Method and apparatus for creating ocular surgical and relaxing incisions

• US 10,709,548 B2
• Filed: 03/25/2015
• Issued: 07/14/2020
• Est. Priority Date: 03/13/2007
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: AMO Development LLC (Johnson & Johnson)
• Inventors: Culbertson, William, Angeley, David, Marcellino, George, Andersen, Dan E.
• Primary Examiner(s): Eiseman, Lynsey C
• Assistant Examiner(s): Hough, Jessandra F
• Application Number:
  US14/668,696
• Publication Number:
  US 20150196429A1
• Time in Patent Office: 1,938 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

A scanning system for treating target tissue in a patient'"'"'s eye includes an ultrafast laser source configured to deliver a laser beam comprising a plurality of laser pulses; an Optical Coherence Tomography (OCT) device configured to generate signals which may be used to create an image of the cornea and limbus of the eye of the patient; a scanner configured to focus and direct the laser beam in a pattern within the cornea or limbus to create incisions therein; and a controller operatively coupled to the laser source and scanner configured to control the scanner to adjust the position of the laser beam based upon the signals from the OCT device to create a cataract incision in the cornea or limbus that provides access for lens removal instrumentation to a crystalline lens of the patient'"'"'s eye, and a relaxation incision in the cornea or limbus.

Claims

1. A scanning system for treating target tissue in a patient'"'"'s eye, comprising:

a) an ultrafast laser source configured to deliver a laser beam comprising a plurality of laser pulses;

b) an Optical Coherence Tomography (OCT) device configured to generate signals which may be used to create an image of the cornea and limbus of the eye of the patient;

c) a scanner configured to focus and direct the laser beam in a pattern within the cornea or limbus to create incisions therein; and

d) a controller operatively coupled to the laser source and scanner programmed to determine a treatment pattern based upon the signals from the OCT device, the treatment pattern forming a cataract incision in the cornea that provides access for lens removal instrumentation to a crystalline lens of the patient'"'"'s eye and one or more relaxation incisions in the cornea or limbus, wherein the cataract incision has an arcuate extent of less than 360 degrees in a top view, wherein the cataract incision includes a bevel shape in a cross-sectional view, the bevel shape including a first segment and a second segment which intersect each other at an angle, the cataract incision being entirely located in the cornea and intersecting both an anterior surface and a posterior surface of the cornea, and to control the scanner to scan the position of the laser beam in the treatment pattern.

2. The system of claim 1, wherein the controller is programmed to operate the laser source and scanner such that at least one of the incisions only partially extends through the target tissue.

3. The system of claim 1, further comprising:

a profilometer for measuring a surface profile of a surface of the cornea of the patient'"'"'s eye, wherein the controller is programmed to determine the treatment pattern in response to the measured surface profile.

4. The system of claim 1, wherein the OCT device is configured to measure scattering properties from different locations on the patient'"'"'s eye, wherein the controller is programmed to determine the treatment pattern in response to the scattering properties.

5. The system of claim 1, wherein the controller is programmed to operate the laser source and scanner to create incisions within the tissue at a depth based upon the signals from the OCT device.

6. The system of claim 1, wherein the scanner comprises a Z-scan device operable to move a focus position of the laser beam along a z-axis and a X-Y scan device operable to move the focus position of the laser beam laterally relative to the z-axis.

7. The system of claim 6, wherein the OCT device produces an OCT beam that passes through the Z-scan device and the X-Y scan device.

8. The system of claim 1, wherein the ultrafast laser source is configured to deliver a laser beam having a wavelength between 1010 nm to 1100 nm.

9. The system of claim 1, wherein the ultrafast laser source is configured to deliver laser pulses having pulse lengths of 100 fs to 10000 fs.

10. The system of claim 1, wherein the ultrafast laser source is configured to deliver a plurality of laser pulses having a pulse repetition frequency of 10 kHz to 250 kHz.

11. The system of claim 1, wherein the OCT device comprises an OCT light source configured to generate a light beam having wavelengths of 800 nm to 1400 nm.

12. The system of claim 1, wherein the OCT device comprises a broadband OCT light source.

13. The system of claim 1, wherein the OCT device is a frequency domain OCT device.

14. The system of claim 13, wherein the frequency domain OCT device comprises a swept light source.

15. The system of claim 1, further comprising a wavefront sensing system configured to measure the optical aberration of the eye.

16. The system of claim 15, wherein the wavefront sensing system comprises a Shack-Hartmann wavefront sensor configured to measure a shape of a wavefront of light that exits the eye'"'"'s pupil.

17. The system of claim 16, wherein a correction to the shape of the cornea is made based on the shape of the wavefront.