Apparatus for patterned plasma-mediated laser ophthalmic surgery

• US 9,474,648 B2
• Filed: 11/23/2015
• Issued: 10/25/2016
• 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., Mordaunt, David H., Andersen, Dan E.
• Primary Examiner(s): Thomson, William
• Assistant Examiner(s): Lipitz, Jeffrey
• Application Number:
  US14/949,645
• Publication Number:
  US 20160074229A1
• Time in Patent Office: 337 Days
• Field of Search: 606/4, 606/5, 606/11, 606/12, 606/16
• US Class Current: 1/1
• 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

A system for ophthalmic surgery on an eye includes: a pulsed laser which produces a treatment beam; an OCT imaging assembly capable of creating a continuous depth profile of the eye; an optical scanning system configured to position a focal zone of the treatment beam to a targeted location in three dimensions in one or more floaters in the posterior pole. The system also includes one or more controllers programmed to automatically scan tissues of the patient'"'"'s eye with the imaging assembly; identify one or more boundaries of the one or more floaters based at least in part on the image data; iii. identify one or more treatment regions based upon the boundaries; and operate the optical scanning system with the pulsed laser to produce a treatment beam directed in a pattern based on the one or more treatment regions.

Claims

1. A laser surgical system for making incisions in ocular tissues during a cataract surgical procedure, the system comprising:

a laser system comprising a scanning assembly;

a laser operable to generate a laser beam configured to incise ocular tissue;

an imaging device configured to acquire image data of at least a portion of the lens; and

a control system operably coupled to the laser system and configured to;

operate the imaging device to generate image data for the patient'"'"'s crystalline lens;

process the image data to determine an anterior capsule incision scanning pattern for scanning a focal zone of the laser beam for performing an anterior capsule incision; and

operate the laser and the scanning assembly to scan the focal zone of the laser beam in the anterior capsule incision scanning pattern to perform the anterior capsule incision, wherein positioning of the focal zone is determined in part by the control system based on the image data.

2. The system of claim 1, wherein the imaging device comprises an optical coherence tomography (OCT) imaging device.

3. The system of claim 2, wherein the control system is configured to control the scanning assembly to scan the laser beam relative to the lens to provide the sample input to the OCT imaging device to generate three-dimensional location data for the anterior capsule of the lens of the patient'"'"'s eye;

and the control system is configured to determine the anterior capsulotomy scanning pattern based on the three-dimensional location data for the anterior capsule.

4. The system of claim 1, wherein the laser beam has a wavelength between 800 nm and 1,100 nm, the laser beam comprises pulses having pulse energy between 1.0 micro joules and 1000 micro joules, a pulse duration between about 100 femtoseconds and about 10 picoseconds, and a pulse repetition rate between 1 kHz and about 100 kHz.

5. The system of claim 1, wherein the anterior capsule incision scanning pattern is configured to scan the focal zone to different depths, and wherein the focal zone is first scanned at a maximum depth and then scanned to sequentially shallower depths.

6. The system of claim 1, wherein the control system is configured to control the laser and the scanning assembly to scan the focal zone of the laser beam to segment the lens into the discrete fragments by scanning the focal zone in one or more lens fragmentation scanning patterns.

7. The system of claim 6, wherein the discrete fragments are sized to be removable through a lumen of an ophthalmic aspiration probe.

8. The system of claim 6, wherein the one or more lens fragmentation scanning patterns include at least one of a linear pattern, a planar pattern, a radial pattern, a circular pattern, a spiral pattern, a curvilinear pattern, or two or more overlapping line segments.

9. The system of claim 6, wherein:

scanning the focal zone in the one or more lens fragmentation scanning patterns comprises sequentially applying laser pulses to different depths within the lens; and

the laser pulses are first applied at a maximum depth within the lens and then applied to sequentially shallower depths within the lens.

10. The system of claim 1, wherein:

the scanning assembly comprises a z-axis scanning device and a transverse scanning device, the z-axis device being operable to change the location of the focal zone of the laser beam parallel to the direction of propagation of the laser beam, the transverse scanning device being operable to scan the location of the focal zone transverse to the direction of propagation of the laser beam; and

the scanning assembly is configured such that the laser beam is acted upon by the z-axis scanning device before being acted upon by the transverse scanning device.

11. The system of claim 10, wherein:

the z-axis scanning device comprises one or more movable lenses; and

the transverse scanning device comprises one or more controllable scanning elements.

12. The system of claim 1, wherein the control system is configured to:

process the image data to determine one or more axial locations of the anterior capsule of the lens; and

or more anterior capsule axial locations.

13. The system of claim 12, wherein the control system is configured to determine a posterior cutting boundary for the anterior capsule incision scanning pattern based on the one or more anterior capsule axial locations.

14. The system of claim 1, wherein the control system is configured to determine an anterior cutting boundary for the anterior capsule incision scanning pattern based on the one or more anterior capsule axial locations.

15. The system of claim 1, wherein the control system configures the anterior capsule incision scanning pattern based in part on an input from a user interface.