This present disclosure relates generally to ophthalmic laser systems and, more particularly, to ophthalmic laser systems with multi-focal optics.
Ophthalmic laser systems deliver laser pulses to focus spots along a scan pattern in a target. These laser systems have a variety of uses. For example, the systems may be used to perform a surgical procedure on ophthalmic tissue. The laser pulses create plasma or cavitation bubbles at the focus spots when the beam intensity or energy density exceeds a plasma or photo-disruption threshold. The pattern of bubbles can form surgical incisions or photo-disrupted regions.
As another example, ophthalmic laser systems may be used to adjust a light (or laser) adjustable lens (LAL). In cataract surgery, the cloudy natural lens is removed and replaced with an artificial intraocular lens (IOL). Pre-surgery eye measurements are used to calculate the power and type of IOL that will optimize vision after surgery. However, because of the limited accuracy of pre-surgical measurements and because eyes heal differently, it can be difficult to obtain the desired visual outcome.
A light adjustable lens can be adjusted after surgery to improve vision. The lens is made of a photo-sensitive material with refractive properties that can change in response to light. After the eye heals, the patient's vision is tested, and a laser system is used to scan light into the patient's eye to adjust the lens.
In certain embodiments, an ophthalmic laser system comprises a laser source, multi-focal optics, scanners, delivery optics, and a computer. The laser source generates a laser beam of ultrashort laser pulses. The multi-focal optics multiplex the laser beam to yield focus spots in a target along a propagation axis of the laser beam. The scanners direct the laser beam in x, y, and z directions, where the z direction is defined by an optical axis of the laser system and the x and y directions are orthogonal to the z-direction. The delivery optics focus the laser beam within the target to form the focus spots in the target along the propagation axis of the laser beam. The computer instructs the scanners and the delivery optics to direct and to focus the focus spots at the target according to a scan pattern.
Embodiments may include none, one, some, or all of the following features.
The multi-focal optics comprise a diffractive optical element that multiplexes the laser beam to yield the focus spots along the propagation axis of the laser beam.
The multi-focal optics comprise a holographic optical element with an interference pattern with a high diffraction efficiency that yields the focus spots along the propagation axis of the laser beam.
The multi-focal optics comprises a computer-controlled spatial light modulator that modulates a feature of the laser beam to form the focus spots along the propagation axis of the laser beam.
At least two of the focus spots are spatially separated by a distance greater than the depth of focus of the laser beam.
The target comprising a lens for an eye. The lens may comprise an intraocular lens (IOL) for the eye or a contact lens for the eye. The computer may determine the scan pattern for the lens for hyperopia, myopia, or astigmatism correction of the eye.
The target comprises a cataractous lens of an eye. The computer instructs the scanners and the delivery optics to direct and to focus the focus spots to open a lens capsule with an incision, and emulsify the cataractous lens.
The target comprises a cornea of an eye. The computer instructs the scanners and the delivery optics to direct and to focus the focus spots to create an incision in the cornea.
In certain embodiments, an ophthalmic laser system comprises a laser source, multi-focal optics, scanners, delivery optics, and a computer. The laser source generates a laser beam of ultrashort laser pulses. The multi-focal optics multiplex the laser beam to yield focus spots in a target along a propagation axis of the laser beam. The target comprises a lens for an eye. The scanners direct the laser beam in x, y, and z directions, where the z direction is defined by an optical axis of the laser system and the x and y directions are orthogonal to the z-direction. The delivery optics focus the laser beam within the target to form the focus spots in the target along the propagation axis of the laser beam. The computer determines a scan pattern for hyperopia, myopia, or astigmatism correction of the eye, and instructs the scanners and the delivery optics to direct and to focus the focus spots at the target according to a scan pattern.
Embodiments may include none, one, some, or all of the following features.
The multi-focal optics comprise a diffractive optical element that multiplexes the laser beam to yield the focus spots along the propagation axis of the laser beam.
The multi-focal optics comprise a holographic optical element with an interference pattern with a high diffraction efficiency that yields the focus spots along the propagation axis of the laser beam.
The multi-focal optics comprise a computer-controlled spatial light modulator that modulates a feature of the laser beam to form the focus spots along the propagation axis of the laser beam.
In certain embodiments, a method for scanning a laser beam of an ophthalmic laser system comprises: generating, by a laser source, a laser beam of ultrashort laser pulses; multiplexing, by multi-focal optics, the laser beam to yield focus spots in a target along a propagation axis of the laser beam; directing, by scanners, the laser beam in x, y, and z directions; focusing, by delivery optics, the laser beam within the target to form the focus spots in the target along the propagation axis of the laser beam; and instructing, by a computer, the scanners and the delivery optics to direct and to focus the focus spots at the target according to a scan pattern.
Embodiments may include none, one, some, or all of the following features.
The method further comprises spatially separating at least two of the focus spots by a distance greater than the depth of focus of the laser beam.
The target comprises a lens for an eye. The method further comprises determining, by the computer, the scan pattern for the lens for hyperopia, myopia, or astigmatism correction of the eye.
The target comprises a cataractous lens of an eye. The method further comprises instructing, by the computer, the scanners and the delivery optics to direct and to focus the focus spots to: open a lens capsule with an incision; and emulsify the cataractous lens.
The target comprises a cornea of an eye. The method further comprises instructing, by the computer, the scanners and the delivery optics to direct and to focus the focus spots to create an incision in the cornea.
Referring now to the description and drawings, example embodiments of the disclosed apparatuses, systems, and methods are shown in detail. The description and drawings are not intended to be exhaustive or otherwise limit the claims to the specific embodiments shown in the drawings and disclosed in the description. Although the drawings represent possible embodiments, the drawings are not necessarily to scale and certain features may be simplified, exaggerated, removed, or partially sectioned to better illustrate the embodiments.
In general, the present disclosure relates to ophthalmic laser systems with multi-focal optics. In certain embodiments, an ophthalmic laser system includes multi-focal optics that multiplexes a laser beam to yield multiple (e.g., double, triple, or more) focus spots along the propagation axis of the beam. In this way, the effective laser repetition rate can be multiplied (e.g., doubled, tripled, or more) without facing the technical challenges of increasing the repetition rate of a laser source or of increasing the speed of the scanners. Additionally, the spatial separation between focus spots along the propagation axis may be selected to reduce or minimize shadowing effects that a bubble at a shallower focus spot may have on forming a bubble at a deeper depth. Accordingly, embodiments provide a solution for increasing the effective repetition rate of an ophthalmic laser system, resulting in decreased treatment time. These embodiments may be particularly useful for customizing femtosecond laser adjustable lenses (FLALs), which are intraocular lenses that comprise material with a refractive index that can be modified by femtosecond laser pulses.
System 100 includes optics. “Optics” refers to one or more optical elements that act on (e.g., transmit, reflect, refract, diffract, collimate, condition, shape, focus, modulate, and/or otherwise act on) beam 101. Examples of optical elements include a lens, prism, mirror, diffractive optical element (DOE), holographic optical element (HOE), and a spatial light modulator (SLM). A diffractive optical element typically has a microstructured surface relief profile that reshapes light to a different distribution by diffraction. Examples of diffractive optical elements include a beam-splitter, pattern generator, kinoform, beam shaper, and linear or circular grating. A holographic optical element is an optical element with an interference pattern produced using holographic imaging processes. Examples of a holographic optical elements include a lens, filter, beam splitter, or diffraction grating. A spatial light modulator is a computer-controlled device that modulates one or more features (e.g., the amplitude, phase, and/or polarization) of light waves in space and time. A spatial light modulator may have translucent (LCD) or reflective (LCOS) liquid crystal micro-displays.
In certain embodiments, laser source 110 comprises a laser engine capable of generating beam 101 of ultrashort laser pulses, e.g., pulses in the femtosecond, picosecond, or attosecond range. In certain variants, laser source 110 comprises a chirped pulse amplification (CPA) laser, which may include: an oscillator to generate femtosecond seed pulses; a stretcher to stretch the seed pulses by a factor of 10-1000 to the picosecond range; an amplifier to amplify the picosecond pulses; and a compressor to compress the duration of the amplified pulses back to the femtosecond range. In certain variants, laser source 110 comprises a cavity-dumped regenerative amplifier laser, which may include: an oscillator, stretcher-compressor, and optical amplifier. Examples of laser source 110 include a bulk laser, fiber laser, or hybrid laser.
In certain variants, the laser pulses generated by laser source 110 may have any suitable values for the following parameters, where example ranges of the values are as follows.
Multi-focal optics 107 described herein multiplex beam 101 to yield a plurality of focus spots 102 in a target along the propagation axis of beam 101. Multi-focal optics 107 may multiplex beam 101 by altering the pulses of beam 101 to yield multiple focus spots 102, e.g., by diffracting or refracting different portions of beam to different focus spots 102, or by modulating the amplitude, phase, and/or polarization of beam 101 to yield different focus spots 102. Examples of multi-focal optics 107 include a diffractive optical element, holographic optical element, and spatial light modulator. A diffractive optical element may have a microstructured surface relief profile or a pattern of different refractive indices that alters a laser beam to form multiple focus spots along the propagation axis of the laser beam. A holographic optical element may have an interference pattern with a high diffraction efficiency that forms the multiple focus spots. A spatial light modulator may modulate the amplitude, phase, and/or polarization of the laser beam to form the multiple focus spots, e.g., the modulator may be an electrically-addressed spatial light modulator that modulates the phase. Examples of multi-focal optics 107 are described in more detail with reference to
Scanners 120 scan beam 101 to direct focus spots 102 of beam 101 towards points of target 103 in response to instructions from laser controller 160. Scanners 120 include any suitable combination of xy-scanner(s) and z-scanner(s). The optical axis of the laser system 100 defines the z-axis, and an xy-plane is orthogonal to the z-axis. An xy-scanner scans focus spot 102 of beam 101 in an xy-plane, while a z-scanner scans focus spot 102 of beam 101 in the z-direction parallel to the z-axis. Scanners 120 may include galvo scanners, which are computer controlled electromagnetic devices that rotate mirrors mounted at the ends of a rotary shaft. The mirror deflects beam 101 to scan the beam in the xy-plane. Scanners 120 may also include linear servomotors that scan beam 101 in the z-direction.
Delivery optics 130 focuses beam 101 to yield focus spots 102 in target 103 in response to instructions from laser controller 160. Delivery optics 130 may include a focusing objective lens, a beam expander, a birefringent lens, and other lenses to direct, collimate, condition, and/or focus the scanned beam 101 through patient interface 140 to focus spot 102 of target 103.
Patient interface 140 may attach to and immobilize target 103 during a laser procedure. Patient interface 140 may include, for example, a one or two-piece transparent applanation lens attached to a mount on delivery optics 130. The mount can provide a stable connection between the patient interface and delivery optics 130.
In certain embodiments, target 103 may comprise a particular type of artificial intraocular lens (IOL), a laser adjustable lens (LAL) (also known as “light adjustable lens”). A light adjustable lens is an artificial lens implanted during, e.g., cataract surgery. After the eye has healed, the refractive properties of the lens can be adjusted by directing beam 101 onto the lens from outside of the eye to form spots 102. A laser adjustable lens may be a femtosecond laser adjustable lens (FLAL), which comprises material with a refractive index that can be modified by femtosecond laser pulses. The laser pulses may modify the refractive index in any suitable manner. For example, the pulses may change the hydration level of the lens material (as well as that of the cornea). Increasing the hydration level decreases the refractive index, and decreasing hydration level increases the refractive index. As another example, the pulses may change the crosslinking of the lens material (or that of the cornea), which alters the refractive index.
In other embodiments, target 103 may comprise a contact lens that comprises material with a refractive index that can be modified by femtosecond laser pulses. The laser pulses may modify the refractive index in any suitable manner, e.g., the manners as described above with reference to FLALs. The refractive power and high order aberrations of the contact lens can be customized according the high order aberrations of the patient. In these embodiments, the contact lens is placed on a holder when modified by the laser pulses, i.e., the contact lens is not on an eye.
In yet other embodiments, target 103 may comprise an eye. A laser pulse may create a plasma or cavitation bubble in the eye at a focus spot 102 of beam 101 when the intensity or energy density exceeds a plasma or photo-disruption threshold of the eye. For example, in cataract surgery, focus spots 102 may be form incisions in the cornea and/or capsule to access the cataractous lens of the eye. Focus spots 102 may also emulsify the cataractous lens, and the multiple focus spots may decrease lens fragmentation time. As another example, in refractive surgery, focus spots 102 may be form incisions (e.g., a flap, a lenticule, or other incision) or other patterns in the cornea to change the refractive properties of the cornea.
Imaging device 150 receives imaging light 104 and generates real-time images of target 103 during a procedure. Imaging device 150 may generate image data 105 and send the data 105 to a laser controller 160. Examples of an imaging device 150 include a surgical microscope, video microscope, digital microscope, ophthalmoscope, optical coherence tomography (OCT) imaging system, and/or camera.
Laser controller 160 is a computer that comprises memory M storing instructions executable by a processor P to control pulsed laser source 110, multi-focal optics 107, scanners 120, delivery optics 130, and/or imaging devices 150. Typically, the processor of laser controller 160 comprises one or more CPUs (such as those manufactured by Intel, AMD, and others), microprocessors, field-programmable gate arrays (FPGAs), application-specific integrated circuits (ASICs), digital-signal processors (DSPs), or system-on-chip (SoC) processors communicatively coupled to memory. The memory may comprise a non-transitory computer-readable medium, and may include volatile or non-volatile memory including, magnetic media, optical media, random access memory (RAM), read-only memory (ROM), removable media, or analogous components. The memory may store software instructions executable by the processor to generate control signals 106 that control the operation of pulsed laser source 110, scanners 120, delivery optics 130, and imaging device 150.
In certain embodiments, laser controller 160 generates signals 106 to control parameters of beam 101 generated by pulsed laser source 110, such as a repetition rate, pulse length, and pulse energy. Laser controller 160 also generates signals 106 to instruct multi-focal optics 107, scanners 120, and/or delivery optics 130 to direct and focus spots 102 according to a scan pattern. A scan pattern may be any suitable two-dimensional or three-dimensional shape or pattern, including spiral, raster, zig-zag, circular, elliptical, or cylindrical patterns.
Laser controller 160 may determine the scan pattern according to the purpose of the operation. In certain embodiments, a scan pattern may be used to adjust the refractive properties of a light adjustable lens. For example, the scan pattern may form focus spots 102 in a light adjustable lens to change the refractive properties of the lens. Laser controller 160 may determine the scan pattern according to the type of correction. For hyperopia or myopia correction, the refractive properties may be changed to yield an intraocular lens that directs light onto the retina of the eye. For example, to treat hyperopia, the refractive index may be increased at in a central area and/or or decreased in a peripheral area. To treat myopia, the refractive index may be decreased in a central area and/or or increased in a peripheral area.
A central area may be described by a diameter that is a percentage of the total diameter of the lens, where the percentage has a value in the range of, e.g., 2 to 5, 5 to 10, 10 to 25, and/or 25 to 50 percent. For example, if the percentage is 10 percent, the central area is described by a diameter that is 10 percent of the total diameter of the lens. A peripheral area may be an annular region, where the outer ring may be described by a diameter r1 that is a percentage of the total diameter of the lens, and the inner ring may be described by a diameter d2 that is also a percentage of the total diameter of the lens, but d2<d1. The percentages may have a value in the range of, e.g., 60 to 70, 70 to 80, 80 to 90, and/or 90 to 99 percent.
For astigmatism correction, focus spots 102 may be formed in a band across the lens. The band may be of any suitable size and shape to compensate for refractive errors of the eye, which may be determined by, e.g., an aberrometer or corneal topographer.
In other embodiments, a scan pattern may be used to perform a surgical procedure on an eye. For example, in cataract surgery, a scan pattern directs focus spots 102 to form incisions in the cornea and/or capsule to access the lens of the eye. A scan pattern may also direct focus spots 102 to open the lens capsule with a circular incision and emulsify the cataractous lens. As another example, in refractive surgery, a scan pattern directs focus spots 102 to form incisions (e.g., a flap, a lenticule, or other incision) or other pattern in the cornea to change the refractive properties of the cornea.
In the illustrated example, beam conditioning optics 172 conditions beam 101, such as expand and/or collimate beam 101. Beam conditioning optics 172 may include, e.g., an expander and/or collimator. Multi-focal optics 107 multiplexes beam 101 to yield a plurality of focus spots 102 in a target along propagation axis 109 of the beam 101. Directing optics 176 directs beam 101 towards focusing objective 178, which focuses beam 101 to focus spots 102. In the illustrated example, directing optics 176 may be a mirror that reflects beam 101 towards focusing objective 178. Note that even though directing optics 176 changes the direction of beam 101, the focus spots are still located along propagation axis 109 of the beam 101. In other examples, directing optics 176 may transmit or refract beam 101 or may be omitted.
In certain targets 103, e.g., where target 103 is a part of an eye, the plasma bubble formed by focus spot F1 may obscure the beam energy that is directed towards focus spot F2, yielding energy loss at focus spot F2. In some targets 103, e.g., where target 103 is a light adjustable lens, no plasma bubble is formed by focus spot F1, so this type of energy loss is not a concern.
Although the parameters of the illustrated example may have any suitable values, specific values have been assigned to more easily describe the relationship. In the example, the portion of beam that forms focus spot F2 forms a cone with a cone angle A of any suitable value, e.g., 0.1 to 0.2 radian, such as 0.15 radian. Separation S between focus spots F1 and F2 may have any suitable value, e.g., the z-separation may be larger than the depth of focus of the laser beam, such as 5 to 50, 50 to 100, 100 to 300, 300 to 500, and/or greater than 500 micrometers (μm), such as 200 μm. The diameter dp1 of plasma bubble formed by focus spot F1 may be any suitable value, e.g., 2 to 5 μm, such as 3 μm.
In the illustrated example, focus spot F1 is closer to delivery optics 130 than focus spot F2 is to delivery optics 130, i.e., focus spot F1 is shallower than focus spot F2 or focus spot F2 deeper than focus spot F1. In certain situations, the plasma bubble formed by focus spot F1 may obscure the beam energy directed towards focus spot F2, yielding energy loss at focus spot F2. In the situations, the separation S between focal spots F 1 and F2 may be selected to make negligible the energy loss caused by the obscuration effect of focus spot F1 on focus spot F2. Generally, increasing the separation S between focal spots F1 and F2 and/or increasing the cone angle A of the beam that forms focus spot F2 reduces the energy loss caused by the obscuration effect of focus spot F1 on focus spot F2.
The diameter db2 of the cone that forms focus spot F2, measured at the plane 111 orthogonal to propagation axis 109 where focus spot F1 intersects propagation axis 109, can be calculated from angle A and separation S:
d
b2=2×angle A×separation S=2×0.15×200 μm=60 μm
The amount of obscuration may be measured by an obscuration ratio R:
R=(dp1/db2)2=(3 μm/60 μm)2=1/400=0.0025=0.25%
The energy loss EL may be calculated from obscuration ratio R:
EL=R=0.25%
In certain embodiments such as in cataract or refractive surgery, a 0.25% energy loss may be regarded as acceptable. A maximum acceptable energy loss P may depend on the type of surgery.
The method starts at step 310, where system 100 determines a scan pattern. The scan pattern may be used to adjust a light adjustable lens or perform a surgical procedure in ophthalmic tissue (e.g., lens or cornea). In certain embodiments, laser controller 106 determines a scan pattern with a cone angle A and separation S between focus spots that satisfies a maximum acceptable energy loss P, as described with reference to
Laser source 110 generates laser beam 101 at step 312. Beam conditioning optics 172 conditions beam 101 at step 314. Multi-focal options 107 multiplexes beam 101 at step 316 to yield focus spots along propagation axis 109 of beam 101. Scanners 120 scan beam 101 according to the scan pattern at step 318. Delivery optics 130 focuses beam 101 at step 320 to form focus spots 102 in target 103. The method then ends.
A component (such as laser controller 160) of the systems and apparatuses disclosed herein may include an interface, logic, and/or memory, any of which may include computer hardware and/or software. An interface can receive input to the component and/or send output from the component, and is typically used to exchange information between, e.g., software, hardware, peripheral devices, users, and combinations of these. A user interface (e.g., a Graphical User Interface (GUI)) is a type of interface that a user can utilize to interact with a computer. Examples of user interfaces include a display, touchscreen, keyboard, mouse, gesture sensor, microphone, and speakers.
Logic can perform operations of the component. Logic may include one or more electronic devices that process data, e.g., execute instructions to generate output from input. Examples of such an electronic device include a computer, processor, microprocessor (e.g., a Central Processing Unit (CPU)), and computer chip. Logic may include computer software that encodes instructions capable of being executed by the electronic device to perform operations. Examples of computer software include a computer program, application, and operating system.
A memory can store information and may comprise tangible, computer-readable, and/or computer-executable storage medium. Examples of memory include computer memory (e.g., Random Access Memory (RAM) or Read Only Memory (ROM)), mass storage media (e.g., a hard disk), removable storage media (e.g., a Compact Disk (CD) or Digital Video or Versatile Disk (DVD)), database, network storage (e.g., a server), and/or other computer-readable media. Particular embodiments may be directed to memory encoded with computer software.
Although this disclosure has been described in terms of certain embodiments, modifications (such as changes, substitutions, additions, omissions, and/or other modifications) of the embodiments will be apparent to those skilled in the art. Accordingly, modifications may be made to the embodiments without departing from the scope of the invention. For example, modifications may be made to the systems and apparatuses disclosed herein. The components of the systems and apparatuses may be integrated or separated, or the operations of the systems and apparatuses may be performed by more, fewer, or other components, as apparent to those skilled in the art. As another example, modifications may be made to the methods disclosed herein. The methods may include more, fewer, or other steps, and the steps may be performed in any suitable order, as apparent to those skilled in the art.
To aid the Patent Office and readers in interpreting the claims, Applicants note that they do not intend any of the claims or claim elements to invoke 35 U.S.C. § 112(f), unless the words “means for” or “step for” are explicitly used in the particular claim. Use of any other term (e.g., “mechanism,” “module,” “device,” “unit,” “component,” “element,” “member,” “apparatus,” “machine,” “system,” “processor,” or “controller”) within a claim is understood by the applicants to refer to structures known to those skilled in the relevant art and is not intended to invoke 35 U.S.C. § 112(f).
Number | Date | Country | |
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63039769 | Jun 2020 | US |