Abstract: Embodiments of the present invention encompass systems and methods for customized vision treatments that account for effects associated with corneal flap creation.

Abstract: Systems and methods for locating the center of a lens in the eye are provided. These systems and methods can be used to improve the effectiveness of a wide variety of different ophthalmic procedures. In one embodiment, a system and method is provided for determining the center of eye lens by illuminating the eye with a set of light sources, and measuring the resulting first image of the light sources reflected from an anterior surface of the lens and the resulting second image of the light sources reflected from a posterior surface of the lens. The location of the center of the lens of the eye is then determined using the measurements. In one embodiment, the center of the lens is determined by interpolating between the measures of the images. Such a determination provides an accurate location of the geometric center of the lens.

Abstract: A system for determining a vision treatment for an eye of a patient is provided which comprises a memory configured to store programmed instructions and data. The system also comprises a processor in communication with the memory. The processor is configured to receive an original target profile for the eye of the patient. The processor is also configured to obtain a cut-off spatial domain kernel filter and convolve the original target profile with the cut-off spatial domain kernel filter to provide a convolved target profile. The processor is further configured to determine the vision treatment based on the convolved target profile.

Abstract: A laser pulse energy control system which includes a laser source and a beam divider positioned to receive a calibration laser pulse produced by the laser source. The beam divider reflects a first portion of the calibration laser pulse along a first optical path toward a first plane and transmits a second portion of the calibration laser pulse along a second optical path toward a second plane. An energy meter determines an energy of the first portion of the calibration laser pulse at the first plane and a fluence profiler determines a fluence profile of the second portion of the calibration laser pulse at the second plane. The processor controls an energy of an ablation laser pulse produced by the laser source based on the fluence profile of the second portion of the calibration laser pulse and the energy of the first portion of the calibration laser pulse.

Abstract: Random human eye generators are provided for use in evaluating aspects of treatment in refractive surgery or other therapeutic vision modalities. Exemplary random eye generators include an optical parameter such as a manifest refractive sphere parameter or a wavefront sphere parameter, and incorporate a Rayleigh distribution for such parameters.

Abstract: Systems are provided for delivering a calibrated ultraviolet radiation pulse at a treatment plane during a laser-ablation treatment of a patient's eye. Exemplary systems include an ultraviolet radiation source, and a fluorescent plate positioned to receive an initial ultraviolet radiation pulse produced by the ultraviolet radiation source. The fluorescent plate generates a visible light pulse in response to the initial ultraviolet radiation pulse.

Abstract: Systems and methods to treat a region of a cornea of an eye having an epithelial layer disposed over a stromal layer. Exemplary techniques include the administration of epithelial sequence ablation laser pulses and stromal sequence ablation laser pulses to the eye. A treatment laser generates a laser beam for ablation of eye tissue, and a movable scan component scans the laser beam over the region. A processor system is coupled to the laser and the movable scan component, and the processor system is configured to arrange pulses of laser beam to treat the epithelial and stromal layers of the region.

Abstract: A method and apparatus for performing ophthalmic laser surgery using a pulsed laser beam is provided. The method includes establishing an initial cutting pattern comprising a plurality of original photodisruption points, establishing an enhanced cutting pattern comprising a plurality of enhanced photodisruption points selected to decrease potential adverse effects due to patient movement and having increased density over a fixed area as compared with the plurality of original photodisruption points, and performing an ocular surgical procedure according to the enhanced cutting pattern. Enhanced cutting patterns may include circular cuts around the periphery of a capsule, vertical side cuts for lens fragmentation, raster lamellar cuts, and grid lamellar cuts. Each photodisruption point in the initial cutting pattern and the enhanced cutting pattern comprises a laser target point.

Abstract: System and method of photoaltering a region of an eye using a high resolution digital image of the eye. The system includes a laser assembly for outputting a pulsed laser beam, an imaging system for capturing a real-time high resolution digital image of the eye and displaying the digital image of the eye, a user interface receiving at least one laser parameter input, and a controller coupled to the laser assembly, imaging system, and user interface. The controller directs the laser assembly to output the pulsed laser beam to the region of the eye based on the laser parameter input.

Abstract: Systems and methods for removing an epithelial layer disposed over a stromal layer in a cornea irradiate a region of the epithelial layer with a pulsed beam of ablative radiation. The ablative radiation is scanned to vary the location of the beam within the region in accordance with a pulse sequence. The pulse sequence is arranged to enhance optical feedback based on a tissue fluorescence of the epithelial layer. The penetration of the epithelial layer is detected in response to the optical feedback. The use of scanning with the pulse sequence arranged to enhance optical feedback allows large areas of the epithelium to be ablated such penetration of the epithelial layer can be detected.

Abstract: Deconvolution systems and methods based on cornea smoothing can be used to obtain an ablation target or treatment shape that does not induce significant high order aberrations such as spherical aberration. Exemplary ablation targets or treatment shapes can provide a post-operative spherical aberration that is equal to or below a naturally occurring amount of spherical aberration.

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: Systems and methods related to corneal ablation for treatment of one or more high-order optical aberrations are provided. A method includes providing a defect-correcting prescription, determining an ablation profile to impose the prescription on the cornea, and determining a sequence of laser-energy ablations to impose the ablation profile on the cornea. The prescription may include a high-order optical correction. The ablation profile includes a first-segment profile and a second-segment profile. The second-segment profile corresponds to at least one high-order optical correction. The ablation sequence includes applying ablations corresponding to the first-segment profile prior to applying ablations corresponding to the second-segment profile.

Abstract: A method of modifying a refractive profile of an eye having an intraocular device implanted therein, wherein the method includes determining a corrected refractive profile for the eye based on an initial refractive profile, identifying one or more locations within the intraocular device based on the corrected refractive profile, and directing a pulsed laser beam at the locations to produce the corrected refractive profile. A system of modifying an intraocular device located within an eye, wherein the system includes a laser assembly and a controller coupled thereto. The laser assembly outputs a pulsed laser beam having a pulse width between 300 picoseconds and 10 femtoseconds. The controller directs the laser assembly to output the pulsed laser beam into the intraocular device. One or more slip zones are formed within the intraocular device in response thereto, and the slip zones are configured to modify a refractive profile of the intraocular device.

Abstract: Apparatus and methods are provided for interfacing a surgical laser with an eye using a patient interface device that minimizes aberrations through a combination of a contact lens surface positioning and a liquid medium between an anterior surface of the eye and the contact lens surface. Further, support rings, ocular stability devices, and methods for interfacing an eye during laser surgery are provided. In an embodiment, by way of example only, a support ring includes a first end surface, a second end surface opposite the first end surface, and an outer surface extending between the first end surface and the second end surface. The second end surface has a width that is greater than a width of the first end surface and extends toward a central opening in the support ring to define a concave curvature configured to substantially match a curvature of a patient's eye.

Abstract: Devices, systems, and methods perform diagnostic and/or treatment procedures on an eye using a pupilometer to determine a change in pupil size, a processor and a variable illumination source. In response to a change in pupil size as determined by the pupilometer, the processor may determine an optical light output sufficient to induce a pupillary response and mitigate the change in pupil size. The system directs the desired optical light output to the eye with the variable illumination source optionally to prevent the pupil size from exceeding certain limits so as to improve torsional tracking of markers of the eye.

Abstract: Methods and systems for obtaining an ocular aberration measurement of an eye of a patient are provided. Exemplary techniques involve obtaining a first induced metric for the eye that corresponds to a first accommodation state of the eye, obtaining a second induced metric for the eye that corresponds to a second accommodation state of the eye, and determining a natural metric of the eye based on the first and second induced metrics. An induced metric may include a pupil size or a spherical aberration. Techniques can also include determining a target metric for the eye base on the natural metric, determining whether an actual metric of the eye meets the target metric, obtaining an ocular aberration measurement of the eye if the actual metric meets the target metric, and determining a treatment for the eye based on the ocular aberration measurement.

Abstract: Wavefront measurements of eyes are often taken when the pupil is in a first configuration in an evaluation context. The results can be represented by a set of basis function coefficients. Prescriptive treatments are often applied in a treatment context, which is different from the evaluation context. Hence, the patient pupil can be in a different, second configuration, during treatment. Systems and methods are provided for determining a transformed set of basis function coefficients, based on a difference between the first and second configurations, which can be used to establish the vision treatment.

Abstract: Embodiments of the present invention encompass systems and methods for generating a vision treatment target for an eye of a patient. Exemplary techniques can involve obtaining a wavefront measurement for the eye of the patient, processing the wavefront measurement, using a low pass filter, to obtain an ocular wavefront, and generating the vision treatment target based on the ocular wavefront. In some cases, the wavefront is processed by applying a Fourier transform to the wavefront measurement to obtain a Fourier spectrum of the wavefront, convolving, in the Fourier domain, the Fourier spectrum of the wavefront and the low pass filter to obtain a Fourier spectrum convolution result, and applying an inverse transform to the convolution result to obtain the ocular wavefront. The ocular wavefront can represent a low pass filtered version of the wavefront measurement, such that high spatial frequency features present in the wavefront measurement are not present in the ocular wavefront.

Abstract: Deconvolution systems and methods based on cornea smoothing can be used to obtain an ablation target or treatment shape that does not induce significant high-order aberrations such as spherical aberration. Exemplary ablation targets or treatment shapes can provide a post-operative spherical aberration that is equal to or below a naturally occurring amount of spherical aberration.