Some embodiments disclosed here provide for a method fragmenting a cataractous lens of a patient's eye using an ultra-short pulsed laser. The method can include determining, within a lens of a patient's eye, a high NA zone where a cone angle of a laser beam with a high numerical aperture is not shadowed by the iris, and a low NA zone radially closer to the iris where the cone angle of the laser beam with a low numerical aperture is not shadowed by the iris. Laser lens fragmentation is accomplished by delivering the laser beam with the high numerical aperture to the high NA zone, and the laser beam with the low numerical aperture to the low NA zone. This can result in a more effective fragmentation of a nucleus of the lens without exposing the retina to radiation above safety standards.

Embodiments of this invention generally relate to ophthalmic laser procedures and, more particularly, to systems and methods for lenticular laser incision. In an embodiment, an ophthalmic surgical laser system comprises a laser delivery system for delivering a pulsed laser beam to a target in a subject's eye, an XY-scan device to deflect the pulsed laser beam, a Z-scan device to modify a depth of a focus of the pulsed laser beam, and a controller configured to form a top lenticular incision and a bottom lenticular incision of a lens in the subject's eye.

An apparatus for laser assisted eye treatment comprises: a laser device configured to provide focused laser radiation and having an adapter coupling port; an adapter module including first and second sub-modules, the first sub-module configured to detachably couple to the laser device at the adapter coupling port and having a contact surface for an eye, the second sub-module including an eye suction ring portion having a ring axis, wherein the second sub-module delimits at least one suction space, and the adapter module includes a vacuum inlet port in association with each of the at least one suction chamber, wherein the adapter module includes an evacuation path system configured to establish a vacuum communication connection between each of the at least one suction space and the associated vacuum inlet port, wherein the vacuum inlet port is provided at the first sub-module and the evacuation path system extends from the first sub-module to the second sub-module.

A method of cataract surgery in an eye of a patient includes identifying a feature selected from the group consisting of an axis, a meridian, and a structure of an eye by corneal topography and forming fiducial mark incisions with a laser beam along the axis, meridian or structure in the cornea outside the optical zone of the eye. A laser cataract surgery system a laser source, a topography measurement system, an integrated optical subsystem, and a processor in operable communication with the laser source, corneal topography subsystem and the integrated optical system. The processor includes a tangible non-volatile computer readable medium comprising instructions to determine one of an axis, meridian and structure of an eye of the patient based on the measurements received from topography measurement system, and direct the treatment beam so as to incise radial fiducial mark incisions.

An ophthalmic laser treatment apparatus includes: an aiming optical system configured to irradiate an aiming beam to a patient's eye; a laser irradiation optical system configured to irradiate a laser beam for treatment to the patient's eye; a shift unit configured to make a shift of a focus shift position corresponding to a focus position of the laser beam to a posterior or anterior position with respect to a focus position of the aiming beam; a selection receiving unit configured to receive an instruction to select any one of a plurality of treatment modes; and a control unit configured to control operations of the ophthalmic laser treatment apparatus. The control unit sets a value of a parameter related to irradiation of the laser beam, the parameter including a parameter related to the shift of the focus shift position, according to the treatment mode selected with the selection receiving unit.

Systems and methods for fragmenting a lens by a laser cataract surgery system includes a sub-nanosecond laser source generating a treatment beam that includes a plurality of laser beam pulses. An optical delivery system is coupled to the sub-nanosecond laser source to receive and direct the treatment beam. A processor is coupled to the sub-nanosecond laser source and the optical delivery system. The processor includes a tangible non-volatile computer readable medium comprising instructions to determine a lens cut pattern for lens fragmentation and determine a plurality of energies of the treatment beam as a linear function of a depth of the lens cut pattern. The treatment beam is output according to the lens cut pattern and the determined energies.

A laser eye surgery system focuses light along a beam path to a focal point having a location within a lens of the eye. The refractive index of the lens is determined in response to the location. The lens comprises a surface adjacent a second material having a second refractive index. The beam path extends a distance from the surface to the focal point. The index is determined in response to the distances from the surface to the targeted focal point and from the surface to the actual focal point, which corresponds to a location of a peak intensity of an optical interference signal of the focused light within the lens. The determined refractive index is mapped to a region in the lens, and may be used to generate a gradient index profile of the lens to more accurately place laser beam pulses for incisions.

A system for corneal treatment includes a light source that activates cross-linking in at least one selected region of a cornea treated with a cross-linking agent. The light source delivers photoactivating light to the at least one selected region of the cornea according to a set of parameters. The system includes a controller that receives input relating to the cross-linking agent and the set of parameters. The controller includes computer-readable storage media storing: (A) program instructions for determining cross-linking resulting from reactions involving ROS including at least peroxides, superoxides, and hydroxyl radicals, and (B) program instructions for determining cross-linking from reactions not involving oxygen. The controller executes the program instructions to output a calculated amount of cross-linking in the at least one selected region of the cornea. In response to the calculated amount of cross-linking, the light source adjusts at least one value in the set of parameters.

A treatment device for the surgical correction of defective vision in an eye. The device includes a laser apparatus controlled by a controller. The controller determines a desired correction of defective vision from measurement data of the eye to produce control data for the laser, and to control the laser to emit radiation according to the control data, such that a lenticule-shaped volume is isolated in the cornea. The controller computes a lenticule-shaped intended volume, the removal of which from the cornea leads to an actual correction of defective vision in an optical zone in the eye which differs from the desired correction more at the edge of the optical zone than at the center of the optical zone. The thickness of the lenticule-shaped intended volume is less than the thickness of a lenticule-shaped comparison volume, the removal of which would bring about the desired correction of defective vision.

Laser assisted cataract surgery methods and devices utilize one or more treatment laser beams to create a shaped opening in the anterior lens capsule of the eye when performing a capsulorrhexis procedure. A light absorbing agent may be applied to the anterior lens capsule to facilitate laser thermal separation of tissue along a treatment beam path on the lens capsule. Relative or absolute reflectance from the eye, and optionally from a surgical contact lens, may be measured to confirm and optionally quantify the presence of the light absorbing agent, before the treatment beam is applied. Such measurements may be used to determine that sufficient light absorbing agent is present in the lens capsule so that transmission of the treatment beam through the capsule will be below a predetermined threshold deemed safe for the retina and other interior portions of the eye, and may also be used to determine that sufficient light absorbing agent is present to result in complete laser thermal separation of the anterior capsule along the treatment beam path. Visualization patterns produced with one or more target laser beams may be projected onto the lens capsule tissue to aid in the capsulorrhexis procedure. In addition or alternatively, virtual visualization patterns may presented on a display integrated with a laser assisted cataract surgery device to aid in the procedure. The visual axis of the eye may be determined, during surgery for example, with a laser beam on which the patient is fixated. The orientation of a toric IOL may be assessed during or after placement by observing the reflection from the back of the eye of a laser beam on which the patient is fixated. The devices disclosed herein may be attached to or integrated with microscopes.