US20090177189A1 - Photodisruptive laser fragmentation of tissue - Google Patents
Photodisruptive laser fragmentation of tissue Download PDFInfo
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- US20090177189A1 US20090177189A1 US12/351,784 US35178409A US2009177189A1 US 20090177189 A1 US20090177189 A1 US 20090177189A1 US 35178409 A US35178409 A US 35178409A US 2009177189 A1 US2009177189 A1 US 2009177189A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—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
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—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
- A61F9/007—Methods or devices for eye surgery
- A61F9/00736—Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—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
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—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
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00844—Feedback systems
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—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
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
- A61F2009/0087—Lens
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—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
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00897—Scanning mechanisms or algorithms
Definitions
- This application relates to laser surgery techniques and systems for operating on eyes.
- Laser light can be used to perform surgical operations on various parts of an eye for vision correction and other medical treatment. Techniques for performing such procedures with higher efficiency may provide desired benefits.
- the method of fragmenting biological tissue with a photodisruptive laser includes selecting a target region of the tissue for fragmentation, directing a beam of laser pulses to the selected target region of the tissue, and forming cells in the target region of the tissue by directing the laser beam to generate cell boundaries.
- the tissue is a tissue of an eye.
- the tissue is a crystalline lens of the eye.
- the method further includes inserting an aspiration needle into the target region and removing fragmented tissue from the target region already scanned by the laser beam by using the aspiration needle.
- the forming the cells includes forming cells with size sufficiently small to pass through the aspiration needle.
- the forming the cells includes forming the cells arranged in an array.
- the array is a regular array.
- the regular array is one of a simple cubic lattice, a face centered lattice, a body centered lattice, a hexagonal lattice, a Bravais lattice, and a stack of two dimensional lattices.
- the array is essentially a random array.
- the forming the cells includes fragmenting the target tissue into cells of spheres or polyhedra.
- the forming the cells includes scanning the laser beam to form multiple cells in parallel in a layer.
- the forming the cells includes directing the laser beam to form individual cells successively.
- the forming the cells includes scanning the laser beam to form a cell array progressing from a posterior to an anterior direction, or scanning the laser beam to form a cell array progressing from an anterior to a posterior direction.
- the directing the laser beam to generate cell boundaries includes generating the cell boundaries by creating layers of bubbles in the target region of the tissue.
- the creating layers of bubbles includes creating a layer of bubbles by applying a laser beam with an essentially constant power, or with a varying power.
- the directing the beam of laser pulses includes applying the laser pulses with a laser parameter of at least one of: a pulse duration between 0.01 picosecond and 50 picoseconds, a repetition rate between 10 kiloHertz and 100 megaHertz, a pulse energy between 1 microjoule and 25 microjoule, and a pulse target separation between 0.1 micron and 50 microns.
- the directing the beam of laser pulses comprises applying the laser pulses with a laser parameter based on a preoperative measurement of structural properties of the target region of the tissue, or an age dependent algorithm.
- the method also includes applying additional laser pulses to one or more locations outside the target region of the tissue to create an opening for an additional procedure.
- the method includes identifying a surgical goal, and selecting laser parameters and method features to achieve the identified surgical goal.
- the surgical goal is an optimization of one or more of a speed of the method of fragmenting, a total amount of energy applied to the eye during the fragmenting, and a total number of generated bubbles.
- the surgical goal is one or more of: maximization of the speed of the method of fragmenting, minimization of the total amount of energy applied to the eye during the fragmenting, and minimization of the total number of generated bubbles.
- the method includes selecting laser parameters and method features to achieve a total time of fragmentation of one of less than 2 minutes, less than 1 minute, and less than 30 seconds.
- the method includes selecting laser parameters and method features to achieve a ratio of a cell size to a bubble size of one of: larger than 10, larger than 100, and larger than 1000.
- a laser system for fragmenting biological tissue includes a pulsed laser to produce a laser beam of pulses, and a laser control module to direct the laser beam to a selected target region of the tissue and to direct the laser beam to generate cell boundaries to form cells in the target region of the tissue.
- the laser control module is configured to form cells in a regular array.
- the laser control module formed to generate the laser pulses with laser parameters of at least one of: a pulse duration between 0.01 and 50 picoseconds, a repetition rate between 10 kHz and 100 megahertz, a pulse energy between 1 microjoule and 25 microjoule, and a pulse target separation between 0.1 micron and 50 microns.
- a method of fragmenting a tissue in an eye with a photodisruptive laser includes selecting a target region in the eye for fragmentation, and forming an array of cells in the target region by directing a beam of laser pulses to generate cell boundaries in the target region, with a cell size and laser parameters of the laser beam such that the tissue fragmentation requires a surgical time of less than two minutes, whereas a volumetric tissue fragmentation of the same target region with the same laser parameters would require a surgical time in excess of two minutes.
- the laser parameters are at least one of a pulse duration between 0.01 and 50 picoseconds, a repetition rate between 10 kHz and 100 MHz, a pulse energy between 1 microjoule and 25 microjoule, and a pulse target separation between 0.1 micron and 50 microns, and the cell size is between 1 microns and 50 microns.
- FIGS. 1 a - c illustrate a volumetric eye disruption procedure.
- FIG. 2 illustrates an aspiration step
- FIG. 3 illustrates an ophthalmic surgery system
- FIGS. 4 a - b illustrate a regular cell array.
- FIGS. 5 a - d illustrate a layer-by-layer formation of a cell array.
- FIGS. 6 a - b illustrate a formation of a cell array on a cell-by-cell basis.
- FIGS. 7 a - c illustrate spherical and polyhedral cell structures.
- This application describes examples and implementations of techniques and systems for laser surgery on the crystalline lens via photodisruption caused by laser pulses.
- Various lens surgical procedures for removal of the crystalline lens utilize various techniques to break up the lens into small fragments that can be removed from the eye through small incisions. These procedures may use manual mechanical instruments, ultrasound, heated fluids or lasers and tend to have significant drawbacks, including the need to enter the eye with probes in order to accomplish the fragmentation, and the limited precision associated with such lens fragmentation techniques.
- Photodisruptive laser technology can deliver laser pulses into the lens to optically fragment the lens without the insertion of a probe and thus can offer the potential for lens removal with improved control and efficiency.
- Laser-induced photodisruption has been widely used in laser ophthalmic surgery. In particular, Nd: YAG lasers have been frequently used as the laser sources, including lens fragmentation via laser induced photodisruption.
- laser pulses interact with the lens tissue to generate gas in form of cavitation bubbles and decrease the lens tissue transparency. Because the laser pulses are sequentially delivered into the lens, the cavitation bubbles and reduced lens tissue transparency caused by the initial laser pulses can obscure the optical path of subsequent laser pulses and thus can interfere with the delivery of subsequent laser pulses directed to additional target positions in the lens by blocking, attenuating or scattering the subsequent laser pulses. This effect can reduce the actual optical power level of the subsequent laser pulses and thus adversely affect fragmentation at the deeper locations in the lens. Some known laser-induced lens fragmentation processes do not provide effective solutions to address this technical issue.
- techniques, apparatus and systems described in this application can be used to effectively fragment the crystalline lens to remove a portion of or the entirety of the lens by using photodisruptive laser pulses with reduced interference caused by laser-induced air bubbles in the eye during the photodisruption process.
- the present methods and apparatus allow fragmentation of the entire or significant portions of the crystalline lens utilizing a photodisruptive laser delivered with minimized interference from gas generated during photodisruption.
- the method allows the use of significantly less total laser energy to treat the eye and reduces potential undesired effects such as heat generated by the laser and reduces overall procedure time.
- the removal of a portion of or the entirety of the crystalline lens can be achieved via aspiration with reduced or no need of other lens fragmentation or modification modalities.
- the crystalline lens has multiple optical functions in the eye, including preservation of a transparent optical path and dynamic focusing capability.
- the lens is a unique tissue in the human body in that it continues to grow in size during gestation, after birth and throughout life. Since new lens fiber cells are added from a germinal center located on the equatorial periphery of the lens, the oldest lens fibers are located centrally in the lens. This region, called the lens nucleus, has been further subdivided into embryonal, fetal and adult nuclear zones. While the lens increases in diameter, it may also undergo compaction so that the properties of the nucleus are different from the cortex (Freel et al BMC Opthalmology 2003, 3:1).
- lens fiber cells undergo progressive loss of cytoplasmic elements and since there is no blood supply or lymphatics to supply the inner zone of the lens, it becomes progressively more difficult to preserve the optical clarity and other properties (e.g., lens flexibility) that serve the function of the lens.
- optical clarity and other properties e.g., lens flexibility
- the central core of the lens occupying the inner approximately 6-8 mm in equatorial diameter and approximately 2-3.5 mm in axial diameter. This region has been shown to have reduced permeability to and from the metabolically active cortex and outer nucleus (Sweeney et al Exp Eye res, 1998:67, 587-95).
- FIGS. 1 a - c illustrate an example where a photodistruptive laser system is operated to place laser pulses essentially uniformly within a surgical region, e.g., the eye lens, to be treated to allow aspiration and removal of the lens material.
- a photodistruptive laser system is operated to place laser pulses essentially uniformly within a surgical region, e.g., the eye lens, to be treated to allow aspiration and removal of the lens material.
- One way to fill the volume with laser is to direct the laser pulses with a scanner to form a bubble layer and fill the entire volume with a multitude of layers, as shown in FIG. 1 c.
- FIG. 2 illustrates that after the laser treatment, an aspiration device can be used to remove the disrupted lens material.
- the laser pulse characteristics such as their duration can range from 0.01 picoseconds (ps) to 50 picoseconds.
- the laser pulse energy, layer, line and spot separations can be optimized to achieve the highest effectiveness of breaking up the tissue wile minimizing the effects of gas spreading, laser exposure and procedure time.
- the threshold laser pulse parameters to achieve this can vary as well.
- the laser energy per pulse can range from 1 microjoule ( ⁇ J) to 25 ⁇ J and the spatial pulse separation between two initial pulses adjacent in space can fall within the range of 0.1 micron to 50 microns.
- the laser pulse duration can range from 0.01 picoseconds to 50 picoseconds and the laser repetition rate from 10 kHz to 100 MHz.
- the parameters of the laser pulses and the scan pattern can be determined by various methods. For example, they can be based on a preoperative measurement of the lens optical or structural properties.
- the laser energy and the spot separation can also be selected based on a preoperative measurement of lens optical or structural properties and the use of an age-dependant algorithm.
- the pulsed laser is operated to direct a sequence of laser pulses to a target lens region of the lens to fragment the target lens region.
- the laser pulses may also be directed to one or more regions of the lens other than the target lens region, e.g., peripheral locations and/or the lens capsule, to create an opening or incision in the lens. After the desired fragmentation and incision are achieved, the laser pulses can be terminated and the fragmented target lens region and any other selected portions of the lens are removed from the lens body by aspiration.
- the following sections describe techniques and laser systems for applying laser pulses to surfaces and boundaries of cells of predetermined size, shape and spatial distribution that differ from the above described uniform volumetric distribution of the laser pulses within the treated volume.
- the lens tissue can subsequently break up along the surfaces and boundaries of the cells.
- the size of the cells or granules can be determined to be small enough that they can easily be removed by using e.g. an aspiration device.
- a typical aspiration device is a needle attached to a suction pump. For example a 23 gauge needle has an inner diameter of 0.34 mm. Cells smaller than the inner diameter of the aspiration needle can pass through the needle without clogging.
- FIG. 3 illustrates a laser surgical system for performing such a non-uniform laser distribution process.
- An optics module 310 can focus and direct the laser beam to a target lens 301 .
- the optics module 310 can include one or more lenses and may further include one or more reflectors.
- a control actuator can be included in the optics module 310 to adjust the focusing and the beam direction in response to a beam control signal.
- a system control module 320 can control both a pulsed laser 302 via a laser control signal and the optics module 310 via the beam control signal.
- An imaging device 330 may collect reflected or scattered light or sound from the target lens 301 to capture image data via the target lens 301 .
- the captured image data can then be processed by the laser system control module 320 to determine the placement of the applied laser pulses.
- This control can be a dynamic alignment process during the surgical process to ensure that the laser beam is properly directed at each target position.
- the imaging device 330 can be implemented in various forms, including an optical coherent tomography (OCT) device. In other implementations, an ultrasound imaging device can also be used.
- the system control module 320 may process image data from the imaging device 330 that includes the position offset information for the photodisruption byproducts in the target region. Based on the offset information obtained from the image data, the beam control signal can be generated to control the optics module 310 , which can adjust the laser beam in response.
- a digital processing unit can be included in the system control module 320 to perform various data processing functions for the laser alignment and laser surgery. The digital processing unit can be programmed to control the laser parameters of the initial laser pulses and the additional laser pulses, laser beam scanning direction from the posterior to anterior direction for the initial laser pulses and the laser movement of the additional laser pulses.
- the pulsed laser 302 can be a high repetition rate pulsed laser at a pulse repetition rate of thousands of shots per second or higher with relatively low energy per pulse.
- a laser can be operated to use relatively low energy per pulse to localize the tissue effect caused by laser-induced photodisruption.
- a form of this tissue effect is the formation of cavitation bubbles.
- the impacted tissue region can have a size of the order of microns or tens of microns. This localized tissue effect can improve the precision of the laser surgery and can be desirable in certain ophthalmic surgical procedures.
- placement of many hundred, thousands or millions of contiguous or near contiguous pulses can be used to achieve certain desired surgical effect placement.
- Such procedures using high repetition rate pulsed lasers may require high precision in positioning each pulse in the target region during surgery, both regarding their absolute position with respect to a target location and their relative position with respect to preceding pulses.
- subsequent laser pulses may be required to be delivered next to each other with an accuracy of a few microns, when the time between pulses (the repetition rate) can be of the order of microseconds.
- FIGS. 4 a - b show an implementation of an ophthalmic surgical procedure, during which laser spots (or bubbles) are generated to form granules, the granules themselves forming a granule array.
- the laser spots can be generated to form a regular spatial pattern of the granules, as shown in FIG. 4 b .
- Regularly spaced granules utilize the laser pulses well, since they require a limited amount of laser energy to break up a target region. Nevertheless, in other implementations the granules may form an irregular or even random array.
- the cells can be packed next to one another. Creating the side wall of one cell can simultaneously create the side of the neighboring cell as well, making the process efficient.
- the design of the individual cells and the cell pattern may be selected based on the physical properties of the tissue to be treated.
- the bulk of the lens consists of concentric layers of elongated fiber cells. Cleavage of tissue parallel and perpendicular to the layers and individual fibers is different. Therefore, in some implementations a higher spot density and/or laser pulse energy can be used to form cell boundaries which are perpendicular to layers and fibers.
- a regular pattern can be built all at once or granule by granule. Which method to use may depend on the particular laser scanner and it is a matter of optimization to achieve higher precision and shorter procedure time.
- the granules, or cells can be cubes.
- this pattern of cells can be described as a Simple Cubic (SC) crystal. Layers of these cubes can be formed simultaneously, followed by repeating the procedure in subsequent layers.
- SC Simple Cubic
- FIGS. 5 a - d illustrate that in some implementations first a bubble layer can be generated with the laser pulses to form the bottom layer of the SC crystal, as shown in FIG. 5 a .
- this bottom layer can be essentially transverse, or perpendicular, to an optical axis of the lens or the eye.
- an optical axis can be defined in several different ways, with somewhat different outcomes. In what follows, the term “optical axis” will be used to refer to an axis defined by any one of these procedures, or even a compromise axis, defined as a direction falling between differently defined axes.
- FIG. 5 b illustrates that subsequent to the formation of the bottom layer, a regular array of cell walls can be generated. These walls can be essentially parallel to the optical axis, formed with a predetermined cell height.
- FIGS. 5 b and 5 c illustrate that the scanner can raster, or sweep, first in one direction ( FIG. 5 b ) then in an orthogonal direction ( FIG. 5 c ).
- FIG. 5 d illustrates that a layer of cells can be completed by placing a bubble-layer to form the top of the cells. This “top” bubble-layer can then form the bottom bubble-layer for the next layer of cells.
- the target volume can be filled up with a regular array of granules/cell by repeating the steps 5 a - d.
- a smooth boundary layer can be formed around the regular array of cells in the surgical target region, partially, or in its entirety. Such a boundary layer can provide a smooth surface without the raggedness of the edges of the cell array.
- the crystalline cell array/structure can be oriented differently, the bottom layer forming any angle with the optical axis of the eye.
- the layers themselves can be somewhat curved, to accommodate the natural curvature of the lens target region itself or the natural curvature of the focal plane of the surgical system.
- Such structures may not be entirely regular. They may contain deformations or lattice defects. These defects can be formed intentionally or may emerge during the creation of the cell array.
- FIGS. 6 a - b illustrate an alternative implementation, where complete cells of a layer can be formed individually one after the other by controlling the scanner to form all walls of a single cell, and to start forming the next cell only after the previous cell is completed.
- FIG. 6 a illustrates that rows of cells can be formed first to build a layer of cells.
- FIG. 6 b illustrates that subsequent layers can be formed on top of already created layers, to fill a surgical target volume.
- FIGS. 7 a - c illustrate that the shape of the cells can be different from the simplest shapes, like cubes.
- the cell array can have a hexagonal base to form a Simple Hexagonal (SH) lattice.
- a target volume can be broken up into cells of a different type, such as spheres ( FIG. 7 a ), separated by complementary small interstitial regions.
- Spherical cell shapes can minimize the occurrence of clogging in the aspiration needle.
- the type of the lattice, formed by the spherical cells can be selected to optimize the ratio of the volume of the spheres to the volume of the interstitial regions.
- These lattice types are known as “close packed” crystals structures. Face Centered Cubic (FCC) and Hexagonal Closest Packing (HCP) are two such structures.
- FCC Face Centered Cubic
- HCP Hexagonal Closest Packing
- the cells can have shapes which approximate spheres, such as polyhedral shapes.
- the polyhedral cells can form close packed structures, analogously to the lattice of spheres.
- FIG. 7 b illustrates a Truncated Rhombic Dodecahedron, which is an example of a polyhedron approximating a sphere.
- FIG. 7 c illustrates that truncated rhombic dodecahedrons can be close packed to form a layer, and fill a target volume with a stack of layers. When passing through the aspiration needle, these polyhedra can more readily roll than cubes and the likelihood of clogging is smaller.
- the laser scanner pattern can be optimized to speed up completion of the whole pattern. Creating individual cells with sizes of the order of 100 to 200 micrometers require small scanner displacements and can be performed at higher scanner speed. Larger scale moves of the scanner can be slower.
- the design of the scanner can be optimized effectively for achieving the shortest overall procedure time. Applying a combination of two different scanner types, a fast small displacement scanner and a slow but larger displacement scanner, can further optimize system performance. Building cells individually is also consistent with modular software design practices.
- a complete volumetric pattern can be created from building blocks; cells, rows and layers of cells and finally the complete pattern.
- An analogous approach can be effective in constructing a software code for the scanner drivers as well.
- the above described or other patterns can be created by proceeding from the posterior to the anterior side of the lens or from the anterior to the posterior side.
- the former can be advantageous to avoid blocking the laser beam by bubbles previously formed in the target tissue.
- the latter may be preferable when a cataract is present in the lens and penetration of laser light through the cataract is already compromised. In that case fragmentation of the anterior portion of the lens may be necessary followed by aspiration of the treated portion and successive laser treatment and aspiration of the deeper-lying parts of the lens until the full volume is fragmented.
- Table 1 illustrates some results of the comparison, contrasting tissue breakdown by performing a volumetric method and by forming a Simple Cubic lattice of cells.
- the volume of an individual gas bubbles is approximately proportional to the energy of the femtosecond laser pulse which created the bubble. This proportionality holds for energies not too close to the threshold of producing plasma.
- the individual pulses are directed such that the gas bubbles touch each other. In the volumetric method this translates to the spot, line, and layer separation being approximately equal to one another, all being set by the diameter of the bubbles. In the cellular implementation this translates to the cell boundaries being formed by touching spheres. It is noted that in practice, some overlap may be necessary for both volumetric and cell-array methods.
- Table 1 reports comparison results, varying the spot separation from 2 microns to 20 microns and the cell size from 50 microns to 300 microns.
- the speed of the procedure was characterized by the number of pulses needed for a given total volume and the total energy needed.
- the total energy needed to break down the tissue in the target region can be approximately independent of the size of the bubbles. This energy is of the order of 1 Joule per cubic millimeter of target volume. This relationship holds most accurately in the energy range in which the volume of an individual bubble is proportional to the laser pulse energy.
- the speed and the corresponding energy depends both on the size of the individual bubbles and on the size of the cell.
- the speed increases with increasing cell sizes and decreasing bubble sizes. This is the result of the change in the volume to surface ratio of the cells as a function of their size.
- This comparison is based on using a 23 gauge needle which has inner diameter of 340 micrometers.
- the largest size cube which can enter the tube at the least favored orientation, with its body diagonal perpendicular to the length of the tube, is about 196 micrometers. Actual implementations may use smaller grain sizes, such as 150 microns.
- methods based on forming cell-lattices can exhibit an increase of speed by a factor of 2.9 to 25.3 over the speed of the volumetric method as the size of the bubbles is varied.
- the increase of speed can be about 5.4-fold.
- the speed ratio increases with decreasing bubble size.
- the improvement in the procedure time is approximately a factor of 10 for 5 micron bubble size and 25 for 2 micron bubble sizes. These are quite significant improvements over the volumetric method.
- the required total laser energy is proportional to the total volume of gas produced, which is proportional to the number of bubbles for bubbles of a fixed size. Therefore, among methods which use the same average laser power and create similarly sized bubbles, the procedure time is approximately proportional to the number of bubbles created.
- the speed improvement of the cell-array methods over the volumetric methods is proportional to the ratio R of the total number of pulses, as demonstrated in Table 1. Implementations with a different bubble size in general require different laser average power, repetition rate, and scanner speed setting. Nevertheless, it remains true for implementations with all bubble sizes that granular/cellular fragmentation decreases the total energy and time required compared to volumetric fragmentation with the same bubble size.
- R can be approximately proportional to the Volume/Surface ratio of the cell. Since the volume of gas produced is approximately proportional to the product of the area of the cell boundaries multiplied with the bubble size, R is approximately proportional to a ratio of a cell size to a bubble size.
- Granular fragmentation with the smallest bubble size produces the smallest amount of gas in the target tissue and uses the smallest amount of total laser energy.
- the bubbles are closely packed, and the corresponding spot separation and line separation is nearly equal to the bubble size when creating the surface of a cell boundary.
- the laser parameters, average power, pulse energy and repetition rate can be chosen over a wide enough range to achieve the desired bubble size, spot and line separations, the scanning system can be limited in its speed and acceleration to generate a particular pattern. To keep the acceleration of the scanner under control at turning points, in some implementations the linear speed of progression of the bubble placement can be kept smaller than a limiting value, v lim .
- the total area of the cell boundaries, A and as demonstrated in Table 1.
- T max is the maximum procedure time tolerable by the clinical environment, less than 1 minute is acceptable, less than 30 seconds is desirable, dictated mainly by the tolerance of the patient to keep still during the procedure.
- the highest linear speed v lim and the largest acceptable bubble size can be selected.
- the largest acceptable bubble size is determined by the amount of gas produced, pulse energy used, and by the required precision of the surgery.
- Some implementations of the surgical system maximize the speed of scanner and lower the laser energy threshold for the formation of cavitation bubbles, in order to minimize bubble size.
- the surgeon has the choice to select particular parameters within the limitation of the surgical system to optimize the parameters for particular surgical outcomes.
- the decision may take into account the size of the surgically affected area, tissue parameters the age of the patient and other factors.
Abstract
A method of photodisruptive laser surgery includes selecting a target region of a tissue for fragmentation, directing a beam of laser pulses to the selected target region of the tissue, and forming cells in the target region of the tissue by directing the laser beam to generate cell boundaries. The cells can be arranged in regular or irregular arrays. The cells can be generated in parallel or successively, with cell sizes and laser parameters which reduce the time of ophthalmic surgery considerably.
Description
- This application claims benefit from and priority of provisional application “Photodisruptive laser fragmentation of tissue”, Ser. No. 61/020,115, filed on Jan. 9, 2008, which incorporated by reference in its entirety as part of the disclosure of this application.
- This application relates to laser surgery techniques and systems for operating on eyes.
- Laser light can be used to perform surgical operations on various parts of an eye for vision correction and other medical treatment. Techniques for performing such procedures with higher efficiency may provide desired benefits.
- A method of photodisruptive laser surgery and corresponding system are provided. In some implementations the method of fragmenting biological tissue with a photodisruptive laser includes selecting a target region of the tissue for fragmentation, directing a beam of laser pulses to the selected target region of the tissue, and forming cells in the target region of the tissue by directing the laser beam to generate cell boundaries.
- In some implementations the tissue is a tissue of an eye.
- In some implementations the tissue is a crystalline lens of the eye.
- In some implementations the method further includes inserting an aspiration needle into the target region and removing fragmented tissue from the target region already scanned by the laser beam by using the aspiration needle.
- In some implementations the forming the cells includes forming cells with size sufficiently small to pass through the aspiration needle.
- In some implementations the forming the cells includes forming the cells arranged in an array.
- In some implementations the array is a regular array.
- In some implementations the regular array is one of a simple cubic lattice, a face centered lattice, a body centered lattice, a hexagonal lattice, a Bravais lattice, and a stack of two dimensional lattices.
- In some implementations the array is essentially a random array.
- In some implementations the forming the cells includes fragmenting the target tissue into cells of spheres or polyhedra.
- In some implementations the forming the cells includes scanning the laser beam to form multiple cells in parallel in a layer.
- In some implementations the forming the cells includes directing the laser beam to form individual cells successively.
- In some implementations the forming the cells includes scanning the laser beam to form a cell array progressing from a posterior to an anterior direction, or scanning the laser beam to form a cell array progressing from an anterior to a posterior direction.
- In some implementations the directing the laser beam to generate cell boundaries includes generating the cell boundaries by creating layers of bubbles in the target region of the tissue.
- In some implementations the creating layers of bubbles includes creating a layer of bubbles by applying a laser beam with an essentially constant power, or with a varying power.
- In some implementations the directing the beam of laser pulses includes applying the laser pulses with a laser parameter of at least one of: a pulse duration between 0.01 picosecond and 50 picoseconds, a repetition rate between 10 kiloHertz and 100 megaHertz, a pulse energy between 1 microjoule and 25 microjoule, and a pulse target separation between 0.1 micron and 50 microns.
- In some implementations the directing the beam of laser pulses comprises applying the laser pulses with a laser parameter based on a preoperative measurement of structural properties of the target region of the tissue, or an age dependent algorithm.
- In some implementations the method also includes applying additional laser pulses to one or more locations outside the target region of the tissue to create an opening for an additional procedure.
- In some implementations the method includes identifying a surgical goal, and selecting laser parameters and method features to achieve the identified surgical goal.
- In some implementations the surgical goal is an optimization of one or more of a speed of the method of fragmenting, a total amount of energy applied to the eye during the fragmenting, and a total number of generated bubbles.
- In some implementation the surgical goal is one or more of: maximization of the speed of the method of fragmenting, minimization of the total amount of energy applied to the eye during the fragmenting, and minimization of the total number of generated bubbles.
- In some implementations the method includes selecting laser parameters and method features to achieve a total time of fragmentation of one of less than 2 minutes, less than 1 minute, and less than 30 seconds.
- In some implementations the method includes selecting laser parameters and method features to achieve a ratio of a cell size to a bubble size of one of: larger than 10, larger than 100, and larger than 1000.
- In some implementations a laser system for fragmenting biological tissue includes a pulsed laser to produce a laser beam of pulses, and a laser control module to direct the laser beam to a selected target region of the tissue and to direct the laser beam to generate cell boundaries to form cells in the target region of the tissue.
- In some implementations the laser control module is configured to form cells in a regular array.
- In some implementations the laser control module formed to generate the laser pulses with laser parameters of at least one of: a pulse duration between 0.01 and 50 picoseconds, a repetition rate between 10 kHz and 100 megahertz, a pulse energy between 1 microjoule and 25 microjoule, and a pulse target separation between 0.1 micron and 50 microns.
- In some implementations a method of fragmenting a tissue in an eye with a photodisruptive laser includes selecting a target region in the eye for fragmentation, and forming an array of cells in the target region by directing a beam of laser pulses to generate cell boundaries in the target region, with a cell size and laser parameters of the laser beam such that the tissue fragmentation requires a surgical time of less than two minutes, whereas a volumetric tissue fragmentation of the same target region with the same laser parameters would require a surgical time in excess of two minutes.
- In some implementations the laser parameters are at least one of a pulse duration between 0.01 and 50 picoseconds, a repetition rate between 10 kHz and 100 MHz, a pulse energy between 1 microjoule and 25 microjoule, and a pulse target separation between 0.1 micron and 50 microns, and the cell size is between 1 microns and 50 microns.
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FIGS. 1 a-c illustrate a volumetric eye disruption procedure. -
FIG. 2 illustrates an aspiration step. -
FIG. 3 illustrates an ophthalmic surgery system. -
FIGS. 4 a-b illustrate a regular cell array. -
FIGS. 5 a-d illustrate a layer-by-layer formation of a cell array. -
FIGS. 6 a-b illustrate a formation of a cell array on a cell-by-cell basis. -
FIGS. 7 a-c illustrate spherical and polyhedral cell structures. - This application describes examples and implementations of techniques and systems for laser surgery on the crystalline lens via photodisruption caused by laser pulses. Various lens surgical procedures for removal of the crystalline lens utilize various techniques to break up the lens into small fragments that can be removed from the eye through small incisions. These procedures may use manual mechanical instruments, ultrasound, heated fluids or lasers and tend to have significant drawbacks, including the need to enter the eye with probes in order to accomplish the fragmentation, and the limited precision associated with such lens fragmentation techniques. Photodisruptive laser technology can deliver laser pulses into the lens to optically fragment the lens without the insertion of a probe and thus can offer the potential for lens removal with improved control and efficiency. Laser-induced photodisruption has been widely used in laser ophthalmic surgery. In particular, Nd: YAG lasers have been frequently used as the laser sources, including lens fragmentation via laser induced photodisruption.
- In a laser-induced lens fragmentation process, laser pulses interact with the lens tissue to generate gas in form of cavitation bubbles and decrease the lens tissue transparency. Because the laser pulses are sequentially delivered into the lens, the cavitation bubbles and reduced lens tissue transparency caused by the initial laser pulses can obscure the optical path of subsequent laser pulses and thus can interfere with the delivery of subsequent laser pulses directed to additional target positions in the lens by blocking, attenuating or scattering the subsequent laser pulses. This effect can reduce the actual optical power level of the subsequent laser pulses and thus adversely affect fragmentation at the deeper locations in the lens. Some known laser-induced lens fragmentation processes do not provide effective solutions to address this technical issue.
- Based on effects of distinct regional properties of the lens and laser pulse parameters on spreading of gas produced during photodisruption, techniques, apparatus and systems described in this application can be used to effectively fragment the crystalline lens to remove a portion of or the entirety of the lens by using photodisruptive laser pulses with reduced interference caused by laser-induced air bubbles in the eye during the photodisruption process. The present methods and apparatus allow fragmentation of the entire or significant portions of the crystalline lens utilizing a photodisruptive laser delivered with minimized interference from gas generated during photodisruption. In addition to reduced gas generation the method allows the use of significantly less total laser energy to treat the eye and reduces potential undesired effects such as heat generated by the laser and reduces overall procedure time. The removal of a portion of or the entirety of the crystalline lens can be achieved via aspiration with reduced or no need of other lens fragmentation or modification modalities.
- The crystalline lens has multiple optical functions in the eye, including preservation of a transparent optical path and dynamic focusing capability. The lens is a unique tissue in the human body in that it continues to grow in size during gestation, after birth and throughout life. Since new lens fiber cells are added from a germinal center located on the equatorial periphery of the lens, the oldest lens fibers are located centrally in the lens. This region, called the lens nucleus, has been further subdivided into embryonal, fetal and adult nuclear zones. While the lens increases in diameter, it may also undergo compaction so that the properties of the nucleus are different from the cortex (Freel et al BMC Opthalmology 2003, 3:1). In addition, since lens fiber cells undergo progressive loss of cytoplasmic elements and since there is no blood supply or lymphatics to supply the inner zone of the lens, it becomes progressively more difficult to preserve the optical clarity and other properties (e.g., lens flexibility) that serve the function of the lens. Of particular importance is the central core of the lens, occupying the inner approximately 6-8 mm in equatorial diameter and approximately 2-3.5 mm in axial diameter. This region has been shown to have reduced permeability to and from the metabolically active cortex and outer nucleus (Sweeney et al Exp Eye res, 1998:67, 587-95). A correlation with this observation is the progressive loss of transparency that is identified in the most common type of cataract in the same region in patients, as well as increases in lens stiffness that occur with age in a gradient fashion from the peripheral to central portion of the lens (Heys et al Molecular Vision 2004: 10:956-63). One result of such changes is the development of presbyopia and cataract that increase in severity and incidence with age.
- The above identification of a central zone with different transport, optical and biomechanical properties has significant implications for fragmentation techniques with photodisruption, because one significant limitation to various laser-based lens fragmentation techniques is the uncontrolled spread of gas bubbles that can occur during photodisruption that can reduce the effectiveness of subsequent laser pulses in interacting with the lens. The layered structure of the lens body at different locations exhibits differing resistance to spread of cavitation bubble gas. Additionally, the softer peripheral layers can be sufficiently soft so as not to require photodisruption and/or significant fragmentation prior to aspiration and removal. These softer, less resistant peripheral layers however can allow the gas generated by photodisruption to spread and block subsequent laser pulses that are directed to fragment the harder central core. The precise determination of regions of a lens that are more or less resistant to the spread of cavitation bubble gas depends on individual characteristics of each patient including the age of the patient. The spread of gas can also be influenced by the particular laser parameters and treatment pattern applied to the target.
- The tissue of the lens can be treated in an essentially uniform fashion.
FIGS. 1 a-c illustrate an example where a photodistruptive laser system is operated to place laser pulses essentially uniformly within a surgical region, e.g., the eye lens, to be treated to allow aspiration and removal of the lens material. One way to fill the volume with laser is to direct the laser pulses with a scanner to form a bubble layer and fill the entire volume with a multitude of layers, as shown inFIG. 1 c. -
FIG. 2 illustrates that after the laser treatment, an aspiration device can be used to remove the disrupted lens material. - In such procedures, the laser pulse characteristics, such as their duration can range from 0.01 picoseconds (ps) to 50 picoseconds. The laser pulse energy, layer, line and spot separations can be optimized to achieve the highest effectiveness of breaking up the tissue wile minimizing the effects of gas spreading, laser exposure and procedure time.
- One determining factor of the laser pulse characteristics is the need to avoid or minimize a triggering of an uncontrolled gas spreading. Since the conditions and properties of the lenses can vary from patient to patient, the threshold laser pulse parameters to achieve this can vary as well. In some implementations, the laser energy per pulse can range from 1 microjoule (μJ) to 25 μJ and the spatial pulse separation between two initial pulses adjacent in space can fall within the range of 0.1 micron to 50 microns. The laser pulse duration can range from 0.01 picoseconds to 50 picoseconds and the laser repetition rate from 10 kHz to 100 MHz.
- The parameters of the laser pulses and the scan pattern can be determined by various methods. For example, they can be based on a preoperative measurement of the lens optical or structural properties. The laser energy and the spot separation can also be selected based on a preoperative measurement of lens optical or structural properties and the use of an age-dependant algorithm. The pulsed laser is operated to direct a sequence of laser pulses to a target lens region of the lens to fragment the target lens region. The laser pulses may also be directed to one or more regions of the lens other than the target lens region, e.g., peripheral locations and/or the lens capsule, to create an opening or incision in the lens. After the desired fragmentation and incision are achieved, the laser pulses can be terminated and the fragmented target lens region and any other selected portions of the lens are removed from the lens body by aspiration.
- The following sections describe techniques and laser systems for applying laser pulses to surfaces and boundaries of cells of predetermined size, shape and spatial distribution that differ from the above described uniform volumetric distribution of the laser pulses within the treated volume. Following such a laser treatment the lens tissue can subsequently break up along the surfaces and boundaries of the cells. The size of the cells or granules can be determined to be small enough that they can easily be removed by using e.g. an aspiration device. A typical aspiration device is a needle attached to a suction pump. For example a 23 gauge needle has an inner diameter of 0.34 mm. Cells smaller than the inner diameter of the aspiration needle can pass through the needle without clogging.
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FIG. 3 illustrates a laser surgical system for performing such a non-uniform laser distribution process. Anoptics module 310 can focus and direct the laser beam to atarget lens 301. Theoptics module 310 can include one or more lenses and may further include one or more reflectors. A control actuator can be included in theoptics module 310 to adjust the focusing and the beam direction in response to a beam control signal. Asystem control module 320 can control both apulsed laser 302 via a laser control signal and theoptics module 310 via the beam control signal. Animaging device 330 may collect reflected or scattered light or sound from thetarget lens 301 to capture image data via thetarget lens 301. The captured image data can then be processed by the lasersystem control module 320 to determine the placement of the applied laser pulses. This control can be a dynamic alignment process during the surgical process to ensure that the laser beam is properly directed at each target position. Theimaging device 330 can be implemented in various forms, including an optical coherent tomography (OCT) device. In other implementations, an ultrasound imaging device can also be used. - The
system control module 320 may process image data from theimaging device 330 that includes the position offset information for the photodisruption byproducts in the target region. Based on the offset information obtained from the image data, the beam control signal can be generated to control theoptics module 310, which can adjust the laser beam in response. A digital processing unit can be included in thesystem control module 320 to perform various data processing functions for the laser alignment and laser surgery. The digital processing unit can be programmed to control the laser parameters of the initial laser pulses and the additional laser pulses, laser beam scanning direction from the posterior to anterior direction for the initial laser pulses and the laser movement of the additional laser pulses. - In one implementation, the
pulsed laser 302 can be a high repetition rate pulsed laser at a pulse repetition rate of thousands of shots per second or higher with relatively low energy per pulse. Such a laser can be operated to use relatively low energy per pulse to localize the tissue effect caused by laser-induced photodisruption. A form of this tissue effect is the formation of cavitation bubbles. In some implementations, the impacted tissue region can have a size of the order of microns or tens of microns. This localized tissue effect can improve the precision of the laser surgery and can be desirable in certain ophthalmic surgical procedures. In one example of such surgery, placement of many hundred, thousands or millions of contiguous or near contiguous pulses, which may be separated by microns or tens of microns, can be used to achieve certain desired surgical effect placement. Such procedures using high repetition rate pulsed lasers may require high precision in positioning each pulse in the target region during surgery, both regarding their absolute position with respect to a target location and their relative position with respect to preceding pulses. For example, in some cases, subsequent laser pulses may be required to be delivered next to each other with an accuracy of a few microns, when the time between pulses (the repetition rate) can be of the order of microseconds. -
FIGS. 4 a-b show an implementation of an ophthalmic surgical procedure, during which laser spots (or bubbles) are generated to form granules, the granules themselves forming a granule array. The laser spots can be generated to form a regular spatial pattern of the granules, as shown inFIG. 4 b. Regularly spaced granules utilize the laser pulses well, since they require a limited amount of laser energy to break up a target region. Nevertheless, in other implementations the granules may form an irregular or even random array. - The cells can be packed next to one another. Creating the side wall of one cell can simultaneously create the side of the neighboring cell as well, making the process efficient. The design of the individual cells and the cell pattern may be selected based on the physical properties of the tissue to be treated. The bulk of the lens consists of concentric layers of elongated fiber cells. Cleavage of tissue parallel and perpendicular to the layers and individual fibers is different. Therefore, in some implementations a higher spot density and/or laser pulse energy can be used to form cell boundaries which are perpendicular to layers and fibers.
- During the formation of a particular spatial pattern, different implementations of the present surgical method may utilize different scanning paths. A regular pattern can be built all at once or granule by granule. Which method to use may depend on the particular laser scanner and it is a matter of optimization to achieve higher precision and shorter procedure time.
- In a particular implementation the granules, or cells, can be cubes. With an analogy to crystal cell structures, this pattern of cells can be described as a Simple Cubic (SC) crystal. Layers of these cubes can be formed simultaneously, followed by repeating the procedure in subsequent layers.
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FIGS. 5 a-d illustrate that in some implementations first a bubble layer can be generated with the laser pulses to form the bottom layer of the SC crystal, as shown inFIG. 5 a. In some implementations, this bottom layer can be essentially transverse, or perpendicular, to an optical axis of the lens or the eye. As it is known, an optical axis can be defined in several different ways, with somewhat different outcomes. In what follows, the term “optical axis” will be used to refer to an axis defined by any one of these procedures, or even a compromise axis, defined as a direction falling between differently defined axes. -
FIG. 5 b illustrates that subsequent to the formation of the bottom layer, a regular array of cell walls can be generated. These walls can be essentially parallel to the optical axis, formed with a predetermined cell height. -
FIGS. 5 b and 5 c illustrate that the scanner can raster, or sweep, first in one direction (FIG. 5 b) then in an orthogonal direction (FIG. 5 c). -
FIG. 5 d illustrates that a layer of cells can be completed by placing a bubble-layer to form the top of the cells. This “top” bubble-layer can then form the bottom bubble-layer for the next layer of cells. The target volume can be filled up with a regular array of granules/cell by repeating the steps 5 a-d. - In some implementations, a smooth boundary layer can be formed around the regular array of cells in the surgical target region, partially, or in its entirety. Such a boundary layer can provide a smooth surface without the raggedness of the edges of the cell array.
- In other implementations, the crystalline cell array/structure can be oriented differently, the bottom layer forming any angle with the optical axis of the eye. In yet other implementations, the layers themselves can be somewhat curved, to accommodate the natural curvature of the lens target region itself or the natural curvature of the focal plane of the surgical system. Such structures may not be entirely regular. They may contain deformations or lattice defects. These defects can be formed intentionally or may emerge during the creation of the cell array.
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FIGS. 6 a-b illustrate an alternative implementation, where complete cells of a layer can be formed individually one after the other by controlling the scanner to form all walls of a single cell, and to start forming the next cell only after the previous cell is completed. -
FIG. 6 a illustrates that rows of cells can be formed first to build a layer of cells. -
FIG. 6 b illustrates that subsequent layers can be formed on top of already created layers, to fill a surgical target volume. - The implementations which form the cells individually may have the following features.
- First,
FIGS. 7 a-c illustrate that the shape of the cells can be different from the simplest shapes, like cubes. For example, the cell array can have a hexagonal base to form a Simple Hexagonal (SH) lattice. Or a target volume can be broken up into cells of a different type, such as spheres (FIG. 7 a), separated by complementary small interstitial regions. Spherical cell shapes can minimize the occurrence of clogging in the aspiration needle. The type of the lattice, formed by the spherical cells can be selected to optimize the ratio of the volume of the spheres to the volume of the interstitial regions. These lattice types are known as “close packed” crystals structures. Face Centered Cubic (FCC) and Hexagonal Closest Packing (HCP) are two such structures. - In some implementations, the cells can have shapes which approximate spheres, such as polyhedral shapes. In these implementations, the polyhedral cells can form close packed structures, analogously to the lattice of spheres.
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FIG. 7 b illustrates a Truncated Rhombic Dodecahedron, which is an example of a polyhedron approximating a sphere. -
FIG. 7 c illustrates that truncated rhombic dodecahedrons can be close packed to form a layer, and fill a target volume with a stack of layers. When passing through the aspiration needle, these polyhedra can more readily roll than cubes and the likelihood of clogging is smaller. - Second, the laser scanner pattern can be optimized to speed up completion of the whole pattern. Creating individual cells with sizes of the order of 100 to 200 micrometers require small scanner displacements and can be performed at higher scanner speed. Larger scale moves of the scanner can be slower. The design of the scanner can be optimized effectively for achieving the shortest overall procedure time. Applying a combination of two different scanner types, a fast small displacement scanner and a slow but larger displacement scanner, can further optimize system performance. Building cells individually is also consistent with modular software design practices. A complete volumetric pattern can be created from building blocks; cells, rows and layers of cells and finally the complete pattern. An analogous approach can be effective in constructing a software code for the scanner drivers as well.
- The above described or other patterns can be created by proceeding from the posterior to the anterior side of the lens or from the anterior to the posterior side. The former can be advantageous to avoid blocking the laser beam by bubbles previously formed in the target tissue. The latter may be preferable when a cataract is present in the lens and penetration of laser light through the cataract is already compromised. In that case fragmentation of the anterior portion of the lens may be necessary followed by aspiration of the treated portion and successive laser treatment and aspiration of the deeper-lying parts of the lens until the full volume is fragmented.
- Additional features of implementations which fragment the target tissue in a granular or cellular form include the following.
- 1) Reduction of the amount of gas bubbles formed in the eye and thus reduction of the induced opacity of the tissue. Since a similar degree of tissue disruption can be achieved by considerably smaller number of bubbles in a granular/cellular procedure, this aspect can increase the effectiveness of the laser treatment to a substantial degree.
- 2) Reduction of the number of pulses applied to the tissue, which increases the speed of the procedure. Time is at a premium during eye surgery, as after about two minutes patients sometimes develop an increasing, hard-to-control eye movement. This can necessitate the abandonment of the surgical procedure. Therefore, if a new feature in a surgical procedure is capable of reducing a time of the surgery from above two minutes to below two minutes, that feature may increase the utility of the surgical procedure qualitatively.
- 3) Reduction of the required total energy applied to the tissue, which reduces potential undesired side-effects related to the exposure of the eye to laser light. In most procedures, a substantial portion of the laser light passes through the surgical region and continues its way to the retina. The retina being a strongly light sensitive tissue itself, this transmitted surgical laser light may damage the retina to an undesirable or unacceptable degree. Thus, a reduction of the transmitted laser light can be an advantageous feature.
- To quantitatively assess the different implementations, a comparison is provided for the amount of laser energy required for treating a given volume, and for the number of laser pulses required for volumetric and cellular fragmentation procedures.
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TABLE 1 Number of Number of Ratio of pulses, Spot Cube pulses per mm3 pulses per mm3 volumetric vs. separation size volumetric granular granular, ratio (um) (um) breakdown breakdown of procedure time 2 50 125000000 14400000 8.7 2 150 125000000 4933333 25.3 2 250 125000000 2976000 42.0 5 50 8000000 2160000 3.7 5 150 8000000 773333 10.3 5 250 8000000 470400 17.0 10 50 1000000 480000 2.1 10 150 1000000 186667 5.4 10 250 1000000 115200 8.7 20 50 125000 90000 1.4 20 150 125000 43333 2.9 20 250 125000 27600 4.5 - Table 1 illustrates some results of the comparison, contrasting tissue breakdown by performing a volumetric method and by forming a Simple Cubic lattice of cells. Typically, the volume of an individual gas bubbles is approximately proportional to the energy of the femtosecond laser pulse which created the bubble. This proportionality holds for energies not too close to the threshold of producing plasma. Further, the individual pulses are directed such that the gas bubbles touch each other. In the volumetric method this translates to the spot, line, and layer separation being approximately equal to one another, all being set by the diameter of the bubbles. In the cellular implementation this translates to the cell boundaries being formed by touching spheres. It is noted that in practice, some overlap may be necessary for both volumetric and cell-array methods.
- Table 1 reports comparison results, varying the spot separation from 2 microns to 20 microns and the cell size from 50 microns to 300 microns. The speed of the procedure was characterized by the number of pulses needed for a given total volume and the total energy needed.
- In some implementations of the volumetric breakdown, the total energy needed to break down the tissue in the target region can be approximately independent of the size of the bubbles. This energy is of the order of 1 Joule per cubic millimeter of target volume. This relationship holds most accurately in the energy range in which the volume of an individual bubble is proportional to the laser pulse energy.
- For implementations which form a lattice of cells, the speed and the corresponding energy depends both on the size of the individual bubbles and on the size of the cell. The speed increases with increasing cell sizes and decreasing bubble sizes. This is the result of the change in the volume to surface ratio of the cells as a function of their size. This comparison is based on using a 23 gauge needle which has inner diameter of 340 micrometers. The largest size cube which can enter the tube at the least favored orientation, with its body diagonal perpendicular to the length of the tube, is about 196 micrometers. Actual implementations may use smaller grain sizes, such as 150 microns.
- As Table 1 illustrates, methods based on forming cell-lattices can exhibit an increase of speed by a factor of 2.9 to 25.3 over the speed of the volumetric method as the size of the bubbles is varied. For a typical bubble size of 10 microns, the increase of speed can be about 5.4-fold. The speed ratio increases with decreasing bubble size. The improvement in the procedure time is approximately a factor of 10 for 5 micron bubble size and 25 for 2 micron bubble sizes. These are quite significant improvements over the volumetric method.
- As mentioned above, the required total laser energy is proportional to the total volume of gas produced, which is proportional to the number of bubbles for bubbles of a fixed size. Therefore, among methods which use the same average laser power and create similarly sized bubbles, the procedure time is approximately proportional to the number of bubbles created. Thus, the speed improvement of the cell-array methods over the volumetric methods is proportional to the ratio R of the total number of pulses, as demonstrated in Table 1. Implementations with a different bubble size in general require different laser average power, repetition rate, and scanner speed setting. Nevertheless, it remains true for implementations with all bubble sizes that granular/cellular fragmentation decreases the total energy and time required compared to volumetric fragmentation with the same bubble size. Thus
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- When the cell size is significantly larger than the bubble size, R can be approximately proportional to the Volume/Surface ratio of the cell. Since the volume of gas produced is approximately proportional to the product of the area of the cell boundaries multiplied with the bubble size, R is approximately proportional to a ratio of a cell size to a bubble size.
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- Granular fragmentation with the smallest bubble size produces the smallest amount of gas in the target tissue and uses the smallest amount of total laser energy. In some implementations there can be a practical limit, how small a bubble size should be used. In some implementations the bubbles are closely packed, and the corresponding spot separation and line separation is nearly equal to the bubble size when creating the surface of a cell boundary. Although the laser parameters, average power, pulse energy and repetition rate can be chosen over a wide enough range to achieve the desired bubble size, spot and line separations, the scanning system can be limited in its speed and acceleration to generate a particular pattern. To keep the acceleration of the scanner under control at turning points, in some implementations the linear speed of progression of the bubble placement can be kept smaller than a limiting value, vlim.
- For a given granular pattern the total area of the cell boundaries, A, and as demonstrated in Table 1. the total number of pulses N per total volume are given for given bubble size. For example, for a close packed area A=N*bubble_size2.
- The total linear path of bubble placement s may equal N*bubble_size, which is also the speed of progression of bubble placement times the total procedure time, s=v*T. Therefore, in some approaches, the product v*T*bubble_size may be approximately constant.
- In order to minimize the total amount of gas produced and the total amount of laser energy used for a granular pattern, some approaches minimize the bubble size by selecting the linear speed of progression and the procedure time to their largest acceptable value vlim and Tmax. Here Tmax is the maximum procedure time tolerable by the clinical environment, less than 1 minute is acceptable, less than 30 seconds is desirable, dictated mainly by the tolerance of the patient to keep still during the procedure.
- On the other hand, to minimize procedure time, the highest linear speed vlim and the largest acceptable bubble size can be selected. The largest acceptable bubble size is determined by the amount of gas produced, pulse energy used, and by the required precision of the surgery.
- Some implementations of the surgical system maximize the speed of scanner and lower the laser energy threshold for the formation of cavitation bubbles, in order to minimize bubble size. The surgeon has the choice to select particular parameters within the limitation of the surgical system to optimize the parameters for particular surgical outcomes. The decision may take into account the size of the surgically affected area, tissue parameters the age of the patient and other factors.
- While this specification contains many specifics, these should not be construed as limitations on the scope of an invention or of what may be claimed, but, rather, as descriptions of features specific to particular embodiments of the invention. Certain features that are described in this specification in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination can in some cases be excised from the combination, and the claimed combination may be directed to a subcombination or a variation of a subcombination.
Claims (28)
1. A method of fragmenting biological tissue with a photodisruptive laser, comprising the steps of:
selecting a target region of the tissue for fragmentation;
directing a beam of laser pulses to the selected target region of the tissue; and
directing the laser beam to generate cell boundaries in the selected target region of the tissue to form cells in the selected target region.
2. The method of claim 1 wherein the tissue is a tissue of an eye.
3. The method of claim 2 , wherein the tissue is a crystalline lens of the eye.
4. The method of claim 1 , comprising:
inserting an aspiration needle into the selected target region; and
removing fragmented tissue from the selected target region already scanned by the laser beam by using the aspiration needle.
5. The method of claim 4 , the forming the cells comprising:
forming cells with size sufficiently small to pass through the aspiration needle.
6. The method of claim 1 , the forming the cells comprising:
forming the cells arranged in an array.
7. The method of claim 6 , wherein the array is a regular array.
8. The method of claim 7 , wherein the regular array is one of a simple cubic lattice, a face centered lattice, a body centered lattice, a hexagonal lattice, a bravais lattice, and a stack of two dimensional lattices.
9. The method of claim 8 , wherein the array is essentially a random array.
10. The method of claim 1 , the forming the cells comprising:
fragmenting the target tissue into cells of at least one of spheres and polyhedra.
11. The method of claim 1 , the forming the cells comprising:
scanning the laser beam to form multiple cells in parallel in a layer.
12. The method of claim 1 , the forming the cells comprising:
directing the laser beam to form individual cells successively.
13. The method of claim 1 , the forming the cells comprising at least one of:
scanning the laser beam to form a cell array progressing from a posterior to an anterior direction; and
scanning the laser beam to form a cell array progressing from an anterior to a posterior direction.
14. The method of claim 1 , the directing the laser beam to generate cell boundaries comprising:
generating the cell boundaries by creating layers of bubbles in the selected target region of the tissue.
15. The method of claim 14 , the creating layers of bubbles comprising at least one of:
creating a layer of bubbles by applying a laser beam with an essentially constant power; and
creating a layer of bubbles by applying a laser beam with a varying power.
16. The method of claim 1 , wherein the directing the beam of laser pulses comprises applying the laser pulses with a laser parameter of at least one of:
a pulse duration between 0.01 picosecond and 50 picoseconds;
a repetition rate between 10 kiloHertz and 100 megaHertz;
a pulse energy between 1 microjoule and 25 microjoule; and
a pulse target separation between 0.1 micron and 50 microns.
17. The method of claim 1 , wherein the directing the beam of laser pulses comprises applying the laser pulses with a laser parameter based on at least one of:
a preoperative measurement of structural properties of the selected target region of the tissue; and
an age dependent algorithm.
18. The method of claim 1 , comprising:
applying additional laser pulses to one or more locations outside the selected target region of the tissue to create an opening for an additional procedure.
19. The method of claim 1 , the method comprising:
identifying a surgical goal; and
selecting laser parameters and method features to achieve the identified surgical goal.
20. The method of claim 19 , the surgical goal being an optimization of one or more of:
a speed of the method of fragmenting;
a total amount of energy applied to the eye during the fragmenting; and
a total number of generated bubbles.
21. The method of claim 19 , the surgical goal being one or more of:
maximization of the speed of the method of fragmenting;
minimization of the total amount of energy applied to the eye during the fragmenting; and
minimization of the total number of generated bubbles.
22. The method of claim 19 , comprising:
selecting laser parameters and method features to achieve a total time of fragmentation of one of:
less than 2 minutes;
less than 1 minute; and
less than 30 seconds.
23. The method of claim 19 , comprising:
selecting laser parameters and method features to achieve a ratio of a cell size to a bubble size of one of:
larger than 10;
larger than 100; and
larger than 1000.
24. A laser system for fragmenting biological tissue, comprising:
a pulsed laser to produce a laser beam of pulses; and
a laser control module
to direct the laser beam to a selected target region of the tissue; and
to direct the laser beam to generate cell boundaries to form cells in the selected target region of the tissue.
25. The laser system of claim 24 , wherein the laser control module is configured to form cells in a regular array.
26. The laser system of claim 24 , the laser control module formed to generate the laser pulses with laser parameters of at least one of:
a pulse duration between 0.01 and 50 picoseconds;
a repetition rate between 10 kHz and 100 megahertz;
a pulse energy between 1 microjoule and 25 microjoule; and
a pulse target separation between 0.1 micron and 50 microns.
27. A method of fragmenting a tissue in an eye with a photodisruptive laser, comprising the steps of:
selecting a target region in the eye for fragmentation; and
forming an array of cells in the target region by directing a beam of laser pulses to generate cell boundaries in the target region, with a cell size and laser parameters of the laser beam such that the tissue fragmentation requires a surgical time of less than two minutes, whereas a volumetric tissue fragmentation of the same target region with the same laser parameters would require a surgical time in excess of two minutes.
28. The method of claim 27 , wherein
the laser parameters are at least one of:
a pulse duration between 0.01 and 50 picoseconds;
a repetition rate between 10 kHz and 100 megahertz;
a pulse energy between 1 microjoule and 25 microjoule; and
a pulse target separation between 0.1 micron and 50 microns; and
the cell size is between 1 microns and 50 microns.
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Cited By (43)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20070185475A1 (en) * | 2006-01-20 | 2007-08-09 | Frey Rudolph W | System and method for providing the shaped structural weakening of the human lens with a laser |
US20090137993A1 (en) * | 2007-09-18 | 2009-05-28 | Kurtz Ronald M | Methods and Apparatus for Integrated Cataract Surgery |
US20090137988A1 (en) * | 2007-11-02 | 2009-05-28 | Lensx Lasers, Inc | Methods And Apparatus For Improved Post-Operative Ocular Optical Performance |
US20090137991A1 (en) * | 2007-09-18 | 2009-05-28 | Kurtz Ronald M | Methods and Apparatus for Laser Treatment of the Crystalline Lens |
US20090143772A1 (en) * | 2007-09-05 | 2009-06-04 | Kurtz Ronald M | Laser-Induced Protection Shield in Laser Surgery |
US20090149841A1 (en) * | 2007-09-10 | 2009-06-11 | Kurtz Ronald M | Effective Laser Photodisruptive Surgery in a Gravity Field |
US20090149840A1 (en) * | 2007-09-06 | 2009-06-11 | Kurtz Ronald M | Photodisruptive Treatment of Crystalline Lens |
US20090171327A1 (en) * | 2007-09-06 | 2009-07-02 | Lensx Lasers, Inc. | Photodisruptive Laser Treatment of the Crystalline Lens |
US20110118609A1 (en) * | 2009-11-16 | 2011-05-19 | Lensx Lasers, Inc. | Imaging Surgical Target Tissue by Nonlinear Scanning |
US20110166560A1 (en) * | 2010-01-07 | 2011-07-07 | Solar System Beauty Corporation | Skin care laser device |
WO2011097647A1 (en) * | 2010-02-08 | 2011-08-11 | Optimedica Corporation | System for plasma-mediated modification of tissue |
EP2501349A2 (en) * | 2009-11-16 | 2012-09-26 | Alcon LenSx, Inc. | Variable stage optical system for ophthalmic surgical laser |
WO2012137062A1 (en) * | 2011-04-07 | 2012-10-11 | Technolas Perfect Vision Gmbh | System and method for performing lens fragmentation |
US8382745B2 (en) | 2009-07-24 | 2013-02-26 | Lensar, Inc. | Laser system and method for astigmatic corrections in association with cataract treatment |
US8459794B2 (en) | 2011-05-02 | 2013-06-11 | Alcon Lensx, Inc. | Image-processor-controlled misalignment-reduction for ophthalmic systems |
US8465478B2 (en) | 2009-07-24 | 2013-06-18 | Lensar, Inc. | System and method for performing LADAR assisted procedures on the lens of an eye |
US20130158531A1 (en) * | 2011-12-19 | 2013-06-20 | Ilya Goldshleger | Image processor for intra-surgical optical coherence tomographic imaging of laser cataract procedures |
WO2013096348A1 (en) * | 2011-12-19 | 2013-06-27 | Alcon Lensx, Inc. | Image processor for intra-surgical optical coherence tomographic imaging of laser cataract procedures |
WO2013096347A1 (en) * | 2011-12-19 | 2013-06-27 | Alcon Lensx, Inc. | Intra-surgical optical coherence tomographic imaging of cataract procedures |
US8480659B2 (en) | 2008-07-25 | 2013-07-09 | Lensar, Inc. | Method and system for removal and replacement of lens material from the lens of an eye |
US8500723B2 (en) | 2008-07-25 | 2013-08-06 | Lensar, Inc. | Liquid filled index matching device for ophthalmic laser procedures |
US8556425B2 (en) | 2010-02-01 | 2013-10-15 | Lensar, Inc. | Purkinjie image-based alignment of suction ring in ophthalmic applications |
USD694890S1 (en) | 2010-10-15 | 2013-12-03 | Lensar, Inc. | Laser system for treatment of the eye |
USD695408S1 (en) | 2010-10-15 | 2013-12-10 | Lensar, Inc. | Laser system for treatment of the eye |
US8617146B2 (en) | 2009-07-24 | 2013-12-31 | Lensar, Inc. | Laser system and method for correction of induced astigmatism |
US20140012240A1 (en) * | 2011-03-21 | 2014-01-09 | Arthur Ho | Restoration of accommodation by lens refilling |
JP2014087608A (en) * | 2012-10-01 | 2014-05-15 | Nidek Co Ltd | Ophthalmic surgical ultrasonic chip, ophthalmic surgical handpiece with ophthalmic surgical ultrasonic chip, and ophthalmic surgical ultrasonic apparatus with ophthalmic surgical ultrasonic chip |
US8758332B2 (en) | 2009-07-24 | 2014-06-24 | Lensar, Inc. | Laser system and method for performing and sealing corneal incisions in the eye |
US8764737B2 (en) | 2007-09-06 | 2014-07-01 | Alcon Lensx, Inc. | Precise targeting of surgical photodisruption |
US8801186B2 (en) | 2010-10-15 | 2014-08-12 | Lensar, Inc. | System and method of scan controlled illumination of structures within an eye |
WO2014158618A1 (en) * | 2013-03-12 | 2014-10-02 | Bausch & Lomb Incorporated | System and method for configuring fragmentation segments of a crystalline lens for a lensectomy |
US9180051B2 (en) | 2006-01-20 | 2015-11-10 | Lensar Inc. | System and apparatus for treating the lens of an eye |
US9254082B2 (en) * | 2013-07-16 | 2016-02-09 | Riken | Method of measuring the elasticity of crystalline lens, a method of determining whether crystalline lens is presbyopic, an apparatus for measuring the elasticity of crystalline lens and an apparatus for determining whether crystalline lens is presbyopic |
US9375349B2 (en) | 2006-01-20 | 2016-06-28 | Lensar, Llc | System and method for providing laser shot patterns to the lens of an eye |
WO2017003694A1 (en) * | 2015-07-01 | 2017-01-05 | Optimedica Corporation | Sub-nanosecond laser surgery system utilizing multiple pulsed laser beams |
US9545338B2 (en) | 2006-01-20 | 2017-01-17 | Lensar, Llc. | System and method for improving the accommodative amplitude and increasing the refractive power of the human lens with a laser |
US9592157B2 (en) | 2012-11-09 | 2017-03-14 | Bausch & Lomb Incorporated | System and method for femto-fragmentation of a crystalline lens |
US9622913B2 (en) | 2011-05-18 | 2017-04-18 | Alcon Lensx, Inc. | Imaging-controlled laser surgical system |
US9889043B2 (en) | 2006-01-20 | 2018-02-13 | Lensar, Inc. | System and apparatus for delivering a laser beam to the lens of an eye |
US10463541B2 (en) | 2011-03-25 | 2019-11-05 | Lensar, Inc. | System and method for correcting astigmatism using multiple paired arcuate laser generated corneal incisions |
US11083625B2 (en) | 2015-07-01 | 2021-08-10 | Amo Development, Llc | Sub-nanosecond laser surgery system utilizing multiple pulsed laser beams |
CN113490463A (en) * | 2019-02-28 | 2021-10-08 | 奥林巴斯株式会社 | Calculus crushing device and calculus crushing system |
WO2022130137A1 (en) * | 2020-12-16 | 2022-06-23 | Alcon Inc. | Adjusting laser pulses to compensate for interfering objects |
Families Citing this family (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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US20110028948A1 (en) | 2009-07-29 | 2011-02-03 | Lensx Lasers, Inc. | Optical System for Ophthalmic Surgical Laser |
US8262647B2 (en) | 2009-07-29 | 2012-09-11 | Alcon Lensx, Inc. | Optical system for ophthalmic surgical laser |
US8267925B2 (en) | 2009-07-29 | 2012-09-18 | Alcon Lensx, Inc. | Optical system for ophthalmic surgical laser |
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US10182943B2 (en) | 2012-03-09 | 2019-01-22 | Alcon Lensx, Inc. | Adjustable pupil system for surgical laser systems |
US8852177B2 (en) | 2012-03-09 | 2014-10-07 | Alcon Lensx, Inc. | Spatio-temporal beam modulator for surgical laser systems |
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US10004596B2 (en) | 2014-07-31 | 2018-06-26 | Lensgen, Inc. | Accommodating intraocular lens device |
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DE102015212877A1 (en) | 2015-07-09 | 2017-01-12 | Carl Zeiss Meditec Ag | Arrangement and method for processing a surface in a processing volume of a transparent material by means of a focused radiation |
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AU2018352182A1 (en) | 2017-10-17 | 2020-03-05 | Alcon Inc. | Customized ophthalmic surgical profiles |
DE102019135607B4 (en) * | 2019-12-20 | 2023-09-07 | Schwind Eye-Tech-Solutions Gmbh | Method for controlling an ophthalmic surgical laser and treatment device |
CA3182976A1 (en) | 2020-07-31 | 2022-02-03 | David Thoe | Systems and methods for eye cataract removal |
Citations (89)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4538608A (en) * | 1984-03-23 | 1985-09-03 | Esperance Jr Francis A L | Method and apparatus for removing cataractous lens tissue by laser radiation |
US4633866A (en) * | 1981-11-23 | 1987-01-06 | Gholam Peyman | Ophthalmic laser surgical method |
US4638801A (en) * | 1983-07-06 | 1987-01-27 | Lasers For Medicine | Laser ophthalmic surgical system |
US4686366A (en) * | 1985-05-15 | 1987-08-11 | Max-Planck-Gesellschaft Zur Foerderung Der Wissenschaften E.V. | Laser mass spectrometer |
US4694828A (en) * | 1986-04-21 | 1987-09-22 | Eichenbaum Daniel M | Laser system for intraocular tissue removal |
US4766896A (en) * | 1986-01-24 | 1988-08-30 | Pao David S C | Anterior capsulotomy procedures |
US4907586A (en) * | 1988-03-31 | 1990-03-13 | Intelligent Surgical Lasers | Method for reshaping the eye |
US5013319A (en) * | 1989-06-05 | 1991-05-07 | Mount Sinai School Of Medicine Of The City University Of New York | Apparatus and method for cornea marking |
US5036592A (en) * | 1990-01-19 | 1991-08-06 | Marshall Forrest A | Determining and marking apparatus and method for use in optometry and ophthalmology |
US5089022A (en) * | 1989-04-26 | 1992-02-18 | The Trustees Of Columbia University In The City Of New York | Rectified intraocular lens |
US5139022A (en) * | 1990-10-26 | 1992-08-18 | Philip Lempert | Method and apparatus for imaging and analysis of ocular tissue |
US5225862A (en) * | 1989-02-08 | 1993-07-06 | Canon Kabushiki Kaisha | Visual axis detector using plural reflected image of a light source |
US5246435A (en) * | 1992-02-25 | 1993-09-21 | Intelligent Surgical Lasers | Method for removing cataractous material |
US5336215A (en) * | 1993-01-22 | 1994-08-09 | Intelligent Surgical Lasers | Eye stabilizing mechanism for use in ophthalmic laser surgery |
US5423841A (en) * | 1994-03-15 | 1995-06-13 | Kornefeld; Michael S. | Intraocular knife |
US5439462A (en) * | 1992-02-25 | 1995-08-08 | Intelligent Surgical Lasers | Apparatus for removing cataractous material |
US5442412A (en) * | 1994-04-25 | 1995-08-15 | Autonomous Technologies Corp. | Patient responsive eye fixation target method and system |
US5520679A (en) * | 1992-12-03 | 1996-05-28 | Lasersight, Inc. | Ophthalmic surgery method using non-contact scanning laser |
US5549632A (en) * | 1992-10-26 | 1996-08-27 | Novatec Laser Systems, Inc. | Method and apparatus for ophthalmic surgery |
US5656186A (en) * | 1994-04-08 | 1997-08-12 | The Regents Of The University Of Michigan | Method for controlling configuration of laser induced breakdown and ablation |
US5669923A (en) * | 1996-01-24 | 1997-09-23 | Gordon; Mark G. | Anterior capsulotomy device and procedure |
US5738677A (en) * | 1992-04-10 | 1998-04-14 | Premier Laser Systems, Inc. | Apparatus and method for performing eye surgery |
US5957921A (en) * | 1996-11-07 | 1999-09-28 | Optex Ophthalmologics, Inc. | Devices and methods useable for forming small openings in the lens capsules of mammalian eyes |
US6010497A (en) * | 1998-01-07 | 2000-01-04 | Lasersight Technologies, Inc. | Method and apparatus for controlling scanning of an ablating laser beam |
US6066138A (en) * | 1998-05-27 | 2000-05-23 | Sheffer; Yehiel | Medical instrument and method of utilizing same for eye capsulotomy |
US6099522A (en) * | 1989-02-06 | 2000-08-08 | Visx Inc. | Automated laser workstation for high precision surgical and industrial interventions |
US6197018B1 (en) * | 1996-08-12 | 2001-03-06 | O'donnell, Jr. Francis E. | Laser method for restoring accommodative potential |
US6217570B1 (en) * | 1999-04-12 | 2001-04-17 | Herbert J. Nevyas | Method of aligning the optical axis of a laser for reshaping the cornea of a patients eye with the visual axis of the patient's eye |
US6254595B1 (en) * | 1998-10-15 | 2001-07-03 | Intralase Corporation | Corneal aplanation device |
US20020013574A1 (en) * | 1997-04-30 | 2002-01-31 | Jens Elbrecht | Method and arrangement for phacoemulsification |
US6344040B1 (en) * | 1999-03-11 | 2002-02-05 | Intralase Corporation | Device and method for removing gas and debris during the photodisruption of stromal tissue |
US6392020B1 (en) * | 1996-12-06 | 2002-05-21 | Akzo Nobel N.V. | Monoclonal antibody to the clonotypic structure of a T-cell receptor, a pharmaceutical compostion and a diagnostic reagent comprising the same |
US20020097374A1 (en) * | 2000-06-28 | 2002-07-25 | Peter Alfred Payne | Ophthalmic uses of lasers |
US20020133145A1 (en) * | 2001-01-11 | 2002-09-19 | Mario Gerlach | Laser slit lamp with laser radiation source |
US6508812B1 (en) * | 2000-03-13 | 2003-01-21 | Memphis Eye & Cataract Associates Ambulatory Surgery Center | Control system for high resolution high speed digital micromirror device for laser refractive eye surgery |
US20030073983A1 (en) * | 2001-10-12 | 2003-04-17 | Josef Bille | Device and method for performing refractive surgery |
US6579282B2 (en) * | 2001-04-25 | 2003-06-17 | 20/10 Perfect Vision Optische Geraete Gmbh | Device and method for creating a corneal reference for an eyetracker |
US20040044355A1 (en) * | 2002-08-28 | 2004-03-04 | Nevyas Herbert J. | Minimally invasive corneal surgical procedure for the treatment of hyperopia |
US6712809B2 (en) * | 2001-12-14 | 2004-03-30 | Alcon Refractivehorizons, Inc. | Eye positioning system and method |
US6726697B2 (en) * | 1996-07-23 | 2004-04-27 | United States Surgical Corporation | Anastomosis instrument and method |
US6730074B2 (en) * | 2002-05-24 | 2004-05-04 | 20/10 Perfect Vision Optische Geraete Gmbh | Cornea contact system for laser surgery |
US20040102765A1 (en) * | 2001-03-27 | 2004-05-27 | Karsten Koenig | Method for the minimal-to non-invase optical treatment of tissues of the eye and for diagnosis thereof and device for carrying out said method |
US20040106929A1 (en) * | 2002-08-20 | 2004-06-03 | Samuel Masket | Method and apparatus for performing an accurately sized and placed anterior capsulorhexis |
US6751033B2 (en) * | 2001-10-12 | 2004-06-15 | Intralase Corp. | Closed-loop focal positioning system and method |
US20040151466A1 (en) * | 2003-01-24 | 2004-08-05 | Janet Crossman-Bosworth | Optical beam scanning system for compact image display or image acquisition |
US20050015120A1 (en) * | 2003-07-11 | 2005-01-20 | Seibel Eric J. | Scanning laser device and methods of use |
US6863667B2 (en) * | 2001-01-29 | 2005-03-08 | Intralase Corp. | Ocular fixation and stabilization device for ophthalmic surgical applications |
US20050081393A1 (en) * | 2003-10-17 | 2005-04-21 | Kung-Ho Su | Invertible laser instrument |
US20050090813A1 (en) * | 2001-12-12 | 2005-04-28 | Dietrich Schweitzer | Method for removing waste products produced while stripping material in transparent objects by laser-induced plasma formation |
US20050107773A1 (en) * | 2002-01-18 | 2005-05-19 | Carl Zeiss Meditec Ag | Femtosescond laser system for the exact manipulation of material and tissues |
US6899707B2 (en) * | 2001-01-29 | 2005-05-31 | Intralase Corp. | Applanation lens and method for ophthalmic surgical applications |
US6902561B2 (en) * | 2002-03-23 | 2005-06-07 | Intralase Corp. | System and method for improved material processing using a laser beam |
US20050165387A1 (en) * | 2004-01-23 | 2005-07-28 | Holger Lubatschowski | Control for a surgical laser |
US20060020172A1 (en) * | 2004-07-21 | 2006-01-26 | Rowiak Gmbh. | OCT laryngoscope |
US6991629B1 (en) * | 1998-10-15 | 2006-01-31 | Intralase Corp. | Device and method for reducing corneal induced aberrations during ophthalmic laser surgery |
US7027233B2 (en) * | 2001-10-12 | 2006-04-11 | Intralase Corp. | Closed-loop focal positioning system and method |
US20060100613A1 (en) * | 2004-11-02 | 2006-05-11 | Mcardle George J | Apparatus and processes for preventing or delaying one or more symptoms of presbyopia |
US7044602B2 (en) * | 2002-05-30 | 2006-05-16 | Visx, Incorporated | Methods and systems for tracking a torsional orientation and position of an eye |
US20060179921A1 (en) * | 2003-03-05 | 2006-08-17 | Jochen Winkler | Method, device, and computer program for measuring the leakage of injection systems, especially for internal combustion engines of motor vehicles |
US20060192921A1 (en) * | 2005-02-25 | 2006-08-31 | Frieder Loesel | Device and method for aligning an eye with a surgical laser |
US20060195076A1 (en) * | 2005-01-10 | 2006-08-31 | Blumenkranz Mark S | Method and apparatus for patterned plasma-mediated laser trephination of the lens capsule and three dimensional phaco-segmentation |
US20070121069A1 (en) * | 2005-11-16 | 2007-05-31 | Andersen Dan E | Multiple spot photomedical treatment using a laser indirect ophthalmoscope |
US20070129709A1 (en) * | 2005-12-01 | 2007-06-07 | Andersen Dan E | System and method for minimally traumatic ophthalmic photomedicine |
US20070126985A1 (en) * | 2005-10-28 | 2007-06-07 | Wiltberger Michael W | Photomedical treatment system and method with a virtual aiming device |
US20070129775A1 (en) * | 2005-09-19 | 2007-06-07 | Mordaunt David H | System and method for generating treatment patterns |
US20070147730A1 (en) * | 2005-09-19 | 2007-06-28 | Wiltberger Michael W | Optical switch and method for treatment of tissue |
US20070173795A1 (en) * | 2006-01-20 | 2007-07-26 | Frey Rudolph W | System and apparatus for treating the lens of an eye |
US20070173759A1 (en) * | 1999-10-08 | 2007-07-26 | Augustine Scott D | Intravenous fluid warming cassette with stiffening member and integral handle |
US20070185475A1 (en) * | 2006-01-20 | 2007-08-09 | Frey Rudolph W | System and method for providing the shaped structural weakening of the human lens with a laser |
US20070189664A1 (en) * | 2006-01-12 | 2007-08-16 | Andersen Dan E | Optical delivery systems and methods of providing adjustable beam diameter, spot size and/or spot shape |
US20080033406A1 (en) * | 2006-04-28 | 2008-02-07 | Dan Andersen | Dynamic optical surgical system utilizing a fixed relationship between target tissue visualization and beam delivery |
US20080049188A1 (en) * | 2004-06-10 | 2008-02-28 | Wiltberger Michael W | Scanning Ophthalmic Fixation Method And Apparatus |
US20080071254A1 (en) * | 2001-01-29 | 2008-03-20 | Advanced Medical Optics, Inc. | Ophthalmic interface apparatus and system and method of interfacing a surgical laser with an eye |
US20080088795A1 (en) * | 2006-04-11 | 2008-04-17 | Goldstein Lee E | Ocular imaging |
US7402159B2 (en) * | 2004-03-01 | 2008-07-22 | 20/10 Perfect Vision Optische Geraete Gmbh | System and method for positioning a patient for laser surgery |
US20090012507A1 (en) * | 2007-03-13 | 2009-01-08 | William Culbertson | Method for patterned plasma-mediated modification of the crystalline lens |
US20090088734A1 (en) * | 2007-09-28 | 2009-04-02 | Eos Holdings, Llc | Laser-assisted thermal separation of tissue |
US20090137993A1 (en) * | 2007-09-18 | 2009-05-28 | Kurtz Ronald M | Methods and Apparatus for Integrated Cataract Surgery |
US20090137988A1 (en) * | 2007-11-02 | 2009-05-28 | Lensx Lasers, Inc | Methods And Apparatus For Improved Post-Operative Ocular Optical Performance |
US20090137991A1 (en) * | 2007-09-18 | 2009-05-28 | Kurtz Ronald M | Methods and Apparatus for Laser Treatment of the Crystalline Lens |
US20090143772A1 (en) * | 2007-09-05 | 2009-06-04 | Kurtz Ronald M | Laser-Induced Protection Shield in Laser Surgery |
US20090149840A1 (en) * | 2007-09-06 | 2009-06-11 | Kurtz Ronald M | Photodisruptive Treatment of Crystalline Lens |
US20090149841A1 (en) * | 2007-09-10 | 2009-06-11 | Kurtz Ronald M | Effective Laser Photodisruptive Surgery in a Gravity Field |
US20090171327A1 (en) * | 2007-09-06 | 2009-07-02 | Lensx Lasers, Inc. | Photodisruptive Laser Treatment of the Crystalline Lens |
US20100004641A1 (en) * | 2006-01-20 | 2010-01-07 | Frey Rudolph W | System and apparatus for delivering a laser beam to the lens of an eye |
US20100004643A1 (en) * | 2006-01-20 | 2010-01-07 | Frey Rudolph W | System and method for improving the accommodative amplitude and increasing the refractive power of the human lens with a laser |
US20100022996A1 (en) * | 2008-07-25 | 2010-01-28 | Frey Rudolph W | Method and system for creating a bubble shield for laser lens procedures |
US20100022995A1 (en) * | 2008-07-25 | 2010-01-28 | Frey Rudolph W | Method and system for removal and replacement of lens material from the lens of an eye |
US20100022994A1 (en) * | 2008-07-25 | 2010-01-28 | Frey Rudolph W | Liquid filled index matching device for ophthalmic laser procedures |
Family Cites Families (63)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4081207A (en) * | 1976-07-01 | 1978-03-28 | Cincinnati Electronics Corporation | Scanning lens system |
US4481948A (en) | 1980-12-29 | 1984-11-13 | Sole Gary M | Medical instrument, and methods of constructing and utilizing same |
FR2524298A1 (en) | 1982-04-01 | 1983-10-07 | Essilor Int | LASER OPHTHALMOLOGICAL SURGICAL APPARATUS |
US4888015A (en) | 1982-08-20 | 1989-12-19 | Domino Rudolph S | Method of replacing an eye lens |
US4744360A (en) * | 1986-12-18 | 1988-05-17 | Bath Patricia E | Apparatus for ablating and removing cataract lenses |
EP0397777A1 (en) * | 1988-01-25 | 1990-11-22 | Refractive Laser Research And Development, Inc. | Method and apparatus for laser surgery |
US5214538A (en) * | 1988-07-25 | 1993-05-25 | Keymed (Medical And Industrial Equipment) Limited | Optical apparatus |
JPH0268055A (en) * | 1988-09-03 | 1990-03-07 | Hoya Corp | Device for removing diseased part in eyeball |
JPH0475654A (en) * | 1990-07-19 | 1992-03-10 | Topcon Corp | Laser incising device for lenticular capsule |
US5333018A (en) | 1991-01-07 | 1994-07-26 | Heine Optotechnik Gmbh | Binocular ophthalmoscope |
US6322556B1 (en) | 1991-10-30 | 2001-11-27 | Arlene E. Gwon | Method of laser photoablation of lenticular tissue for the correction of vision problems |
US5984916A (en) | 1993-04-20 | 1999-11-16 | Lai; Shui T. | Ophthalmic surgical laser and method |
EP1159986A3 (en) | 1991-11-06 | 2004-01-28 | LAI, Shui, T. | Corneal surgery device and method |
US5269787A (en) | 1991-12-17 | 1993-12-14 | Cozean Jr Charles H | Apparatus and method for capsulorhexis |
US5261923A (en) | 1992-04-23 | 1993-11-16 | Soares Christopher J | Method and apparatus for continuous circular capsulorehexis |
JPH06304142A (en) | 1993-04-22 | 1994-11-01 | Canon Inc | Device for detecting line of sight |
US5993438A (en) | 1993-11-12 | 1999-11-30 | Escalon Medical Corporation | Intrastromal photorefractive keratectomy |
DE69528024T2 (en) | 1994-08-18 | 2003-10-09 | Zeiss Carl | Surgical apparatus controlled with optical coherence tomography |
US6454761B1 (en) | 1995-01-30 | 2002-09-24 | Philip D. Freedman | Laser surgery device and method |
SE9501714D0 (en) | 1995-05-09 | 1995-05-09 | Pharmacia Ab | A method of selecting an intraocular lens to be implanted into an eye |
US7655002B2 (en) * | 1996-03-21 | 2010-02-02 | Second Sight Laser Technologies, Inc. | Lenticular refractive surgery of presbyopia, other refractive errors, and cataract retardation |
US6352535B1 (en) * | 1997-09-25 | 2002-03-05 | Nanoptics, Inc. | Method and a device for electro microsurgery in a physiological liquid environment |
ATE224172T1 (en) * | 1996-10-26 | 2002-10-15 | Asclepion Meditec Ag | DEVICE AND METHOD FOR SHAPING SURFACES |
DE19734732A1 (en) | 1996-12-10 | 1998-06-18 | Wavelight Laser Technologie Gm | Arrangement for treating bodily substances |
US5777719A (en) | 1996-12-23 | 1998-07-07 | University Of Rochester | Method and apparatus for improving vision and the resolution of retinal images |
US6409718B1 (en) | 1998-02-03 | 2002-06-25 | Lasersight Technologies, Inc. | Device and method for correcting astigmatism by laser ablation |
JP2000033097A (en) * | 1998-07-16 | 2000-02-02 | Akira Shibata | Perfusion sleeve of 1.6 mm in outside diameter |
JP2002522191A (en) * | 1998-08-12 | 2002-07-23 | ライ、ミン | Method for scanning pulsed laser beam for surface ablation |
US6146375A (en) | 1998-12-02 | 2000-11-14 | The University Of Michigan | Device and method for internal surface sclerostomy |
US6165190A (en) | 1999-06-01 | 2000-12-26 | Nguyen; Nhan | Capsulectomy device and method therefore |
DE19940712A1 (en) | 1999-08-26 | 2001-03-01 | Aesculap Meditec Gmbh | Method and device for treating opacities and / or hardening of an unopened eye |
US6391020B1 (en) | 1999-10-06 | 2002-05-21 | The Regents Of The Univerity Of Michigan | Photodisruptive laser nucleation and ultrasonically-driven cavitation of tissues and materials |
US6451006B1 (en) | 2001-02-14 | 2002-09-17 | 20/10 Perfect Vision Optische Geraete Gmbh | Method for separating lamellae |
DE10108797A1 (en) | 2001-02-21 | 2002-09-05 | Zeiss Carl Jena Gmbh | Procedure for determining distances at the anterior segment of the eye |
US20020193704A1 (en) | 2001-04-19 | 2002-12-19 | Peter Goldstein | Method and system for photodisruption of tissue of the eye |
US6533769B2 (en) | 2001-05-03 | 2003-03-18 | Holmen Joergen | Method for use in cataract surgery |
US6702807B2 (en) | 2001-09-10 | 2004-03-09 | Minu, L.L.C. | Ablatable intracorneal inlay with predetermined refractive properties |
US7101364B2 (en) | 2001-10-12 | 2006-09-05 | 20/10 Perfect Vision Optische Geraete Gmbh | Method and apparatus for intrastromal refractive surgery |
US20030171809A1 (en) | 2002-03-05 | 2003-09-11 | Phillips Andrew F. | Axial-displacement accommodating intraocular lens |
US7873083B2 (en) | 2002-10-17 | 2011-01-18 | Lumenis Ltd. | System, method, and apparatus to provide laser beams of two or more wavelengths |
DE10300091A1 (en) | 2003-01-04 | 2004-07-29 | Lubatschowski, Holger, Dr. | microtome |
JP4080379B2 (en) | 2003-05-30 | 2008-04-23 | 株式会社ニデック | Ophthalmic laser equipment |
US7351241B2 (en) | 2003-06-02 | 2008-04-01 | Carl Zeiss Meditec Ag | Method and apparatus for precision working of material |
US7131968B2 (en) * | 2003-06-02 | 2006-11-07 | Carl Zeiss Meditec Ag | Apparatus and method for opthalmologic surgical procedures using a femtosecond fiber laser |
DE50310420D1 (en) | 2003-06-10 | 2008-10-09 | Sie Ag Surgical Instr Engineer | Ophthalmic device for the dissolution of ocular tissue |
US7238176B2 (en) | 2004-04-29 | 2007-07-03 | 20/10 Perfect Vision Optische Geraete Gmbh | Method for intrastromal photodisruption of dome-shaped surfaces |
JP2005323956A (en) * | 2004-05-12 | 2005-11-24 | Shigeo Taniguchi | Surgical perfusion and suction instrument |
US20050284774A1 (en) | 2004-06-24 | 2005-12-29 | Mordaunt David H | Ophthalmic lens assembly utilizing replaceable contact element |
JP5060949B2 (en) | 2004-06-28 | 2012-10-31 | トプコン・メディカル・レーザー・システムズ・インコーポレイテッド | Optical scanning system for performing therapy |
EP2417903A1 (en) | 2005-01-21 | 2012-02-15 | Massachusetts Institute of Technology | Methods and apparatus for optical coherence tomography scanning |
US9675495B2 (en) | 2005-04-13 | 2017-06-13 | David Scott Michelson | Capsulotomy instrument |
US20060235428A1 (en) | 2005-04-14 | 2006-10-19 | Silvestrini Thomas A | Ocular inlay with locator |
US7391520B2 (en) | 2005-07-01 | 2008-06-24 | Carl Zeiss Meditec, Inc. | Fourier domain optical coherence tomography employing a swept multi-wavelength laser and a multi-channel receiver |
WO2007084627A2 (en) * | 2006-01-20 | 2007-07-26 | Lensar, Inc. | System and method for improving the accommodative amplitude and increasing the refractive power of the human lens with a laser |
US8596281B2 (en) * | 2006-03-07 | 2013-12-03 | Szymon Suckewer | Devices, methods and compositions for presbyopia correction using ultrashort pulse laser |
WO2007118129A1 (en) | 2006-04-05 | 2007-10-18 | The General Hospital Corporation | Methods, arrangements and systems for polarization-sensitive optical frequency domain imaging of a sample |
US20080001320A1 (en) * | 2006-06-28 | 2008-01-03 | Knox Wayne H | Optical Material and Method for Modifying the Refractive Index |
EP2094208B1 (en) * | 2006-11-10 | 2013-09-04 | Lars Michael Larsen | Apparatus for non or minimally disruptive photomanipulation of an eye |
CA2678506C (en) | 2007-02-23 | 2016-10-18 | Mimo Ag | Ophthalmologic apparatus for imaging an eye by optical coherence tomography |
US8568393B2 (en) | 2007-03-13 | 2013-10-29 | Topcon Medical Laser Systems, Inc. | Computer guided patterned laser trabeculoplasty |
WO2009023774A1 (en) | 2007-08-15 | 2009-02-19 | The Cleveland Clinic Foundation | Precise disruption of tissue in retinal and preretinal structures |
US20100324543A1 (en) | 2007-09-18 | 2010-12-23 | Kurtz Ronald M | Method And Apparatus For Integrating Cataract Surgery With Glaucoma Or Astigmatism Surgery |
US20100324542A1 (en) | 2007-11-02 | 2010-12-23 | Kurtz Ronald M | Method to Guide a Cataract Procedure by Corneal Imaging |
-
2009
- 2009-01-09 DE DE112009000064T patent/DE112009000064T5/en not_active Withdrawn
- 2009-01-09 WO PCT/US2009/030676 patent/WO2009089504A2/en active Application Filing
- 2009-01-09 PL PL18158235T patent/PL3363415T3/en unknown
- 2009-01-09 ES ES18158235T patent/ES2757628T3/en active Active
- 2009-01-09 PL PL15163334T patent/PL2926780T3/en unknown
- 2009-01-09 DK DK15163334.4T patent/DK2926780T3/en active
- 2009-01-09 PT PT181582354T patent/PT3363415T/en unknown
- 2009-01-09 US US12/351,784 patent/US20090177189A1/en not_active Abandoned
- 2009-01-09 EP EP15163334.4A patent/EP2926780B1/en active Active
- 2009-01-09 TR TR2018/15101T patent/TR201815101T4/en unknown
- 2009-01-09 DK DK18158235T patent/DK3363415T3/en active
- 2009-01-09 ES ES09700876.7T patent/ES2537205T3/en active Active
- 2009-01-09 PT PT15163334T patent/PT2926780T/en unknown
- 2009-01-09 EP EP18158235.4A patent/EP3363415B1/en active Active
- 2009-01-09 EP EP09700876.7A patent/EP2240108B1/en active Active
- 2009-01-09 ES ES15163334.4T patent/ES2690975T3/en active Active
- 2009-01-09 JP JP2010542393A patent/JP5373820B2/en active Active
-
2014
- 2014-08-05 US US14/451,881 patent/US9427356B2/en active Active
-
2016
- 2016-07-28 US US15/222,730 patent/US11026838B2/en active Active
-
2021
- 2021-05-05 US US17/308,833 patent/US11654054B2/en active Active
Patent Citations (99)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4633866A (en) * | 1981-11-23 | 1987-01-06 | Gholam Peyman | Ophthalmic laser surgical method |
US4638801A (en) * | 1983-07-06 | 1987-01-27 | Lasers For Medicine | Laser ophthalmic surgical system |
US4538608A (en) * | 1984-03-23 | 1985-09-03 | Esperance Jr Francis A L | Method and apparatus for removing cataractous lens tissue by laser radiation |
US4686366A (en) * | 1985-05-15 | 1987-08-11 | Max-Planck-Gesellschaft Zur Foerderung Der Wissenschaften E.V. | Laser mass spectrometer |
US4766896A (en) * | 1986-01-24 | 1988-08-30 | Pao David S C | Anterior capsulotomy procedures |
US4694828A (en) * | 1986-04-21 | 1987-09-22 | Eichenbaum Daniel M | Laser system for intraocular tissue removal |
US4907586A (en) * | 1988-03-31 | 1990-03-13 | Intelligent Surgical Lasers | Method for reshaping the eye |
US6099522A (en) * | 1989-02-06 | 2000-08-08 | Visx Inc. | Automated laser workstation for high precision surgical and industrial interventions |
US6913603B2 (en) * | 1989-02-06 | 2005-07-05 | Visx, Inc. | Automated laser workstation for high precision surgical and industrial interventions |
US5225862A (en) * | 1989-02-08 | 1993-07-06 | Canon Kabushiki Kaisha | Visual axis detector using plural reflected image of a light source |
US5089022A (en) * | 1989-04-26 | 1992-02-18 | The Trustees Of Columbia University In The City Of New York | Rectified intraocular lens |
US5013319A (en) * | 1989-06-05 | 1991-05-07 | Mount Sinai School Of Medicine Of The City University Of New York | Apparatus and method for cornea marking |
US5036592A (en) * | 1990-01-19 | 1991-08-06 | Marshall Forrest A | Determining and marking apparatus and method for use in optometry and ophthalmology |
US5139022A (en) * | 1990-10-26 | 1992-08-18 | Philip Lempert | Method and apparatus for imaging and analysis of ocular tissue |
US5246435A (en) * | 1992-02-25 | 1993-09-21 | Intelligent Surgical Lasers | Method for removing cataractous material |
US5439462A (en) * | 1992-02-25 | 1995-08-08 | Intelligent Surgical Lasers | Apparatus for removing cataractous material |
US5738677A (en) * | 1992-04-10 | 1998-04-14 | Premier Laser Systems, Inc. | Apparatus and method for performing eye surgery |
US5549632A (en) * | 1992-10-26 | 1996-08-27 | Novatec Laser Systems, Inc. | Method and apparatus for ophthalmic surgery |
US5520679A (en) * | 1992-12-03 | 1996-05-28 | Lasersight, Inc. | Ophthalmic surgery method using non-contact scanning laser |
US5336215A (en) * | 1993-01-22 | 1994-08-09 | Intelligent Surgical Lasers | Eye stabilizing mechanism for use in ophthalmic laser surgery |
US5423841A (en) * | 1994-03-15 | 1995-06-13 | Kornefeld; Michael S. | Intraocular knife |
US5656186A (en) * | 1994-04-08 | 1997-08-12 | The Regents Of The University Of Michigan | Method for controlling configuration of laser induced breakdown and ablation |
USRE37585E1 (en) * | 1994-04-08 | 2002-03-19 | The Regents Of The University Of Michigan | Method for controlling configuration of laser induced breakdown and ablation |
US5442412A (en) * | 1994-04-25 | 1995-08-15 | Autonomous Technologies Corp. | Patient responsive eye fixation target method and system |
US5669923A (en) * | 1996-01-24 | 1997-09-23 | Gordon; Mark G. | Anterior capsulotomy device and procedure |
US6726697B2 (en) * | 1996-07-23 | 2004-04-27 | United States Surgical Corporation | Anastomosis instrument and method |
US6197018B1 (en) * | 1996-08-12 | 2001-03-06 | O'donnell, Jr. Francis E. | Laser method for restoring accommodative potential |
US5957921A (en) * | 1996-11-07 | 1999-09-28 | Optex Ophthalmologics, Inc. | Devices and methods useable for forming small openings in the lens capsules of mammalian eyes |
US6392020B1 (en) * | 1996-12-06 | 2002-05-21 | Akzo Nobel N.V. | Monoclonal antibody to the clonotypic structure of a T-cell receptor, a pharmaceutical compostion and a diagnostic reagent comprising the same |
US20020013574A1 (en) * | 1997-04-30 | 2002-01-31 | Jens Elbrecht | Method and arrangement for phacoemulsification |
US6010497A (en) * | 1998-01-07 | 2000-01-04 | Lasersight Technologies, Inc. | Method and apparatus for controlling scanning of an ablating laser beam |
US6066138A (en) * | 1998-05-27 | 2000-05-23 | Sheffer; Yehiel | Medical instrument and method of utilizing same for eye capsulotomy |
US6254595B1 (en) * | 1998-10-15 | 2001-07-03 | Intralase Corporation | Corneal aplanation device |
US6991629B1 (en) * | 1998-10-15 | 2006-01-31 | Intralase Corp. | Device and method for reducing corneal induced aberrations during ophthalmic laser surgery |
US6344040B1 (en) * | 1999-03-11 | 2002-02-05 | Intralase Corporation | Device and method for removing gas and debris during the photodisruption of stromal tissue |
US6676653B2 (en) * | 1999-03-11 | 2004-01-13 | Intralase Corp. | Device and method for removing gas and debris during the photodisruption of stromal tissue |
US6217570B1 (en) * | 1999-04-12 | 2001-04-17 | Herbert J. Nevyas | Method of aligning the optical axis of a laser for reshaping the cornea of a patients eye with the visual axis of the patient's eye |
US20070173759A1 (en) * | 1999-10-08 | 2007-07-26 | Augustine Scott D | Intravenous fluid warming cassette with stiffening member and integral handle |
US6508812B1 (en) * | 2000-03-13 | 2003-01-21 | Memphis Eye & Cataract Associates Ambulatory Surgery Center | Control system for high resolution high speed digital micromirror device for laser refractive eye surgery |
US20020097374A1 (en) * | 2000-06-28 | 2002-07-25 | Peter Alfred Payne | Ophthalmic uses of lasers |
US20020133145A1 (en) * | 2001-01-11 | 2002-09-19 | Mario Gerlach | Laser slit lamp with laser radiation source |
US6899707B2 (en) * | 2001-01-29 | 2005-05-31 | Intralase Corp. | Applanation lens and method for ophthalmic surgical applications |
US7018376B2 (en) * | 2001-01-29 | 2006-03-28 | Intralase Corp. | Ocular fixation and stabilization device for ophthalmic surgical applications |
US20080071254A1 (en) * | 2001-01-29 | 2008-03-20 | Advanced Medical Optics, Inc. | Ophthalmic interface apparatus and system and method of interfacing a surgical laser with an eye |
US6863667B2 (en) * | 2001-01-29 | 2005-03-08 | Intralase Corp. | Ocular fixation and stabilization device for ophthalmic surgical applications |
US7371230B2 (en) * | 2001-01-29 | 2008-05-13 | Amo Development, Llc | Ocular fixation and stabilization device for ophthalmic surgical applications |
US20040102765A1 (en) * | 2001-03-27 | 2004-05-27 | Karsten Koenig | Method for the minimal-to non-invase optical treatment of tissues of the eye and for diagnosis thereof and device for carrying out said method |
US6579282B2 (en) * | 2001-04-25 | 2003-06-17 | 20/10 Perfect Vision Optische Geraete Gmbh | Device and method for creating a corneal reference for an eyetracker |
US6751033B2 (en) * | 2001-10-12 | 2004-06-15 | Intralase Corp. | Closed-loop focal positioning system and method |
US6610051B2 (en) * | 2001-10-12 | 2003-08-26 | 20/10 Perfect Vision Optische Geraete Gmbh | Device and method for performing refractive surgery |
US7027233B2 (en) * | 2001-10-12 | 2006-04-11 | Intralase Corp. | Closed-loop focal positioning system and method |
US20030073983A1 (en) * | 2001-10-12 | 2003-04-17 | Josef Bille | Device and method for performing refractive surgery |
US20050090813A1 (en) * | 2001-12-12 | 2005-04-28 | Dietrich Schweitzer | Method for removing waste products produced while stripping material in transparent objects by laser-induced plasma formation |
US6712809B2 (en) * | 2001-12-14 | 2004-03-30 | Alcon Refractivehorizons, Inc. | Eye positioning system and method |
US20050107773A1 (en) * | 2002-01-18 | 2005-05-19 | Carl Zeiss Meditec Ag | Femtosescond laser system for the exact manipulation of material and tissues |
US6902561B2 (en) * | 2002-03-23 | 2005-06-07 | Intralase Corp. | System and method for improved material processing using a laser beam |
US6730074B2 (en) * | 2002-05-24 | 2004-05-04 | 20/10 Perfect Vision Optische Geraete Gmbh | Cornea contact system for laser surgery |
US7044602B2 (en) * | 2002-05-30 | 2006-05-16 | Visx, Incorporated | Methods and systems for tracking a torsional orientation and position of an eye |
US20040106929A1 (en) * | 2002-08-20 | 2004-06-03 | Samuel Masket | Method and apparatus for performing an accurately sized and placed anterior capsulorhexis |
US20040044355A1 (en) * | 2002-08-28 | 2004-03-04 | Nevyas Herbert J. | Minimally invasive corneal surgical procedure for the treatment of hyperopia |
US20040151466A1 (en) * | 2003-01-24 | 2004-08-05 | Janet Crossman-Bosworth | Optical beam scanning system for compact image display or image acquisition |
US20050173817A1 (en) * | 2003-01-24 | 2005-08-11 | University Of Washington | Optical beam scanning system for compact image display or image acquisition |
US20060179921A1 (en) * | 2003-03-05 | 2006-08-17 | Jochen Winkler | Method, device, and computer program for measuring the leakage of injection systems, especially for internal combustion engines of motor vehicles |
US20050015120A1 (en) * | 2003-07-11 | 2005-01-20 | Seibel Eric J. | Scanning laser device and methods of use |
US20050081393A1 (en) * | 2003-10-17 | 2005-04-21 | Kung-Ho Su | Invertible laser instrument |
US20050165387A1 (en) * | 2004-01-23 | 2005-07-28 | Holger Lubatschowski | Control for a surgical laser |
US7402159B2 (en) * | 2004-03-01 | 2008-07-22 | 20/10 Perfect Vision Optische Geraete Gmbh | System and method for positioning a patient for laser surgery |
US20080049188A1 (en) * | 2004-06-10 | 2008-02-28 | Wiltberger Michael W | Scanning Ophthalmic Fixation Method And Apparatus |
US20060020172A1 (en) * | 2004-07-21 | 2006-01-26 | Rowiak Gmbh. | OCT laryngoscope |
US20060100613A1 (en) * | 2004-11-02 | 2006-05-11 | Mcardle George J | Apparatus and processes for preventing or delaying one or more symptoms of presbyopia |
US20060195076A1 (en) * | 2005-01-10 | 2006-08-31 | Blumenkranz Mark S | Method and apparatus for patterned plasma-mediated laser trephination of the lens capsule and three dimensional phaco-segmentation |
US20060192921A1 (en) * | 2005-02-25 | 2006-08-31 | Frieder Loesel | Device and method for aligning an eye with a surgical laser |
US7390089B2 (en) * | 2005-02-25 | 2008-06-24 | 20/10 Perfect Vision Optische Geraete Gmbh | Device and method for aligning an eye with a surgical laser |
US20070129775A1 (en) * | 2005-09-19 | 2007-06-07 | Mordaunt David H | System and method for generating treatment patterns |
US20070147730A1 (en) * | 2005-09-19 | 2007-06-28 | Wiltberger Michael W | Optical switch and method for treatment of tissue |
US20070126985A1 (en) * | 2005-10-28 | 2007-06-07 | Wiltberger Michael W | Photomedical treatment system and method with a virtual aiming device |
US20070121069A1 (en) * | 2005-11-16 | 2007-05-31 | Andersen Dan E | Multiple spot photomedical treatment using a laser indirect ophthalmoscope |
US20070129709A1 (en) * | 2005-12-01 | 2007-06-07 | Andersen Dan E | System and method for minimally traumatic ophthalmic photomedicine |
US20070189664A1 (en) * | 2006-01-12 | 2007-08-16 | Andersen Dan E | Optical delivery systems and methods of providing adjustable beam diameter, spot size and/or spot shape |
US20100004643A1 (en) * | 2006-01-20 | 2010-01-07 | Frey Rudolph W | System and method for improving the accommodative amplitude and increasing the refractive power of the human lens with a laser |
US20070185475A1 (en) * | 2006-01-20 | 2007-08-09 | Frey Rudolph W | System and method for providing the shaped structural weakening of the human lens with a laser |
US20070173794A1 (en) * | 2006-01-20 | 2007-07-26 | Frey Rudolph W | System and method for treating the structure of the human lens with a laser |
US20070173795A1 (en) * | 2006-01-20 | 2007-07-26 | Frey Rudolph W | System and apparatus for treating the lens of an eye |
US20100004641A1 (en) * | 2006-01-20 | 2010-01-07 | Frey Rudolph W | System and apparatus for delivering a laser beam to the lens of an eye |
US20080088795A1 (en) * | 2006-04-11 | 2008-04-17 | Goldstein Lee E | Ocular imaging |
US20080033406A1 (en) * | 2006-04-28 | 2008-02-07 | Dan Andersen | Dynamic optical surgical system utilizing a fixed relationship between target tissue visualization and beam delivery |
US20090012507A1 (en) * | 2007-03-13 | 2009-01-08 | William Culbertson | Method for patterned plasma-mediated modification of the crystalline lens |
US20090143772A1 (en) * | 2007-09-05 | 2009-06-04 | Kurtz Ronald M | Laser-Induced Protection Shield in Laser Surgery |
US20090171327A1 (en) * | 2007-09-06 | 2009-07-02 | Lensx Lasers, Inc. | Photodisruptive Laser Treatment of the Crystalline Lens |
US20090149840A1 (en) * | 2007-09-06 | 2009-06-11 | Kurtz Ronald M | Photodisruptive Treatment of Crystalline Lens |
US20090149841A1 (en) * | 2007-09-10 | 2009-06-11 | Kurtz Ronald M | Effective Laser Photodisruptive Surgery in a Gravity Field |
US20090137991A1 (en) * | 2007-09-18 | 2009-05-28 | Kurtz Ronald M | Methods and Apparatus for Laser Treatment of the Crystalline Lens |
US20090137993A1 (en) * | 2007-09-18 | 2009-05-28 | Kurtz Ronald M | Methods and Apparatus for Integrated Cataract Surgery |
US20090088734A1 (en) * | 2007-09-28 | 2009-04-02 | Eos Holdings, Llc | Laser-assisted thermal separation of tissue |
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ES2537205T3 (en) | 2015-06-03 |
EP2926780B1 (en) | 2018-08-15 |
US20210322219A1 (en) | 2021-10-21 |
JP2011509162A (en) | 2011-03-24 |
US11654054B2 (en) | 2023-05-23 |
PL2926780T3 (en) | 2019-01-31 |
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DK2926780T3 (en) | 2018-12-10 |
PT2926780T (en) | 2018-11-07 |
ES2757628T3 (en) | 2020-04-29 |
EP2240108A4 (en) | 2011-09-07 |
ES2690975T3 (en) | 2018-11-23 |
TR201815101T4 (en) | 2018-11-21 |
EP3363415A1 (en) | 2018-08-22 |
WO2009089504A3 (en) | 2009-09-24 |
US9427356B2 (en) | 2016-08-30 |
EP2240108A2 (en) | 2010-10-20 |
EP2240108B1 (en) | 2015-04-29 |
EP2926780A1 (en) | 2015-10-07 |
PL3363415T3 (en) | 2020-03-31 |
WO2009089504A2 (en) | 2009-07-16 |
EP3363415B1 (en) | 2019-10-02 |
DK3363415T3 (en) | 2019-11-25 |
US20160331590A1 (en) | 2016-11-17 |
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PT3363415T (en) | 2019-11-05 |
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