Hydration and topography tissue measurements for laser sculpting

• US 6,592,574 B1
• Filed: 07/27/2000
• Issued: 07/15/2003
• Est. Priority Date: 07/28/1999
• Status: Expired due to Term

• Current Assignee: Amo Manufacturing Usa, Llc (Johnson & Johnson)
• Original Assignee: VISX Incorporated
• Inventors: Shimmick, John Karl, Munnerlyn, Charles R., Caudle, George, Clapham, Terrance N.
• Primary Examiner(s): Dvorak, Linda C. M.
• Assistant Examiner(s): FARAH, AHMED M
• Application Number:
  US09/626,732
• Time in Patent Office: 1,083 Days
• Field of Search: 604/20, 604/289, 604/294, 250/365, 250/370, 250/461.1, 356/57, 600/310, 600/473, 600/476, 607/94, 606/4-6, 606/10-13, 606/17, 351/200, 351/206, 351/211-221
• US Class Current: 606/4
• CPC Class Codes: A61B 3/107 for determining the shape or measuring the curvature of the cornea
• CPC Class Codes: A61F 2009/00844 Feedback systems
• CPC Class Codes: A61F 2009/00855 Calibration of the laser system
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/0088 based on wavefront
• CPC Class Codes: A61F 2009/00882 based on topography
• CPC Class Codes: A61F 9/00804 Refractive treatments
• CPC Class Codes: A61F 9/00806 Correction of higher orders
• CPC Class Codes: A61F 9/00817 Beam shaping with masks

Abstract

Improved systems, devices, and methods measure and/or change the shape of a tissue surface, particularly for use in laser eye surgery. Fluorescence of the tissue may occur at and immediately underlying the tissue surface. The excitation energy can be readily absorbed by the tissue within a small tissue depth, and may be provided from the same source used for photodecomposition of the tissue. Changes in the fluorescence spectrum of a tissue correlate with changes in the tissue'"'"'s hydration.

Claims

1. A system for measuring hydration of a corneal tissue of an eye, the system comprising:

a light source directing an excitation light toward the corneal tissue so that the corneal tissue generates fluorescent light, the fluorescent light varying in response to corneal tissue hydration increasing from a normal hydration to an increased hydration;

a fluorescent light sensor in an optical path of the fluorescent light from the tissue, the sensor generating a signal indicating the fluorescent light; and

a processor coupled to the sensor, the processor generating a hydration signal indicating the increased hydration of the tissue from the fluorescent light signal.

2. The system of claim 1, further comprising an output device coupled to the processor, the output showing a display in response to the hydration signal.

3. The system of claim 1, wherein the sensor comprises a spectrometer, and further comprising imaging optics directing the fluorescent light along the optical path from the tissue to the spectrometer, the imaging optics forming an image of a target area of the tissue adjacent a detector surface of the spectrometer.

4. The system, of claim 1, further comprising an ablation energy delivery system coupled to the processor, the excitation light comprising an ablative light energy, the delivery system directing the ablative energy toward the corneal tissue, the ablative energy from the delivery system varying in response to the hydration signal.

5. The system of claim 4, wherein the delivery system comprises an optical delivery system transmitting photoablative laser energy toward the corneal tissue so as to selectively alter an optical characteristic of the eye.

6. The system of claim 5, wherein the processor varies a quantity of change in the optical characteristic of the eye in response to the hydration signal.

7. The system of claim 1, wherein an intensity of the fluorescent spectrum of the tissue varies with the hydration, and wherein the signal indicates an intensity of the fluorescent light at a first frequency.

8. The system of claim 7 wherein the processor normalizes the signal using an intensity of the fluorescent light at a second frequency.

9. The system of claim 8, wherein the intensity of the fluorescent light at the second frequency is less sensitive to hydration than the intensity of the fluorescent light at the first frequency.

10. In an apparatus for resculpting a corneal tissue of an eye, the apparatus directing a pattern of light energy from a laser under direction of a processor to effect a desired change in an optical characteristic of the eye, a system comprising:

a sensor coupled to the processor, the sensor measuring hydration and generating a signal indicating the measured hydration of the corneal tissue; and

an adjustment module of the processor, the module varying the pattern in response to the measured hydration signal from the sensor.

11. The apparatus of claim 10, wherein the signal varies in response to a thickness of a film of fluid covering a surface of the corneal tissue, the sensor comprising an ellipsometer.

12. A method for measuring hydration-induced swelling of a corneal tissue, the method comprising:

directing an excitation light toward the tissue so that the tissue generates fluorescent light that varies with changes in response to changes in hydration of the tissue;

sensing the fluorescent light;

calculating the hydration of the tissue using the sensed fluorescent light; and

determining the swelling of the tissue in response to the calculated hydration.

13. The compensation method of claim 12, wherein the excitation light comprises the laser energy.

14. The compensation method of claim 12 wherein the sensing step comprises measuring a thickness of a fluid film on a surface of the eye by ellipsometry.

15. In a procedure for resculpting a corneal tissue of an eye by selectively directing a pattern of laser energy toward the eye to effect a predetermined change in an optical characteristic of the eye, a compensation method comprising:

sensing a hydration of the tissue; and

adjusting the pattern of laser energy in response to the sensed hydration.

16. The compensation method of claim 15, wherein the hydration sensing step comprises:

directing an excitation light toward the tissue so that the tissue generates fluorescent light;

measuring an intensity of the fluorescent light at a first frequency relative to a second frequency;

calculating hydration of the tissue using the measured relative intensity.

17. The compensation method of claim 15, further comprising estimating ablation rate for the calculated hydration, wherein the pattern adjusting step varies the pattern in response to the estimated ablation rate.

18. A method for sculpting of a corneal tissue of an eye to effect a desired change in an optical property of the eye, the method comprising:

sensing hydration of the corneal tissue;

determining a desired change in shape of the eye in response to the hydration and the desired change in optical property; and

planning a pattern of laser energy to direct toward the corneal tissue to effect the determined change in shape.

19. The method of claim 18, the desired change in optical quality determined while the eye has a first hydration, wherein the eye swells and the hydration increases from the first hydration to a second hydration, and wherein the desired change in shape is determined using the second hydration.

20. The method of claim 19, wherein the hydration increases and the corneal tissue swells in response to at least one member selected from the group consisting of a therapeutic compound applied to the eye and incising of the eye to expose a tissue for ablation.

21. The method of claim 19, further comprising increasing a total depth of corneal tissue removed from the eye to compensate for swelling of the corneal tissue.

22. The method of claim 21, wherein the corneal tissue increases in thickness in by up to about 50% with the increase from the first hydration to the second hydration.

23. The method of claim 22, wherein the corneal tissue increases in thickness in a range from about 10% to about 50% with the increase in hydration, wherein a first tissue removal depth will effect the desired change in optical property when the eye has the first hydration, and wherein the increased tissue removal depth is between about 10% and about 50% greater than the first tissue removal depth.

24. A method for sculpting of a corneal tissue of an eye to effect a desired change in an optical property of the eye, the method comprising:

determining the desired change in the optical property while the corneal tissue of the eye has a first hydration;

sensing a second hydration of the corneal tissue, wherein the eye swells and the hydration increases from the first hydration to the second hydration;

determining a desired change in shape of the eye in response to the second hydration and the desired change in optical property; and

planning a pattern of laser energy to direct toward the corneal tissue to effect the determined change in shape.

25. The method of claim 24, wherein the hydration increases and the corneal tissue swells in response to at least one member selected from the group consisting of a therapeutic compound applied to the eye and incising of the eye to expose a tissue for ablation.

26. The method of claim 24, further comprising increasing a total depth of corneal tissue removed from the eye to compensate for swelling of the corneal tissue.

27. The method of claim 26, wherein the corneal tissue increases in thickness in by up to about 50% with the increase from the first hydration to the second hydration.

28. The method of claim 27, wherein the corneal tissue increases in thickness a range from about 10% to about 50% with the increase in hydration, wherein a first tissue removal depth will effect the desired change in optical property when the eye has the first hydration, and wherein the increased tissue removal depth is between about 10% and about 50% greater than the first tissue removal depth.