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.

Method for controlling an eye surgical laser of a treatment device for the separation of a volume body with a predefined posterior interface and a predefined anterior interface from a human or animal cornea. The method includes controlling the laser by means of a control device of the treatment device such that it emits pulsed laser pulses in a shot sequence in a predefined pattern into the cornea. The interfaces of the volume body are defined by the predefined pattern and are generated by means of an interaction of the individual laser pulses with the cornea by the generation of a plurality of cavitation bubbles by photodisruption along at least one cavitation bubble path. At least a partial area of an outer cavitation bubble path of the volume body is generated with a higher cavitation bubble density than an inner cavitation bubble path.

Devices and approaches for activating cross-linking within corneal tissue to stabilize and strengthen the corneal tissue following an eye therapy treatment. A feedback system is provided to acquire measurements and pass feedback information to a controller. The feedback system may include an interferometer system, a corneal polarimetry system, or other configurations for monitoring cross-linking activity within the cornea. The controller is adapted to analyze the feedback information and adjust treatment to the eye based on the information. Aspects of the feedback system may also be used to monitor and diagnose features of the eye. Methods of activating cross-linking according to information provided by a feedback system in order to improve accuracy and safety of a cross-linking therapy are also provided.

A laser eye surgery system includes a laser to generate a laser beam. A spatial measurement system generates a measurement beam and measure a spatial disposition of an eye. A processor is coupled to the laser and the spatial measurement system, the processor comprising a tangible medium embodying instructions to determine a spatial model of the eye in an eye coordinate reference system based on the measurement beam. The spatial model is mapped from the eye coordinate reference system to a machine coordinate reference system. A laser fragmentation pattern is determined based on a plurality of laser fragmentation parameters. The laser fragmentation pattern and the spatial model is rotated by a first rotation angle such that the spatial model is aligned with the reference axis of the machine coordinate reference system and the rotated laser fragmentation pattern is aligned with the corneal incision.

Methods and apparatus are configures to measure an eye without contacting the eye with a patient interface, and these measurements are used to determine alignment and placement of the incisions when the patient interface contacts the eye. The pre-contact locations of one or more structures of the eye can be used to determine corresponding post-contact locations of the one or more optical structures of the eye when the patient interface has contacted the eye, such that the laser incisions are placed at locations that promote normal vision of the eye. The incisions are positioned in relation to the pre-contact optical structures of the eye, such as an astigmatic treatment axis, nodal points of the eye, and visual axis of the eye.

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.

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.

The presently disclosed subject matter provides techniques for inducing collagen cross-linking in human tissue, such as cartilage, by inducing ionization of the water contained in the tissue to produce free radicals that induce chemical cross-linking in the human tissue. In an embodiment, a femtosecond laser operates at sufficiently low laser pulse energy to avoid optical breakdown of the tissue being treated. In an embodiment, the femtosecond laser operates in the infrared frequency range.

In general, one aspect disclosed features a scleral contact lens for an eye of a patient, the scleral contact lens comprising: an anterior surface; and a posterior surface, the posterior surface comprising: a central optic zone defined by a base curve according to an apical radius of the cornea of the eye; a peripheral corneal zone peripheral to the central optic zone, a clearance control zone peripheral to the optic zone, and a scleral landing zone peripheral to the clearance control zone, the scleral landing zone having a single surface shape.

An ultrashort pulsed laser instrument is used to perform refractive surgery. The invention operates in ablative and incisional modalities. In the ablative mode, spiral ablation disks consisting of individual laser pulses are produced at high scanning speeds. Ablation profile may be produced in cornea by stacking and arranging multiple ablation disks to produce a specified shape change. Placement of ablation disks is assisted by an optical tracking and control system that compensates for eye motion. A preferred embodiment allows for ablative corrections to be performed on non-planar posterior surface of a laser cut flap affixed to registration platen, thereby avoiding exposing the eye interior to high radiant power. Laser cut and contrast agent dyed fiduciary marks may serve as reference features for the optical tracking system. Incisional procedures, such as corneal flaps for LASIK, may also be performed.