Abstract: Methods and systems for planning and forming incisions in a cornea, lens capsule, and/or crystalline lens nucleus are disclosed. A method includes measuring spatial dispositions, relative to a laser surgery system, of at least portions of the corneal anterior and posterior surfaces. A spatial disposition of an incision of the cornea is generated based at least in part on the measured corneal anterior and posterior spatial dispositions and at least one corneal incision parameter. A composite image is displayed that includes an image representative of the measured corneal anterior and posterior surfaces and an image representing the corneal incision.

Abstract: Embodiments of this invention generally relate to ophthalmic laser procedures and, more particularly, to systems and methods for photorefractive keratectomy. In an embodiment, an ophthalmic surgical laser system comprises a laser source generating a pulsed laser beam and a laser delivery system delivering the pulsed laser beam to a cornea of an eye. A patient interface couples to and constrains the eye relative to the laser delivery system. A controller controls the laser delivery system to perform an anterior surface volume dissection on the cornea.

Abstract: A system and method for inserting an intraocular lens in a patient's eye includes a light source for generating a light beam, a scanner for deflecting the light beam to form an enclosed treatment pattern that includes a registration feature, and a delivery system for delivering the enclosed treatment pattern to target tissue in the patient's eye to form an enclosed incision therein having the registration feature. An intraocular lens is placed within the enclosed incision, wherein the intraocular lens has a registration feature that engages with the registration feature of the enclosed incision. Alternately, the scanner can make a separate registration incision for a post that is connected to the intraocular lens via a strut member.

Abstract: A single-piece patient interface device (PI) for coupling an patient's eye to an ophthalmic surgical laser system, which includes a rigid shell, a flexible suction ring joined to a lower edge of the shell, an applanation lens, and a flexible annular diaphragm which joins the applanation lens to the shell near the lower edge of the shell. The flexible diaphragm allows the applanation lens to move relative to the shell, including to shift in longitudinal and lateral directions of the shell and to tilt. In operation, the surgeon first secures the PI to the patient's eye by hand, and then couples the laser system to the PI by lowering the laser delivery head into the PI shell. During the lowering process, the laser delivery head presses the applanation lens down relative to the PI to applanate the cornea of the eye.

Abstract: An ophthalmic measurement and laser surgery system includes: a laser source; a corneal topography subsystem; an axis determining subsystem; a ranging subsystem comprising an Optical Coherence Tomographer (OCT); and a refractive index determining subsystem. All of the subsystems are under the operative control of a controller. The controller is configure to: operate the corneal topography subsystem to obtain corneal surface information; operate the axis determining subsystem to identify one or more ophthalmic axes of the eye; operate the OCT to sequentially scan the eye in a plurality of OCT scan patterns, the plurality of scan patterns configured to determine an axial length of the eye; operate the refractive index determining subsystem so to determine an index of refraction of one or more ophthalmic tissues, wherein at least one of the corneal surface information, ophthalmic axis information, and axial length is modified based on the determined index of refraction.

Abstract: A laser system calibration method and system are provided. In some methods, a calibration plate may be used to calibrate a video camera of the laser system. The video camera pixel locations may be mapped to the physical space. A xy-scan device of the laser system may be calibrated by defining control parameters for actuating components of the xy-scan device to scan a beam to a series of locations. Optionally, the beam may be scanned to a series of locations on a fluorescent plate. The video camera may be used to capture reflected light from the fluorescent plate. The xy-scan device may then be calibrated by mapping the xy-scan device control parameters to physical locations. A desired z-depth focus may be determined by defining control parameters for focusing a beam to different depths. The video camera or a confocal detector may be used to detect the scanned depths.

Abstract: An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using “fast-scan-slow-sweep” scanning scheme. A high frequency scanner forms a fast scan line, which is placed by the XY and Z scanners at a location tangential to a parallel of latitude of the surface of the lenticule. The XY and Z scanners then move the scan line in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, and a prism is used to change the orientation of the scan line of the high frequency scanner between successive sweeps. In each sweep, the sweeping speed along the meridian is variable, being the slowest at the edge of the lenticule and the fastest near the apex.

Abstract: A method of performing laser surgery in a patient's eye includes generating a light beam, deflecting the light beam using a scanner to form an enclosed treatment pattern that is configured to form an enclosed capsulorhexis incision that includes a registration feature, and delivering the enclosed treatment pattern to target tissue in the patient's eye to form in an anterior lens capsule of the patient's eye the enclosed capsulorhexis incision that includes the registration feature. The registration feature is configured so that an edge of the target tissue formed by the enclosed capsulorhexis incision mates with an intraocular lens registration feature on an intraocular lens so as to rotationally register the intraocular lens relative to the registration feature.

Abstract: Apparatus and method for interfacing an ophthalmic surgical laser system with a patient's eye using a single-piece patient interface (PI). The PI includes a hollow shell, with an applanation lens and a flexible skirt at its lower end. Through channels are formed around the applanation lens to connect the spaces above and below the lens. When the PI is coupled to the laser system and the eye, the upper rim of the shell forms a seal with the laser system and the flexible skirt forms a seal with the eye. A vacuum is applied to the interior of the shell via a vacuum port on the laser system, and the vacuum is communicated to the space enclosed by the applanation lens, the skirt and the eye through the channels around the lens. A magnetic mechanism is also provided to hold the PI shell to the laser system.

Abstract: A system and method for inserting an intraocular lens in a patient's eye includes a light source for generating a light beam, a scanner for deflecting the light beam to form an enclosed treatment pattern that includes a registration feature, and a delivery system for delivering the enclosed treatment pattern to target tissue in the patient's eye to form an enclosed incision therein having the registration feature. An intraocular lens is placed within the enclosed incision, wherein the intraocular lens has a registration feature that engages with the registration feature of the enclosed incision. Alternately, the scanner can make a separate registration incision for a post that is connected to the intraocular lens via a strut member.

Abstract: An ophthalmic system may comprise an imaging device having a field of view oriented toward the eye of the patient; a patient interface housing defining a passage therethrough, having a distal end coupled to one or more seals configured to be directly engaged with one or more surfaces of the eye of the patient, and wherein the proximal end is configured to be coupled to the patient workstation such that at least a portion of the field of view of the imaging device passes through the passage; and two or more registration fiducials coupled to the patient interface housing in a predetermined geometric configuration relative to the patient interface housing within the field of view of the imaging device such that they may be imaged by the imaging device in reference to predetermined geometric markers on the eye of the patient which may also be imaged by the imaging device.

Abstract: Apparatus and methods are provided for interfacing an ophthalmic surgical laser with an eye using a patient interface (PI). The PI may include a closed, fluid-filled bladder having fiducials that contacts and deforms to the eye. Or, the PI may have an applanation lens with an outer ring portion and an inner concave portion for receiving the apex of the cornea. Another PI features a suction ring with a flexible skirt for contacting the sclera that is non-circular and/or non-planar. A system for injecting an index matching fluid into the area above the eye may also be incorporated. An integrated system includes a co-molded lens cone and attachment ring, with a lens window at the bottom of the lens cone which provides a sealed volume for vacuum-attaching a laser delivery system above the lens cone.

Abstract: A photo detector is selectively coupled to a first integrator or a second integrator with switching circuitry when the laser pulses. An integration time of the signal from the photo detector can be substantially greater than an amount of time between successive laser beam pulses in order to provide an accurate measurement of each laser beam pulse of a high repetition rate pulsed laser. The laser may comprise a clock coupled to an optical switch of the laser system, and control circuitry can control switching and coupling of the detector to the first integrator or the second integrator in response to the clock signal. The first integrator and the second integrator can be selectively coupled to an output such that the first integrator or the second integrator is coupled to the output of the energy detection circuitry when the other integrator is coupled to the detector.

Abstract: Embodiments of this invention generally relate to ophthalmic laser procedures and, more particularly, to systems and methods for lenticular laser incision. In an embodiment, an ophthalmic surgical laser system comprises a laser delivery system for delivering a pulsed laser beam to a target in a subject's eye, an XY-scan device to deflect the pulsed laser beam, a Z-scan device to modify a depth of a focus of the pulsed laser beam, and a controller configured to form a top lenticular incision and a bottom lenticular incision of a lens in the subject's eye, where each of the top and bottom lenticular incision includes a center concave portion and an edge transition portion that has a smooth convex shape and is smoothly joined to the center concave portion.

Abstract: A measurement apparatus for measuring a laser focus spot size, which includes a two-dimensional image detector and an imaging system which forms a magnified image of a focus spot located an object plane onto the image detector. The imaging system includes at least an objective lens. A sealed liquid container is secured over a part of the objective lens such as the optical surface of the objective lens is immersed in the liquid (e.g. water) within the container. The liquid container has a window through which the laser beam enters. An image processing method is also disclosed which processes the image obtained by the image detector to obtain the focus spot size while implementing an algorithm that corrects for the effect of ambient vibration.

Abstract: Apparatus to treat an eye comprises an annular retention structure to couple to an anterior surface of the eye. The retention structure is coupled to a suction line to couple the retention structure to the eye with suction. A coupling sensor is coupled to the retention structure or the suction line to determine coupling of the retention structure to the eye. A fluid collecting container can be coupled to the retention structure to receive and collect liquid or viscous material from the retention structure. A fluid stop comprising a porous structure can be coupled to an outlet of the fluid collecting container to inhibit passage of the liquid or viscous material when the container has received an amount of the liquid or viscous material. The coupling sensor can be coupled upstream of the porous structure to provide a rapid measurement of the coupling of the retention structure to the eye.

Abstract: An apparatus to treat a patient comprises a laser beam, a measurement module, a scanner and a curved patient interface lens. The curved patient interface is measured with a pattern so as to determine a plurality of distances of the curved surface at a plurality of measurement locations. The measurement pattern may comprise the plurality of measurement locations distributed about a central measurement axis corresponding to the laser treatment axis. The plurality of measurement locations of the curved surface may correspond to a portion of a planned treatment profile, such that the measured distances correspond to alignment of the planned treatment. The plurality of distances can be used to determine an apex of the curved surface of the patient interface and to align the laser treatment axis with the apex of the curved surface.

Abstract: 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.

Abstract: Methods and systems for performing laser-assisted surgery on an eye form one or more small anchoring capsulotomies in the lens capsule of the eye. The one or more anchoring capsulotomies are configured to accommodate corresponding anchoring features of an intraocular lens and/or to accommodate one or more drug-eluting members. A method for performing laser-assisted eye surgery on an eye having a lens capsule includes forming an anchoring capsulotomy in the lens capsule and coupling an anchoring feature of the intraocular lens with the anchoring capsulotomy. The anchoring capsulotomy is formed by using a laser to incise the lens capsule. The anchoring feature can protrude transverse to a surface of the intraocular lens that interfaces with the lens capsule adjacent to the anchoring capsulotomy.

Abstract: Systems and methods automatically locate optical surfaces of an eye and automatically generate surface models of the optical surfaces. A method includes OCT scanning of an eye. Returning portions of a sample beam are processed to locate a point on the optical surface and first locations on the optical surface within a first radial distance of the point. A first surface model of the optical surface is generated based on the location of the point and the first locations. Returning portions of the sample beam are processed so as to detect second locations on the optical surface beyond the first radial distance and within a second radial distance from the point. A second surface model of the optical surface is generated based on the location of the point on the optical surface and the first and second locations on the optical surface.