Described herein are devices and methods for creating a capsulorhexis. In some embodiments, the device includes a template with a tearing profile, which, when placed against the capsular bag, defines a perimeter of a capsulorhexis. In some embodiments, the device further includes rigid sections and bendable sections which are configured to transition the template between a first bent configuration for insertion through a corneal incision and a second unbent configuration for creation of the capsulorhexis. In some embodiments, the device further includes connecting elements which enter through the corneal incision and, when manipulated, transition the device between the first bent configuration and the second unbent configuration. In some embodiments, the connectors are configured to impart a downward force on the template and thus the capsular bag during the capsulorhexis creation.

An exemplary surgical device includes a shaft with a lumen defined therethrough and an element movable from a stored position to a deployed position in which a larger portion of the element extends out of the distal end of the lumen; wherein motion from the stored position to the deployed position causes a first leg of the element to advance distally relative to the distal end of the shaft, and causes a second leg of the element to move proximally relative to the distal end of the shaft.

There is provided a system, apparatus and methods for developing laser systems that can create precise predetermined clear corneal incisions that are capable of reducing induced astigmatism. The systems, apparatus and methods further provide laser systems that can provide these incisions at or below Bowman's membrane.

A system for laser ophthalmic surgery includes: a single laser source, under the operative control of a controller, configured to alternatively deliver a first treatment laser beam and a second treatment laser beam. The first treatment laser beam has a pulse energy of 10 to 500 μJ. The second pulsed laser beam has a second pulse energy of about 0.1 to 10 μJ, lower than the first treatment laser beam. An optical system focuses the first treatment laser beam to a first focal spot and directs the first focal spot in a first treatment pattern into a first intraocular target. The optical system also focuses the second treatment laser beam to a second focal spot and direct the second focal spot in a second treatment pattern into a second intraocular target. The first intraocular target and second intraocular target are different.

There is provided a system, apparatus and methods for developing laser systems that can create precise predetermined clear corneal incisions that are capable of reducing induced astigmatism. The systems, apparatus and methods further provide laser systems that can provide these incisions at or below Bowman's membrane.

A method of generating three dimensional shapes for a cornea and lens, the method including illuminating an eye with multiple sections of light and obtaining multiple sectional images of the eye based on the multiple sections of light. For each obtained multiple sectional image, the following processes are performed: a) automatically identifying arcs corresponding to anterior and posterior corneal and lens surfaces of the eye by image analysis and curve fitting of the obtained multiple sectional images; and b) determining an intersection of lines ray traced back from the identified arcs with a known position of a section of space containing the section of light that generated the obtained multiple sectional images, wherein the intersection defines a three-dimensional arc curve. The method further including reconstructing three-dimensional shapes of the cornea surfaces and the lens surfaces based on fitting the three-dimensional arc curve to a three-dimensional shape.

Laser assisted cataract surgery methods and devices utilize one or more treatment laser beams to create a shaped opening in the anterior lens capsule of the eye when performing a capsulorrhexis procedure. A light absorbing agent may be applied to the anterior lens capsule to facilitate laser thermal separation of tissue along a treatment beam path on the lens capsule. Relative or absolute reflectance from the eye, and optionally from a surgical contact lens, may be measured to confirm and optionally quantify the presence of the light absorbing agent, before the treatment beam is applied. Such measurements may be used to determine that sufficient light absorbing agent is present in the lens capsule so that transmission of the treatment beam through the capsule will be below a predetermined threshold deemed safe for the retina and other interior portions of the eye, and may also be used to determine that sufficient light absorbing agent is present to result in complete laser thermal separation of the anterior capsule along the treatment beam path. Visualization patterns produced with one or more target laser beams may be projected onto the lens capsule tissue to aid in the capsulorrhexis procedure. In addition or alternatively, virtual visualization patterns may presented on a display integrated with a laser assisted cataract surgery device to aid in the procedure. The visual axis of the eye may be determined, during surgery for example, with a laser beam on which the patient is fixated. The orientation of a toric IOL may be assessed during or after placement by observing the reflection from the back of the eye of a laser beam on which the patient is fixated. The devices disclosed herein may be attached to or integrated with microscopes.

A laser eye surgery system includes a laser source, a ranging subsystem, an integrated optical subsystem, and a patient interface assembly. The laser source produces a treatment beam that includes a plurality of laser pulses. The ranging subsystem produces a source beam used to locate one or more structures of an eye. The ranging subsystem includes an optical coherence tomography (OCT) pickoff assembly that includes a first optical wedge and a second optical wedge separated from the first optical wedge. The OCT pickoff assembly is configured to divide an OCT source beam into a sample beam and a reference beam. The integrated optical subsystem is used to scan the treatment beam and the sample beam. The patient interface assembly couples the eye with the integrated optical subsystem so as to constrain the eye relative to the integrated optical subsystem.

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.

An exemplary surgical device includes an element positionable within a shaft having a lumen defined therethrough with the element movable from a stored position to a deployed position in which a larger portion of the element extends out of the distal end of the lumen. The element forming a closed loop which is positioned around the lens while the lens is within a capsular bag. The closed loop is reduced in size to form a cut in the lens.