Patient interface for ophthalmologic diagnostic and interventional procedures

• US 9,642,748 B2
• Filed: 12/10/2015
• Issued: 05/09/2017
• Est. Priority Date: 10/21/2011
• Status: Active Grant

• Current Assignee: OptiMedica Corporation (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Gooding, Phillip, Wiltberger, Michael W., Beltran, Christine, Talamo, Jonathan H.
• Primary Examiner(s): Thomson, William
• Assistant Examiner(s): Downey, John R
• Application Number:
  US14/965,830
• Publication Number:
  US 20160095517A1
• Time in Patent Office: 516 Days
• Field of Search: 606 4- 6
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3979 infrared
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• 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 3/0025 characterised by electronic signal processing, e.g. eye models
• CPC Class Codes: A61B 3/102 for optical coherence tomography [OCT]
• CPC Class Codes: A61B 3/14 Arrangements specially adapted for eye photography apparatus or arrangements for taking photographs per se G03B
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 9/00814 Laser features or special beam parameters therefor
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/0084 Laser features or special beam parameters therefor
• 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

An ophthalmic system may comprise an imaging device having a field of view oriented toward the eye of the patient; a patient interface housing defining a passage therethrough, having a distal end coupled to one or more seals configured to be directly engaged with one or more surfaces of the eye of the patient, and wherein the proximal end is configured to be coupled to the patient workstation such that at least a portion of the field of view of the imaging device passes through the passage; and two or more registration fiducials coupled to the patient interface housing in a predetermined geometric configuration relative to the patient interface housing within the field of view of the imaging device such that they may be imaged by the imaging device in reference to predetermined geometric markers on the eye of the patient which may also be imaged by the imaging device.

Claims

1. A method for ophthalmic intervention on an eye of a patient, comprising:

a. orienting a field of view of an imaging device toward the eye of the patient;

b. coupling a distal end of a patient interface housing to one or more seals configured to be directly engaged with one or more surfaces of the eye of the patient, and coupling a proximal end of the patient interface housing to a patient workstation such that at least a portion of the field of view of the imaging device passes through a passage of the patient housing defined by the proximal and distal ends;

c. imaging, within the field of the view of the imaging device, three or more registration fiducials, which include first and second registration fiducials coupled to the patient interface housing in a predetermined geometric configuration relative to the patient interface housing in reference to predetermined geometric markers on the eye of the patient, which are also imaged by the imaging device; and

d. processing imaging data generated via the imaging device so as to determine an angular orientation of the eye relative to the patient interface based on the first and second fiducial and the predetermined geometric markers and also to determine an up or down orientation of the patient interface housing relative to the eye based on the location of a third fiducial.

2. The method of claim 1, wherein a laser system is operatively coupled to the imaging device.

3. The method of claim 2, further comprising producing a treatment beam with the laser system that may be directed through the passage of the patient interface housing and into the eye of the patient.

4. The method of claim 3, wherein the treatment beam is suitable for creating dielectric breakdown within a cataractous crystalline lens of the eye.

5. The method of claim 4, wherein the treatment beam is a pulsed treatment beam with a pulse repetition rate between about 1 kHz and about 200 kHz.

6. The method of claim 4, wherein the treatment beam has a wavelength between about 800 nm and about 1,100 nm.

7. The method of claim 4, wherein the treatment beam is a pulsed treatment beam having a pulse energy between about 1 microjoule and about 1,000 microjoules.

8. The method of claim 4, wherein the treatment beam is a pulsed treatment beam with a pulse duration between about 100 femtoseconds and about 10 picoseconds.

9. The method of claim 1, wherein the patient interface housing comprises an optical lens coupled to the housing having a focal axis aligned to pass through the passage of the housing.

10. The method of claim 1, further comprising directing illumination radiation from a position adjacent the imaging device toward the eye of the patient.

11. The method of claim 1, wherein at least a portion of the illumination radiation is directed through the passage of the patient interface housing.

12. The method of claim 1, wherein at least a portion of the patient interface housing is translucent to the illumination radiation, and at least a portion of the illumination radiation is directed across the translucent portion of the patient interface housing toward the eye of the patient.

13. The method of claim 10, wherein the illumination radiation is infrared radiation.

14. The method of claim 10, wherein the illumination radiation is visible light radiation.

15. The method of claim 1, wherein the imaging device comprises an optical coherence tomography system configured to measure the coherence of radiation scattered into an interferometer from the field of view.

16. The method of claim 13, wherein the fiducials comprise one or more materials that fluoresce in infrared radiation.

17. The method of claim 13, wherein the fiducials comprise one or more materials that highly contrast in infrared radiation relative to other surrounding materials.

18. The method of claim 13, wherein the fiducials comprise one or more surface irregularities relative to other surrounding surfaces.

19. The method of claim 18, wherein the one or more surface irregularities are selected from the group consisting of:

a concave feature, a convex feature, a depressed edge, a depressed step, a projecting edge, a projecting step, and an intersection of lines.

20. The method of claim 14, wherein the fiducials comprise one or more materials that highly contrast in visible light radiation relative to other surrounding materials.

21. The method of claim 14, wherein the fiducials comprise one or more surface irregularities relative to other surrounding surfaces.

22. The method of claim 21, wherein the one or more surface irregularities are selected from the group consisting of:

a concave feature, a convex feature, a depressed edge, a depressed step, a projecting edge, a projecting step, and an intersection of lines.

23. The method of claim 15, wherein the fiducials comprise one or more surface irregularities relative to other surrounding surfaces.

24. The method of claim 23, wherein the one or more surface irregularities are selected from the group consisting of:

a concave feature, a convex feature, a depressed edge, a depressed step, a projecting edge, a projecting step, and an intersection of lines.

25. The method of claim 1, wherein the three or more fiducials are positioned upon an inner annulus formed by the distal end of the patient interface housing.

26. The method of claim 25, wherein the first and second fiducials are positioned at opposite sides of the inner annulus.

27. The method of claim 25, wherein the three or more fiducials comprise three fiducials distributed nonhomogeneously about the inner annulus.