Refractive index writing system and methods employing a pulsed laser source for providing a pulsed laser output at a first wavelength; an objective lens for focusing the pulsed laser output to a focal spot in an optical material; a scanner for relatively moving the focal spot with respect to the optical material at a relative speed and direction along a scan region for writing one or more traces in the optical material defined by a change in refractive index; and a controller for controlling laser exposures along the one or more traces in accordance with a calibration function for the optical material to achieve a desired refractive index profile in the optical material. The refractive index writing system may be for writing traces in in vivo optical tissue, and the controller may be configured with a calibration function obtained by calibrating refractive index change induced in enucleated ocular globes. A real-time process control monitor for detecting emissions from the optical material transmitted through the objective lens at a second wavelength may further be employed while writing the one or more traces.

Methods and apparatus for the treatment of the eye to reduce pain can treat at least an outer region of the tissue so as to denervate nerves extending into the inner region and reduce the pain. For example, the cornea of the eye may comprise an inner region having an epithelial defect, and an outer portion of the cornea can be treated to reduce pain of the epithelial defect. The outer portion of the cornea can be treated to denervate nerves extending from the outer portion to the inner portion. The outer portion can be treated in many ways to denervate the nerve, for example with one or more of heat, cold or a denervating noxious substance such as capsaicin. The denervation of the nerve can be reversible, such that corneal innervation can return following treatment.

A conformable covering comprises an outer portion with rigidity to resist movement on the cornea and an inner portion to contact the cornea and provide an environment for epithelial regeneration. The inner portion of the covering can be configured in many ways so as to conform at least partially to an ablated stromal surface so as to correct vision. The conformable inner portion may have at least some rigidity so as to smooth the epithelium such that the epithelium regenerates rapidly and is guided with the covering so as to form a smooth layer for vision. The inner portion may comprise an amount of rigidity within a range from about 1×10−4 Pa*m3 to about 5×10−4 Pa*m3 so as to deflect and conform at least partially to the ablated cornea and smooth an inner portion of the ablation with an amount of pressure when deflected.

A method of laser eye surgery including linking retinal vessel architecture to corneal topography. This enables registration of the steep axis of the cornea in order to orient a toric intraocular lens, and/or to place astigmatic keratotomy incisions. First, a detailed pre-operative retinal image of the vasculature of the retina is obtained. In addition, a pre-operative image of the topography of the eye is obtained. The retinal image is then correlated or superimposed on the topography image to provide a reference. After the patient lies down under the laser eye surgery system, and during the surgery, the retinal vasculature is monitored which provides a reference to the surgery system about the topography of the eye. This process enables registration of the steep axis of the cornea in order to orient a toric intraocular lens and/or to place astigmatic keratotomy incisions.

An apparatus includes a laser source and a scanner. The laser source is configured to generate electromagnetic radiation. The scanner scans at least part of a limbal area of an eye with the electromagnetic radiation generated by the laser source, thereby directing the electromagnetic radiation through an entire thickness of the limbal area of the eye without any contact with the eye and irradiating one or more regions of a trabecular meshwork of the eye with the electromagnetic radiation.

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 topographic-based excimer laser surgical systems. Generating treatment recommendations generally includes determining a topographic vector, a posterior astigmatism vector and an anterior astigmatism vector, and generating an internal astigmatism vector using the topographic vector, the posterior astigmatism vector, the anterior astigmatism vector, and a manifest astigmatism vector. In embodiments, the cylinder compensation is generated using multiple vectors while subtracting the internal astigmatism vector and the posterior astigmatism vector which remain in the eye after treatment, and the spherical compensation is generated using an initial spherical compensation modified by addback modifiers and a regression analysis nomogram. In procedures where the corneal epithelium is removed, an epithelial refractive vector is determined from an epithelial thickness/topography map and added to the other vectors.

Equipment and methods for refractive surgery, including for keratoplasty. The invention describes equipment and methods for the production and implantation of a lamella of a tissue or material for the purpose of correcting a corneal geometry at maximum precision that is thus improved in relation to the prior art. The invention facilitates restoration of normal corneal geometry together with optical functionality of the cornea which is improved in relation to the prior art. A planning device, a treatment system and a planning method are designed to couple a device coordinate systems of the laser devices involved and characterization devices by application of registration and to uniquely register the supplied measurement data for generating the lamella to be implanted to the device coordinate systems by a specific, defined edge geometry of a blank from which the lamella is produced, and by the lamella, and by additional system and method aids.

A device and a method for the femtosecond laser surgery of tissue, especially in the vitreous humor of the eye. The device includes an ultrashort pulse laser with pulse widths in the range of approximately 10 fs-1 ps, especially approximately 300 fs, pulse energies in the range of approximately 5 nJ-5 μJ, especially approximately 1-2 μJ and pulse repetition rates of approximately 10 kHz-10 MHz, especially 500 kHz. The laser system is coupled to a scanner system which allows the spatial variation of the focus in three dimensions (x, y and z). In addition to the therapeutic laser/scanner optical system, the device includes a navigation system.

A vibrating tissue separator suitable for use in separating a lenticule established by a femtosecond laser during a smile procedure may include a surgical implement such as a blunt spatula mounted on a handle that carries a haptic actuator for applying vibratory motion to the surgical implement. A damping arrangement may be provided to isolate the surgeons hand from the vibrations which would otherwise be transmitted through the handle. The actuator may apply a linear vibration along the axis of the handle which applies a lifting and chopping motion to the tip of a surgical implement having a bend. The tip may be suitable to the tissue being separated. For example, for SMILE lenticule separation, a blunt or semi-sharp spatula, blunted wire or loop may be used. The direction of vibration at the tip may be changed by rotating the implement in a plane other than the plane of the bend or by rotating an actuator such as an LRA with respect to the handle.

The invention relates to a method for controlling an eye surgical laser (18) for removing a volume body (12) from a cornea (44) with an anterior interface (16) of the cornea (44) and a posterior interface (14) of the cornea (44), comprising the steps of: presetting the posterior actual interface (14); determining a first imaging point (48) of the cornea (44); determining an anterior target interface (46) depending on the posterior actual interface (14) and the first imaging point (48) based on a mathematical model (M); determining a shape of the volume body (12) to be generated by presetting the determined anterior target interface (46); and generating control data for generating the volume body (12) such that the anterior actual interface (16) corresponds to the determined anterior target interface (46) after removing the volume body (12) from the cornea (44).

Further, the invention relates to a treatment apparatus (10), to a computer program product as well as to a computer-readable medium.