Rather than rely solely upon pupillary occlusion or tracking of eye movement to protect the fundus from accidental exposure to electromagnetic radiation, the present invention also utilizes an electromagnetic radiation pathway with a profile such that the energy density at the iris is greater than the energy density at the posterior portion of the eye. This disparity in energy density allows for efficacy at the anterior iris treatment site, without injury to the fundus.

In certain embodiments, an ophthalmic surgical system for adjusting a dimension of an eye includes a camera and a computer. The camera generates a surgical image of the eye in contact with a patient interface, which distorts the cornea. The surgical image includes the pupil with a real pupil diameter. The computer accesses a diagnostic image of the eye with the cornea having a natural curvature. The natural curvature affects the real pupil diameter to yield a diagnostic pupil diameter of the diagnostic image that is different from the real pupil diameter of the surgical image. The computer adjusts the real pupil diameter of the surgical image using an eye model to yield a refracted pupil diameter that takes into account the curvature of the cornea and uses the refracted pupil diameter to compensate for the difference between the diagnostic and real pupil diameters.

The present invention predicts prior to a laser iris color-change procedure what a patient's iris color will be after the procedure. The present invention does so by identifying and measuring a variety of anatomical features of the patient's eye that affect or are otherwise relevant to predicting the patient's post-operative iris color, translating these measurements into a post-operative iris color prediction, and communicating this prediction to the patient in a manner sufficient to manage the patient's expectations with respect to the aesthetic outcome of the procedure.

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 system (20) includes a laser (48), configured to irradiate a target site (41) in an iris (35) of an eye (25), and a controller (44). The controller is configured to identify, in one or more images of at least part of the iris, an indication of fluid flow through the target site, and in response to identifying the indication, inhibit the laser from further irradiating the target site. Other embodiments are also described.

A method for altering an eye color of a patient with a color alteration procedure is disclosed that may include determining a laser power to deliver to stromal pigment in an iris of the eye of the patient by at least retrieving a set of laser criteria for delivery of an exposure less than 100 times a maximum permissible exposure that causes elimination of at least a portion of the stromal pigment. A laser system may be set to deliver laser light at the laser power which is less than the set of laser criteria and the laser light may be delivered with the laser system.

In a laser cataract procedure that also corrects for astigmatism, an iris registration method compares an iris image of a patient's eye taken when the eye is not docked to a patient interface device with an iris image of the same eye that is docked to the patient interface, to calculate a rotation angle between the two images. The astigmatism axis of the eye is measured when the eye is not docked, and the measured axis is rotated by the calculated rotation angle to obtain a rotated astigmatism axis relative to the iris image of the docked eye. The laser cataract procedure is performed based on the rotated astigmatism axis. The rotation angle is calculated by optimizing a transformation that transforms the undocked iris image to match the docked iris image, where the transformation includes a dilation factor that accounts for different pupil dilation of the two iris images.

Rather than rely solely upon pupillary occlusion or tracking of eye movement to protect the fundus from accidental exposure to electromagnetic radiation, the present invention also utilizes an electromagnetic radiation pathway with a profile such that the energy density at the iris is greater than the energy density at the posterior portion of the eye. This disparity in energy density allows for efficacy at the anterior iris treatment site, without injury to the fundus.

A method for altering an eye color of a patient with a color alteration procedure is disclosed that may include determining a laser power to deliver to stromal pigment in an iris of the eye of the patient by at least retrieving a set of laser criteria for delivery of an exposure less than 100 times a maximum permissible exposure that causes elimination of at least a portion of the stromal pigment. A laser system may be set to deliver laser light at the laser power which is less than the set of laser criteria and the laser light may be delivered with the laser system.

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.