CORNEAL TOPOGRAPHY MEASUREMENTS AND FIDUCIAL MARK INCISIONS IN LASER SURGICAL PROCEDURES

• US 20160095752A1
• Filed: 10/16/2015
• Published: 04/07/2016
• Est. Priority Date: 04/17/2013
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Golda, Jeffrey A., Gonzalez, Javier G., Scott, David D., Dewey, David A., Bareket, Noah, Schuele, Georg, Srinivasan, Rajeshwari
• Granted Patent: US 10,369,053 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 3/107 for determining the shape or measuring the curvature of the cornea
• CPC Class Codes: A61F 2009/00846 Eyetracking
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/00853 Laser thermal keratoplasty or radial keratotomy
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/00876 Iris
• CPC Class Codes: A61F 2009/0088 based on wavefront
• CPC Class Codes: A61F 2009/00882 based on topography
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00889 Capsulotomy
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/00827 Refractive correction, e.g. lenticle
• CPC Class Codes: A61F 9/00829 Correction of higher orders
• CPC Class Codes: A61F 9/00834 Inlays; Onlays; Intraocular lenses [IOL]

Abstract

A method of cataract surgery in an eye of a patient includes identifying a feature selected from the group consisting of an axis, a meridian, and a structure of an eye by corneal topography and forming fiducial mark incisions with a laser beam along the axis, meridian or structure in the cornea outside the optical zone of the eye. A laser cataract surgery system a laser source, a topography measurement system, an integrated optical subsystem, and a processor in operable communication with the laser source, corneal topography subsystem and the integrated optical system. The processor includes a tangible non-volatile computer readable medium comprising instructions to determine one of an axis, meridian and structure of an eye of the patient based on the measurements received from topography measurement system, and direct the treatment beam so as to incise radial fiducial mark incisions.

Claims

1. A method of cataract surgery in an eye of a patient comprising:

identifying a feature selected from the group consisting of an axis, a meridian, and a structure of an eye by corneal topography;

forming fiducial mark incisions with a laser beam along the axis, meridian or structure in the cornea outside the optical zone of the eye.

2. The method of claim 1, wherein the feature is a meridian of the cornea.

3. The method of claim 2, wherein the meridian is the steepest meridian.

4. The method of claim 1, wherein the fiducial mark incisions are instrasomal corneal incisions.

5. The method of claim 1, wherein the fiducial mark incisions do not alter the optical properties of the eye.

6. The method of claim 5, wherein the length of each fiducial mark incision is less than 1.5 mm.

7. The method of claim 1, wherein identifying the feature comprises measuring the corneal topography with one or more of a keratometry system, an optical coherence tomography system, a Placido disc topography system, a Hartmann-Shack topography system, a Scheimpflug image topography system, a confocal tomography system, or a low coherence reflectometry system

8. The method of cataract surgery according to claim 1, further comprising:

removing the lens of the patient;

placing an IOL having an IOL aberration correcting axis into the eye of the patient; and

aligning the IOL stigmatic axis with the fiducial mark incisions.

9. The method of claim 1 further comprising:

coupling a removable corneal topography measurement structure to a patient interface structure to place the topography measurement structure in front of the eye;

measuring the eye with the topography measurement structure and the patient interface away from the eye;

decoupling the corneal topography measurement structure from the patient interface structure;

coupling the patient interface structure to a component of the patient interface in order to contact the eye; and

determining an astigmatism axis of the eye.

10. A laser cataract surgery system, comprising:

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

a topography measurement system for measuring a topography of the cornea of the eye;

an integrated optical subsystem configured to receive and direct the treatment beam,

a processor in operable communication with the laser source, corneal topography subsystem and the integrated optical system, the processor comprising a tangible non-volatile computer readable medium comprising instructions to;

determine one of an axis, meridian and structure of an eye of the patient based on the measurements received from topography measurement system, and

direct the treatment beam so as to incise radial fiducial mark incisions disposed along the axis, meridian or structure in the cornea at the periphery of the eye and centered on one of the limbus, iris or scanned capsule.

11. The system of claim 10, wherein the topography measurement system further comprises a removable corneal topography measurement structure.

12. The system of claim 11, wherein the processor with the non-volatile computer readable medium further comprises instructions to measure the eye with the topography measurement structure and the patient interface away from the eye.

13. The method of claim 12, wherein the system further comprises a patient user interface.

14. The system of claim 13, wherein the processor with the non-volatile computer readable medium further comprises instructions to determine the axis, meridian and structure while the patient interface structure is coupled to an eye of the patient.

15. The system of claim 10, wherein the feature is a meridian of the cornea.

17. The method of claim 10, wherein the fiducial mark incisions are instrasomal corneal incisions.

18. The method of claim 10, wherein the fiducial mark incisions do not alter the optical properties of the eye.

19. The method of claim 18, wherein the length of each fiducial mark incision is less than 1.5 mm.

16. The method of claim 16, wherein the meridian is the steepest meridian.