Abstract: Apparatus to treat an eye with an ophthalmic laser system comprises a patient interface having 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. Liquid is added above the eye to act as a transmissive medium. A coupling sensor is coupled to the suction line to determine coupling of the retention structure to the eye. A separate pressure monitoring circuit having a much smaller volume than the suction line is connected to the annular retention structure to measure suction pressure therein. A system processor coupled to the monitoring pressure sensor includes instructions to interrupt firing of a laser when the pressure measured with a monitoring pressure sensor rises above a threshold amount.

Abstract: A laser surgical method for performing a corneal incision while maintaining iris exposure below a predetermined exposure limit includes: determining an initial iris exposure based on an initial treatment scan, determining whether the initial iris exposure is less than the predetermined exposure limit; generating a revised treatment scan comprising one or more treatment scan modifying elements when the initial iris exposure is greater than the predetermined exposure limit, and scanning the focal zone of a pulsed laser beam according to the revised treatment scan, thereby performing the corneal incision, wherein the one or more treatment scan modifying elements causes the iris exposure to be smaller than the predetermined exposure limit.

Abstract: A system for determining a vision treatment for an eye of a patient is provided which includes a memory and a processor, in communication with the memory, configured to receive a first treatment target corresponding to a first target shape of a surface of the eye, obtain a periphery modification function (PMF), determine a second treatment target corresponding to a second target shape of the surface of the eye by multiplying, for each of a plurality of points on the surface of the eye, the PMF by the first treatment target, and scale the second treatment target using a scaling factor such that values of the second treatment target are scaled to be greater at a mid-periphery of the eye and scaled to be lower at a far-periphery of the eye. A treatment parameter of a treatment applied to the surface of the eye is controlled by the scaled second treatment target.

Abstract: An ophthalmic laser surgical system uses a confocal detector assembly to continuously detect a confocal signal during laser treatment, and based on the confocal signal, detects in real time a loss of tissue contact with the patient interface (PI) output surface. The detection is partly based on the change of reflectivity at the PI output surface when the optical interface changes from a lens-tissue interface to a lens-air interface. The behavior of the confocal signal upon loss of tissue contact is dependent on the treatment laser scan pattern being performed at the time of tissue contact loss. Thus, different confocal signal analysis algorithms are applied to detect tissue contact loss during different scans, such as the bed cut and side cut for a corneal flap. The real time confocal signal may also be used during eye docking to detect the establishment of tissue contact with the PI output surface.

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: An optical measurement system and method measure a characteristic of a subject's eye. The optical measurement system receives from an operator, via a user interface of the optical measurement instrument, a begin measurement instruction indicating the start of a measurement period for objectively measuring at least one characteristic of the subject's eye. Subsequent to receiving the begin measurement instruction, the optical measurement system determines whether a criterion associated with the tear film quality of the subject's eye is not satisfied. In response to determining that the criterion is not satisfied, the optical measurement instrument takes one or more corrective actions to measure the characteristic of the subject's eye under a condition wherein the criterion is satisfied.

Abstract: A system and method of treating target tissue in a patient's eye, which includes generating a light beam, deflecting the light beam using a scanner to form first and second treatment patterns, delivering the first treatment pattern to the target tissue to form an incision that provides access to an eye chamber of the patient's eye, and delivering the second treatment pattern to the target tissue to form a relaxation incision along or near limbus tissue or along corneal tissue anterior to the limbus tissue of the patient's eye to reduce astigmatism thereof.

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 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: 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: System and method for making incisions in eye tissue at different depths. The system and method focuses light, possibly in a pattern, at various focal points which are at various depths within the eye tissue. A segmented lens can be used to create multiple focal points simultaneously. Optimal incisions can be achieved by sequentially or simultaneously focusing lights at different depths, creating an expanded column of plasma, and creating a beam with an elongated waist.

Abstract: As shown in the drawings for purposes of illustration, a method and system for making physical modifications to intraocular targets is disclosed. In varying embodiments, the method and system disclosed herein provide many advantages over the current standard of care. Specifically, linear absorption facilitated photodecomposition and linear absorption facilitated plasma generation to modify intraocular tissues and synthetic intraocular lenses.

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 femtosecond laser system for ophthalmic applications, which employs a number of chirped mirrors in the laser beam delivery system between the laser head and the objective lens. The chirped mirrors perform the dual function of both turning the laser beam in desired directions and compensating for beam broadening due to group delay dispersion (GDD) of the optical elements of the system. Each chirped mirror reflects the laser beam only once. Four chirped mirrors are used, each providing up to ?5000 fs2 of negative GDD per bounce, to provide a total of ?18,000 fs2 negative GDD to compensate for the positive GDD of +18,000 fs2 introduced by other optical elements in the laser beam delivery system. This eliminates the need for a pulse compressor that would employ a grating pair, prism pair or grism pair, and therefore significantly reduces the size of the system and the alignment requirements.

Abstract: An optical measurement instrument includes optical coherence tomography (OCT) interferometer and a pupil retro illumination system which directs laser light onto the retina of an eye via the sample arm of the OCT interferometer. The laser light passes through an intraocular lens (IOL) implanted into the eye, and an iris camera captures an image of the eye from a portion of the light returned from the retina of the eye, the returned light also passing through the IOL. One or more fiducials of the IOL are detected from the captured image, and an angular orientation of the eye is ascertained from the one or more detected fiducials.

Abstract: An optical coherence tomography (OCT) system includes: a light source; a multi-focal delay line; and a light detector. The multi-focal delay line includes: a positive lens; and an optical switch configured to: receive a light from the light source; selectively direct the sample light to the positive lens via a selected one of a plurality of light interfaces each located a different distance from the focal plane of the positive lens; and direct the sample light to an object to be measured. The light detector is configured to receive return light returned from the object to be measured in response to the sample light, and to receive a reference light produced from the light from the light source, and in response thereto to detect at least one interference signal. An associated OCT method may be performed with the OCT system.

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 method of laser eye surgery including linking retinal vessel architecture to corneal topography. This enables registration of the steep axis of the cornea in order to orient a toric intraocular lens, and/or to place astigmatic keratotomy incisions. First, a detailed pre-operative retinal image of the vasculature of the retina is obtained. In addition, a pre-operative image of the topography of the eye is obtained. The retinal image is then correlated or superimposed on the topography image to provide a reference. After the patient lies down under the laser eye surgery system, and during the surgery, the retinal vasculature is monitored which provides a reference to the surgery system about the topography of the eye. This process enables registration of the steep axis of the cornea in order to orient a toric intraocular lens and/or to place astigmatic keratotomy incisions.

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.