Generation of treatment recommendations for topographic-based excimer laser surgical procedures is described that includes generating accurate cylinder compensation and spherical compensation values that are adjusted to compensate for unique characteristics of topographic-based excimer laser surgical systems. Generating treatment recommendations generally includes determining a topographic vector, a posterior astigmatism vector and an anterior astigmatism vector, and generating an internal astigmatism vector using the topographic vector, the posterior astigmatism vector, the anterior astigmatism vector, and a manifest astigmatism vector. In embodiments, the cylinder compensation is generated using multiple vectors while subtracting the internal astigmatism vector and the posterior astigmatism vector which remain in the eye after treatment, and the spherical compensation is generated using an initial spherical compensation modified by addback modifiers and a regression analysis nomogram. In procedures where the corneal epithelium is removed, an epithelial refractive vector is determined from an epithelial thickness/topography map and added to the other vectors.

Generation of treatment recommendations for topographic-based excimer laser surgical procedures is described that includes generating accurate cylinder compensation and spherical compensation values that are adjusted to compensate for unique characteristics of advanced topographic-based excimer laser surgical systems. Generating treatment recommendations generally includes determining a topographic vector from a topographic corneal map of the eye, determining a posterior astigmatism vector and an anterior astigmatism vector for the eye, and generating an interior astigmatism vector using the topographic vector, the posterior astigmatism vector, the anterior astigmatism vector, and a manifest astigmatism vector. In various embodiments, the cylinder compensation is generated using the interior astigmatism vector and the posterior astigmatism vector, and the spherical compensation is generated using an initial spherical compensation modified by a topographic addback modifier and a cylinder addback modifier.

Improved devices, systems, and methods for diagnosing, planning treatments of, and/or treating the refractive structures of an eye of a patient incorporate results of prior refractive corrections into a planned refractive treatment of a particular patient by driving an effective treatment vector function based on data from the prior eye treatments. The exemplary effective treatment vector employs an influence matrix which may allow improved refractive corrections to be generated so as to increase the overall accuracy of laser eye surgery (including LASIK, PRK, and the like), customized intraocular lenses (IOLs), refractive femtosecond treatments, and the like.

The present disclosure provides a refractive laser surgery system including a processor having access to memory media storing instructions or sets of instructions executable by the processor to identify a surgical parameter; correct the surgical parameter based on a nomogram specific for the refractive laser surgery system to provide a nomogram-based corrected surgical parameter; store the surgical parameter and the nomogram-based corrected surgical parameter in the memory media as data for a patient or for one or both eyes of the patient; and compare the surgical parameter and nomogram-based corrected surgical parameter to generate a graphical representation of the surgical parameter, a target outcome parameter associated with the surgical parameter, or both, and the nomogram-based corrected surgical parameter, to generate a warning based on a comparison of the nomogram-based corrected surgical parameter to the surgical parameter or an absolute value, or both. Methods of using the system are also provided.

A laser eye surgery system includes a laser to generate a laser beam. A topography measurement system measures corneal topography. A processor is coupled to the laser and the topography measurement system, the processor embodying instructions to measure a first corneal topography of the eye. A first curvature of the cornea is determined. A target curvature of the cornea that treats the eye is determined. A first set of incisions and a set of partial incisions in the cornea smaller than the first set of incisions are determined. The set of partial incisions is incised on the cornea by the laser beam. A second corneal topography is measured. A second curvature of the cornea is determined. The second curvature is determined to differ from the target curvature and a second set of incisions are determined. The second set of incisions is incised on the cornea.

A system and method of treating target tissue in a patient's eye, which includes generating a light beam, deflecting the light beam using a scanner to form first and second treatment patterns, delivering the first treatment pattern to the target tissue to form an incision that provides access to an eye chamber of the patient's eye, and delivering the second treatment pattern to the target tissue to form a relaxation incision along or near limbus tissue or along corneal tissue anterior to the limbus tissue of the patient's eye to reduce astigmatism thereof.

An optical beam scanning system for incising target tissue in a patient's eye includes a laser source configured to deliver a laser beam to produce optical breakdown and initiate a plasma-mediated process; an OCT imaging device used to create an image of eye tissue that includes the cornea; a delivery system for delivering the laser beam to the target tissue to form a cataract incision; a scanner operable to scan the focal spot of the laser beam to different locations within the patient's eye; and a controller operatively coupled to the laser source, the imaging device, and the scanner. The OCT device is configured to scan the eye tissue to generate imaging data used to define an incision pattern configured to incise one or more relaxation incisions into the cornea, so that the one or more relaxation incisions are formed starting from the inside and proceeding outward.

A laser eye surgery system includes a laser to generate a laser beam. A topography measurement system measures corneal topography. A processor is coupled to the laser and the topography measurement system, the processor embodying instructions to measure a first corneal topography of the eye. A first curvature of the cornea is determined. A target curvature of the cornea that treats the eye is determined. A first set of incisions and a set of partial incisions in the cornea smaller than the first set of incisions are determined. The set of partial incisions is incised on the cornea by the laser beam. A second corneal topography is measured. A second curvature of the cornea is determined. The second curvature is determined to differ from the target curvature and a second set of incisions are determined. The second set of incisions is incised on the cornea.

A system and method of treating target tissue in a patient's eye, which includes generating a light beam, deflecting the light beam using a scanner to form first and second treatment patterns, delivering the first treatment pattern to the target tissue to form an incision that provides access to an eye chamber of the patient's eye, and delivering the second treatment pattern to the target tissue to form a relaxation incision along or near limbus tissue or along corneal tissue anterior to the limbus tissue of the patient's eye to reduce astigmatism thereof.

The methods and apparatus disclosed herein can be used to adjust the effective lens position (ELP) of the eye in order to correct refractive error of the eye. The methods and apparatus can be configured to apply energy to the sclera and other regions of the eye in order to adjust the effective lens position of the eye for far vision. The sclera can be treated in order to shrink or relax the sclera, and combinations thereof in order to adjust the position of the lens of the eye in order to correct vision related to refractive error of the eye. A target location of the lens can be determined to correct the refractive error of the eye, and the energy applied in order to move the lens toward the target location.