Method and apparatus for patterned plasma-mediated laser trephination of the lens capsule and three dimensional phaco-segmentation

• US 20060195076A1
• Filed: 01/09/2006
• Published: 08/31/2006
• Est. Priority Date: 01/10/2005
• Status: Active Grant

• Current Assignee: AMO Development LLC (Johnson & Johnson)
• Original Assignee: OptiMedica Corporation (Johnson & Johnson)
• Inventors: Palanker, Daniel V., Blumenkranz, Mark S., Andersen, Dan E., Mordaunt, David H.
• Granted Patent: US 8,394,084 B2
• Time in Patent Office: Days
• US Class Current: 606/4
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61F 2/1602 Corrective lenses for use in addition to the natural lenses of the eyes or for pseudo-phakic eyes
• CPC Class Codes: A61F 2009/00844 Feedback systems
• CPC Class Codes: A61F 2009/00851 Optical coherence topography [OCT]
• CPC Class Codes: A61F 2009/00865 Sclera
• CPC Class Codes: A61F 2009/0087 Lens
• CPC Class Codes: A61F 2009/00878 Planning
• CPC Class Codes: A61F 2009/00882 based on topography
• CPC Class Codes: A61F 2009/00887 Cataract
• CPC Class Codes: A61F 2009/00889 Capsulotomy
• CPC Class Codes: A61F 2009/00895 Presbyopia
• CPC Class Codes: A61F 2009/00897 Scanning mechanisms or algorithms
• CPC Class Codes: A61F 9/00736 Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments A61F9/008 takes precedence
• 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 9/00814 Laser features or special beam parameters therefor
• CPC Class Codes: A61F 9/00825 for photodisruption
• CPC Class Codes: A61F 9/00831 : Transplantation
• CPC Class Codes: A61F 9/00834 : Inlays; Onlays; Intraocular lenses [IOL]
• CPC Class Codes: A61F 9/00836 : Flap cutting
• CPC Class Codes: A61F 9/00838 : Correction of presbyopia
• 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

System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye tissue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Claims

1. A method of making an incision in eye tissue, comprising:

generating a beam of light;

focusing the beam at a first focal point located at a first depth in the eye tissue;

scanning the beam in a pattern on the eye while focused at the first depth;

focusing the beam at a second focal point located at a second depth in the eye tissue different than the first depth; and

scanning the beam in the pattern on the eye while focused at the second depth.

2. The method of claim 1, wherein:

the focusing of the beam at the first and second focal points are performed consecutively; and

the scanning of the beam while focused at the first and second depths are performed consecutively.

3. The method of claim 1, wherein the focusing and scanning at the first depth is performed before the focusing and scanning at the second depth, and wherein the first depth is greater than the second depth.

4. The method of claim 1, wherein the focusing of the beam at the first and second focal points are performed simultaneously.

5. The method of claim 4, wherein the focusing of the beam at the first and second focal points includes passing the beam through an optical element having a plurality of segments, and wherein the first and second focal points are laterally displaced from each other.

6. The method of claim 4, wherein the focusing of the beam at the first and second focal points includes passing the beam through a multi-focal length optical element.

7. The method of claim 6, wherein the multi-focal length optical element includes a plurality of segments having different focal lengths.

8. The method of claim 7, wherein the plurality of segments co-axial.

9. The method of claim 7, wherein the plurality of segments off-axial.

10. The method of claim 6, wherein the multi-focal length optical element includes:

a plurality of optical fibers having output ends spaced at varying distances from the eye tissue; and

a lens for imaging the output ends onto the eye tissue.

11. The method of claim 1, further comprising:

generating an image of the eye tissue; and

identifying target portions of the eye tissue using the generated image, wherein the focusing and scanning of the beam are performed at the identified target portions of the eye tissue.

12. The method of claim 11, further comprising:

using the generated image to determine at least one of a number of pulses of the light beam, a repetition rate of the light beam, a configuration of the pattern, and a focusing element for the focusing of the light beam.

13. A method of making an incision in eye tissue, comprising:

generating a beam of light; and

passing the beam through a multi-focal length optical element so that a first portion of the beam is focused at a first focal point located at a first depth in the eye tissue and a second portion of the beam is focused at a second focal point located at a second depth in the eye tissue different than first depth.

14. The method of claim 13, wherein the multi-focal length optical element includes a plurality of segments having different focal lengths.

15. The method of claim 14, wherein plurality of the segments co-axial.

16. The method of claim 15, wherein plurality of the segments off-axial.

17. The method of claim 13, wherein the multi-focal length optical element includes:

a plurality of optical fibers having output ends spaced at varying distance from the eye tissue; and

a lens for imaging the output ends onto the eye tissue.

18. The method of claim 13, wherein:

the multi-focal length optical element includes a plurality of segments; and

the first and second focal points are laterally displaced from each other.

19. A method of making an incision in eye tissue, comprising:

generating a beam of light having at least a first pulse of light and a second pulse of light; and

focusing the first and second pulses of light consecutively into the eye tissue, wherein the first pulse creates a plasma at a first depth within the eye tissue, and wherein the second pulse arrives before the plasma disappears and is absorbed by the plasma to extend the plasma in the eye tissue along the beam.

20. The method of claim 19, wherein the first and second pulses are separated by at least 0.1 ps but not more than 10 ns.

21. The method of claim 20, wherein the first and second pulses each have an energy of at least about 1 μ

J.

22. A method of making an incision in eye tissue, comprising:

generating a beam of light; and

focusing the light into the eye tissue to create an elongated column of focused light within the eye tissue, wherein the focusing includes subjecting the light to at least one of a non-spherical lens, a highly focused lens with spherical aberrations, a curved mirror, a cylindrical lens, an adaptive optical element, a prism, and a diffractive optical element.

23. The method of claim 22, wherein the elongated column extends in a direction generally perpendicular to a propagation direction of the light beam.

24. The method of claim 22, wherein the elongated column extends in a direction generally parallel to a propagation direction of the light beam.

25. A method of removing a lens and debris from an eye, comprising:

generating a beam of light;

focusing the light into the eye to fragment the lens into pieces;

removing the pieces of lens; and

then

focusing the light into the eye to ablate debris in the eye.

26. The method of claim 25, wherein the generated light is pulsed.

27. The method of claim 25, wherein the removing of the pieces of the lens include at least one of irrigating the eye and inserting an aspirating probe into the eye.

28. A method of removing a lens from a lens capsule in an eye, comprising:

generating a beam of light;

focusing the light into the eye to form incisions in the lens capsule;

inserting an ultrasonic probe through the incision and into the lens capsule to break the lens into pieces;

removing the lens pieces from the lens capsule;

rinsing the lens capsule to remove endothermial cells therefrom; and

inserting at least one of a synthetic foldable intraocular lens or an optically transparent gel into the lens capsule.

29. An ophthalmic surgical system for treating eye tissue, comprising:

a light source for generating a beam of light;

a delivery system for focusing the beam onto the eye tissue; and

a controller for controlling the light source and the delivery system such that the light beam is focused at multiple focal points in the eye tissue at multiple depths within the eye tissue.

30. The system of claim 29, wherein the delivery system includes a multi-focal length optical element for focusing the beam into the eye tissue at the multiple focal points and at the multiple depths simultaneously.

31. The system of claim 30, wherein the multi-focal length optical element includes a plurality of segments having different focal lengths.

32. The system of claim 31, wherein the plurality of segments co-axial.

33. The system of claim 31, wherein the plurality of segments off-axial.

34. The system of claim 30, wherein the multi-focal length optical element includes:

a plurality of optical fibers having output ends spaced at varying distances from the eye tissue; and

a lens for imaging the output ends onto the eye tissue.

35. The system of claim 30, wherein the multi-focal length optical element includes a plurality of segments, and the multiple focal points are laterally displaced from each other.

36. The system of claim 29, wherein:

the delivery system includes at least one moving optical element under the control of the controller for deflecting the light beam in a pattern and for changing the depths of the focal points in the eye tissue; and

the controller causes the light beam to scan across the eye tissue in the pattern a first time with the focal point at a first depth within the eye tissue and a second time with the focal point at a second depth within the eye tissue different than the first depth.

37. The system of claim 36, wherein the controller causes the scanning with the focal point at the first depth to be performed before the scanning with the focal point at the second depth, and wherein the first depth is greater than the second depth.

38. The system of claim 36, wherein the delivery system includes a multi-focal length optical element for focusing the beam into the eye tissue at the multiple focal points and at the multiple depths simultaneously.

39. The system of claim 38, wherein the multi-focal length optical element includes a plurality of segments having different focal lengths.

40. The system of claim 39, wherein the plurality of segments co-axial.

41. The system of claim 39, wherein the plurality of segments off-axial.

42. The system of claim 38, wherein the multi-focal length optical element includes:

a plurality of optical fibers having output ends spaced at varying distances from the eye tissue; and

a lens for imaging the output ends onto the eye tissue.

43. The system of claim 36, further comprising:

an image device for generating an image of the eye tissue from which a target portion of the eye tissue can be identified, wherein the controller causes the scanning of the pattern to occur at the identified target portion of the eye tissue.

44. The system of claim 43, wherein the controller causes the determination of at least one of a number of pulses of the light beam, a repetition rate of the light beam, a configuration of the pattern, and a focusing element for the focusing of the light beam using the generated image from the image device.

46. The system of claim 44, wherein the first and second pulses are separated by at least 0.1 ps and not more than 10 ns.

45. An ophthalmic surgical system for treating eye tissue, comprising:

a light source for generating a beam of light having at least a first pulse of light and a second pulse of light;

a delivery system for focusing the beam onto the eye tissue; and

a controller for controlling the light source and the delivery system such that the first and second pulses of light are consecutively focused onto the eye tissue, wherein the first pulse creates a plasma at a first depth within the eye tissue, and wherein the second pulse is arrives before the plasma disappears and absorbed by the plasma to extend the plasma in the eye tissue along the beam.

47. The system of claim 45, wherein the first and second pulses each have an energy of at least about 1 μ

J.

49. The system of claim 47, wherein the elongated column extends in a direction generally perpendicular to a propagation direction of the light beam.

50. The system of claim 47, wherein the elongated column extends in a direction generally parallel to a propagation direction of the light beam.

48. An ophthalmic surgical system for treating eye tissue, comprising:

a light source for generating a beam of light;

a delivery system for focusing the beam onto the eye tissue, the delivery system including at least one of a non-spherical lens, a highly focused lens with spherical aberrations, a curved mirror, a cylindrical lens, an adaptive optical element, a prism, and a diffractive optical element; and

a controller for controlling the light source and the delivery system such that an elongated column of focused light within the eye tissue is created.