An initial treatment pattern defining an initial volume of ocular tissue to be modified for treating glaucoma is designed. An initial laser treatment is delivered by scanning a laser beam across ocular tissue at an initial placement in the eye in accordance with the initial treatment pattern to thereby photo disrupt the initial volume of ocular tissue. A postoperative measure of intraocular pressure (IOP) is evaluated relative to an IOP criterion to determine if the treatment was successful. If the treatment was not successful, meaning the IOP criterion was not satisfied, then a subsequent treatment pattern that defines a subsequent volume of ocular tissue to be modified, and/or a subsequent placement in the eye is determined. A subsequent laser treatment is delivered by scanning a laser beam across ocular tissue at the subsequent placement within the eye in accordance with the subsequent treatment pattern to thereby photo disrupt the subsequent volume of ocular tissue.

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.

In certain embodiments, a system for aligning an eye with a patient interface of a laser device includes a camera, a display screen, and a computer. The camera records images of the eye through the patient interface of the laser device. A liquid is disposed between and is in contact with the patient interface and the outer surface of the eye. The images include an outline of the liquid. The display screen displays the images of the eye. The computer aligns the eye with the patient interface by: identifying the outline of the liquid in an image received from the camera; determining a misalignment of the eye according to the outline; and instructing the display screen to display a description of the misalignment.

A method for providing control data for an eye surgical laser of a treatment apparatus for removing tissue is disclosed. The method includes utilizing a control device for determining a corneal geometry and an ocular wavefront of a human or animal eye from predetermined examination data. A corneal wavefront is then determined from the corneal geometry using a physical model, and an internal wavefront is calculated from a difference between the ocular wavefront and the corneal wavefront. A wavefront to be achieved is calculated from a difference of a preset target wavefront and the calculated internal wavefront. A target corneal geometry is determined from the wavefront to be achieved by the physical model, and a tissue geometry to be removed is calculated from a difference of the corneal geometry and the target corneal geometry, and control data for controlling the eye surgical laser is provided.

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.

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.

Techniques are described for generating and using an illumination pattern for corneal topography. The illumination pattern is projected onto an eye of a user wearing a head-mounted assembly. The illumination pattern is based on a reference pattern and corresponds to selective illumination of dots arranged along a two-dimensional grid. An image sensor captures a reflected image produced by reflection of the illumination pattern off the eye. A reflected pattern is identified based on glints in the reflected image and mapped to the reference pattern to generate an aligned reflected pattern. An eye model including a topography of a cornea is calculated by comparing the aligned reflected pattern to the reference pattern to determine a deviation in a shape of the cornea based on a difference between the aligned reflected pattern and the reference pattern. The eye model can be applied in various ways, including for eye tracking or biometric authentication.

A device for producing control data for a laser device for the surgical correction of defective vision. The device produces the control data such that the laser emits the laser radiation such that a volume in the cornea is isolated. The device calculates a radius of curvature R.sub.CV* to determine the control data, the cornea reduced by the volume having the radius of curvature R.sub.CV* and the radius of curvature being site-specific and satisfying the following equation: R.sub.CV*(r,φ)=1/((1/R.sub.CV(r,φ))+B.sub.COR(r,φ)/(n.sub.c-1))+F, wherein R.sub.CV(r,φ) is the local radius of curvature of the cornea before the volume is removed, n.sub.c is the refractive index of the material of the cornea, F is a coefficient, and B.sub.COR(r,φ) is the local change in refractive force required for the desired correction of defective vision in a plane lying in the vertex of the cornea, and at least two radii r1 and r2 satisfy the equation B.sub.COR(r=r1,φ)≠B.sub.COR(r=r2,φ).

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.

A method for controlling an eye surgical laser is disclosed for the separation of a volume body with a predefined posterior interface and a predefined anterior interface. The method includes controlling the laser by means of a control device such that it emits pulsed laser pulses into the cornea. Predefined posterior and anterior interfaces are generated by means of an interaction of the individual laser pulses with the cornea by the generation of cavitation bubbles along a rotation path. A respective interface is divided at least into an inner annulus and an outer annulus, and the cavitation bubbles are generated along the rotation path from an inner boundary of the outer annulus to an outer boundary of the outer annulus. Also disclosed in relation to the method are a computer program, a computer-readable medium and a treatment apparatus.