Method and apparatus for creating ocular surgical and relaxing incisions

• US 10,376,356 B2
• Filed: 03/25/2015
• Issued: 08/13/2019
• Est. Priority Date: 03/13/2007
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Culbertson, William, Angeley, David, Marcellino, George, Andersen, Dan E.
• Primary Examiner(s): Eiseman, Lynsey C
• Assistant Examiner(s): Hough, Jessandra
• Application Number:
  US14/668,677
• Publication Number:
  US 20150196428A1
• Time in Patent Office: 1,602 Days
• CPC Class Codes: A61F 2/16 Intraocular lenses
• CPC Class Codes: A61F 2/1613 having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
• CPC Class Codes: A61F 2/1637 Correcting aberrations caused by inhomogeneities; correcting intrinsic aberrations, e.g. of the cornea, of the surface of the natural lens, aspheric, cylindrical, toric lenses
• CPC Class Codes: A61F 2/1648 Multipart lenses
• CPC Class Codes: A61F 2/1662 Instruments for inserting intraocular lenses into the eye
• CPC Class Codes: A61F 2002/1683 having filiform haptics
• CPC Class Codes: A61F 2002/16901 Supporting structure conforms to shape of capsular bag
• CPC Class Codes: A61F 2009/00859 considering nomograms
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00872 Cornea
• CPC Class Codes: A61F 2009/0088 based on wavefront
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 9/00 Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand caps with means for protecting the eyes A42B1/018; visors for helmets A42B3/22; retractors A61B17/02; manipulators specially adapted for use in surgery A61B34/70; appliances to aid invalids to move about A61H3/00; exercisers for the eyes A61H5/00; eye baths A61H35/02; sunglasses or goggles having the same features as spectacles G02C
• CPC Class Codes: A61F 9/00754 for cutting or perforating the anterior lens capsule, e.g. capsulotomes
• CPC Class Codes: A61F 9/008 using laser
• CPC Class Codes: A61F 9/00812 Inlays; Onlays; Intraocular lenses [IOL]
• CPC Class Codes: A61F 9/00825 for photodisruption
• 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 optical beam scanning system for incising target tissue in a patient'"'"'s eye includes a laser source configured to deliver a laser beam to produce optical breakdown and initiate a plasma-mediated process; an OCT imaging device used to create an image of eye tissue that includes the cornea; a delivery system for delivering the laser beam to the target tissue to form a cataract incision; a scanner operable to scan the focal spot of the laser beam to different locations within the patient'"'"'s eye; and a controller operatively coupled to the laser source, the imaging device, and the scanner. The OCT device is configured to scan the eye tissue to generate imaging data used to define an incision pattern configured to incise one or more relaxation incisions into the cornea, so that the one or more relaxation incisions are formed starting from the inside and proceeding outward.

Claims

1. An optical beam scanning system for incising target tissue in a patient'"'"'s eye, the optical beam scanning system comprising:

a laser source configured to deliver a laser beam comprising a plurality of laser pulses, the laser beam being configured to produce optical breakdown and initiate a plasma-mediated process within the target tissue at a focal spot of the laser beam;

an Optical Coherence Tomography (OCT) imaging device configured to generate signals that can be used to create an image of eye tissue that includes the cornea of the patient'"'"'s eye;

a delivery system for delivering the laser beam to the target tissue to form a cataract incision;

a scanner operable to scan the focal spot of the laser beam to different locations within the patient'"'"'s eye; and

a controller operatively coupled to the laser source, the OCT imaging device and the scanner, the optical beam scanning, the controller programmed to;

scan the eye tissue with the OCT device to generate imaging data for the target tissue that includes imaging data for the cornea;

generate an incision pattern based at least in part on the imaging data, the incision pattern forming one or more relaxation incisions into the cornea, wherein each of the relaxation incision extends in an angular direction for a predetermined length less than a full circle, and wherein at least one of the one or more relaxation incisions is a partially penetrating incision that leaves an un-incised tissue thickness; and

scan the focal spot of the laser beam in the incision pattern, wherein the focal spot of the laser beam is guided based on the imaging data so that the focal spot of the laser beam is scanned from a posterior portion of the eye and proceeding anteriorly.

2. The system of claim 1, further comprising a profilometer for measuring a surface profile of the cornea of the patient'"'"'s eye, wherein the measured corneal surface profile is used to define the incision pattern so as to treat astigmatism of the patient'"'"'s eye.

3. The system of claim 2, wherein the profilometer is disposed distal to the scanner to allow for a continuous unobstructed view of the cornea of the patient'"'"'s eye.

4. The system of claim 1, wherein the laser source and scanner are operated to incise at least one of the one or more relaxation incisions at a depth based at least in part upon the signals generated by the OCT device.

5. The system of claim 1, wherein at least one of the one or more relaxation incisions does not cross at least one of:

(a) an anterior surface of the target tissue and (b) a posterior surface of the target tissue.

6. The system of claim 1, wherein the one or more relaxation incisions comprises a plurality of discrete incisions within the cornea.

7. The system of claim 6, wherein the plurality of discrete incisions comprise a cataract incision and a corneal relaxing incision.

8. The system of claim 6, wherein the plurality of discrete incisions comprise a plurality of corneal relaxing incisions.

9. The system of claim 1, wherein the scanner includes an X-Y scan device and a Z-scan device, the Z-scan device being operable to move the focal spot of the laser beam along a z-axis that is substantially aligned with the laser beam, the X-Y scan device being operable to move the focus position laterally to the z-axis, wherein the laser beam propagates through the Z-scan device prior to propagating through the X-Y scan device.

10. The system of claim 9, wherein the OCT device produces an OCT beam that is focused by the Z-scan device and scanned by the X-Y scan device.

11. The system of claim 9, wherein the OCT device produces an OCT beam that is focused and scanned by the scanner.

12. The system of claim 9, where in the OCT device is configured to generate signals used to generate three-dimensional positional data for the cornea.

13. An optical beam scanning system for incising target tissue in a patient'"'"'s eye, the optical beam scanning system comprising:

a laser source configured to deliver a laser beam comprising a plurality of laser pulses, the laser beam being configured to produce optical breakdown and initiate a plasma-mediated process within the target tissue at a focal spot of the laser beam;

an Optical Coherence Tomography (OCT) imaging device configured to generate signals that can be used to create an image of eye tissue that includes the limbus and the sclera of the patient'"'"'s eye;

a delivery system for delivering the laser beam to the target tissue to form a cataract incision; and

a scanner operable to scan the focal spot of the laser beam to different locations within the patient'"'"'s eye; and

a controller operatively coupled to the laser source, the OCT imaging device and the scanner, the controller programmed to;

scan the eye tissue using the OCT device to generate imaging data for the target tissue that includes imaging data for at least one of the cornea, the limbus, and the sclera;

generate an incision pattern based at least in part on the image data, the incision pattern forming one or more relaxation incisions into at least one of the limbus and the sclera, wherein each of the relaxation incision extends in an angular direction for a predetermined length less than a full circle, and wherein at least one of the one or more relaxation incisions is a partially penetrating incision that leaves an un-incised tissue thickness; and

scan the focal spot of the laser beam in the incision pattern, wherein the focal spot of the laser beam is guided based on the imaging data so that the laser pulses incise the one or more relaxation incisions into at least one of the limbus and the sclera.

14. The system of claim 13, further comprising a profilometer for measuring a surface profile of the cornea of the patient'"'"'s eye, wherein the measured corneal surface profile is used to define the incision pattern so as to treat astigmatism of the patient'"'"'s eye.

15. The system of claim 14, wherein the profilometer is disposed distal to the scanner to allow for a continuous unobstructed view of the cornea of the patient'"'"'s eye.

16. The system of claim 13, further comprising a wavefront sensor to optically characterize the patient'"'"'s eye, wherein measurements of the patient'"'"'s eye made by the wavefront sensor are used to define the incision pattern so as to treat astigmatism of the patient'"'"'s eye.

17. The system of claim 13, wherein the laser source and scanner are operated to incise at least one of the one or more relaxation incisions at a depth based at least in part upon the signals generated by the OCT device.

18. The system of claim 13, wherein the one or more relaxation incisions comprises a plurality of discrete incisions within at least one of the limbus and the sclera of the patient'"'"'s eye.

19. The system of claim 18, wherein the plurality of discrete incisions comprise a cataract incision and a corneal relaxing incision.

20. The system of claim 13, wherein:

the imaging data includes imaging data for the limbus; and

the imaging data is processed to determine the location of the limbus.

21. The system of claim 13, wherein at least one of the one or more relaxation incisions are incised starting from the inside and proceeding outward.

22. The system of claim 13, wherein the scanner includes an X-Y scan device and a Z-scan device, the Z-scan device being operable to move the focal spot of the laser beam along a z-axis that is substantially aligned with the laser beam, the X-Y scan device being operable to move the focus position laterally to the z-axis, wherein the laser beam propagates through the Z-scan device prior to propagating through the X-Y scan device.

23. The system of claim 22, wherein the OCT device produces an OCT beam that is focused by the Z-scan device and scanned by the X-Y scan device.

24. The system of claim 13, wherein the OCT device is configured to generate signals used to generate three-dimensional positional data for at least one of the cornea, the limbus, and the sclera of the patient'"'"'s eye.