Method and apparatus for analysis and correction of abnormal refractive errors of the eye

• US 4,669,466 A
• Filed: 01/16/1985
• Issued: 06/02/1987
• Est. Priority Date: 01/16/1985
• Status: Expired due to Term

• Current Assignee: VISX Incorporated
• Original Assignee: LRI Corporation
• Inventors: L'Esperance, Francis A.
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Shay, David
• Application Number:
  US06/691,923
• Time in Patent Office: 867 Days
• Field of Search: 128/645, 128/745, 128/303.1, 128/660, 358/96, 358/98, 364/413, 364/488-491, 340/709, 340/710
• US Class Current: 606/3
• CPC Class Codes: A61B 3/107 for determining the shape or measuring the curvature of the cornea
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61F 2009/00853 Laser thermal keratoplasty or radial keratotomy
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/00882 based on topography
• CPC Class Codes: A61F 9/00804 Refractive treatments

Abstract

The invention contemplates instrumentation to aid in performing refraction-corrective surgery on the conrea, (1) by determining the topography of the anterior surface of the cornea, the determination being in the form of digitized data entered into computer storage, (2) by determining the local thickness of the cornea along multiple axes, the determination being also in the form of digitized data entered into computer storage, and (3) by providing a CAD/CAM display of both categories of data, correlated as appropriate for the surgeon'"'"'s selective display of a corneal region, aspect or section, as the surgeon may deem pertinent to a prospective operation.

Claims

1. The method of using a digital computer to correctively improve optical properties of an eye by changing the curvature of the anterior surface of the cornea in approach to a computer-stored digital definition of an idealized three-dimensional anterior-surface curvature, which method comprises:

(a) determining and digitizing the topography of the anterior surface of the cornea as a three-dimensional curved surface, and entering digitized topography data thereof into computer storage;

(b) creating from said topography data and from said stored digital definition a displayed numerical statement of the spherical and cylindrical-components of difference bewteen the determined and the idealized curvatures, whereby the displayed numerical statement is also a statement which is definitive of a characterized volumetric removal of corneal tissue necessary to proceed from the determined to the idealized curvature;

(c) directing ultraviolet laser radiation to the anterior surface of the cornea to selectively ablate the same by photodecomposition; and

(d) using said computer-storage data to control the laser radiation to achieve a curvature change in approach to the diealized surface curvature in a volumetric removal of tissue from the anterior surface and with penetration into the stroma.

2. The method of claim 1, in which said numerical statement is in diopters.

3. The method of claim 1, in which a modification of said numerical statement is entered into computer storage and is used as the basis of control of step (d), said modificaton being in the form of a digital definition of a three-dimensional anterior-surface curvature which is intermediate the determined and the idealized curvatures.

4. The method of claim 1, wherein the computer-stored digital definition of an idealized curvature is the product of a memory bank reflecting entries specific to prior corneal-sculpture operations which have been deemed successful.

5. The method of using a digital computer to correctively improve optical properties of an eye by changing the curvature of the anterior surface of the cornea, which method comprises:

(a) determining and digitizing the topography of the anterior surface of the cornea as a three-dimensional curved surface, and entering digitized topography data thereof into computer storage;

(b) entering into computer storage, as another three-dimensional curved surface, digitized data for the anterior-surface topography of an idealized cornea wherein optical improvement is the achievement objective based on measured parameter data for the eye, whereby computer storage contains digitized data which is definitive of a characterized volumetric removal necessary to proceed from one to the other of said curved surfaces;

(c) directing ultraviolet laser radiation to the anterior surface of the cornea to selectively ablate the same by photodecomposition; and

(d) using said computer-storage data to control the laser radiation to achieve said other curved surface in a volumetric removal of tissue from the anterior surface and with penetration into the stroma.

6. The method of claim 5, in which emmetropia is the achievement objective of step (b).

7. The method of claim 5, in which the achievement objective of step (b) is a three-dimensional curved surface which represents a predetermined fractional change toward achieving an ultimate optical property of substantial emmetropia for the involved eye, whereby an opportunity is presented to evaluate optical and/or topographical features of the eye after completion of step (d) to determine the degree to which the achieved fractional change conforms to the predetermination thereof.

8. The method of claim 5, in which separate visual displays are created for corresponding viewing aspects of the stored digitized data of step (a) and for the stored digitized data of step (b).

9. The method of claim 5, wherein the following additional steps are performed:

(e) an optical determination is made as to whether step (d) has produced substantial emmetropia, and if substantial emmetropia has been achieved, a digital determination is made of the topography of the thus-improved anterior surface of the cornea, with said digital determination and associated laser-control data being entered into computer storage, the digitized storage entry for this step (e) being one of a plurality of entries wherein each entry is applicable to a different eye for which the procedure of steps (a) through (d) has produced substantial emmetropia;

(f) averaging the stored plural-eye data to thereby provide topography data for an idealized eye; and

(g) using the idealized eye data of step (f) in step (b) of a subsequent performance of the method of claim 5 in application to another eye.

10. The method of using a digital computer to correctively improve optical properties of an eye by changing the curvature of the anterior surface of the cornea, which method comprises:

(a) measuring and digitizing the topography of the anterior surface of the cornea as a three-dimensional curved surface, and entering digitized topography data thereof into computer storage;

(b) creating from the stored digitized topography data a center-identified display of the front elevation of the cornea;

(c) creating on said display a straight marker line along a meridian through the center of the display and at a slected orientation;

(d) entering into computer storage digitized data for the corneal topography of an idealized eye wherein emmetropia is the achievement objective;

(e) creating from the stored digitized data for the measured eye and for the idealized eye a coordinated display of both curvature along said meridian, whereby computer storage contains digitized data which is definitive and said coordinated display is visually indicative of a characterized volumetric removal of corneal tissue necessary to proceed from the measured curvature toward the idealized curvature;

(f) directing ultraviolet laser radiation to the anterior surface of the cornea to selectively ablate the same by photodecomposition; and

(g) using said computer-storage data to control the laser radiation to approach the idealized curvature in a volumetric removal of tissue from the anterior surface and with penetration into the stroma.

11. The method of claim 10, wherein the meridian marker line of step (c) is selectively rotatable about the center of the display, whereby astigmatism can be visually apparent in the coordinated display of step (e).

12. The method of claim 10, wherein for the case of a given eye that is hyperopic and therefore requires an idealized-eye meridional profile which is more curved and less flat than the meridional profile of the idealized eye, the coordination of the display of step (d) is caused to position the eye-axis intercept of the idealized-eye meridian profile to coincide with the eye-axis intercept of the meridian profile of the measured eye.

13. The method of claim 10, wherein for the case of a given eye that is myopic and therefore requires an idealized-eye meridional profile which is more flat and less curved than the meridional profile of the idealized eye, the coordination of the display of step (d) is caused to position the idealized-eye meridian profile to intersect with the meridian profile of the measured eye at points symmetrically spaced on opposite sides of the optical axis of the eye and near but short of the limbus region of the cornea.