DEVICE FOR TREATING EYE TISSUE BY MEANS OF A PULSED LASER BEAM
20210401622 · 2021-12-30
Inventors
Cpc classification
International classification
Abstract
An ophthalmological device comprises a laser source, an application head having focusing optics and a patient interface, a scanner system and circuit. The circuit is configured to control the scanner system to incise an incision surface, which is symmetrical with respect to the central axis of the patient interface, in the eye tissue, a pulsed laser beam being steered onto treatment points on the incision surface on a first treatment path, and the treatment path being curved while extending around the projection axis of the focusing optics. In the event of a tilt of the eye with respect to the central axis of the patient interface, the circuit determines an apex of a tilted incision surface by a co-tilt of the incision surface corresponding to the tilt of the eye, and determines a transformed treatment path, which extends around the apex and determines treatment points on the tilted incision surface.
Claims
1. Ophthalmological device for treating eye tissue of an eye, comprising: a laser source which is configured to generate a pulsed laser beam; an application head having focusing optics and a patient interface, the focusing optics having a projection axis and being configured to focus the pulsed laser beam in the eye tissue onto a treatment point, and the patient interface having a central axis and being configured to fix the application head on the eye; a scanner system which is configured to steer the pulsed laser beam in the eye tissue onto treatment points on a treatment path; and a circuit which is configured to control the scanner system in order to incise an incision surface, which is symmetrical with respect to the central axis of the patient interface, in the eye tissue, the pulsed laser beam being steered onto treatment points on the incision surface on a first treatment path, and the first treatment path being curved while extending around the projection axis of the focusing optics, wherein the circuit is furthermore configured, in the event of a tilt of the eye with respect to the central axis of the patient interface, to determine an apex of a tilted incision surface, which is determined by a co-tilt of the incision surface corresponding to the tilt of the eye, to determine a transformed second curved treatment path, which extends around the apex and determines treatment points on the tilted incision surface, and to control the scanner system in such a way that the pulsed laser beam is steered onto treatment points on the transformed second curved treatment path.
2. Ophthalmological device according to claim 1, wherein the focusing optics are configured to adjust a treatment height of the treatment points in the direction of the projection axis with a focus adjustment speed, in that the scanner system is configured to displace treatment points on the treatment path with a scan speed that is higher than the focus adjustment speed, and in that the circuit is configured to determine the transformed second curved treatment path with height changes in the direction of the projection axis which are adjustable during a movement of treatment points with the scan speed without exceeding the focus adjustment speed of the focusing optics.
3. Ophthalmological device according to claim 2, wherein the first treatment path has a continual height change component in the direction of the projection axis, and in that the circuit is configured to determine the transformed second curved treatment path with a treatment height component increasing continually or decreasing continually in the direction of the projection axis.
4. Ophthalmological device according to claim 1, wherein the first treatment path has a continual height change component in the direction of the projection axis, and in that the circuit is configured to determine the transformed second curved treatment path with a treatment height component increasing continually or decreasing continually in the direction of the projection axis.
5. Ophthalmological device according to claim 4, wherein the first treatment path has a continual height change component in the direction of the projection axis, and in that the circuit is configured to determine subsections of the transformed second curved treatment path with a path section treatment height that is respectively constant in the direction of the projection axis, and to prevent generation of the pulsed laser beam by the laser source while the focusing optics are adjusting the path section treatment height of two subsections, which two subsections are adjacent in the direction of the projection axis, of the transformed second curved treatment path.
6. Ophthalmological device according to claim 1, wherein the first treatment path has a continual height change component in the direction of the projection axis, and in that the circuit is configured to determine subsections of the transformed second curved treatment path with a path section treatment height that is respectively constant in the direction of the projection axis, and to prevent generation of the pulsed laser beam by the laser source while the focusing optics are adjusting the path section treatment height of two subsections, which two subsections are adjacent in the direction of the projection axis, of the transformed second curved treatment path.
7. Ophthalmological device according to claim 6, wherein subsections of the first treatment path respectively have a path section treatment height that is constant in the direction of the projection axis, and in that the circuit is configured to determine the transformed second curved treatment path with a treatment height component increasing continually or decreasing continually in the direction of the projection axis.
8. Ophthalmological device according to claim 1, wherein subsections of the first treatment path respectively have a path section treatment height that is constant in the direction of the projection axis, and in that the circuit is configured to determine the transformed second curved treatment path with a treatment height component increasing continually or decreasing continually in the direction of the projection axis.
9. Ophthalmological device according to claim 1, wherein subsections of the first treatment path respectively have a path section treatment height that is constant in the direction of the projection axis, and in that the circuit is configured to determine subsections of the transformed second curved treatment path with a path section treatment height that is respectively constant in the direction of the projection axis, and to prevent generation of the pulsed laser beam by the laser source while the focusing optics are adjusting the path section treatment height of two subsections, adjacent in the direction of the projection axis, of the transformed second curved treatment path.
10. Ophthalmological device according to claim 1, wherein the circuit is configured to determine the transformed second curved treatment path with a treatment height component alternately increasing and decreasing in the direction of the projection axis.
11. Ophthalmological device according to claim 1, wherein the first treatment path comprises path sections having at least one of the following shapes: a circular path section, an elliptical path section, a parabolic path section, a hyperbolic path section, a helical path section, or a spline path section.
12. Ophthalmological device according to claim 1, wherein the circuit is configured to determine the transformed second curved treatment path on the basis of the first curved treatment path by carrying out at least one of the following operations: stretching first regions of the first curved treatment path, compressing second regions of the first curved treatment path, or interrupting third regions of the first curved treatment path.
13. Ophthalmological device according to claim 1, wherein the circuit is configured to control the scanner system in order to incise a lenticule, which lenticule is formed by two incision surfaces and is symmetrical with respect to the central axis of the patient interface in the eye tissue, and in the event of a tilt of the eye with respect to the central axis of the patient interface, to determine an apex of a tilted lenticule which is determined by a co-tilt of the lenticule corresponding to the tilt of the eye, to determine transformed third curved treatment paths which extend around the apex and determine treatment points on the incision surfaces of the tilted lenticule, and to control the scanner system in such a way that the pulsed laser beam is steered onto treatment points on the transformed third curved treatment paths.
14. Ophthalmological device according to claim 1, wherein the patient interface comprises a curved internal space, which is symmetrical with respect to the central axis, for receiving a corneal region of the eye.
15. Ophthalmological device according to claim 1, wherein the patient interface comprises a planar internal space, which is symmetrical with respect to the central axis, for receiving a corneal region of the eye.
16. Ophthalmological device according to claim 1, wherein the ophthalmological device comprises a measuring device which is configured to register reference structures and/or reference markings in or on the eye tissue, and in that the circuit is configured to determine the tilt of the eye with respect to the central axis of the patient interface on the basis of the reference structures and/or reference markings registered by the measuring device.
17. Ophthalmological device according to claim 1, further comprising one or more suction elements, which are configured to fix the patient interface on the eye.
18. Ophthalmological device according to claim 1, wherein the scanner system comprises a first scan device, which is configured to steer the pulsed laser beam in the eye tissue with a feed speed along a feed line on the treatment path, and in that the scanner system comprises a second scan device, which is configured to steer the pulsed laser beam in the eye tissue with a scan speed, which is higher than the feed speed, along a scan line extending transversely with respect to the feed line on the treatment path.
19. Ophthalmological device for treating eye tissue of an eye, comprising: a laser source which is configured to generate a pulsed laser beam; an application head having focusing optics and a patient interface, the focusing optics having a projection axis and being configured to focus the pulsed laser beam in the eye tissue onto a treatment point, and the patient interface having a central axis and being configured to fix the application head on the eye; a scanner system which is configured to steer the pulsed laser beam in the eye tissue onto treatment points on a treatment path; and a circuit which is configured to: control the scanner system in order to incise an incision surface, which is symmetrical with respect to the central axis of the patient interface, in the eye tissue, the pulsed laser beam being steered onto treatment points on the incision surface on a first treatment path, and the first treatment path being curved while extending around the projection axis of the focusing optics, in the event of a tilt of the eye with respect to the central axis of the patient interface, determine an apex of a tilted incision surface, which is determined by a co tilt of the incision surface corresponding to the tilt of the eye, to determine a transformed second curved treatment path, which extends around the apex and determines treatment points on the tilted incision surface, and control the scanner system in such a way that the pulsed laser beam is steered onto treatment points on the transformed second curved treatment path.
20. A method comprising: generating a pulsed laser beam; focusing the pulsed laser beam in the eye tissue onto a treatment point; fixing an application head on the eye; steering the pulsed laser beam in eye tissue onto treatment points on a treatment path; controlling a scanner system to incise an incision surface, which is symmetrical with respect to a central axis of a patient interface, in the eye tissue, the pulsed laser beam being steered onto treatment points on the incision surface on a first treatment path, and the first treatment path being curved while extending around a projection axis of focusing optics; in the event of a tilt of the eye with respect to the central axis of the patient interface, determining an apex of a tilted incision surface, which is determined by a co-tilt of the incision surface corresponding to the tilt of the eye, to determine a transformed second curved treatment path, which extends around the apex and determines treatment points on the tilted incision surface; and controlling the scanner system in such a way that the pulsed laser beam is steered onto treatment points on the transformed second curved treatment path.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0032] An embodiment of the present disclosure will be explained below with the aid of an example. The embodiment example is illustrated by the following appended figures:
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DESCRIPTION OF THE EMBODIMENTS
[0045] In
[0046] As is schematically represented in
[0047] The laser source 3 is configured to generate a pulsed laser beam L. The laser source 3 comprises in particular a femtosecond laser for generating femtosecond laser pulses, which have pulse widths of typically from 10 fs to 1000 fs (1 fs=10.sup.−15 s). The laser source 3 is arranged in a separate housing or a common housing with the focusing optics 51.
[0048] The scanner system 4 is configured to steer the pulsed laser beam L delivered by the laser source 3 by means of the focusing optics 51 in the eye tissue 60 onto treatment points F on a treatment path t, t′ (trajectories t and t′). As is schematically represented in
[0049] The scan device 42 (slow scan module) placed in front of the focusing optics 51 is configured to steer the pulsed laser beam L, or its laser pulses, in the eye tissue 60 in an x/y treatment plane with a feed speed (a speed of advance) along a feed line (a line of advance) on the treatment path t, t′, as is illustrated for example in
[0050] In an embodiment, the scan device 41 (as a fast scan module) preceding the scan device 42 is configured to steer the pulsed laser beam L, or its laser pulses, in the eye tissue 60 in the x/y treatment plane with a scan speed that is higher in relation to the feed speed along a scan line extending transversely with respect to the feed line. The two scan devices 41 and 42 are configured and coupled in such a way that the scan movement, extending along the scan line, of the scan device 41 is superimposed on the feed line of the scan device 42. The scan device 41 comprises one or more movable deflecting mirrors, for example a rotating polygonal mirror (polygon scanner), one or more resonant mirrors (resonant scanner) or oscillating mirrors (oscillating scanner), which are for example piezo-driven (piezo scanner), or MEM (Micro-ElectroMechanical) scanner, or the scan device 41 comprises an AOM (Acousto-Optical Modulator) scanner or an EOM (Electro-Optical Modulator) scanner. The scan device 41 has a scan speed that is higher, for example several times, than the subsequent scan device 42 (feed speed). In order to avoid misunderstandings, it should be mentioned at this point that in the embodiment in which the scan device 41 configured as a fast scan module generates scan lines that extend transversely with respect to the feed line of the scan device 42, the feed line of the subsequent scan device 42 corresponds to the treatment path t, t′, the transversely extending scan lines of the scan device 41 placed in front treating intermediate spaces between the treatment path t, t′.
[0051] As is schematically represented in
[0052] For the treatment and incision of incision surfaces C, C′ which have a lateral component in the x/y treatment plane normal to the projection direction which is comparatively larger than the depth component in the projection direction along the projection axis p, the scanner system 4 is configured to displace the treatment points F, onto which the laser pulses are focused, with a higher scan speed on the treatment path t, t′ in relation to the focus adjustment speed of the focusing optics 51.
[0053] As is schematically represented in
[0054] As is schematically represented in
[0055] As is schematically represented in
[0056]
[0057]
[0058] A treatment path t for incising the incision surface C is illustrated in the example of
[0059]
[0060] In the following sections, with reference to
[0061] In step S1, the circuit 2 receives the reference structures and/or reference markings in or on the eye tissue 60 currently registered by the measuring device 7 and determines any tilt of the eye 6 in relation to the central axis m of the patient interface 52. To this end, the circuit 2 determines displacements and/or rotations of the currently registered reference structures and/or reference markings in relation to the place and orientation of stored reference structures and/or reference markings which have been registered in a previously carried out preparatory step for the eye 6 in question with an untilted alignment of the eye 6 in relation to the central axis m of the patient interface 52 or a reference system. As an alternative, the tilt of the eye 6 in relation to the central axis m of the patient interface 52 (without a measuring device) is determined by the user, who for example carries out a displacement movement in the docked state.
[0062] In the event of a tilt of the eye 6 with respect to the central axis m of the patient interface 52, the circuit 2 determines in step S2, on the basis of the stored control data for the treatment path t of the incision surface C to be incised in the eye tissue 60, the apex S′ of a tilted incision surface C′. The tilted incision surface C′ is defined by a co-tilt of the incision surface C, which corresponds to the tilt of the eye 6 determined in step S1. In other words, the tilted incision surface C′ may be incised in the tilted eye 6′ in order to incise the incision surface C, defined in the untilted eye 6 by the stored control data, in the eye tissue 60. The determination of the apex S′ of the tilted incision surface C′ is carried out by determining the highest point of the tilted incision surface C′ in respect of the direction of the projection axis p by using and according to the tilt of the eye 6 determined in step S1. Depending on the surface curvature of the incision surface C, or of the tilted incision surface C′, in respect of the surface curvature of the curving of the patient interface 52 (or of the eye curvature of the eye 6 adapted to by this curving), the apex S′ of the tilted incision surface C′ is displaced in relation to the apex S of the untilted incision surface C, as may be seen in the example of
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[0064] In step S3, the circuit 2 determines a transformed treatment path t′ for incising the tilted incision surface C′.
[0065] Like the original treatment path t for incising the untilted incision surface C, the treatment path t′ transformed by the circuit 2 for incising the tilted incision surface C′ can be scanned by the scanner system 4 with the pulsed laser beam L in the x/y treatment plane extending normal to the projection axis p with the scan speed which is higher than the focus adjustment speed of the focusing optics 51, and has height changes in the direction of the projection axis p which the focusing optics 51 can traverse by continual and preferably continuous adjustment of the treatment height (focal depth of the pulsed laser beam L) in the direction of the projection axis p with the focus adjustment speed. Depending on the treatment variant, the treatment height along the transformed treatment path t′ may be set by the focusing optics 51 with a continually and continuously increasing or a continually and continuously decreasing treatment height component synchronously with the scanner system 4, or with the scanning, for example in order to scan the treatment points along the transformed treatment path t′, by the scanner system 4. In an embodiment, the circuit 2 determines the transformed treatment path t′ for incising the tilted incision surface C′ with a treatment height component alternately increasing and decreasing in the direction of the projection axis p. In an embodiment, the circuit 2 determines individual path sections of the transformed treatment path t′ with a treatment height component alternately increasing and decreasing in the direction of the treatment axis p and/or with an invariant (constant) treatment height.
[0066] The transformed treatment path t′ comprises one or more mutually separated or connected transformed path sections. The transformed treatment path t′ determines treatment points on the tilted incision surface C′ for incising the tilted incision surface C′. The circuit 2 determines the transformed treatment path t′ on the basis of the original treatment path t defined by the stored control data by one or more of the following transformation steps: distorting one or more regions or the entire original treatment path t by stretching one or more regions or the entire original treatment path t or by compressing one or more regions or the entire original treatment path t, and/or interrupting one or more regions of the entire original treatment path t or of the transformed treatment path t′.
[0067] The transformed treatment path t′ in the example of
[0068] The transformed treatment path t′ in the example of
[0069] In step S4, the circuit 2 controls the scanner system 4 so that the pulsed laser beam L is steered onto treatment points F on the transformed treatment path t′. The circuit 2 controls the scanner system 4 so that the pulsed laser beam L scans the transformed treatment path t′ and incises the tilted incision surface C′. In the case of interrupted path sections on the transformed treatment path t′, the circuit 2 controls the laser source 3 so that the pulsed laser beam L is turned off in interruptions of the transformed treatment path t′. As soon as the adjustment of the focusing optics 51 in the direction of the projection axis p has reached the treatment height and the scanner system 4 has reached the x/y position (for example in relation to the projection axis p) of the first treatment point after the interruption of the transformed treatment path t′, the circuit 2 controls the laser source 3 so that the pulsed laser beam L is again activated, or switched on, and focused onto the relevant treatment point F on the transformed treatment path t′. In embodiments, or treatment variants, in which subsections of the treatment path t and/or of the transformed treatment path t′ have an invariant (constant) treatment height, the circuit 2 controls the focusing optics 51 so that it leaves the treatment height unchanged on the relevant subsections and then adjusts the treatment height before or during the treatment of the subsequent path section of the treatment path t and/or of the transformed treatment path t′.