surgery on an eye having an anterior chamber, the system comprising:

a laser configured to generate a laser beam comprising a plurality of laser pulses;

a scanning assembly configured to scan a focal point of the laser beam within the eye to incise eye tissue; and

a controller configured to scan the focal point to incise eye tissue so as to account for at least one optical characteristic of an OVD in the anterior chamber to determine one or more control parameters used to control scanning of the focal point.

16. The system of claim 15, further comprising an imaging device configured to generate output in response to imaging the eye, wherein the controller is configured to process output from the imaging device to determine dimensional attributes of the anterior chamber and use the dimensional attributes of the anterior chamber in conjunction with an index of refraction for the OVD disposed in the anterior chamber to operate the scanning assembly to scan the focal point to incise eye tissue so as to account for the at least one optical characteristic of the OVD.

17. A method for performing laser-assisted cataract surgery on an eye having an anterior chamber, the method comprising:

generating a laser beam comprising a plurality of pulses; and

scanning a focal point of the laser beam within the eye to incise tissue of the eye disposed posterior to the anterior chamber so as to account for at least one optical characteristic of an OVD disposed in the anterior chamber to determine one or more control parameters used to control scanning of the focal point.

18. The method of claim 17, wherein the OVD has an index of refraction and the accounted for at least one optical characteristic of the OVD includes the index of refraction.

19. The method of claim 18, further comprising:

processing output from an imaging device to determine dimensional attributes of the anterior chamber; and

using the dimensional attributes of the anterior chamber in conjunction with the index of refraction of the OVD to operate the scanning assembly to scan the focal point to incise eye tissue so as to account for the at least one optical characteristic of the OVD.

20. A method for performing a laser-assisted posterior capsulotomy on a lens posterior capsule of an eye, the method comprising:

injecting fluid between a replacement lens and the lens posterior capsule to separate the lens posterior capsule and the replacement lens; and

performing a posterior capsulotomy on the lens posterior capsule by using a laser to incise the lens posterior capsule.

21. The method of claim 20, wherein the fluid is an OVD.

22. The method of claim 20, further comprising injecting fluid between the lens posterior capsule and an anterior hyaloid membrane of the eye to separate the lens posterior capsule and the anterior hyaloid membrane.

23. The method of claim 20, wherein the posterior capsulotomy leaves the anterior hyaloid membrane completely intact.

24. The method of claim 20, wherein the posterior capsulotomy is performed using an incision depth between 400 μ

m to 800 μ

m.

25. The method of claim 20, wherein the posterior capsulotomy is performed using a pulse energy between 7 μ

J to 10 μ

J.

26. The method of claim 20, wherein the posterior capsulotomy is performed using a capsulotomy diameter of at least 3.5 mm.

27. The method of claim 20 wherein performing the posterior capsulotomy includes compensating for the presence of the replacement lens by using an index of refraction for the replacement lens to determine control parameters used to scan the laser to incise the lens posterior capsule.

28. The method of claim 20, further comprising:

performing an anterior capsulotomy on the lens capsule by using a laser to incise the lens capsule;

removing at least a portion of the lens nucleus; and

installing the replacement lens so that the replacement lens is at least partially constrained by the lens capsule having the anterior capsulotomy.