Abstract: Disclosed herein are systems and methods for adjusting an intraocular lens (IOL) with optical coherence tomography (OCT) guidance. The IOL can comprise an optic portion and a plurality of haptics. In one embodiment, a method can comprise directing a laser beam generated by a laser system at a composite material making up part of the IOL. At least part of the composite material can expand in volume in response to the laser beam directed at the composite material. The method can also comprise measuring a volume change of the composite material or a change in at least part of the IOL by analyzing OCT images produced by an OCT imaging apparatus and determining a change in a base power of the IOL based on the measurements.

Abstract: The present disclosure generally relates to methods and apparatus for accurate identification of the visual axis of the eye. In one embodiment, a visual axis identification system includes a fixation light source, a camera, a processing system, and a multifocal lens. The patient focuses their gaze through the multifocal lens and onto a fixation light beam provided by the fixation light source. The passage of the fixation light beam through the multifocal lens creates two or more images on or near to the patient's retina. The multifocal lens and/or the patient's eye are then moved relative to each other while the patient continuously maintains their gaze on the fixation light beam. The patient's visual axis may be located by determining the location of the optical center of the multifocal trial lens relative to the patient's eye when the centers of the multiple images coincide on the retina.

Abstract: Particular embodiments disclosed herein provide an apparatus for performing optometric measurements includes an optical coherence tomography (OCT) imaging system configured to output scanned parallel laser beams across a patient's eye. A line in the OCT image is identified, the line representing a retina of the patient's eye. A shape of the line is then used by the refractive error calculator to measure refractive error of the patient's eye. The height of the line due to curvature indicates degree of myopia or hyperopia. More complex curvature of the line corresponds to higher order aberrations. OCT images for a plurality of section planes may be used to calculate a wavefront elevation map.

Abstract: Systems and methods are provided for in vivo pre-surgical characterization of lenses, such as cataractous lenses. A method comprises obtaining an electromagnetically-measured value related to the axial thickness of the lens, obtaining an ultrasound-measured value related to the axial thickness of the lens, calculating a relationship value based upon the electromagnetically-measured value and the ultrasound-measured value, and determining a mechanical property value based upon the calculated relationship value. The mechanical property may relate to lens hardness, rigidity, or density, or the amount of energy for a phacoemulsification procedure. A system may comprise an optical interferometer for measuring data to obtain the electromagnetically-measured value and an ultrasound biometer for measuring data to obtain the ultrasound-measured value.

Abstract: Particular embodiments disclosed herein enable psychophysical evaluation of vitreous floaters. One or more patient stimulus images are projected onto the patient's retina, the patient images including a stationary or mobile fixation target. While the patient stimulus images are displayed, images of the patient's retina are captured, such as using an SLO, and shadow images are derived from the images. The shadow images include representations of shadows cast by floaters. Observer stimulus images are generated from the shadow images and the patient stimulus images and projected onto the retinas of an observer, such as using a virtual reality display device.

Abstract: Particular embodiments disclosed herein provide a system for treating vitreous floaters. Light from a first laser (e.g., laser diode) is focused at a plurality of points within a vitreous of a patient's eye using a scanner while measuring reflected light from the plurality of points. The reflected light (e.g., images) are evaluated to identify a portion of the plurality of points corresponding to one or more vitreous floaters. Second light from a second laser (e.g., pulsed laser) is focused at the portion of the plurality of points using the scanner in order to disintegrate the one or more vitreous floaters.

Abstract: Particular embodiments disclosed herein provide a method for training a machine learning model to estimate the clinical significance of floaters in a patient's eye. One or more images, such as SLO images or en face retinal OCT images, are evaluated to identify shaded regions corresponding to floaters. The shaded regions are measured and the measurements processed using a machine learning model to obtain an estimated significance. The machine learning model is then updated according to a comparison of the estimated significance to a human-assigned clinical significance. The machine learning model may additionally or alternatively be updated by evaluating the estimated category with respect to visibility threshold data, such as one or more visibility threshold surfaces defined with respect to two or more variables.

Abstract: Systems and methods for intraocular lens selection include receiving, by one or more computing devices implementing a prediction engine, pre-operative multi-dimensional images of an eye; extracting, by the prediction engine, pre-operative measurements of the eye based on the pre-operative images; estimating, by the prediction engine using a prediction model based on a machine learning strategy, a post-operative position of an intraocular lens based on the extracted pre-operative measurements; selecting a power of the intraocular lens based on the estimated post-operative position of the intraocular lens; and selecting the intraocular lens based on the selected power. In some embodiments, the systems and methods further include receiving post-operative multi-dimensional images of the eye after implantation of the selected intraocular lens, extracting post-operative measurements of the eye, and updating the prediction model based on the pre-operative measurements and the post-operative measurements.

Abstract: In certain embodiments, an ophthalmic surgical laser system for imaging and treating an eye floater includes an SLO subsystem, a treatment laser subsystem, a scanner, optical elements, and a computer. The SLO subsystem provides an SLO laser beam with an SLO focal point, and the treatment laser subsystem provides a treatment laser beam with a treatment focal point that spatially coincides with the SLO focal point. The scanner scans the SLO laser beam across a scan region and directs the treatment laser beam to the xy-location of the scan region. The optical elements aim the SLO laser beam and the treatment laser beam at substantially the same point of the scan region. The computer receives an SLO image of the floater, determines an xy-location of the floater, and instructs the treatment laser subsystem to direct the treatment laser beam towards the xy-location and the z-scan location of the floater.

Abstract: Systems and methods for intraocular lens selection include receiving, by one or more computing devices implementing a prediction engine, pre-operative multi-dimensional images of an eye; extracting, by the prediction engine, pre-operative measurements of the eye based on the pre-operative images; estimating, by the prediction engine using a prediction model based on a machine learning strategy, a post-operative position of an intraocular lens based on the extracted pre-operative measurements; selecting a power of the intraocular lens based on the estimated post-operative position of the intraocular lens; and selecting the intraocular lens based on the selected power. In some embodiments, the systems and methods further include receiving post-operative multi-dimensional images of the eye after implantation of the selected intraocular lens, extracting post-operative measurements of the eye, and updating the prediction model based on the pre-operative measurements and the post-operative measurements.

Abstract: Systems and methods are provided for in vivo pre-surgical characterization of lenses, such as cataractous lenses. A method comprises obtaining an electromagnetically-measured value related to the axial thickness of the lens, obtaining an ultrasound-measured value related to the axial thickness of the lens, calculating a relationship value based upon the electromagnetically-measured value and the ultrasound-measured value, and determining a mechanical property value based upon the calculated relationship value. The mechanical property may relate to lens hardness, rigidity, or density, or the amount of energy for a phacoemulsification procedure. A system may comprise an optical interferometer for measuring data to obtain the electromagnetically-measured value and an ultrasound biometer for measuring data to obtain the ultrasound-measured value.

Abstract: In certain embodiments, an ophthalmic laser surgical system for treating a floater in an eye includes a scanning laser ophthalmoscopy (SLO) device, a treatment laser device, and an xy-scanner. The SLO device directs an SLO beam towards the retina of the eye, generates an image that includes the floater shadow from the SLO beam reflected from the eye, determines the xy-location of the floater shadow, and determines the z-location of the floater relative to the retina using the confocal filter. The treatment laser device receives the z-location of the floater from the SLO device, and directs a laser beam towards the z-location. The xy-scanner receives the SLO beam from the SLO device and directs the SLO beam towards the xy-location of the floater shadow. The xy-scanner also receives the laser beam from the treatment laser device and directs the laser beam towards the xy-location of the floater shadow.

Abstract: In certain embodiments, an ophthalmic laser surgical system for imaging and treating a target in an eye includes a laser device, imaging system, and computer. The laser device directs the focus of a laser beam towards an intended location (x0, y0, z0) of the target to yield a cavitation bubble in the vitreous. The imaging system directs imaging beams towards the target, receives the imaging beams reflected from the eye, generates an image of the cavitation bubble from the reflected imaging beams, and measures an actual location (x, y, z) of the cavitation bubble according to the image. The computer determines an error vector that describes an error between the intended location and the actual location, determines a correction vector to compensate for the error, and instructs the laser device to use the correction vector to direct the laser beam towards the target to treat the target.

Abstract: In certain embodiments, an ophthalmic laser system includes a laser device, an ophthalmic microscope, and a controller. The laser device directs laser pulses towards a target within an eye. The target has a dimension. The laser device includes a laser configured to generate a laser beam and one or more laser beam multiplexers. A laser beam multiplexer modulates the laser beam to yield a pulse pattern of laser pulses. The pulse pattern has a coverage related to the dimension of the target to limit movement of the target. The ophthalmic microscope gathers light reflected from within the eye to yield an image of the eye. The controller instructs the laser device to direct the laser pulses towards the target to yield the pulse pattern of laser pulses.

Abstract: In certain embodiments, an ophthalmic laser system that performs a laser procedure on an eye includes a laser device, an ophthalmic microscope, a y-direction motor, a user interface device, and a controller. The laser device includes a laser delivery head that directs a laser beam towards a target within the eye. The laser beam defines a z-axis, which defines an xy-plane with a y-axis that defines a y-direction. The ophthalmic microscope receives light from within the eye to provide an image of the eye. The user interface device receives instructions from a user. The controller receives an instruction from the user interface device to move the laser delivery head and the ophthalmic microscope in the y-direction, and instructs the y-direction motor to move the laser delivery head and the ophthalmic microscope in the y-direction in response to the instruction.

Abstract: In certain embodiments, an ophthalmic surgical system for viewing an eye includes an ophthalmic microscope and a laser device. The ophthalmic microscope receives light reflected or scattered backwards from within the vitreous of the eye in order to provide an image of an object within the vitreous. The ophthalmic microscope includes a slit illumination source (which includes a light source and an optical element), a spectral filter, and oculars. The slit illumination source illuminates the eye with light, where the light source provides the light, and the optical element directs the light into the eye. The spectral filter filters out red spectral components of the light. The oculars receive the light from the eye in order to provide the image of the object. The laser device generates a laser beam to direct towards the object within the eye.

Abstract: In certain embodiments, an ophthalmic laser surgical system for treating a target tissue in an eye includes a target detection system and a laser device. The target tissue has an optical breakdown threshold. The target detection system directs detection beams along a detection beam path towards the target tissue in a vitreous of the eye, and determines a location of the target tissue within the vitreous. The laser device includes a femtosecond laser that generates subthreshold laser pulses that have a pulse energy below the optical breakdown threshold of the tissue. The laser device directs a laser beam comprising the subthreshold laser pulses along a laser beam path towards the target tissue.

Abstract: In certain embodiments, an ophthalmic laser surgical system for treating a floater in an eye comprises a scanning laser ophthalmoscope (SLO) device that: generates an SLO image of a floater shadow cast by the floater onto a retina of the eye, and provides an xy-location of the floater shadow, where the xy-location is related to the xy-scanner. An interferometer device provides a z-location of the floater, where the z-location is relative to the retina. A laser device generates a laser beam and includes a z-focusing component that focuses a focal point of the laser beam onto the z-location of the floater. An xy-scanner directs an SLO beam from the SLO device along an SLO beam path towards the xy-location of the floater shadow, and directs the laser beam from the laser device along the SLO beam path towards the xy-location of the floater shadow.

Abstract: In certain embodiments, an ophthalmic laser system for treating a floater in a vitreous of an eye includes a laser device that directs laser pulses towards the floater to yield cavitation bubbles that create a bubble jet to treat the floater. In some examples, the laser device includes a beam multiplexer that splits a laser beam into multiple beams that form the cavitation bubbles that create the bubble jet. In some examples, the laser device directs laser pulses towards the floater according to a pulse pattern that forms the cavitation bubbles that create the bubble jet.

Abstract: In certain embodiments, an ophthalmic laser surgical system for treating a floater in a vitreous of an eye includes a floater detection system, a laser device, and a computer. The floater detection system determines the location of the floater in the vitreous of the eye. The laser device directs a laser beam along a laser beam path towards the floater. The computer accesses a three-dimensional scan pattern for the laser beam that yields a three-dimensional pulse pattern of laser pulses. The three-dimensional pulse pattern has a bubble shield pulse pattern at the posterior side of the three-dimensional pulse pattern. The bubble shield pulse pattern forms a bubble shield that reduces laser radiation exposure at a retina of the eye. The computer instructs the laser device to direct the laser beam towards the floater according to the three-dimensional scan pattern.