In certain embodiments, an ophthalmic laser surgical system for treating a target tissue in an eye includes a target detection system and a laser device. The target tissue has an optical breakdown threshold. The target detection system directs detection beams along a detection beam path towards the target tissue in a vitreous of the eye, and determines a location of the target tissue within the vitreous. The laser device includes a femtosecond laser that generates subthreshold laser pulses that have a pulse energy below the optical breakdown threshold of the tissue. The laser device directs a laser beam comprising the subthreshold laser pulses along a laser beam path towards the target tissue.

In certain embodiments, an ophthalmic laser surgical system for imaging and treating a target in an eye includes an imaging system. The imaging system includes a scanning laser ophthalmoscope (SLO) device and an optical coherence tomography (OCT) device. The SLO device generates SLO images, and the OCT device generates OCT images. The SLO device and the OCT device share a scanning system and a light detector. The scanning system scans SLO and OCT imaging beams within the eye. The light detector detects the SLO and OCT imaging beams reflected from the eye and generates SLO and OCT signals in response to detecting the imaging beams.

In certain embodiments, an ophthalmic laser surgical system for imaging and treating a target in an eye includes an imaging system with an optical coherence tomography (OCT) device that directs an OCT imaging beam along an imaging beam path towards the target in the eye, and generates OCT images from the OCT imaging beam reflected from the eye. The beam combining and alignment device aligns the OCT imaging beam and the laser beam. The laser-OCT xy-scanner: receives the OCT imaging beam from the imaging system, directs the OCT imaging beam along the imaging beam path towards the eye, and scans the OCT imaging beam in an xy-plane in the eye; and receives the laser beam from the laser device, directs the laser beam along the laser beam path aligned with the imaging beam path towards the eye, and scans the laser beam in the xy-plane in the eye.

In certain embodiments, an ophthalmic laser surgical system for imaging and treating a target in an eye includes a laser device, imaging system, and computer. The laser device directs the focus of a laser beam towards an intended location (x0, y0, z0) of the target to yield a cavitation bubble in the vitreous. The imaging system directs imaging beams towards the target, receives the imaging beams reflected from the eye, generates an image of the cavitation bubble from the reflected imaging beams, and measures an actual location (x, y, z) of the cavitation bubble according to the image. The computer determines an error vector that describes an error between the intended location and the actual location, determines a correction vector to compensate for the error, and instructs the laser device to use the correction vector to direct the laser beam towards the target to treat the target.

In certain embodiments, an ophthalmic laser surgical system for treating a floater in an eye includes a scanning laser ophthalmoscopy (SLO) device, a treatment laser device, and an xy-scanner. The SLO device directs an SLO beam towards the retina of the eye, generates an image that includes the floater shadow from the SLO beam reflected from the eye, determines the xy-location of the floater shadow, and determines the z-location of the floater relative to the retina using the confocal filter. The treatment laser device receives the z-location of the floater from the SLO device, and directs a laser beam towards the z-location. The xy-scanner receives the SLO beam from the SLO device and directs the SLO beam towards the xy-location of the floater shadow. The xy-scanner also receives the laser beam from the treatment laser device and directs the laser beam towards the xy-location of the floater shadow.

In certain embodiments, an ophthalmic laser surgical system for imaging and treating a target in an eye includes a digital micromirror device (DMD) confocal microscope, a laser device, and a computer. The DMD confocal microscope generates of images of the eye and includes a light source, a DMD device, and an image sensor. The light source provides a microscope imaging beam. The DMD device directs the microscope imaging beam along an imaging path towards the eye, receives the microscope imaging beam reflected from the eye, and rejects light of the reflected microscope imaging beam that is not from an image plane to scan the microscope imaging beam. The image sensor detects the scanned microscope imaging beam to generate the images of the eye. The laser device directs a laser beam along a laser beam path towards the target in the eye.

In certain embodiments, an ophthalmic system includes an anamorphic depth gauge (ADG) device and a computer. The ADG device measures the z-location in the interior of an eye and includes a detector array arranged at an oblique angle with respect to the z-axis. The array generates a detector signal in response to detecting a light beam, which has a z-focus in the interior of the eye. A set of line focus optical elements focuses the light beam to form a line focus on the detector array, and a set of nominal focus optical elements focuses the light beam to form a nominal focus on the detector array. The computer: generates an image using the detector signal; determines the position of the nominal focus on the line focus according to the image; and determines the z-location of the z-focus from the position of the nominal focus on the line focus.

A vitrector that includes an adjustable illumination aperture is described. The vitrector may include a probe and a light sleeve assembly extending along and substantially surrounding the probe. The light sleeve assembly may include a plurality of optical fibers. At least a portion of the optical fibers are operable to provide illumination so as to define an illumination aperture about the vitrectomy probe. A portion of the optical fibers may be encapsulated. The light sleeve assembly may be adjustable along a length of the probe, providing adjustment of the illumination aperture to increase or decrease an area of illumination provided thereby.

A surgical cassette for an ophthalmic surgical system includes an irrigation system and an aspiration system. The irrigation system is in fluid communication with a handpiece and carries fluid toward a surgical site. The aspiration system is in fluid communication with the handpiece and carries fluid away from the surgical site. The aspiration system includes an aspiration pump and tubing of an aspiration conduit. The aspiration pump generates a normal vacuum pressure within the aspiration conduit to carry fluid away from the surgical site during normal operation. The tubing has a larger cross-sectional area in response to normal vacuum pressure. The tubing collapses from the larger cross-sectional area to a smaller cross-sectional area in response to an occlusion; maintains the smaller cross-sectional area during a post-occlusion break surge to mitigate the post-occlusion break surge; and returns to the larger cross-sectional area after the post-occlusion break surge.

Surgical apparatus for performing a microsurgery including a cannula having an intraocular portion. The intraocular portion connects to an infusion tube. The intraocular portion includes fenestrations at its distal end. The intraocular portion receives fluid through the infusion tube and dispenses the fluid through the fenestrations lessening the flow at an infusion site in an eye. The surgical apparatus includes a vitreous cutter. The vitreous cutter includes a suction tube at one end and a shaft at another end. The cutting port cuts vitreous into smaller pieces or a laser that liquefies the vitreous. The shaft receives the cut vitreous pieces and the suction tube draws out the cut vitreous pieces from the eye. The surgical apparatus includes a vitreoretinal surgical tool having a vitreoretinal cutter. The vitreoretinal cutter has a scissor-like or forceps-like mechanism. The vitreoretinal cutter holds and/or cuts a membrane in the eye during the microsurgery.