Abstract: Embodiments generally relate to ophthalmic laser procedures and, more particularly, to systems and methods for lenticular laser incisions to form a top lenticular incision, a bottom lenticular incision of a lens in the subject's eye, an added shape between the top and bottom incisions where the added shape has no corrective power and a transition ring bisecting both the top and bottom lenticular incisions.

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: A method implemented in an ophthalmic surgical laser system that employs a resonant scanner, scan line rotator, and XY- and Z-scanners, for forming a corneal flap in a patient's eye with improved bubble management during each step of the flap creation process. A pocket cut is formed first below bed level, followed by the bed connected to the pocket cut, then by a side cut extending from the bed to the anterior corneal surface. The pocket cut includes a pocket region located below the bed level and a ramp region connecting the pocket region to the bed. The bed is formed by a hinge cut and a first ring cut at lower laser energies, followed by a bed cut and then a second ring cut, which ensures that any location in the flap bed is cut twice to minimize tissue adhesion. The side cut is formed by multiple side-cut layers at different depths which are joined together. All cuts are formed by scanning a laser scan line generated by the resonant scanner.

Abstract: An ophthalmic surgical laser system includes a laser beam delivery system having multiple moving components for scanning a laser focal spot in a target eye tissue, where the motors that actuate some of the moving components are equipped with respective digital encoders that measure actual motor positions. A controller controls the laser beam delivery system to perform a treatment scan, while recording the actual motor positions from the encoders. Using the actual motor positions and a calibration relationship between actual motor positions and delivered laser focal spot positions in a target tissue, a laser cutting pattern is digitally reconstructed, which represents the incisions actually achieved by the treatment scan. The reconstructed laser cutting pattern may be visually inspected and further analyzed, e.g. to compare it to the intended laser cutting pattern used to execute the treatment scan, to calculate the achieved refractive correction, or to simulate tissue resetting.

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: 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: Systems and methods are disclosed for flexibly controlling laser pulses being output from a laser system. An example surgical system comprises a laser, an optical switching device, and a laser pulse controller. Optical switching control signals communicated by the laser pulse controller control the length of a pulse picking cycle and the number of laser pulses in each pulse picking cycle to be output from the laser system. The number of laser pulses in each pulse picking cycle to be output from the laser system may be adjustable in a range that includes more than 50% of the laser pulses in each pulse picking cycle.

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: 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, within a central area of the lenticule where the sweeps overlap, the laser is periodically blanked (or delivered with significantly reduced pulse energy) to reduce the total energy delivered in that area.

Abstract: Systems and methods are disclosed for selectively passing or blocking laser electromagnetic energy. A laser system comprises a shutter, whereby when the shutter is rotated one or more open areas of the shutter and one or more solid areas of the shutter are alternately positioned in a path of electromagnetic radiation emitted by the laser. The shutter may operate in different modes, including allowing all laser pulses to pass through in whole or in part, blocking all laser pulses from passing through, and alternately allowing and blocking laser pulses. In some embodiments, the shutter is controlled to allow only a part of each selected laser pulse to pass through. A laser system comprises a waveplate rotatable into different positions corresponding to different operating modes. The different operating modes may include allowing part and blocking part of the laser electromagnetic radiation.

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 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: 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: An ophthalmic surgical laser system includes: a laser that produces a pulsed laser beam having a pulse energy and pulse repetition rate; a high frequency fast scanner; an XY-scan device; a Z-scan device; and a controller. The controller controls the high frequency scanner to produce a scan line having a scan width; controls the XY-scan device and the Z-scan device to carry out of first sweep of the scan line in a first sweep direction and to carry out a second sweep of the scan line in a second sweep direction that is not parallel to the first sweep direction thereby defining an overlap region. At least one of the pulse energy, repetition rate, XY-scan speed, and the scan width is varied so as to accelerate the cutting speed and reduce the exposure of ophthalmic tissue in the overlap region to multiple exposures of laser pulses configured to modify ophthalmic tissue.

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: An ophthalmic surgical laser system includes: a laser that produces a pulsed laser beam having a pulse energy and pulse repetition rate; a high frequency fast scanner; an XY-scan device; a Z-scan device; and a controller. The controller controls the high frequency scanner to produce a scan line having a scan width; controls the XY-scan device and the Z-scan device to carry out of first sweep of the scan line in a first sweep direction and to carry out a second sweep of the scan line in a second sweep direction that is not parallel to the first sweep direction thereby defining an overlap region. At least one of the pulse energy, repetition rate, XY-scan speed, and the scan width is varied so as to accelerate the cutting speed and reduce the exposure of ophthalmic tissue in the overlap region to multiple exposures of laser pulses configured to modify ophthalmic tissue.

Abstract: A method implemented in an ophthalmic surgical laser system for forming a corneal flap in a patient's eye with improved bubble management. The flap includes a horizontal bed and a vertical or near vertical side cut around the periphery of the bed except for an uncut hinge area. The side cut has a bubble barrier layer that can prevent bubbles formed by the laser-tissue interaction from escaping into an interface between the corneal and the patient interface lens. In some embodiments, the bubble barrier layer is a thin uncut layer, located in the epithelium of the cornea, that separates the side cut into two portions. In other embodiments, the side cut does not reach the anterior corneal surface, leaving an uncut bubble barrier layer located with the epithelium. In other embodiments, an additional side cut portion is formed through the uncut bubble barrier layer as the last step.

Abstract: Systems and methods are disclosed for monitoring a laser system using detection of back reflection. In some embodiments, a laser system comprises a laser, at least one optical fiber, and a back-reflection monitoring sensor for detecting electromagnetic radiation reflected back from the optical fiber(s). The back-reflection monitoring sensor may be adapted to detect back-reflected electromagnetic radiation while the laser system is in use. The laser system may further comprise a computing system adapted to calculate an output power of the system based upon the back-reflected electromagnetic radiation. In some embodiments, a method of monitoring a laser system using detection of back reflection comprises transmitting electromagnetic radiation from a laser, receiving the electromagnetic radiation at one or more optical fibers, and detecting electromagnetic radiation that is back reflected at a back-reflection monitoring sensor.

Abstract: Systems and methods are disclosed for a surgical laser system with illumination. In some embodiments, a laser system comprises a surgical laser and an illumination source having their outputs combined into a fiber-optic cable and directed by the fiber-optic cable to a target surface. The illuminating visible light may be continuous and/or in pulses. Surgical laser pulses and illumination pulses may be synchronized for a stroboscopic effect. The laser system may also monitor laser electromagnetic radiation that is returned back through the fiber-optic cable.

Abstract: An ophthalmic system for visualization of interactions between ocular matter and a probe tip of a probe within or in contact with an ocular space of an eye includes: a visualization tool having a field of view that includes at least a portion of the ocular space of the eye where the probe tip interfaces with the ocular matter; and a stroboscopic illumination source configured to stroboscopically illuminate at least the portion of the field of view at an illumination frequency. A method of operating a stroboscopic illumination source during an ophthalmic surgical procedure includes: identifying an illumination source type of the stroboscopic illumination source; identifying a probe type; identifying a first procedure trigger; and operating the stroboscopic illumination source based on the probe type, the illumination source type, and the first procedure trigger.