An ophthalmic measurement and laser surgery system includes: a laser source; a corneal topography subsystem; an axis determining subsystem; a ranging subsystem comprising an Optical Coherence Tomographer (OCT); and a refractive index determining subsystem. All of the subsystems are under the operative control of a controller. The controller is configure to: operate the corneal topography subsystem to obtain corneal surface information; operate the axis determining subsystem to identify one or more ophthalmic axes of the eye; operate the OCT to sequentially scan the eye in a plurality of OCT scan patterns, the plurality of scan patterns configured to determine an axial length of the eye; operate the refractive index determining subsystem so to determine an index of refraction of one or more ophthalmic tissues, wherein at least one of the corneal surface information, ophthalmic axis information, and axial length is modified based on the determined index of refraction.

Provided are systems and methods for correcting a corneal surface irregularity surface in a subject. The system generally comprises a infrared laser, for example, and infrared laser and a laser control unit, a corneal contacting unit, a gel solidifying unit and an electronic device tangibly storing algorithms to operate the units. In the methods, a polymerizable or thermo-reversible gel or polymerized resin is applied to the anterior corneal surface and solidified as a layer over the cornea. A first correcting cut is lasered into the stroma of an applanated cornea, the gel layer is then removed and a second correcting cut is lasered in the stroma of the applanated cornea. The lenticule formed intrastromaly by the first and second correcting cuts is removed such that the cornea has a corrected corneal curvature.

A photo detector is selectively coupled to a first integrator or a second integrator with switching circuitry when the laser pulses. An integration time of the signal from the photo detector can be substantially greater than an amount of time between successive laser beam pulses in order to provide an accurate measurement of each laser beam pulse of a high repetition rate pulsed laser. The laser may comprise a clock coupled to an optical switch of the laser system, and control circuitry can control switching and coupling of the detector to the first integrator or the second integrator in response to the clock signal. The first integrator and the second integrator can be selectively coupled to an output such that the first integrator or the second integrator is coupled to the output of the energy detection circuitry when the other integrator is coupled to the detector.

A first optical subsystem includes a window with a refractive index n.sub.w and an exit lens having a refractive index n.sub.x. The exit lens is configured to couple to the window to define a first optical axis extending through the window and the exit lens. A second optical subsystem is configured to output a light beam. The light beam is directed to be incident at a convex surface of the exit lens along a second optical axis at an angle α that is offset from the first optical axis. The window is configured to detachably couple to the cornea of the eye such that the first optical axis is generally aligned with a direction of view of the eye. The respective refractive indices n.sub.w and n.sub.x are configured to direct the light beam incident at the convex surface of the exit lens through the cornea of the eye toward the irido-corneal angle.

A photodynamic therapy technique for preventing damage to the fovea of the eye or another body portion of a patient is disclosed herein. In one embodiment, a treatment laser is applied to a body portion of a patient using a painting technique, the treatment laser being configured to provide paint brush-type photodynamic therapy (PPDT) using the painting technique to the body portion of the patient by emitting light of a predetermined wavelength that is absorbed by tissue of the body portion of the patient to which a photosensitizer has been applied, the body portion of the patient being afflicted by a medical condition. The application of the treatment laser to the body portion of a patient using the painting technique treats the medical condition, reduces the symptoms associated with the medical condition, and/or alleviates the medical condition.

Transcorneal and fiberoptic laser delivery systems and methods for the treatment of eye diseases wherein energy is delivered by wavelengths transparent to the cornea to effect target tissues in the eye for the control of intraocular pressure in diseases such as glaucoma by delivery systems both external to and within ocular tissues. External delivery may be affected under gonioscopic control. Internal delivery may be controlled endoscopically or fiberoptically, both systems utilizing femtosecond laser energy to excise ocular tissue. The femtosecond light energy is delivered to the target tissues to be treated to effect precisely controlled photodisruption to enable portals for the outflow of aqueous fluid in the case of glaucoma in a manner which minimizes target tissue healing responses, inflammation and scarring.

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.

Rather than rely solely upon pupillary occlusion or tracking of eye movement to protect the fundus from accidental exposure to electromagnetic radiation, the present invention also utilizes an electromagnetic radiation pathway with a profile such that the energy density at the iris is greater than the energy density at the posterior portion of the eye. This disparity in energy density allows for efficacy at the anterior iris treatment site, without injury to the fundus.

Microsurgical instruments having combined illumination, laser ablation, and viscoelastic injection functions. A surgical instrument includes a probe having a main lumen and a port at a distal end thereof. The probe may further include one or more optical fibers within the main lumen, the optical fibers configured to project laser light and illumination light. Laser light may be emitted from the distal end of the probe for disrupting an ocular tissue, while illumination light may be simultaneously emitted, axially or laterally, to provide enhanced visualization of the intraocular space during tissue disruptance. Upon disrupting the tissue, a viscoelastic fluid may be injected from the port to maintain an integrity of the intraocular space.

A look-up table for use in determining an energy parameter for photodisrupting ocular tissue with a laser is generated by determining a plurality of individual spot size distributions, wherein each of the plurality of individual spot size distributions is based on a different set of simulated data and includes an expected spot size of a laser focus at each of a plurality of locations within a modeled target volume of ocular tissue. The plurality of individual spot size distributions are combined to obtain a final spot size distribution that includes a final expected spot size of the laser focus at the plurality of locations of the focus within the modeled target volume of ocular tissue. An energy value is assigned to the plurality of locations of the focus within the modeled target volume of ocular tissue based on the final expected spot size at that location.