GRAPHICAL USER INTERFACE FOR LASER EYE SURGERY SYSTEM

• US 20140114297A1
• Filed: 10/24/2013
• Published: 04/24/2014
• Est. Priority Date: 10/24/2012
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Woodley, Bruce, Sheehy, Katrina Bell, Santos, Daniel Oliveira, Pham, Darrel Q., Gallagher, Paul Daniel, Miller, Lawrence Edward, Gonzalez, Javier
• Granted Patent: US 10,702,209 B2
• Time in Patent Office: Days
• US Class Current: 606/6
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/258 providing specific settings for specific users
• CPC Class Codes: A61B 2090/3735 Optical coherence tomography [OCT]
• CPC Class Codes: A61B 3/0008 provided with illuminating means A61B3/117 takes precedence; goniolenses used for laser treatment A61F9/009; illuminating means for optical instruments G02B27/00
• CPC Class Codes: A61B 3/1005 for measuring distances inside the eye, e.g. thickness of the cornea A61B3/11 takes precedence
• CPC Class Codes: A61B 3/102 for optical coherence tomography [OCT]
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 5/748 Selection of a region of interest, e.g. using a graphics tablet
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence
• CPC Class Codes: A61F 9/00754 for cutting or perforating the anterior lens capsule, e.g. capsulotomes
• CPC Class Codes: A61F 9/008 using laser
• 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

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.

Claims

1. A method of planning a laser surgery procedure on an eye having a cornea, a pupil, and a lens, the cornea having an anterior surface and a posterior surface, the lens being disposed within a lens capsule having an anterior portion and a posterior portion, the method comprising:

coupling the eye to a laser surgery system operable to measure a spatial disposition of an internal structure of the eye relative to the laser surgery system;

measuring a spatial disposition of at least a portion of the corneal anterior surface by using the laser surgery system;

measuring a spatial disposition of at least a portion of the corneal posterior surface by using the laser surgery system;

generating a spatial disposition of an incision of the cornea based at least in part on the measured corneal anterior and posterior spatial dispositions and at least one corneal incision parameter; and

displaying a composite image that includes an image representative of the measured corneal anterior and posterior surfaces and an image representing the corneal incision.

2. The method of claim 1, wherein the at least one corneal incision parameter includes a corneal incision line density parameter to control amount of overlap between adjacent lines of laser pulse focus points that will be used to form the corneal incision.

3. The method of claim 1, wherein the corneal incision extends partially through the cornea so as to leave an uncut region of the cornea aligned with one or more cut portions of the corneal incision, the corneal incision and the uncut region of the cornea defining an access path for a cataract surgery instrument.

4. The method of claim 1, further comprising:

altering the at least one corneal incision parameter in response to user input;

generating a spatial disposition of an altered incision of the cornea based at least in part on the measured corneal anterior and posterior spatial dispositions and the altered corneal incision parameter; and

displaying a second composite image that includes an image representative of the measured corneal anterior and posterior surfaces and an image representing the altered corneal incision.

5. The method of claim 1, further comprising:

measuring a spatial disposition of at least a portion of the anterior portion of the lens capsule by using the laser surgery system;

generating a spatial disposition of a capsulotomy incision of the anterior portion of the lens capsule based at least in part on the measured spatial disposition of the anterior portion of the lens capsule and at least one capsulotomy parameter; and

displaying a third composite image that includes an image representative of the measured anterior portion of the lens capsule and an image representing the capsulotomy incision.

6. The method of claim 5, wherein the at least one capsulotomy parameter includes a capsulotomy line density parameter to control amount of overlap between adjacent lines of laser pulse focus points that will be used to form the capsulotomy incision.

7. The method of claim 5, further comprising:

altering the at least one capsulotomy parameter in response to user input;

generating a spatial disposition of an altered capsulotomy incision of the anterior portion of the lens capsule based at least in part on the measured corneal anterior and posterior spatial dispositions and the altered capsulotomy parameter; and

displaying a fourth composite image that includes an image representative of the measured anterior portion of the lens capsule and an image representing the altered capsulotomy incision.

8. The method of claim 5, further comprising:

measuring a spatial disposition of at least a portion of the posterior portion of the lens capsule by using the laser surgery system;

generating a spatial disposition of a lens fragmentation incision pattern of the lens based at least in part on the measured spatial dispositions of the anterior and posterior portions of the lens capsule and at least one lens fragmentation parameter; and

displaying a fifth composite image that includes an image representative of the measured anterior and posterior portions of the lens capsule and an image representing the lens fragmentation incision pattern.

9. The method of claim 8, wherein the at least one lens fragmentation parameter includes a lens fragmentation line density parameter to control amount of overlap between adjacent lines of laser pulse focus points that will be used to form the lens fragmentation incision pattern.

10. The method of claim 8, further comprising:

altering the at least one lens fragmentation parameter in response to user input;

generating a spatial disposition of an altered lens fragmentation incision pattern of the lens based at least in part on the measured spatial dispositions of the anterior and posterior portions of the lens capsule and the altered at least one lens fragmentation parameter; and

displaying a sixth composite image that includes an image representative of the measured anterior and posterior portions of the lens capsule and an image representing the altered lens fragmentation incision pattern.

11. The method of claim 8, further comprising:

generating a spatial disposition a safety volume within the lens, the incision pattern not overlapping the safety volume, the safety volume separating the lens fragmentation incision pattern from the anterior and posterior portions of the lens capsule and separating the lens fragmentation pattern transverse to the pupil such that a maximum transverse width of the lens fragmentation pattern is less than a diameter of the pupil; and

displaying a safety volume image that includes a representation of the safety volume.

12. The method of claim 8, further comprising:

prior to the coupling of the eye to the laser surgery system, displaying a seventh composite image that includes an image representative of the eye and at least one of an image representing an incision of the cornea corresponding to the at least one corneal incision parameter, an image representing an incision of the anterior portion of the lens capsule corresponding to the at least one capsulotomy parameter, or an image representing a lens fragmentation incision pattern corresponding to the at least one lens fragmentation parameter.

13. The method of claim 12, further comprising:

prior to the coupling of the eye to the laser surgery system,

generating a spatial disposition a safety volume within the lens, the incision pattern not overlapping the safety volume, the safety volume separating the lens fragmentation incision pattern from the anterior and posterior portions of the lens capsule and separating the lens fragmentation pattern transverse to the pupil such that a maximum transverse width of the lens fragmentation pattern is less than a diameter of the pupil; and

displaying a safety volume image that includes a representation of the safety volume.

14. A method of planning a laser surgery procedure of an eye having a cornea and a lens capsule, the method comprising:

coupling the eye to a laser surgery system operable to measure spatial dispositions of, relative to the laser surgery system, the cornea and the lens capsule

generating and displaying a first cross-sectional image of the eye based at least in part on measured spatial dispositions of the cornea and lens capsule, the first cross-sectional image including at least one of a cross section of the cornea and a cross section of a central portion of the lens capsule;

receiving user input designating a plurality of points in the first cross-sectional image corresponding to points on a boundary surface of the cornea or the lens capsule;

generating and displaying a second cross-sectional image of the eye based at least in part on the measured spatial dispositions of the cornea and lens capsule, the second cross-sectional image being transverse to the first cross-sectional image and including at least one of a cross section of the cornea and a cross section of a central portion of the lens capsule;

receiving user input designating a plurality of points in the second cross-sectional image corresponding to points on the boundary surface;

generating a surface model of the boundary surface based on the user designated points; and

generating a spatial disposition of an incision of the cornea or the lens capsule based at least in part on the surface model and at least one incision parameter.

15. A system for planning and performing a laser surgery procedure on an eye having a cornea, a pupil, and a lens, the cornea having an anterior surface and a posterior surface, the lens being disposed within a lens capsule having an anterior portion and a posterior portion, the system comprising:

a laser source configured to produce a treatment beam that includes a plurality of laser pulses;

an integrated optical system that includes an imaging assembly operatively coupled to a treatment laser delivery assembly for the treatment beam such that the imaging assembly and the treatment laser delivery system share at least one common optical element, the integrated optical system being configured to locate at least a portion of the corneal anterior surface and at least a portion of the corneal posterior surface;

a patient interface configured to couple the eye with the integrated optical system so as to constrain the position of the eye relative to the integrated optical system;

a display device; and

a controller operatively coupled with the display device, the laser source, and the integrated optical system;

the controller being configured to;

generate, relative to the integrated optical system, a spatial disposition of the corneal anterior surface and a spatial disposition of the corneal posterior surface by using the integrated optical system to locate at least portions of the corneal anterior and posterior surfaces;

generate a spatial disposition of an incision of the cornea using the generated spatial dispositions of the corneal anterior and posterior surfaces and at least one corneal incision parameter; and

display a composite image on the display device, the composite image including an image representative of the generated spatial dispositions of the corneal anterior and posterior surfaces and an image representing the corneal incision.

16. The system of claim 15, wherein the at least one corneal incision parameter includes a corneal incision line density parameter to control amount of overlap between adjacent lines of laser pulse focus points that will be used to form the corneal incision.

17. The system of claim 15, wherein the corneal incision extends partially through the cornea so as to leave an uncut region of the cornea aligned with one or more cut portions of the corneal incision, the corneal incision and the uncut region of the cornea defining an access path for a cataract surgery instrument.

18. The system of claim 15, further comprising a user input device, the controller being further configured to:

alter the at least one corneal incision parameter in response to user input via the user input device;

generate a spatial disposition of an altered incision of the cornea using the generated corneal anterior and posterior spatial dispositions and the altered corneal incision parameter; and

display a second composite image on the display device, the second composite image including an image representative of the generated spatial dispositions of the corneal anterior and posterior surfaces and an image representing the altered corneal incision.

19. The system of claim 15, wherein the integrated optical system is configured to locate at least a portion of the anterior portion of the lens capsule, the controller being further configured to:

generate a spatial disposition of at least a portion of the anterior portion of the lens capsule by using the integrated optical system to locate at least a portion of the anterior portion of the lens capsule;

generate a spatial disposition of a capsulotomy incision of the anterior portion of the lens capsule using the generated spatial disposition of the anterior portion of the lens capsule and at least one capsulotomy parameter; and

display a third composite image on the display device, the third composite image including an image representative of the generated spatial disposition of the anterior portion of the lens capsule and an image representing the capsulotomy incision.

20. The system of claim 19, wherein the at least one capsulotomy parameter includes a capsulotomy line density parameter to control amount of overlap between adjacent lines of laser pulse focus points that will be used to form the capsulotomy incision.

21. The system of claim 19, further comprising a user input device, the controller being further configured to:

alter the at least one capsulotomy parameter in response to user input via the user input device;

generate a spatial disposition of an altered capsulotomy incision of the anterior portion of the lens capsule using the generated anterior lens capsule spatial disposition and the altered capsulotomy parameter; and

display a fourth composite image on the display device, the fourth composite image including an image representative of the generated spatial disposition of the anterior portion of the lens capsule and an image representing the altered capsulotomy incision.

22. The system of claim 19, wherein the integrated optical system is configured to locate at least a portion of the posterior portion of the lens capsule, the controller being further configured to:

generate a spatial disposition of at least a portion of the posterior portion of the lens capsule by using the integrated optical system to locate at least the portion of the posterior portion of the lens capsule;

generate a spatial disposition of a lens fragmentation incision pattern of the lens using the generated spatial disposition of the posterior portion of the lens capsule and at least one lens fragmentation parameter; and

display a fifth composite image on the display device, the fifth composite image including an image representative of the generated spatial dispositions of the anterior and posterior portions of the lens capsule and an image representing the lens fragmentation incision pattern.

24. The system of claim 22, further comprising a user input device, the controller being further configured to:

alter the at least one lens fragmentation parameter in response to user input via the user input device;

generate a spatial disposition of an altered lens fragmentation incision pattern using the generated spatial dispositions of the anterior and posterior portions of the lens capsule and the altered at least one lens fragmentation parameter; and

display a sixth composite image on the display device, the sixth composite image including an image representative of the generated spatial dispositions of the corneal anterior and posterior surfaces and an image representing the altered lens fragmentation incision pattern.

25. The system of claim 22, the controller being further configured to:

generate a spatial disposition a safety volume within the lens, the incision pattern not overlapping the safety volume, the safety volume separating the lens fragmentation incision pattern from the anterior and posterior portions of the lens capsule and separating the lens fragmentation pattern transverse to the pupil such that a maximum transverse width of the lens fragmentation pattern is less than a diameter of the pupil; and

display a safety volume image that includes a representation of the safety volume.

26. The system of claim 22, wherein the controller is further configured to:

prior to coupling the eye to the integrated optical system,

generate a spatial disposition a safety volume within the lens, the incision pattern not overlapping the safety volume, the safety volume separating the lens fragmentation incision pattern from the anterior and posterior portions of the lens capsule and separating the lens fragmentation pattern transverse to the pupil such that a maximum transverse width of the lens fragmentation pattern is less than a diameter of the pupil; and

display a safety volume image that includes a representation of the safety volume.

23. The system of claim 23, wherein the at least one lens fragmentation parameter includes a lens fragmentation line density parameter to control amount of overlap between adjacent lines of laser pulse focus points that will be used to form the lens fragmentation incision pattern.

27. A system for planning and performing a laser surgery procedure on an eye having a cornea, a pupil, and a lens, the cornea having an anterior surface and a posterior surface, the lens being disposed within a lens capsule having an anterior portion and a posterior portion, the system comprising:

a laser source configured to produce a treatment beam that includes a plurality of laser pulses;

an integrated optical system that includes an imaging assembly operatively coupled to a treatment laser delivery assembly for the treatment beam such that the imaging assembly and the treatment laser delivery system share at least one common optical element, the integrated optical system being configured to locate at least a portion of the corneal anterior surface and at least a portion of the corneal posterior surface;

a patient interface configured to couple the eye with the integrated optical system so as to constrain the position of the eye relative to the integrated optical system;

a display device; and

a controller operatively coupled with the display device, the laser source, and the integrated optical system;

the controller being configured to;

generate and display a first cross-sectional image of the eye based at least in part on spatial dispositions of the cornea and lens capsule measured by the integrated optics system, the first cross-sectional image including at least one of a cross section of the cornea and a cross section of a central portion of the lens capsule;

receive user input designating a plurality of points in the first cross-sectional image corresponding to points on a boundary surface of the cornea or the lens capsule;

generate and display a second cross-sectional image of the eye based at least in part on the measured spatial dispositions of the cornea and lens capsule, the second cross-sectional image being transverse to the first cross-sectional image and including at least one of a cross section of the cornea and a cross section of a central portion of the lens capsule;

receive user input designating a plurality of points in the second cross-sectional image corresponding to points on the boundary surface;

generate a surface model of the boundary surface based at least in part on the user designated points; and

generate a spatial disposition of an incision of the cornea or the lens capsule based at least in part on the surface model and at least one incision parameter.