CLOSED-LOOP LASER EYE SURGERY TREATMENT

• US 20160228296A1
• Filed: 12/14/2015
• Published: 08/11/2016
• Est. Priority Date: 02/06/2015
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Woodley, Bruce R., Simoneau, Michael J., Woo, Raymond, Gonzalez, Javier G.
• Granted Patent: US 10,357,399 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/00859 considering nomograms
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/00882 based on topography
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00804 Refractive treatments
• CPC Class Codes: A61F 9/00806 Correction of higher orders
• CPC Class Codes: A61F 9/00827 Refractive correction, e.g. lenticle
• CPC Class Codes: A61F 9/00829 Correction of higher orders

Abstract

A laser eye surgery system includes a laser to generate a laser beam. A topography measurement system measures corneal topography. A processor is coupled to the laser and the topography measurement system, the processor embodying instructions to measure a first corneal topography of the eye. A first curvature of the cornea is determined. A target curvature of the cornea that treats the eye is determined. A first set of incisions and a set of partial incisions in the cornea smaller than the first set of incisions are determined. The set of partial incisions is incised on the cornea by the laser beam. A second corneal topography is measured. A second curvature of the cornea is determined. The second curvature is determined to differ from the target curvature and a second set of incisions are determined. The second set of incisions is incised on the cornea.

Claims

1. A method of treating an eye, comprising:

measuring a first corneal topography of the eye;

determining a first curvature of the cornea based on the first corneal topography, and a target curvature of the cornea that treats the eye;

determining a first set of incisions in the cornea to achieve the target curvature in the cornea and a set of partial incisions in the cornea smaller than the first set of incisions;

performing the set of partial incisions on the cornea by a laser;

measuring a second corneal topography after performing the set of partial incisions;

determining a second curvature of the cornea on the basis of the second corneal topography;

determining that the second curvature differs from the target curvature;

determining a second set of incisions in the cornea different from the first set of incisions to achieve the target curvature in the cornea; and

performing the second set of incisions on the cornea by the laser.

2. The method of claim 1, further comprising:

measuring a third corneal topography after performing the second set of incisions;

determining a third curvature of the cornea on the basis of the third corneal topography;

determining that the third curvature differs from the target curvature;

determining a third set of incisions to achieve the target curvature in the cornea; and

performing the third set of incisions on the cornea;

measuring a fourth corneal topography after performing the third set of incisions; and

determining a fourth curvature of the cornea on the basis of the fourth corneal topography; and

determining that the fourth curvature achieves the target curvature.

3. The method of claim 1, wherein the first set of incisions and the second set of incisions are based on a nomogram.

4. The method of claim 3, further comprising:

determining the set of partial incisions based on a predetermined uncertainty level of the nomogram.

5. The method of claim 1, wherein the second set of incisions overlaps the first set of incisions so as to deepen the first set of incisions.

6. The method of claim 1, wherein the second set of incisions are parallel to the first set of incisions.

7. The method of claim 1, wherein the corneal topography measurement uses optical coherence tomography imaging.

8. The method of claim 1, wherein the second corneal topography measures a volume of bubbles formed as a result of the set of partial incisions.

9. The method of claim 1, wherein the laser is a femtosecond laser.

10. The method of claim 1, wherein the method treats higher order aberrations of the eye.

11. A laser eye surgery system, comprising:

a laser to generate a laser beam;

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

a processor coupled to the laser and the topography measurement system, the processor comprising a tangible non-volatile computer recordable medium embodying instructions to;

measuring a first corneal topography of the eye using the topography measurement system;

determining a first curvature of the cornea based on the first corneal topography, and a target curvature of the cornea that treats the eye;

determining a first set of incisions in the cornea to achieve the target curvature in the cornea and a set of partial incisions in the cornea smaller than the first set of incisions;

performing the set of partial incisions on the cornea by the laser beam generated by the laser;

measuring a second corneal topography using the topography measurement system after performing the set of partial incisions;

determining a second curvature of the cornea on the basis of the second corneal topography;

determining that the second curvature differs from the target curvature;

determining a second set of incisions in the cornea different from the first set of incisions to achieve the target curvature in the cornea; and

performing the second set of incisions on the cornea by the laser beam generated by the laser.

12. The system of claim 11, wherein the processor comprising a tangible medium embodying instructions to:

measuring a third corneal topography using the topography measurement system after performing the second set of incisions;

determining a third curvature of the cornea on the basis of the third corneal topography;

determining that the third curvature differs from the target curvature;

determining a third set of incisions to achieve the target curvature in the cornea; and

performing the third set of incisions on the cornea by the laser beam generated by the laser;

measuring a fourth corneal topography using the topography measurement system after performing the third set of incisions;

determining a fourth curvature of the cornea on the basis of the fourth corneal topography; and

determining that the fourth curvature achieves the target curvature.

13. The system of claim 11, wherein the first set of incisions and the second set of incisions are based on a nomogram.

14. The method of claim 13, further comprising:

determining the set of partial incisions based on a predetermined uncertainty level of the monogram.

15. The system of claim 11, wherein the second set of incisions overlaps the first set of incisions so as to deepen the first set of incisions.

16. The system of claim 11, wherein the second set of incisions is parallel to the first set of incisions.

17. The system of claim 11, wherein the corneal topography measurement uses optical coherence tomography imaging.

18. The system of claim 11, wherein the second corneal topography measures a volume of bubbles formed as a result of the set of partial incisions.

19. The system of claim 11, wherein the laser is a femtosecond laser.

20. The system of claim 11 treating higher order aberrations of the eye.