The present invention relates to a photoablative laser and relative control method.
As is known, photoablative lasers are commonly used in refractive surgery to reconstruct the cornea to correct visual defects, by removing successive layers of the cornea, varying in area, according to a predetermined ablation profile. Normally, the small-area layers are treated first, and then the larger-area layers. A photoablative laser sends pulse sequences of predetermined frequency and energy onto the cornea to locally evaporate microscopic volumes of cornea tissue. To avoid uneven ablation thickness caused by interaction between the laser spots striking the cornea and the cornea tissue evaporation fumes produced by the immediately preceding laser spots, and to prevent damage caused by overheating, the pulses are emitted to cover the layer for removal in a random as opposed to orderly sequence.
The commonly used method, however, is unsatisfactory, by only being effective as regards the large-area layers. When removing small-area layers of cornea tissue, the problems of uneven ablation thickness and overheating still remain, on account of energy accumulation still being considerable.
It is an object of the present invention to eliminate the aforementioned drawbacks.
According to the present invention, there are provided a photoablative laser and a method of controlling a photoablative laser, as claimed in the attached Claims.
A number of non-limiting embodiments of the invention will be described by way of example with reference to the accompanying drawings, in which:
With reference to
Laser pulse emission apparatus 2 comprises a laser pulse generator 7 controlled by a drive unit 8; an optical system 9; a direction device 10; and an internal target 11.
Laser pulse generator 7 is a known, e.g. excimer or solid-state type, and supplies sequences of laser pulses P of predetermined energy with a generation frequency RG, preferably of over 100 Hz.
Optical system 9, which is also known, is located along the path of laser pulses P, and may, for example, comprise collimators, lens systems, filters (not shown).
Direction device 10 intercepts laser pulses P and directs them as instructed by control device 4. As shown schematically in
More specifically, control device 4 is connected to memory device 5, and generates direction signals SX, SY on the basis of the ablation profile stored in the memory device.
The ablation profile is defined by sets of coordinates relative to a portion of cornea tissue 3a—hereinafter referred to as the target volume VTAR—which must be removed to correct a refractive defect of eye 3. With reference to
Under the control of control device 5, emission apparatus 2 releases laser pulses P to target volume VTAR with a mean release frequency RDK. Here and hereinafter, the term “mean release frequency RDK” refers solely to the mean frequency of the laser pulses P produced by laser pulse generator 7 and directed by direction device 10 to target volume VTAR to remove a generic layer LK in the time interval between commencing ablation of generic layer LK and commencing removal of the next layer L1, L2, . . . , LN. It is also understood that the duration of the step of removing generic layer LK equals the duration of said time interval, and includes steps in which target volume VTAR is reached by laser pulses P, and steps in which target volume VTAR is not reached by laser pulses P. Mean release frequency RDK is therefore less than or at most equal to generation frequency RG.
Control device 4 controls direction device 10 in such a way as to direct laser pulses P alternately to target volume VTAR and off target volume VTAR (preferably to internal target 11), and to control mean release frequency RDK. In fact, the greater the number of laser pulses diverted off target volume VTAR, the lower the mean release frequency RDK.
More specifically, mean release frequency RDK is controlled as a function of areas A1, A2, . . . , AN of layers L1, L2, . . . , LN, so that, when removing each layer L1, L2, . . . , LN, target volume VTAR receives a number of laser pulses P, per unit of time and per unit of area, below a predetermined threshold NT. In the embodiment of the invention described here, mean release frequency RDK is set according to the equation:
RDK=RG*TDK/TREF=RG*AK/AREF (1)
In (1), TREF is the time taken to ablate a reference specimen layer of area AREF greater than areas A1, A2, . . . , AN of layers L1, L2, . . . , LN at generation frequency RG, to achieve a predetermined number NR, below threshold NT, of incident laser pulses P per unit of time and of cornea tissue area.
NR≦NT (2)
TDK is the time taken to send the laser pulses P necessary to remove generic layer LK of area AK, and is given by the equation:
TDK=TREF*AK/AREF (3)
In the embodiment described here, the number of laser pulses P striking target volume VTAR per unit of time and per unit of area when removing each of layers L1, L2, . . . , LN equals number NR, is substantially constant, and is below predetermined threshold NT.
Alternatively, number NR may also vary, always below threshold NT, as a function of area A1, A2, . . . , AN of layers L1, L2, . . . , LN. For example, number NR may be slightly higher to remove layers L1, L2, . . . , LN of smaller area A1, A2, . . . , AN.
The frequency—indicated ROK—with which direction device 10 diverts laser pulses P to internal target 11, on the other hand, is given by the equation:
ROK=RG−RDK (4)
For each layer LK, the total time TOK the mirrors divert the laser spots onto internal target 11 equals
TOK=TREF−TDK (5)
When removing each layer L1, L2, . . . , LN, total time TOK may be an uninterrupted interval or an interval divided into a number of separate intervals.
In other words, control device 4 operates in such a way as to adapt mean release frequency RDK to the respective areas A1, A2, . . . , AN of layers L1, L2, . . . , LN as they are removed.
The photoablative laser according to the invention has the advantage of preventing uneven ablation thickness caused by interaction between the laser pulses striking the cornea and the cornea tissue evaporation fumes produced by the immediately preceding laser pulses, and of preventing overheating of the cornea tissue during treatment and any possible damage this may cause. Obviously, maximum uniformity of ablation thickness is achieved using the same number of pulses per unit of time and area for all the layers.
Control device 104 is connected to the drive unit 8 of laser pulse generator 7, which emits laser pulses P at a variable generation frequency RG. In other words, control device 104 acts on drive unit 8 to directly control generation frequency RG, and to maintain the number NR of laser pulses P sent to target volume VTAR per unit of time and per unit of area below predetermined threshold NT. Number NR is preferably constant for all of layers L1, L2, . . . , LN. In this case, mean release frequency RDK equals generation frequency RG. The generation frequency RG values for each layer L1, L2, . . . , LN are set in each individual case as described above, in particular with reference to equations (1)-(5).
In the
Clearly, changes may be made to the method as described herein without, however, departing from the scope of the present invention as defined in the accompanying claims.
Number | Date | Country | Kind |
---|---|---|---|
MI2004A 002020 | Oct 2004 | IT | national |