Abstract
The present disclosure relates to an ophthalmological laser treatment system for treatment of tissue of an eye comprising an ophthalmological laser treatment device comprising a base station having a treatment laser source configured to generate a treatment laser beam, an arm and an application head, wherein the ophthalmological laser treatment system further comprises an ophthalmological patient interface with a cornea contacting element, and a sclera contacting element, wherein the cornea contacting element and the sclera contacting element define a rotationally asymmetric contact surface configured to contact the eye, wherein the ophthalmological patient interface comprises a through opening, which is configured to enable the treatment laser beam from the application head to pass through the ophthalmological patient interface to penetrate a target volume of tissue of the eye.
Claims
1. An ophthalmological laser treatment system for treatment of tissue of an eye of a person, the ophthalmological laser treatment system comprising: a. an ophthalmological laser treatment device comprising a base station having a treatment laser source configured to generate a treatment laser beam, an arm and an application head, wherein the arm is configured to guide the treatment laser beam from the base station to the application head; b. an ophthalmological patient interface comprising: a coupling portion, configured to be arranged on the application head, an eye fixation portion, configured to be arranged on the eye, wherein the eye fixation portion comprises a cornea contacting element, configured to contact at least partially the cornea of the eye, and a sclera contacting element, configured to contact at least partially the sclera of the eye, for firmly positioning the ophthalmological patient interface on the eye, wherein the cornea contacting element and the sclera contacting element define a rotationally asymmetric contact surface configured to contact the eye, and a through opening, extending through the coupling portion and the eye fixation portion, wherein the through opening is configured to enable the treatment laser beam from the application head to pass through the ophthalmological patient interface to penetrate a target volume of tissue of the eye.
2. The ophthalmological laser treatment system according to claim 1, further comprising an optical mirror element arranged between the application head and the ophthalmological patient interface or within the ophthalmological patient interface, wherein the optical mirror element is configured to deflect the treatment laser beam incidenting from the application head at a specific angle, wherein the angle of incidence of the treatment laser beam on the eye with respect to an optical axis of the eye is determined by the inclined position of the ophthalmological patient interface with respect to the optical axis on the eye and the specific angle of the optical mirror element.
3. The ophthalmological laser treatment system according to claim 2, wherein the optical mirror element comprises at least one adjustable mirror, which is configured to adjust the specific angle based on a position of the tissue of the eye to be treated and the position of the ophthalmological patient interface on the sclera and cornea of the eye to adjust the angle of incidence of the treatment laser beam on the eye.
4. The ophthalmological laser treatment system according to claim 1, further comprising an optical imaging device configured to generate optical image data of the eye of the person, which are configured to be used for positioning of the ophthalmological patient interface on the sclera and cornea of the eye and/or for adapting of the position of the ophthalmological patient interface on the sclera and cornea of the eye.
5. The ophthalmological laser treatment system according to claim 4, wherein the optical imaging device further comprises an optical depth module, which is configured to provide depth information of the eye, which are configured to be used for positioning of the ophthalmological patient interface on the sclera and cornea of the eye and/or for adapting of the position of the ophthalmological patient interface on the sclera and cornea of the eye.
6. The ophthalmological laser treatment system according to claim 5, wherein the optical depth module, which is configured to provide depth information of the eye, is an imaging device based on the Scheimpflug principle, an optical coherence tomography device, a confocal microscopy device, a device for structured lighting and/or a device for stereoscopic vision.
7. The ophthalmological laser treatment system according to claim 4, wherein the ophthalmological laser treatment system further comprises a control module configured to: a. determine, by a processing unit of the control module, the target volume of tissue to be treated using at least one of: the captured image data or the depth information, of the optical imaging device, and b. control, by the processing unit, the treatment laser beam for penetration of the target volume, using the determined target volume of tissue to be treated.
8. The ophthalmological laser treatment system according to claim 1, wherein the cornea contacting element comprises a rotationally asymmetric suction opening configured to be positioned at least partially on the cornea of the eye and configured to be fluidically connected to a negative pressure.
9. The ophthalmological laser treatment system according to claim 1, wherein the through opening is configured to be at least partially filled with a coupling liquid, wherein at least one of: the cornea contacting element or the sclera contacting element comprises a sealing, and wherein the sealing is configured to seal at least partially between the surface of the eye and the ophthalmological patient interface when the ophthalmological patient interface is applied on the eye and the coupling liquid is arranged in the through opening.
10. The ophthalmological laser treatment system according to claim 1, wherein the eye fixation portion comprises a flat contact body arranged in the through opening, wherein the flat contact body is at least partially transparent for the treatment laser beam to enable the penetration of the target volume of tissue of the eye, wherein the flat contact body comprises a flat contact surface, which forms part of the rotationally asymmetric contact surface and which is configured to conform the sclera of the eye-.
11. The ophthalmological laser treatment system according to claim 1, wherein the cornea contacting element comprises a form-fitted contact body comprising a form-fitted contact surface forming part of the rotationally asymmetric contact surface, wherein the form-fitted contact surface is form-fitted to a shape of the outer surface of the cornea of the eye, wherein the form-fitted contact surface is configured to be at least partially in form-fitting contact with the cornea of the eye for firmly positioning the ophthalmological patient interface on the eye.
12. The ophthalmological laser treatment system according to claim 1, wherein at least one of: the cornea contacting element or the sclera contacting element comprises protrusions, which are configured to penetrate tissue of the cornea or the sclera, respectively.
13. The ophthalmological laser treatment system according to claim 1, wherein at least one of: the cornea contacting element or the sclera contacting element comprise at least one suction cup having a flexible contact body configured to contact the eye, thereby forming part of the rotationally asymmetric contact surface, for positioning the ophthalmological patient interface with respect to the eye.
14. The ophthalmological laser treatment system according to claim 13, wherein the ophthalmological patient interface further comprises a bracket arranged between the suction cup and the eye fixation portion, wherein the bracket extends from the eye fixation portion at a specific angle and at a specific length such that the suction cup is configured to contact the cornea of the eye coaxially with respect to the optical axis of the eye.
15. The ophthalmological laser treatment system according to claim 1, wherein the sclera contacting element comprises at least one spoon-shaped gripper arm extending from the coupling portion and/or the eye fixation portion, wherein the spoon-shaped gripper arm extend arc-shaped having an eye-ball radius from the eye fixation portion, thereby forming part of the rotationally asymmetric contact surface, for positioning the ophthalmological patient interface with respect to the eye.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0044] The herein described disclosure will be more fully understood from the detailed description given herein below and the accompanying drawings, which should not be considered limiting to the invention described in the appended claims. The drawings in which:
[0045] FIG. 1 shows a perspective view illustrating schematically an ophthalmological laser treatment system;
[0046] FIG. 2 shows a block diagram illustrating schematically an ophthalmological laser treatment system with an ophthalmological patient interface;
[0047] FIG. 3 shows schematically different components of the ophthalmological laser treatment system including the ophthalmological patient interface;
[0048] FIG. 4 shows schematically a cross section of a first conventional ophthalmological patient interface applied on an eye;
[0049] FIG. 5 shows schematically a cross section of a second conventional ophthalmological patient interface applied on an eye;
[0050] FIG. 6 shows schematically a cross section of an ophthalmological patient interface according to a first embodiment;
[0051] FIG. 7 shows schematically a cross section of an ophthalmological patient interface according to a second embodiment;
[0052] FIG. 8 shows schematically a cross section of an ophthalmological patient interface according to a third embodiment;
[0053] FIG. 9 shows schematically a cross section of an ophthalmological patient interface according to a fourth embodiment;
[0054] FIG. 10 shows schematically a cross section of an ophthalmological patient interface according to a fifth embodiment;
[0055] FIG. 11 shows schematically a cross section of an ophthalmological patient interface according to a sixth embodiment;
[0056] FIG. 12 shows schematically a cross section of an ophthalmological patient interface according to a seventh embodiment;
[0057] FIG. 13 shows schematically a perspective view of an ophthalmological patient interface according to an eight embodiment;
[0058] FIG. 14 shows schematically a perspective view of an ophthalmological patient interface according to a ninth embodiment;
[0059] FIG. 15 shows schematically a top view of an ophthalmological patient interface according to a tenth embodiment;
[0060] FIG. 16 shows schematically a top view of an ophthalmological patient interface according to an eleventh embodiment;
[0061] FIG. 17 shows schematically a top view of an ophthalmological patient interface according to a twelfth embodiment;
[0062] FIG. 18 shows schematically a cross section of an ophthalmological patient interface according to a thirteenth embodiment;
[0063] FIG. 19 shows schematically a block diagram for controlling the ophthalmological laser treatment system by a control module.
DESCRIPTION OF THE EMBODIMENTS
[0064] Reference will now be made in detail to certain embodiments, examples of which are illustrated in the accompanying drawings, in which some, but not all features are shown. Indeed, embodiments disclosed herein may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Whenever possible, like reference numbers will be used to refer to like components or parts.
[0065] FIG. 1 shows a perspective view illustrating schematically an ophthalmological laser treatment system 100. FIG. 2 shows a block diagram illustrating schematically the ophthalmological laser treatment system 100 with an ophthalmological patient interface 6. FIG. 3 shows schematically different components of the ophthalmological laser treatment system 100.
[0066] The FIGS. 1 to 3, schematically illustrate modules and/or elements of various embodiments of the ophthalmological laser treatment system 100 and provide exemplary sequences or arrangement of modules and/or elements, including modules and/or elements in a beam path T. Some modules and/or elements shown in a particular Figure may be combined with modules and/or elements shown in another Figure.
[0067] The ophthalmological laser treatment system 100 comprises an ophthalmological laser treatment device 1 comprising a base station 2. The base station 2 is configured as a fixed or mobile apparatus. The ophthalmological laser treatment device 1 has a treatment laser source 21 arranged in the base station 2, which generates a treatment laser beam T. The base station 2 further includes, for example, a power supply and other auxiliary subsystems necessary for operation of the ophthalmological laser treatment device 1.
[0068] The treatment laser source 21 is configured, for example, to generate an ultraviolet or infrared treatment laser beam T having a wavelength of between 190 nm and 230 nm. For example, the treatment laser source 21 comprises an excimer or a solid-state laser, which produces such an ultraviolet treatment laser beam T. The excimer laser uses a combination of a noble gas and a reactive gas under high pressure and electrical stimulation to generate the treatment laser beam T. In particular, an excimer laser using argon as the noble gas and fluoride as the reaction gas may be used as the treatment laser source 21.
[0069] In an embodiment, the treatment laser beam T is a pulsed laser beam. In an embodiment, the treatment laser source 21 is configured to generate femtosecond laser pulses, which have pulse widths of typically from 10 fs to 1000 fs (1 fs=10.sup.?15 s).
[0070] The base station 2 includes a scanner 22, which is configured to steer the treatment laser beam T delivered by the treatment laser source 21 onto or into treatment points on a treatment pattern (comprising a laser trajectory).
[0071] The ophthalmological laser treatment device 1 comprises an application head 5. The application head 5 is designed to guide the treatment laser beam T into or onto the eye 91 of a patient 9 (as shown, for example, in FIG. 1). The application head 5, for this purpose, can comprise focusing optics 51 configured to focus the treatment laser beam T onto one or more treatment points inside or on the eye 91, in particular the cornea or the sclera for a pointwise tissue disruption or ablation. The focusing optics 51 comprise a lens system having one or more optical lenses. Depending on the embodiment, the focusing optics 51 comprise one or more movable or deformable lenses and/or a drive for moving the entire focusing optics in order to set and adjust the focal depth, or the treatment height, in the projection direction along the projection axis.
[0072] The ophthalmological laser treatment system 100 comprises an ophthalmological patient interface 6. The application head 5 is preferably fixed onto the eye 91 by means of the ophthalmological patient interface 6, which is coupled to the eye for example using negative pressure. Different embodiments of the ophthalmological patient interface 6 of the present disclosure will be described in more detail with reference to the FIGS. 4 to 17.
[0073] Depending on the embodiment, the ophthalmological laser treatment system 100 further comprises an optical imaging device 7 and an optical mirror element 10. The optical imaging device 7 and the optical mirror element 10 will be explained in more detail with reference to FIG. 18 below.
[0074] The ophthalmological laser treatment device 1 comprises an arm 4 arranged between the base station 2 and the application head 5. The arm 4 is configured to provide a beam path for the treatment laser beam T, such that the treatment laser beam T is guided along the inside of the arm 4 from the base station 2 to the application head 5. In an embodiment, the arm 4 comprises one or more joints 41 (as shown in FIG. 1) such that the application head 5 is movable and/or rotatable with respect to the base station 2. Each rotatable joint 41 comprises a mirror arranged in the beam path to reflect the treatment laser beam T along the arm 4.
[0075] The ophthalmological laser treatment system 100 is controlled by a control module 3, by controlling the treatment laser source 21 and the scanner 22, as well as by controlling additional modules of the ophthalmological laser treatment system 100 arranged in the beam path of the treatment laser beam T.
[0076] The ophthalmological laser treatment system 100 optionally includes a user interface comprising, for example, one or more user input devices, such as a keyboard, and one or more output devices, such as a display 8 (as shown in FIG. 1). The display 8 may also be an input device. The user interface is configured to receive user inputs from an eye treatment professional, in particular based on, or in response to, information displayed to the eye treatment professional using the one or more output devices.
[0077] The FIGS. 4 and 5 show schematically a cross section of a first and second conventional ophthalmological patient interface 6 applied on an eye 91 of a person 9. The FIGS. 4 and 5 show schematically the treatment laser source 21, the arm 4 and the application head 5 with the focusing optics 51. The Figures further show schematically the treatment laser beam T and its beam path from the treatment laser source 21 to the eye 91. The conventional ophthalmological patient interface 6 comprises a coupling portion 61, which is configured to be attached to the application head 5, and an eye fixation portion 62, which is configured to contact the cornea of the eye 91. The eye fixation portion 62 comprises a contact surface, which is configured to contact the eye 91, when the ophthalmological patient interface 6 is applied on the eye 91. The Figures further show schematically a ring shaped suction opening 621, which extends ring shaped along the entire contact surface of the eye fixation portion 62. The ring shaped suction opening is connected to a negative pressure or vacuum such that the eye fixation portion 62 is rigidly attachable to the eye 91. The Figures further show that the ophthalmological patient interface 6 comprises a through opening 63, extending through the coupling portion 61 and the eye fixation portion 62. The treatment laser beam T is guided along the through opening 63 to a treatment surface 623 on or in the cornea of the eye 91. The through opening 63 is configured to enable the treatment laser beam T from the application head 5 to pass through the ophthalmological patient interface 6 to penetrate a target volume of tissue of the eye 91. FIG. 5 additionally comprises a contact body 626, which is arranged in the through opening 63 and which is configured to conform/deform the cornea of the eye 91, for example for a conventional LASIK surgery.
[0078] The FIGS. 4 and 5 further show the optical axis v of the eye 91 and an optical axis p of the ophthalmological patient interface 6. The trough opening 63 extends along the axis p. Both axis v, p are arranged coaxially with respect to each other. It is of high importance that these two axis are arranged coaxially with respect to each other for an optimal treatment result using the conventional ophthalmological patient interface 6 for the desired precise treatment. The coaxially alignment is achieved by a rotational symmetry of the contact surface of the eye fixation portion 62, which perfectly aligns with the rotational symmetric surface of the cornea of the eye 91.
[0079] Reference is now made to the embodiments of the present disclosure as shown in the FIGS. 6 to 19.
[0080] The FIGS. 6 to 18 show at first sight that the ophthalmological patient interface 6 of the ophthalmological laser treatment system according to the present disclosure with its axis p is not configured to be arranged coaxially and is also not configured to be arranged co-linear with respect to the optical axis v of the eye 91, when applied on the eye. The axis p of the ophthalmological patient interface 6 is configured to be arranged at an inclination angle ? with respect to the optical axis of the eye 91. The ophthalmological patient interface 6 is configured to be arranged laterally next to the optical axis v of the eye 91, at a different position on the almost spherical eyeball. The ophthalmological patient interface 6 extends, due to its unique features, the possible treatment surface 623, which is reachable by the treatment laser beam T, substantially. The ophthalmological laser treatment system is for example configured to treat the sclera of the eye 91 by the treatment laser beam T. The FIGS. 6 to 8 and 11 further indicate schematically that a coupling liquid is arranged in the through opening 63. The treatment surface 623 is according to these embodiments not deformed by the ophthalmological patient interface 6, which reduces the injury possibility due to the application of the ophthalmological patient interface 6. The FIGS. 9, 10 and 12 shows the ophthalmological patient interface 6 with an applanating contact body, which is configured to conform/deform the surface of the eye 91.
[0081] The FIGS. 6 to 12 show different embodiments of the ophthalmological patient interface 6 according to the present disclosure. All of these Figures show the treatment laser beam T, the application head 5 and the ophthalmological patient interface 6 applied on the eye 91 of a person 9. The Figures further show the focusing optics 51 associated with the application head 5 and the through opening 63 extending through the coupling portion 61 and the eye fixation portion 62. The focusing optics 51 are for example arranged in the coupling liquid or above the coupling liquid.
[0082] The FIGS. 6 to 12 further show that the eye fixation portion 62 of the ophthalmological laser treatment system 100 comprises a cornea contacting element 622a, configured to contact at least partially the cornea of the eye 91, and a sclera contacting element 622b, configured to contact at least partially the sclera of the eye 91, wherein the cornea contacting element 622a and the sclera contacting element 622b define a rotationally asymmetric contact surface 622 configured to contact the eye 91. The contact surface 622 of the eye fixation portion 62 is rotationally asymmetric such that the eye fixation portion 62 is advantageously dockable/arrangeable to the surface of the eye 91 laterally next to the optical axis v of the eye 91. The Figures show that the human eye 91 has not a perfect spherical shape, the cornea of the eye 91 forms a spherical bulge or a spherical protrusion on the eyeball. The optical axis v of the eye 91 is arranged in line with the center of the bulge and the center of the eyeball. A conventional rotational symmetric patient interface, as shown in the FIGS. 4 and 5 can therefore only align perfectly on the surface of the eyeball if arranged coaxially with the optical axis v of the eye 91. The rotationally asymmetry of the ophthalmological patient interface 6 according to the present disclosure enables to position the ophthalmological patient interface 6 perfectly aligned on the surface of the eye 91 at any other position, contacting the cornea, via the cornea contacting element 622a and the sclera via the sclera contacting element 622b of the eye 91. The ophthalmological laser treatment system 100 according to the present disclosure enables therefore for example to treat the sclera and the cornea of the eye 91.
[0083] FIG. 6 shows a first embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure. The rotational asymmetric contact surface 622 is formed by a sealing 624, which forms part of the sclera contacting element 622b, and by a suction opening 621 of the cornea contacting element 622a. In other words, the sealing 624, for example a balloon sealing, and the cornea contacting element 622a comprising the suction opening 621 form or determine the rotational asymmetric contact surface 622 of the patient interface 6. The sealing 624 is configured to seal between the sclera of the eye 91 and the eye fixation portion 62. The suction opening 621, in particular a housing of the suction opening 621, is configured to be arranged at least partially on the cornea of the eye 91 and to position the ophthalmological patient interface 6 rigidly on the eye 61. The suction opening 621 has for example a partial ring shape. The suction opening 621 is configured to be connected to a negative pressure/vacuum. According to this embodiment, the treatment laser beam T can advantageously treat the sclera of the eye 91. The embodiment of the ophthalmological patient interface 6 as shown in FIG. 6 is for example used for a pterygium surgery. The ophthalmological patient interface 6 is for example placed rigidly above the pterygium and the treatment laser beam removes afterwards the pterygium. Further, this embodiment of the ophthalmological patient interface 6 could be used to treat a melanoma of the eye, arranged on the sclera and/or the cornea of the eye in a similar manner as the pterygium treatment. Further, with the ophthalmological patient interface 6 it could be possible to perform a glaucoma surgery from the outside of the eye. The through opening 63 is for example rigidly placed above the schlemm canal (Sinus venosus sclerae). The treatment laser beam T is guided through the sclera and is focused on the schlemm canal to treat the schlemm canal as desired. In another embodiment, a small flap is introduced to the sclera to reach the schlemm canal.
[0084] The FIGS. 7 and 8 shows a second and third embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure. FIGS. 7 and 8 differs from FIG. 6 in the shape of the eye fixation portion 62 of the ophthalmological patient interface 6, which enables to form a larger inclination angle ? between the axis p and the optical axis v of the eye 91, when the ophthalmological patient interface 6 is applied on the eye 91. The rotationally asymmetric contact surface 622 of these embodiments is also formed by a sealing 624, forming the sclera contacting element 622b, and by the cornea contacting element 622a comprising one suction opening 621. The cornea contacting element 622a comprises an extension portion 627, which extends from the coupling portion 61 beyond the maximal extension of the sclera contacting element 622b. The extension portion 627 follows a radius such that the tip of the extension portion 627, which comprises the suction opening 621, is advantageously applicable on the cornea of the eye 91. The embodiments shown in the FIGS. 7 and 8 differ in the length of the extension portions 627. The length of the extension portion 627 determines the inclination angle ? between the axis p of the ophthalmological patient interface 6 and the axis v of the eye 91, when applied on the eye 91. The length of the extension portion 627 therefore also determines the angle of incidence of the treatment laser beam T. In FIG. 7, the treatment surface 623, which is advantageous reachable by the treatment laser beam T, using this specific ophthalmological patient interface 6, is the interior side of the ocular limbus of the eye 91. The embodiment of the ophthalmological patient interface 6 as shown in FIG. 7 is for example used in a stem cell harvesting surgery. The interior side of the ocular limbus comprises stem cells which can be harvested by the treatment laser beam T using the ophthalmological patient interface 6 as shown in FIG. 7.
[0085] In FIG. 8, the treatment surface 623, which is advantageous reachable by the treatment laser beam T, using this specific ophthalmological patient interface 6, is the anterior chamber angle of the eye 91. The ophthalmological patient interface 6, having different lengths of the extension portion 627 is, for example, selected in dependence of the desired treatment. The embodiment of the ophthalmological patient interface 6 as shown in FIG. 8 is for example used in glaucoma surgery to drill holes in the schlemm canal. In this embodiment, the treatment laser beam is guided through the cornea of the eye and focused in the limbus to drill the desired holed in the schlemm canal.
[0086] The FIGS. 9 and 10 show a fourth and fifth embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure. These embodiments comprise a contact body 626, arranged in in the through opening 63. The contact body 626 or contact glass is at least partially transparent for the treatment laser beam T to enable the penetration of the target volume of tissue of the eye 91. The flat contact body 626 comprises a flat contact surface 628, which forms part of the rotationally asymmetric contact surface 622 and which is configured to conform the sclera of the eye 91. These embodiments do not comprise a coupling liquid arranged in the through opening 63 and also do not comprise a corresponding sealing. The fourth embodiment of FIG. 9 comprises a suction opening 621, preferably partially ring shaped and preferably partially surrounding the contact body 626, which is arranged in the cornea contacting element 622a. The sclera contacting element 622b is according to this embodiment at least partially formed by the contact body 626 and the cornea contacting element 622a is formed by the part which houses the suction opening 621 and also partially by the contact body 626. The contact body 626 is, according to this embodiment, configured to contact with its flat contact surface 628 the cornea and the sclera of the eye 91.
[0087] The fifth embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure shown in FIG. 10 comprises at least one protrusion 625, which forms part of the sclera contacting element 622b and which is configured to penetrate tissue of the sclera of the eye 91, when the ophthalmological patient interface 6 is applied on the eye 91. The protrusions 625 are spike shaped and are arranged laterally next to the contact body 626. The protrusions 625 have for example the shape of a pyramid. The protrusions 625 advantageously help to position the ophthalmological patient interface 6 rigidly on the eye 91. Sclera tissue is relatively soft and is not easily damaged by the protrusions 625, compared to cornea tissue. Nevertheless, in a further embodiment, at least one protrusion 625 could be also arranged in the cornea contacting element 622a configured to penetrate the cornea of the eye 91. The protrusions 625 of the cornea contacting element 622a are for example smaller with respect to the protrusions 625 of the sclera contacting element 622b. The protrusions 625 are for example distributed unevenly around the contact surface 622, thereby forming it's rotationally asymmetry. In another embodiment, the protrusions 625 are evenly distributed around the rotationally asymmetric contact surface 622.
[0088] In a further embodiment, not shown in the Figures, the eye fixation portion 62 may comprise protrusions 625 and at least one, preferably a plurality of suction openings 621, arranged in the sclera contacting element 622b and/or in the cornea contacting element 622a.
[0089] In a further embodiment, not shown in the Figures, the contact body 626 comprises instead of the flat contact surface 628 a spherical contact surface, which corresponds to the outer non-deformed surface of the eye 91, onto which the contact body 626 is configured to be applied. The contact body 626 or the ophthalmological patient interface 6 comprising the contact body 626 is, for example, selected in dependence of the outer surface of the specific eye 91 and/or on the position onto which the ophthalmological patient interface 6 should be applied on the eye 91. This improves the alignment of the ophthalmological patient interface 6 on the eye 91.
[0090] FIG. 11 shows schematically a sixth embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure according to the present disclosure. The rotationally asymmetric contact surface 622 is formed by a sealing 624 forming part of the sclera contacting portion 622b and by a form fitted contact body 629 comprising a form fitted contact surface 629a forming part of the cornea contacting portion 622a. As best visible in FIG. 11, the form fitted contact body 629 extends laterally of the ophthalmological patient interface 6 next to the through opening 62 along a shape which corresponds to a negative of a cornea of the eye 91. In other words, the form fitted contact surface 629a, which is configured to contact the cornea of the eye 91, has at least partially the surface shape of the cornea of the eye 91. When applied on the eye, the form fitted contact surface 629a docks advantageously on the cornea of the eye 91, such that the ophthalmological patient interface 6 is advantageously rigidly attached to the eye 91. The surface tension of the tear film provides an advantageous docking of the form-fitted contact body 629 on the eye 91, which advantageously improves the docking of the entire ophthalmological patient interface 6 on the eye 91. In a further embodiment, the form-fitted contact surface 629a corresponds to an individual asphericity of the cornea of the eye 91.
[0091] FIG. 12 shows schematically a seventh embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure according to the present disclosure. The rotational asymmetric contact surface 622 is determined by a suction cup 64, which is arranged next to the treatment surface 623 and which is configured to contact the surface of the eye 91 to position the ophthalmological patient interface 6 rigidly on the eye 91. The suction cup 64 is for example a round rubber part. The suction cup 64 is preferably arranged coaxially with the optical axis v of the eye 91 on the cornea. The suction cup 64 is for example arranged on one tip of a bracket, which extends from the coupling portion 61 or the eye fixation portion 62, the other tip or end of the bracket is connected to the coupling portion 61 or the eye fixation portion 62. The bracket, in particular the bracket length and bracket angle determines the position of the suction cup 64 with respect of the rest of the contact surface 622. The ophthalmological patient interface 6 may comprise a plurality of suction cups 64 arranged around the ophthalmological patient interface 6, having for example different brackets, for an optimized positioning of the ophthalmological patient interface 6 on the eye 91.
[0092] FIG. 13 shows schematically an eight embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure according to the present disclosure. FIG. 13 shows in a perspective view the ophthalmological patient interface 6 applied on the eyeball. FIG. 13 advantageously shows the rotational asymmetry of the contact surface 622 of the eye fixation portion 62. The contact surface 622 as shown in this Figure is not only rotational asymmetric in a plane area but also varies in its vertical extension such that the contact surface 622 advantageously fits/advantageously touches the surface of the eye 91. The contact surface 622 according to this embodiment is formed by the eye fixation portion 62, which extends from the coupling portion 61. The extension length varies around the eye fixation portion 62, such that the contact surface 622 is applicable on the sclera and on the cornea, which extends spherical from the spherical sclera. FIG. 13 further shows that the eye fixation portion 62, in particular the cornea contacting element 622a, comprises a suction opening 621, which has a partial ring shape and which is connectable via a pressure line to a negative pressure. The suction opening 621 is according to this embodiment configured to be arranged on the cornea of the eye 91. In a further embodiment, the suction opening 621 might extends towards the sclera. In a further embodiment, the eye fixation portion 62, in particular the cornea contacting element 622a and or the sclera contacting element 622b, might comprise one or a plurality of suction openings 621.
[0093] FIG. 14 shows schematically a ninth embodiment of the ophthalmological patient interface 6 used in the ophthalmological laser treatment system 100 according to the present disclosure according to the present disclosure. The embodiment as shown in FIG. 14 differs from the embodiment as shown in FIG. 13 in that the eye fixation portion 62 does not comprise a suction opening. The embodiment as shown in FIG. 14 comprises a spoon shaped gripper arm 65. The spoon shaped gripper arm 65 extends from the coupling portion 61 and the eye fixation portion 62 vertically beyond the rest of the contact surface 622. The spoon shaped gripper arm 65 is configured to contact at least partially the eye 91 and forms therefore part of the rotationally asymmetric contact surface 622. The spoon shaped gripper arm 65 extends or follows along an arc, which has an eye-ball radius. In other words, the part of the spoon shaped gripper arm 65 extending beyond the rest of the contact surface 622 follows the form of the eyeball. The spoon shaped gripper arm 65 provides an advantages docking solution for docking of the ophthalmological patient interface 6 on the eye 91. The spoon shaped gripper arm 65 comprises at its tip according to this embodiment an optional suction cup 64. The embodiments of the ophthalmological patient interface 6 show that the eye fixation portion 62 and the coupling portion 61 are two separate parts, which are attached/connected with each other to form the ophthalmological patient interface 6. In the FIGS. 13 and 14, this separation is indicated by a line between the two parts. FIG. 14 further shows that the spoon shaped gripper arm 65 extends along the eye fixation portion 62 and the coupling portion 62. The ophthalmological patient interface 6 as shown in FIG. 14 further comprises a safety coupling 651. The safety coupling 651 according to this embodiment is implemented between the coupling portion 61 and the eye fixation portion 62. Both parts are arranged detachable to each other, such that the safety coupling 651 opens, when a force, for example an unexpected hit by a third person, engages on the ophthalmological patient interface 6. The safety coupling 651 is configured such that it opens, when the force, which engages on the ophthalmological patient interface 6 reaches or surpasses a predefined threshold. The safety coupling 651 may comprise magnets and/or a vacuum/negative pressure and/or a spring element.
[0094] In a further embodiment, not shown in the Figures, the ophthalmological patient interface 6 comprises a plurality of spoon shaped gripper arms 65, for example, two arranged on opposing sides of the ophthalmological patient interface 6. Having a plurality of the spoon shaped gripper arms 65 advantageously helps to improve the rigid positioning of the ophthalmological patient interface 6 on the eye 91.
[0095] The FIGS. 15, 16 and 17 shows schematically a tenth, eleventh and twelfth embodiment of the ophthalmological patient interface 6 used in ophthalmological laser treatment system 100 according to the present disclosure. All of these Figures show a top view of the ophthalmological patient interface 6 arranged on the eye 91. The Figures do not show the entire ophthalmological patient interface 6, but only show the contact surface 622 of the ophthalmological patient interface 6. The FIGS. 15 to 17 advantageously show the rotational asymmetry of the contact surface 622. FIG. 15 and FIG. 16 shows that the contact surface 622 has a circular outer contour. FIG. 15 further show that the contact surface 622 comprises a suction opening 621 arranged in the cornea contacting element 622a, which determines the rotational asymmetry of the contact surface. The suction opening 621 as shown in FIG. 15 is arranged only in the cornea contacting element 622a. The sclera contacting element 622b of this embodiment does not comprise any suction opening. The contact surface 622 of the embodiment as shown in FIG. 15 further comprises a sealing 624, which is arranged mainly on the sclera contacting element 622b but also extends to the cornea contacting element 622a. The contact surface 622 is determined according to this embodiment by the sealing 624 and the suction opening 621.
[0096] FIG. 16 differs from FIG. 15 in that it has a plurality of suction openings 621. One is arranged in the cornea contacting element 622a and two are arranged in the sclera contacting element 622b. According to this embodiment, a sealing 624 is arranged between the suction openings 621. The negative pressure applied on the suction opening 621 of the cornea contacting element 622a is in an embodiment higher compared to the negative pressure applied on the suction openings 621 of the sclera contacting elements 622b. This is for example achieved via different negative pressure lines providing different negative pressures on the suction openings 621.
[0097] FIG. 17 differs from FIG. 16 in that the contact surface 622 of the ophthalmological patient interface 6 as shown in FIG. 17 does not have a circular outer contour. The outer contour of the contact surface 622 has an egg shape or has an oval shape.
[0098] The fourth to twelfth embodiments of the ophthalmological patient interface 6 as shown in the FIGS. 9 to 17 are for example used by the ophthalmological laser treatment system 100 in a pterygium surgery, in a melanoma surgery or in a glaucoma surgery as explained in detail with reference to FIG. 6 above. All of these embodiments enable similarly advantageously to place the through opening 63 above at least partially the sclera of the eye 91, such that the above-mentioned eye-treatment surgeries can be performed advantageously by the treatment laser beam T.
[0099] In a further embodiment, not shown in the Figures, the ophthalmological laser treatment system 100 further comprises a liquid dispenser, which is configured to dispense continuously or on demand coupling liquid into the through opening 63. The ophthalmological patient interface 6 may comprise an opening, for example, in the eye fixation portion 62 and/or in the coupling portion 62, which is configured to supply/dispense the coupling liquid from the liquid dispenser into the through opening 63.
[0100] FIG. 18 shows schematically thirteenth embodiment of the ophthalmological laser treatment system 100. According to this embodiment, the ophthalmological laser treatment system 100 comprises the optical mirror element 10 and an optical imaging device 7. The optical mirror element 10 is arranged in the through opening 63 of the ophthalmological patient interface 6. The optical mirror element 10 is for example attached at the ophthalmological patient interface 6 or at the application head 5. The optical mirror element 10 may form part of the focusing optics 51. The optical mirror element 10 is arranged in the beam path of the treatment laser beam T, comprises a mirror, which is configured to deflect the treatment laser beam T incidenting from the application head 5. FIG. 18 shows that the treatment laser beam T is deflected by the mirror element 10 towards the interior side of the ocular limbus of the eye 91. The embodiment of the ophthalmological patient interface 6 as shown in FIG. 18 is for example used in a stem cell harvesting surgery. The interior side of the ocular limbus comprises stem cells, which can be harvested by the treatment laser beam T using the ophthalmological patient interface 6 as shown in FIG. 18.
[0101] The optical mirror element 10 comprises a mirror, which is configured to deflect the treatment laser beam T. The mirror is in one embodiment rigidly connected to the application head 5. In a further embodiment, the mirror element 10 comprises at least one adjustable mirror, which is configured to adjust the specific angle based on a position of the tissue of the eye 91 to be treated and the position of the ophthalmological patient interface 6 on the sclera and cornea of the eye 91 to optimize the angle of incidence of the treatment laser beam T on the eye 91. With the adjustable mirror, it is possible to optimize the angle of incidence of the treatment laser beam T on the eye 91. The mirror is for example adjusted automatically or manually.
[0102] The optical mirror element 10 is for example implemented in the application head 5, in particular in the focusing optics 51 of the application head 5.
[0103] FIG. 18 further shows schematically the optical imaging device 7, which is configured to generate optical image data of the eye 91. The optical image data is used for positioning of the ophthalmological patient interface 6 on the sclera and cornea of the eye 91. Further, the optical image data could additionally or alternatively be used for adapting of the position of the ophthalmological patient interface 6 on the sclera and cornea of the eye 91, for example in case the position is not perfectly aligned from the beginning.
[0104] The optical imaging device 7 is for example implemented in the application head 5, such that the beam path of the optical imaging device 7 follows the beam path of the treatment laser beam T, such that the optical imaging device 7 is configured to provide optical image data of the treatment surface 63. The optical imaging device 7 is for example also configured to follow the deflection by the optical mirror element. The optical imaging device 7 may comprise a camera.
[0105] The optical imaging device 7 as shown in FIG. 18 may comprises an optical depth module 71, which is configured to provide depth information of the eye 91. The depth information are additionally or alternatively used for positioning of the ophthalmological patient interface 6 on the sclera and cornea of the eye 91 and/or for adapting of the position of the ophthalmological patient interface 6 on the sclera and cornea of the eye 91. The depth module 71 may comprise an imaging device based on the Scheimpflug principle, an optical coherence tomography device, a confocal microscopy device, a device for structured lighting and/or a device for stereoscopic vision.
[0106] FIG. 18 further shows schematically the control unit 3, which is configured to control the treatment laser beam T. FIG. 18 shows that the optical data is transmitted from the optical imaging device 7 to the control unit 3.
[0107] FIG. 19 shows a flow chart of some steps performed by the control module 10 to control the treatment laser beam T of the ophthalmological laser treatment system 100.
[0108] In step S1, the target volume of tissue to be treated is determined by a processing unit of the control module 3 using the captured image data and/or the depth information, of the optical imaging device 7. The data is transmitted from the optical imaging device 7 to the control module 3 for processing. The control module 3 determines for example the extension of the volume to be treated, for example the 3D extension of a pterygium, using the optical data and the depth information.
[0109] In step S2, the treatment laser beam T is controlled by the processing unit of the control module 3 for penetration of the target volume, using the determined target volume of tissue to be treated of step S1. The processing unit determines for example control instructions for different parts (scanner 22, focusing optics 51, mirror element 10) of the ophthalmological laser treatment system 100 in order to control the treatment laser beam T. The control module 3 transmits these control instructions to the respective parts to control the treatment laser beam T as desired.
[0110] For example, based on the 3D extension of the pterygium, a specific cutting pattern is determined by the control module 3. In a further step, the treatment laser beam T is controlled such that it follows the determined specific cutting pattern. In a further step, a control loop is implemented using continuously updated data from the optical imaging device 7 for an iterative control of the treatment laser beam T.
LIST OF REFERENCE SIGNS
[0111] 100 ophthalmological laser treatment system [0112] 1 ophthalmological laser treatment device [0113] 2 base station [0114] 21 treatment laser source [0115] 22 scanner [0116] 23 optical module [0117] 3 control module [0118] 4 arm [0119] 41 first arm joint [0120] 42 second arm joint [0121] 43 third arm joint [0122] 5 application head [0123] 6 patient interface [0124] 61 coupling portion [0125] 62 eye fixation portion [0126] 621 suction opening [0127] 622 rotationally asymmetric contact surface [0128] 622a cornea contacting element [0129] 622b sclera contacting element [0130] 623 treatment surface [0131] 624 sealing [0132] 625 protrusion [0133] 626 contact body [0134] 627 extension portion [0135] 628 flat contact surface [0136] 629 form-fitted contact body [0137] 629a form-fitted contact surface [0138] 63 through opening [0139] 64 suction cup [0140] 65 spoon-shaped gripper arm [0141] 651 safety coupling [0142] 7 optical imaging device [0143] 71 depth module [0144] 8 monitor [0145] 9 person [0146] 91 eye of the person [0147] 10 optical mirror element [0148] T treatment laser beam [0149] v optical axis of an eye [0150] p main central optical axis of the application head [0151] r central axis of the coupling portion [0152] c central axis of the eye fixation portion [0153] ? inclination angle
