Abstract: Improved refractive eye surgery methods, apparatus and systems employ ablative photodecomposition of a cornea to mitigate and/or inhibit presbyopia with minimal vision degradation. A method for treating a cornea includes ablating a superior area of the cornea to enhance near-distance vision and ablating an inferior area of the cornea to enhance far-distance vision. Typically, the inferior area corresponds to an area of the cornea that is blocked (generally by the lower eyelid and/or cheek) from viewing objects when the eye is facing downward. The superior area corresponds to an area of the cornea that is blocked from viewing objects (generally by the patient's upper eyelid) when the eye is facing forward or slightly above the horizon. In some embodiments, a transition zone is ablated between the superior and inferior areas, to enable a smoother visual transition between the two areas.

Abstract: Systems and methods for treating a tissue of an eye with a laser beam include at least one processor that determines angles between a curved surface and a laser beam, controlling an ablative treatment in response to the angles. Angles between a surface of a cornea and a laser beam may be mapped over a treatment area. A mapped area may include an apex of a cornea displaced from a center of a pupil of an eye. Ablation properties may be determined locally in response to the incident angle of a laser beam with respect to a local slope of a tissue surface. The treatment area may be ablated using local ablation properties to form a desired surface shape.

Abstract: Methods and systems for measuring optical aberrations of an eye are provided. In one embodiment, the present invention provides transmitting light from the eye along an optical path to an aberration sensor. An adaptive optic is disposed along the optical path between a target optical system and the aberration sensor. Aberrations of the adaptive optic can be adjusted in response to a signal generated by the aberration sensor so as to provide a desired sensed aberration. The shape of the adjusted adaptive optic can be determined with the aberration sensor by transmitting an adaptive optic configuration measurement beam along the optical path.

Abstract: A sterile hand held slit lamp for laser refractive surgery includes a charging base that charges a battery while a hand held slit lamp is positioned thereon. A sterile supple cover is positioned over a slit lamp handle while supported by the charging base. A sterile gloved operator grasps the slit lamp handle covered by the sterile cover and illuminates an eye with a slit lamp beam. In many embodiments, an operating microscope provides a view of the eye to an operator while the slit lamp beam illuminates the eye. Operator adjustable controls located on the slit lamp handle are manipulated through a sterile cover and control a length, a width and an intensity of the slit lamp beam. An operator wearing sterile gloves adjusts a position of a piece of tissue near an incision, and removes debris from a surgical incision in tissue after viewing the eye illuminated with the hand held slit lamp beam.

Abstract: Systems and methods apply pulsed laser energy to an eye with a pulsed laser system. The laser system includes a pulsed laser, a laser beam delivery system and at least one processor. The laser makes a beam of an ablative light energy. A dimension across the laser beam varies during a treatment of the eye. A firing rate of the laser varies as the dimension across the beam varies during the treatment. The dimension across the beam and the firing rate of the laser can be arranged so as to maintain a power of the beam applied to the eye at a substantially constant level during at least a portion of the treatment. A firing rate of the laser for each pulse may be listed in a treatment table.

Abstract: Optical correction methods, devices, and systems reduce optical aberrations or inhibit refractive surgery induced aberrations. Error source control and adjustment or optimization of ablation profiles or other optical data address high order aberrations. A simulation approach identifies and characterizes system factors that can contribute to, or that can be adjusted to inhibit, optical aberrations. Modeling effects of system components facilitates adjustment of the system parameters.

Abstract: Devices, systems and methods for scaling the size and/or position of a marker on a magnified image of an object. In preferred embodiments, the object is an eye that is undergoing laser eye surgery. The eye is viewed through a magnification system or microscope and an image of the eye is presented on a display. One or more markers are present on the image, each identifying a specific target location or landmark on the eye. When a desired magnification setting is selected, the image is scaled accordingly. In addition, one or more of the markers is scaled in size and/or position to reflect the magnification setting. This allows the marker to maintain identification of the target location while reflecting the selected magnification level.

Abstract: Systems and methods orient sensors of an optical system that measures aberrations of an eye. The aberration measurement system may include an optical aberration sensor and an eye image sensor. An asymmetric feature can be imposed in an optical beam path so as to introduce artifacts at the sensors. The optical aberration sensor is often oriented relative to an eye image sensor in response to the asymmetric feature of an optical beam path. In some embodiments, a tool supported by a rail imposes the asymmetric feature on the optical beam path. Aberrations of the eye are measured along the optical beam path with an optical aberration sensor while an eye image sensor forms an image of a tissue structure of the eye positioned along the beam optical path. An aberration correcting shape is identified and ablated in corneal tissue with a laser.

Abstract: A slit lamp for illuminating an eye comprises several LEDs electrically coupled to an LED driver. A user input accepts input for a length, a width and an intensity of a shaped beam of light. An LED driver selectively drives a set of LEDs of an LED array to form a shaped light beam having a desired size across a beam cross-section. In some embodiments, several optical fibers at a first end of a fiber optic manifold are optically coupled to LEDs of an LED array, and an optic is placed near a second end of a fiber optic manifold. Several ends of optical fibers of the fiber optic manifold are optically coupled to the set of selectively driven LEDs, and are arranged so as to form the shaped light beam having a desired size across the beam cross-section.

Abstract: Methods, devices, and systems for predicting an optical acuity measure of an optical system of an eye. An optical acuity measure can be predicted by determining a point spread function based on a wavefront measurement of an eye, convolving a resolution target with the point spread function to produce an image, and predicting the optical acuity measure of the optical system of the eye based on the image.

Abstract: An ophthalmological laser surgery system having a laser, associated elements for delivering an optical beam from the laser to a patient eye location, a control unit for controlling the operation of the system and a system input/output device, is enabled by a patient data card. The data card originally contains both patient background and system control information, which is transferred to the control unit via the input/output device. During system operation, newly generated information, such as laser beam power, is stored in the data card to provide an independent record of the surgical procedure actually performed. After one use, the data card is invalidated to prevent further use.

Abstract: Methods, systems and software for determine an optical surface model for an optical tissue system using Fourier transformation algorithms. A method of reconstructing optical tissues of an eye comprises transmitting an image through the optical tissues of the eye. The surface gradients from the transmitted image are measured across the optical tissues of the eye. A Fourier transform algorithm is applied to the surface gradients to reconstruct an optical surface model that corresponds to the optical tissues of the eye.

Abstract: A wavefront sensor enhances calibration of a laser ablation system, such as a laser eye surgery system, by measuring one or more characteristics of an ablated test surface. Typically, light is passed through the ablated test surface, and the light is analyzed to determine the test surface characteristics. In some embodiments, the ablated test surface is positioned along a treatment plane. In some embodiments, light is passed through a wavefront sensor, such as a Hartmann-Shack sensor, to convert the light into electrical signals. A processor then converts the electrical signals into data, such as surface maps showing high-order aberrations and/or artifacts on the test surface, refractive power measurements, shape measurements, and the like. Generated data may then be used to calibrate a laser surgery system.

Abstract: Embodiments of the present invention provide methods and systems of temporally smoothing the distortion of a light beam caused by imperfections of an optical element or optical system through which the light beam passes. The optical element is moved relative to the light beam to change a position of the imperfections in the path of the light beam to distribute the distortion of the light beam caused by the imperfection without substantially changing the path of the light beam. In some embodiments, the optical element is axially symmetric with respect to its optical axis, and the distortion of the light beam is distributed by rotating the optical element around its optical axis. In some embodiments, the optical element has geometric uniformity relative to a plane or along a line in a plane, and the distortion of the light beam is distributed by moving the optical element along the plane, or along the line of symmetry in the plane.

Abstract: An ophthalmological surgery system and method for performing ablative photodecomposition of the corneal surface by offset image scanning. The image of a variable aperture, such as a variable width slit and variable diameter iris diaphragm, is scanned in a preselected pattern to perform ablative sculpting of predetermined portions of a corneal surface. The scanning is performed with a movable image offset displacement mechanism capable of effecting radial displacement and angular rotation of the profiled beam exiting from the variable aperture. The profiled beam is rotated by rotating the aperture in conjunction with the offset displacement mechanism. The invention enables wide area treatment with a laser having a narrower beam, and can be used in the treatment of many different conditions, such as hyperopia, hyperopic astigmatism, irregular refractive aberrations, post ablation smoothing and phototherapeutic keratectomy.

Abstract: Methods, devices, and systems establish an optical surface shape that mitigates or treats presbyopia in a particular patient. The combination of distance vision and near vision in a patient can be improved, often based on input patient parameters such as pupil size, residual accommodation, and power need. Iterative optimization may generate a customized corrective optical shape for the patient.

Abstract: A surgical method and a control system is provided. The surgical method and the control system can advantageously be used in a minimally invasive surgical apparatus. The method includes generating a desired surgical instrument movement command signal. It further includes comparing the desired surgical instrument movement command signal with at least one preset surgical instrument movement limitation. Should the desired surgical instrument command signal transgress the preset surgical instrument movement limitation, the desired surgical instrument movement command signal is restricted to yield a restricted surgical instrument movement command signal. A surgical instrument is then caused to move in response to the restricted surgical instrument movement command signal. The method further provides for haptic feedback on a master control in response to restriction of the desired surgical instrument movement command signal.

Abstract: A method for determining a refractive correction for an eye involves measuring an optical error of the eye, calculating at least one image quality parameter for a selected spatial frequency of range of spatial frequencies, based on the measured optical error of the eye, and forming a plan for refractive correction of the optical error, based on the calculated image quality parometer. In some embodiments, measuring the optical error involves taking one or more wavefront measurements. In some embodiments, calculating the parameter involves calculation a modulation transfer function.

Abstract: Improved devices, systems, and methods use a Non-Liner Optic (NLO) to effect a conversion of an input laser energy to an output energy. The output energy will have a wavelength which is different than the input energy, and the conversion will vary in response to both an angle of the energy relative to the NLO and a temperature of the NLO. Passive control over the angle of the NLO based on thermal expansion of a member thermally coupled to the NLO can compensate for the temperature-induced change in the conversion so as to maintain a desired output frequency, conversion efficiency, phase matching, and/or the like.

Abstract: An ophthalmological surgery system and method for performing ablative photodecomposition of the corneal surface by offset image scanning. The image of a variable aperture, such as a variable width slit and variable diameter iris diaphragm, is scanned in a preselected pattern to perform ablative sculpting of predetermined portions of a corneal surface. The scanning is performed with a movable image offset displacement mechanism capable of effecting radial displacement and angular rotation of the profiled beam exiting from the variable aperture. The profiled beam is rotated by rotating the aperture in conjunction with the offset displacement mechanism. The invention enables wide area treatment with a laser having a narrower beam, and can be used in the treatment of many different conditions, such as hyperopia, hyperopic astigmatism, irregular refractive aberrations, post ablation smoothing and phototherapeutic keratectomy.