An embodiment of the invention relates to a process and to an apparatus for determining optical aberrations of an eye, including the optically active constituents of the eye.
It is known to determine wavefront aberrations of an eye according to deviations of a wavefront resulting from an optical system of the eye with respect to a planar wavefront generated using an aberration-free eye model. The wavefront resulting from an optical system may be determined using a Tscherning aberrometer, a Hartman-Shack aberrometer or a digital wavefront sensor.
A Tscherning aberrometer is an apparatus, known as such, for measuring the aberrations of an eye. According to the principle of Tscherning aberrometry, a plurality of component beams are generated from parallel light. The generated component beams exhibit a predetermined two-dimensional arrangement in a plane arranged perpendicular to an optical axis. This arrangement of the component beams is projected through the optical system of the eye, and a first pattern of dots with first projections of the component beams is thereby generated on the retina of the eye as retinal points of light. The first pattern of dots generated on the retina is projected in the reverse direction through the optical system of the eye into a second plane arranged outside the eye, and a second pattern of dots with second projections (second points of light) of the first projections of the component beams generated on the retina is generated by this projection. The second pattern of dots is recorded as an image. Offsets between each second point of light and a projection generated with an aberration-free eye model of the same component beam of the regular two-dimensional arrangement are measured in the image plane. From the plurality of the measured offsets, deviations of a real wavefront generated by the optical system of the eye from the ideal planar wavefront of an ideal, imaging-error-free (aberration-free) eye are reconstructed. From the reconstructed wavefront aberrations of the real eye, the imaging errors of the eye, inclusive of the higher-order imaging errors, can be determined. Regarded as higher-order imaging errors are, for example, coma, trefoil, spherical aberration, quadrafoil, etc. An ocular aberrometer (e.g., Tscherning aberrometer) and a process for utilising the aberrometer, as well as a process for evaluating the second pattern for evaluating the offsets measured in the second pattern of the points of light stemming from the component beams are known in the current art.
The wavefronts of the eye, determined e.g. with the Tscherning aberrometer, that include imaging errors may serve as a basis—together with measurements of the eye, such as the corneal thickness, the anterior-chamber thickness, the lens thickness and the ocular length as well as the topographies of the anterior corneal surface and of the posterior corneal surface, obtained, for example, from OCT (optical coherence tomography) measurements or Scheimpflug recordings—in order to create an eye-specific eye model. From an individual eye model created in this way e.g. an ablation profile for a laser-surgical refraction correction of the anterior corneal surface of the eye and/or a design, and/or a front lens face, for an intraocular lens to be inserted surgically into the eye for the purpose of correcting imaging errors of the optical system of the eye can then be computed.
Processes known hitherto for computing the individual wavefronts of an eye that, due to the imaging errors of the optical system of the eye, differ in their shape from an ideal planar wavefront are based on model assumptions for the biometric data of the eye, e.g., the ocular length. This applies to aberrometers that operate according to the Tscherning principle and also to instruments that utilise a Hartmann-Shack sensor or a digital wavefront sensor.
In known instruments the Gullstrand eye model, for example, with its ocular length of 22.36 mm, serves as a basis. The present embodiment of the invention is derived from the finding, based on computational simulations and clinical experience from applications of the aberrometer and other devices for surveying the optical system of an eye show: the more the actual ocular length differs from the model assumption for the ocular length, the greater the error in the defective vision of the eye computed from wavefront measurements. This is illustrated in the following table. Therein, for five ocular lengths differing from the model assumption (22.36 mm) for the ocular length, the differences of the wavefront, expressed in spherical and cylindrical aberrations of the defective vision, have been computed and compiled:
An object of certain embodiments is to make available certain processes and an apparatuses for determining wavefront aberrations of an eye that enable a more accurate computation or characterisation of the defective vision, inclusive of the higher-order aberrations. The embodiments permit an optimised individual eye model as well as an optimised ablation profile for a laser-surgical refraction correction of the cornea and/or an intraocular lens to be computed with regard to shape and material.
According to certain embodiments, the object is achieved by a process for determining optical aberrations of an eye in accordance with claim 1.
In accordance with an embodiment of the invention, the process comprises reconstructing wavefront aberrations of the eye as a deviation of the wavefront, determined by the optical system of the eye with a process of aberrometry, with respect to an ideal planar wavefront generated by an aberration-free improved eye model. Furthermore, in the eye model the actual ocular length is used as the model ocular length.
The actual ocular length can be determined for this purpose from a biometric measurement of the ocular length carried out in respect of the eye. Measurements of the actual ocular length on the optical axis (i.e. visual axis) of the eye can be carried out with instruments according to the latest known art. The WaveLight OB 820 instrument may be mentioned as an example of these instruments.
The use of the actually measured ocular length in the eye model makes it possible that wavefront aberrations and the imaging errors of the optical system of the eye, derived from the results of the aberrometric measurements, may be computed with higher accuracy and may improve treatment outcomes of wavefront-guided refractive corneal surgery. Furthermore, the computed wavefront aberrations and the imaging errors may improve intraocular lenses inserted into an eye to correct the imaging errors.
In accordance with the inventive determination of the optical aberration of an eye, the anterior surface of the cornea or an intraocular lens (IOL) can be modified to correct presbyopia.
An embodiment of the invention is also applied in order to correct presbyopia by specific induction of aberrations up to the 4th Zernike-order (cylinder, coma, trefoil, quadrafoil and spherical aberrations) in order to achieve better close vision.
The process may comprise the following steps:
The eye model may represent the eye for the purpose of characterising the imaging properties of the eye within the scope of predetermined tolerance limits with regard to predetermined quality parameters.
These techniques for constructing the improved, aberration-free eye model, for measuring the offset, and for reconstructing the wavefront aberrations of the optical system of the eye can be used. In certain cases, the wavefront aberrations can be computed more accurately by replacing the model assumptions for the ocular length by the actually measured value of the ocular length.
The two-dimensional arrangement of the component beams may be matrix-shaped in a first plane arranged substantially perpendicular to an optical axis of the eye.
If the optical axis of the eye is called the first optical axis the second plane may be arranged substantially perpendicular to a second optical axis that is angled with respect to the first optical axis of the eye. The projection of the first pattern into the second plane can be performed by means of instruments for indirect ophthalmoscopy.
The offset of the second projections of the component beams in the second plane is, for example, measured along two coordinate axes (x, y) which are mutually perpendicular in the second plane. In this case an offset in the x-direction and an offset in the y-direction can be measured.
The improved, aberration-free eye model with the actual ocular length can, for example, be constructed using the Gullstrand eye model or the Liou-Brennan eye model. These two eye models mentioned above have proved their worth in examinations, undertaken by the applicant, of wavefront aberrations on the basis of model assumptions for the ocular length. Surprisingly, it has been found that introducing the actual ocular length in place of the model ocular lengths used hitherto in these models makes possible the improvements—far exceeding expectations—in the accuracy of the computed wavefront aberrations and of the imaging errors derived therefrom (aberrations of lower and higher order) of an individual eye. The use of the actual ocular length also yields improved results for eye models other than those named above.
The actual ocular length can be determined from a direct measurement of the ocular length of the eye of the patient. In this case the WaveLight OB 820 instrument already mentioned above may be employed, for example.
The measurement of ocular length can be performed at any suitable point, such as immediately before one of steps (a) to (e). The measurement of ocular length can also be performed using at least a part of the parallel bundle of light rays used in step (a).
In the case of the projection of the arrangement of the component beams through the optical system of the eye, in accordance with step (b) of the process a focal point of the projection may be situated a predetermined distance upstream of the retina of the eye.
In step (g) in the course of the improved reconstructing of the wavefront aberrations the wavefront generated by the optical system of the eye can be represented as a sum of Zernike polynomials normalised to a unit circle and weighted with corresponding Zernike polynomial coefficients. In this case the reconstructing of the wavefront generated by the optical system of the eye may include the determination of the Zernike polynomial coefficients of the Zernike polynomials used for the purpose of representing the wavefront. In the stated sum of the Zernike polynomials the Zernike polynomials can be taken into account as far as the 6th order, and as far as the 8th order. From the determined Zernike polynomial coefficients a spherical refraction of the eye, a cylindrical refraction of the eye and an angle of an astigmatism of the eye can be computed from the Zernike polynomial coefficients for the third, fourth and fifth Zernike polynomial (i.e. from the Zernike polynomials of 2nd order) and also from the radius of the pupil of the eye.
On the basis of the reconstructed wavefront aberrations improved in step (g), an improved patient-specific eye model can be created. The improved patient-specific eye model can furthermore be created on the basis of the following:
In this case, the data stated under point (1) can be determined on the optical axis (e.g. visual axis) of the eye.
The measurements stated under point (2) and carried out in respect of the eye may be interferometric measurements, such as measurements using OCT (optical coherence tomography). The topographies of the anterior corneal surface and of the posterior corneal surface can be acquired, for example, with Scheimpflug measurements. OCT measurements can also be employed for this.
The patient-specific eye model may be used to generate an optimised ablation profile for a laser-surgical refraction correction of the pre-operative anterior corneal surface of the eye or a design, such as a front lens face design, for an intraocular lens to be surgically inserted into the eye for the purpose of correcting imaging errors of the optical system of the pre-operative eye.
According to a second aspect of an embodiment of the invention, an apparatus is made available for determining optical aberrations of a human eye, with its optical system including the cornea and the lens. The apparatus comprises:
In accordance with an embodiment of the invention, the apparatus includes an arithmetic unit, for example a computer, with:
Furthermore, in accordance with an embodiment of the invention, the means for constructing the improved eye model are designed to use an actual ocular length by way of value for the model ocular length. The apparatus according to the second aspect of one embodiment of the invention achieves the same advantages as the process, described above, according to the first aspect.
The improved eye model may represent the eye for the purpose of characterising the imaging properties of the eye within the scope of predetermined tolerance limits with regard to predetermined quality parameters.
In one example, a Tscherning aberrometer may include, for example, the following:
The arithmetic unit may include means for measuring, for each second projection of a component beam recorded with the ophthalmoscopic device, an offset of the second projection in the second plane with respect to a projection, generated with the improved eye model, of the same component beam of the two-dimensional arrangement. For said measurement, a measuring device can be used or any other subject matter performing the defined function.
In the aberrometer the two-dimensional arrangement of the component beams in a first plane arranged substantially perpendicular to a first optical axis (e.g. visual axis) of the eye may be regular, and/or two-dimensionally regular, for example matrix-shaped.
The ophthalmoscopic device may exhibit a second optical axis, angled with respect to the first optical axis, and the second plane may be arranged substantially perpendicular to the second optical axis.
The offset of the second projections can be measured along two mutually perpendicular coordinate axes (x, y) arranged in the second plane, so that consequently for each second projection of a component beam an offset in the x-direction and an offset in the y-direction can be measured.
The ophthalmoscopic device may further include the following:
The recording device may be a CCD camera, which may be equipped with a highly light-sensitive CCD.
The ophthalmoscopic device may further include a diaphragm for defining an optical channel that is axially close with respect to the second optical axis. The diaphragm may be arranged between the ophthalmoscope lens and the recording device.
The light-source may exhibit a laser for generating a laser beam and optics for expanding the laser beam and for generating the bundle of light rays. The laser may be an IR laser or, for example, a laser emitting in the visible (red) region. For the stated optics, a Keplerian telescope device, for example, may be configured.
The apparatus may further an eye-aligning device which exhibits a third optical axis, angled with respect to the first optical axis, and which includes the following:
The second partially transmitting mirror may be arranged between the light-source and the aberroscope lens.
The eye-aligning device may be designed to operate in the infrared region of the light spectrum. For this purpose the second partially transmitting mirror can deflect light emerging from the eye in the infrared region. The second recording device may for this purpose be a CCD camera with an infrared-sensitive CCD sensor. Furthermore, an infrared band-pass filter may be arranged on the third optical axis between the second partially transmitting mirror and the second ophthalmoscope lens.
The two-dimensional arrangement of the component beams can be generated by an aperture mask, arranged in the bundle of light rays, with a plurality of holes or light-transmission apertures provided therein. An arrangement of the holes is may be a two-dimensionally regular arrangement, for example a regular arrangement with a two-dimensionally rectangular or square structure which is formed in each instance by adjacent holes. Such a regular arrangement of the component beams makes it possible that, in the first and second patterns of dots projected through the optical system of the eye, deviations of the pattern of dots or of the position of individual second projections from the regular arrangement are already readily perceptible visually and an experienced ophthalmologist can make an estimation, already based on the visual impression, of the type of defective vision of the eye.
Further possibilities for configuring the process or the apparatus according to embodiments of the invention result from the following detailed description of embodiments. These will be described with reference to the appended drawings, in which:
The first pattern of dots 116 projected onto the retina 40 can be perceived subjectively by the patient. The patient could write down the shape of the perceived pattern of points of light subjectively and at least qualitatively. As regards the arrangement of the points of light, the perceived pattern of points of light differs in its shape from the regular shape of the regular two-dimensional arrangement of the component beams 22-1, . . . , 22-5 beamed in from the left in
The two upper component beams 22-1 and 22-2 (dotted lines) shown in
According to
In an eye with ideal optical properties, i.e. without any optical aberrations, this subjectively discernible pattern of dots would exhibit the same two-dimensional regularity as the component beams 22-1, . . . , 22-5 coming from the left in
In order to quantitatively measure the distortion of the first pattern of dots of light 116 generated on the retina 40, the positions of the individual first projections 117, generated on the retina 40, of the individual component beams 22-i (i=1, . . . , 5) (the so-called retinal points of light) are recorded and their offset with respect to an aberration-free projection is determined. For this purpose, the first pattern of dots 116 generated on the retina 40 is projected by an ophthalmoscopic device 50 including the first partially transmitting mirror 56 and the first ophthalmoscope lens 58 into the second plane 54 arranged of the eye 12. The second plane 54 is, for example, the image plane of a sensor of an image-recording device 60, such as, a video camera. So in the second plane 54 a second pattern of dots 118 is generated with the second projections 119, generated by the ophthalmoscope lens 58 (see
The distortion of the second pattern of dots 118 with respect to the originally regular two-dimensional arrangement 26 of the component beams 22-1, . . . , 22-5 (see
The embodiment shown in
The light-source 14 includes a laser 70 which generates a laser beam 74, a controllable shutter device 73 for switching on and off or modulating the laser beam 74, a collimator device 76 for expanding the laser beam 74 and for generating an expanded bundle of light rays 16 consisting of parallel light. The laser 70 is a laser diode emitting in the red light region (approx. 660 nm) with a beam diameter of about 2 mm and with a power output of about 10 mW. The laser beam 74 is controlled by the electromechanical shutter device 73, so that an opening-time within the range from about 10 ms to 100 ms, or about 60 ms, is generated. By way of collimator device 76, use is made of an arrangement based on the principle of a Keplerian telescope 78, which widens the laser beam to a diameter of about 25 mm and exhibits a spatial filter (not shown) with a diameter of 15 μm. A mask (aperture mask) 19 serves as device 18 for generating the component beams 22. The aperture mask 19 exhibits a plurality of transmission apertures which are distributed in the aperture mask 19 in a regular, two-dimensional arrangement. Thus in a first plane defined by the device 18 (aperture mask 19), which is arranged substantially perpendicular to the first optical axis 20 (i.e. visual axis) of the eye, a matrix-shaped pattern of dots, as shown in the left-hand region of
In certain embodiments, the aberroscope lens 28 is interchangeable, and various aberroscope lenses 28 with varying refractive powers are made available. In practice it may be useful to displace the aberroscope lens. Interchangeable aberroscope lenses having varying refractive powers may also be employed, depending on the mean spherical refractive power of the eye. From the specification that the intraocular focal point 36 is to be situated a predetermined distance 38 upstream of the retina, it follows that the refractive power of the aberroscope lens 28 depends on the mean spherical refractive power of the optical system 30 (cornea and lens) of the eye 12. For the case of an emmetropic eye, the refractive power of the lens 28 is chosen within a range from about +4D to +5D. For a hyperopic eye with a refractive power of more than +2D, an aberroscope lens 28 with a refractive power of more than +5D is employed. The purpose of the aberroscope lens 28 consists in causing the first pattern of dots 116 generated on the retina 40 to be formed always in the same size in such a manner that the individual points of light 117 are separated from one another and easily identifiable. The retinal first pattern of dots 116 has a dimension of about 1 mm2.
The eye 12 with its visual axis is correctly positioned on the first optical axis 20 of the bundle of component beams 22-1, . . . , 22-5 generated by the light-source 14 by means of an eye-aligning device 80 operating in the near infrared. The eye-aligning device 80 includes two diodes emitting in the near infrared (LEDs, not shown, emission wavelength: approx. 880 nm), which are aligned vertically with respect to the eye. The eye 12 is observed by a device likewise operating in the infrared region. Said device includes a second partially transmitting mirror 86 partially reflecting in the infrared region, a second recording device 90 operating in the infrared region, with a CCD video camera 92 with a CCD sensor (not shown) that is sensitive in the infrared region. The second partially transmitting mirror 86 is arranged substantially diagonally with respect to the first optical axis 20, with an angle of approximately 45° between the component-beam-generating device 18 and the aberroscope lens 28. The CCD sensor is arranged in a third plane 84 which is arranged substantially perpendicular to the third optical axis 82 deflected by the second partially transmitting mirror 86. For IR light the mirror 86 deflects the first optical axis 20 (e.g. visual axis) of the eye 12 into a second ophthalmoscope lens 88 arranged on a third optical axis 82, which takes the form of an infrared (IR) lens 89 (i.e. a lens transmitting in the infrared region), and into an infrared band-pass filter 94 adapted to the emission frequency of the infrared light-sources. For the purpose of blocking light in the visible spectral region, filter 94 is arranged on the third optical axis 82 between the second partially transmitting mirror 86 and the second ophthalmoscope lens 88 (i.e. infrared lens 89).
By means of the eye-aligning device 80 the eye is observed via the mirror 86 through the aberroscope lens 28 and the initial aperture of the aberroscope. The second partially transmitting mirror 86, the lens 88 and the second recording device 90 are adjusted, fixed with respect to the first optical axis 20 of the bundle of light rays 16 generated by the collimator device 76, in such a way that the third optical axis 82 coincides with the first optical axis 20 transmitted by the mirror 86. The correctly adjusted position of the eye 12 is then found and is fixed if the narrow bundle of light rays of the slit lamp and the initial aperture of the aberroscope on a monitor to which the infrared image recorded by the second recording device 90 is supplied are centred on the pupil of the eye 12 displayed on the monitor. The head of the patient is fixed for the correctly adjusted position of the eye 12 on a known art chin-rest (not shown) and by means of a known art forehead-stop (likewise not shown).
The first pattern of dots 116 generated by the bundle of the component beams 22 on the retina 40 of the eye 12 is recorded by means of a first ophthalmoscopic device 50. The ophthalmoscopic device 50 includes a first partially transmitting mirror 56 which is arranged on the first optical axis 20 substantially diagonally, i.e. with an angle of approximately 45°, between the aberroscope lens 28 and the initial aperture 27 of the aberroscope, a first ophthalmoscope lens 58, a diaphragm 64, and by way of first recording device 60 a CCD camera 62 with a CCD sensor, the image plane of which, the second plane 54, in which the second pattern of dots 118 generated by way of image of the first pattern of dots 116 generated on the retina by the projection through the optical system 30 of the eye 12 and the ophthalmoscope lens 58 is projected. In certain embodiments, the beam path (the second optical axis 52) is deflected by a deflecting mirror 69. The positions of the first recording device 60 (the CCD camera 62), the ophthalmoscope lens 58 and the deflecting mirror 69 are fixed relative to one another, to define the fixing a second optical axis 52 of the ophthalmoscopic device 50. The position or orientation of the ophthalmoscopic device 50 or the second optical axis 52 with respect to the first partially transmitting mirror 56 is adjusted in such a way that the first optical axis 20 deflected by the mirror 56 coincides with the second optical axis 52 of the ophthalmoscopic device 50.
The ophthalmoscopic device 50 includes a diaphragm 64 arranged immediately upstream of the camera lens 68, the opening of which defines an optical channel 66. The optical channel 66 may have a narrow diameter and may be defined axially closely along the first optical axis 20 (e.g. visual axis) of the eye 12. Channel 66 defines the second optical axis 52 of the ophthalmoscopic device 50 deflected by the mirror 56 in axially close manner. The narrow diameter of the optical channel 66 pierces only a correspondingly small, axially close region of the optical system 30 of the eye 12, so that the ophthalmoscopic projection may be regarded as virtually free from imaging errors.
The ophthalmoscope lens 58 projects the retinal, first pattern of dots 116 together with the camera lens 68 (focal length, e.g., 30 mm) through the narrowly limited optical channel 66 onto the CCD sensor array (in the example with a dimension of 12.8 mm×9.6 mm) of the CCD video camera 62 (e.g., type LH 750LL, Lheritier S. A., Cergy Pontoise, France, or Watec WAT-902H2). The position of the camera is adjustable to inspect various partial regions of the retinal intermediate image (of the first pattern of dots 116), depending on the refractive power of the eye 12. For the purpose of recording the second pattern of dots 118 no optical correction of the optical system 30 of the eye is undertaken.
The image of the second pattern of dots 118 recorded by the first recording device 60 is transmitted to the computer 98, made visible for the treating surgeon on the monitor (not shown) of the computer 98, and stored in the computer 98.
Installed in the computer 98 is image-processing software which serves to determine the coordinates of the geometrical midpoints of all the second projections 119 (points of light) of the second pattern of dots 118 which have arisen out of the ophthalmoscopic projection of the first projections 117 (retinal points of light) of the first pattern of dots 116. The coordinates of the “ideal” points of light 132 which would be generated in the second plane 54 under aberration-free conditions are, as already mentioned, computed on the basis of an aberration-free eye model 130. In accordance with certain embodiments, the actual, for example biometrically measured, ocular length of the eye 12 is used in place of the model ocular length assumed in the eye model. The arrangement of the ideal points of light 132 is the same as the regular two-dimensional arrangement 26 generated by the component-beam-generating device 18 (aperture mask 19) and is magnified merely by a scale of reproduction with respect to the arrangement 26.
The actual ocular length (OL) 198 (see
By way of eye model, the Gullstrand eye model 140 represented schematically in
In the Gullstrand eye model a human eye is approximated by an arrangement shown schematically in
In accordance with certain embodiments, for the model ocular length 149 (OL149) defined from the apex of the front face (e.g. the first surface 142) of the front lens 141 to the model retina 148 a value is now taken that corresponds to the actual ocular length (OL) 198 measured in the eye to be examined aberrometrically. Accordingly, deviating from the value specified in the table shown in
In the Liou-Brennan eye model 150, on the other hand, the optical system of the eye is modelled, in a manner corresponding to reality, by a front concave-convex front lens 151 with a front face (i.e. first surface 152) and with a back face (i.e. second surface 154) which together model a cornea, and by a biconcave rear lens 155, arranged downstream of the front lens 151, with a front face (i.e. third surface 156), with a planar principal plane (i.e. fourth surface 158) and with a back face (i.e. fifth surface 160), and with a model retina 162 in spherical form, as shown in
In accordance with certain embodiments, the spacing between the back lens face 160 (fifth surface) and the retina is chosen in such a way that the model ocular length 164 (OL164), measured from the apex of the first surface 152 to the model retina 162 along the optical axis, corresponds to the actual ocular length of the eye 12 to be examined aberroscopically.
In the following, the process according to certain embodiments for computing the wavefront aberrations 100 of the optical system of the eye is described with reference to
If the optical system 30 of the eye were free from imaging errors (aberrations), component beam 22-1 would be refracted on the optical system 30 at a different (in the example of
The offset in the second plane 54 arranged outside the eye 12, i.e. in the image plane of the recording device 60 (CCD camera 62), is measured, as elucidated above with regard to
The wavefront aberration of the eye can be determined from the change in the angle α of each component beam 22-1, . . . , 22-5 upon passing through the optical system 30 of the eye. As already mentioned, by virtue of the aberroscopic projection a first pattern of dots 116 is generated on the retina 40, which in the aberration-free case would appear undistorted (i.e. without offset) with respect to the regular two-dimensional arrangement 26, generated by the component-beam-generating device 18, of the component beams on the retina 40. In the emmetropic case, from the component beams 22-1, . . . , 22-5 a sharp image point should arise on the retina by virtue of the aberroscopic projection through the optical system 30 of the eye. By virtue of the insertion of the aberroscope lens 28, however, for each component beam 22-1, . . . , 22-5 a defined spacing H40 of the projection (of the point of light) from the first optical axis 20 (i.e. visual axis) of the eye is generated on the retina. The spacing H40 can be computed from the following equation (1):
In equation (1)
Prior to the development of the instruments that have been developed for the purpose of measuring lengths and depths, inclusive of the ocular length, the ocular length OL was not measurable. Therefore in equation (1) it was estimated or assumed approximately by the eye-specific, spherical equivalent Dr measured previously:
Equation (2) holds only for the simplified Gullstrand model 140 of the eye. In equation (2)
The actual spacing, generated by the aberration-burdened projection through the optical system 30 of the eye, of the projection 117 of a component beam 22-1 on the retina 40 can be computed from the spacings H54, measured in the second plane 54, of the second projections 119 from the second optical axis 52, in accordance with:
In equation (3)
From equations (1) and (3) the coordinates are obtained of the point of intersection of a component beam in the optical system 30 of the eye (H30 predetermined by the aberroscope lens 28), the coordinates of the point of incidence of component beam 23-1 on the retina 40 in the aberration-free case (H040: spacing from the optical axis), and the coordinates of the actual point of incidence 117 of component beam 22-1 on the retina 40 (H40: spacing from the optical axis), as determined from the ophthalmoscopic projection into the second plane 54; in this regard see
From the data H030, H040 and H40 the angles of the component beams with respect to the first optical axis 20 in the plane of the optical system 30 (of the cornea 32) can be computed as follows or read off from
In equations (4) and (5)
By inserting equation (1), equation (5) is simplified as follows:
For a highly myopic eye also no aberration lens 28 may be employed. For this case, in the above equations (1) to (5) α28=0 holds, and the beam path shown in
The angle of the component beams, which arises solely by virtue of the presence of the aberrations of the optical system 30 of the eye, is obtained for the two cases of the emmetropic eye (
dW=tan(arctan(tan α30)−arctan(tan α23)) (7)
As can be seen by inserting equations (4) and (6) into the expression on the right-hand side in equation (7), the computation of dW uses the focal length of the aberroscope lens 28 (f28), the spacing of the aberroscope lens 28 from the anterior face of the eye (D29), the ocular length OL, the coordinates of the points of intersection (xk, yk) of the component beam through the optical system 30 of the eye, and the coordinates (H40), determined from the aberroscopic measurement, of the actual points of incidence 117 (points of light) of the component beams on the retina 40. The quantities for the computation of dW are either predetermined by the optical system of the aberroscope, i.e. the apparatus 10, or can be computed from the above equations (7), (6) and (4).
In the following, the representation of the wavefront aberrations according to the decomposition due to Zernike, i.e. the representation of the wavefront aberration 100 generated by the optical system 30 of the eye as a sum of Zernike polynomials normalised to a unit circle and weighted with corresponding Zernike polynomial coefficients, will be elucidated with reference to Tables 1 to 6.
As a result of the evaluation of the ophthalmoscopically projected, second pattern of dots 118 recorded by the recording device 60, i.e. from the measurement, effected for each component beam taken into account, of the offset 124 of component beam 22-1 which is projected in aberration-burdened manner with respect to component beam 23-1 which is projected without aberrations, a set of m coordinate pairs (xk, yk) is obtained with k=1, . . . , m for the points of incidence of the component beams 22-1, . . . , 22-m which are projected in aberration-burdened manner through the optical system of the eye. In this case the coordinates (xk, yk) of the points of incidence 119 are referred to the second optical axis 52, i.e. they are relative coordinates. From these coordinates the deviation of the reconstructed, real or actual wavefront 102 with respect to an ideal, i.e. planar, wavefront 104 can now be computed as wavefront aberrations 100 shown in
The wavefront aberration may be mathematically represented with respect to the coordinates (xk, yk) in the image plane (second plane 54), a suitable descriptive form is chosen. The Zernike polynomials for a sum representation of the wavefront aberrations may be used. According to this, the following formulation is made:
In equation (8)
The Zernike polynomials are defined by equations (19) and (20), specified further below, in polar coordinates (r, φ) and are computed algebraically and listed in polar coordinates in Table 1 (see the Appendix with Tables 1 to 6) in accordance with equations (19) and (20).
According to the definition of the Zernike polynomials, N assumes defined values as specified in the final column of Table 3. Also, only decompositions with complete polynomial orders n and, at the same time, also only the use of even orders, for example n=2, 4, 6, 8, . . . , are meaningful. Thus, for example, including in the decomposition, in addition to N=27 polynomials of the n=6th order, also a 28th or 29th polynomial affords no increase in knowledge.
However, as elucidated above with reference to
of the two-dimensional function W with respect to the coordinates x and y in the plane of projection (second plane 54):
This means that from the determination of the offsets of the points of incidence 117 in the Zernike decomposition for the total of m coordinate pairs (xk, yk) two equation systems result:
A standard equation method is unsuitable for the solution of this equation system. A numerical stability in the numerical solution of these equation systems is obtained by using a solution method such as singular value decomposition (SVD).
The solution of the equation systems is only calculable when at least as many measuring-points (xk, yk) or interpolation nodes as Zernike polynomials (in this case the unknowns) are present:
m≧N or better: m≧2N (12)
As already mentioned, in equation (12) m stands for the number of measuring-points, and N for the number of Zernike polynomials drawn upon in the sum decomposition.
Conversely, equation (12) means that the order of the Zernike polynomials that is capable of being taken into account depends on the number of points of light 117 that are capable of being evaluated in the image generated aberroscopically on the retina.
For example, given the apparatus 10 shown in
It is to be noted, furthermore, that the Zernike polynomials are only defined on a unit circle. So the coordinates of the measuring-points (xk, yk) have to be normalised prior to the computation:
In equation (13), R stands for the radius of the Zernike circle, i.e. the circle on which the computation is effected, and Xk or Yk stands for the coordinates normalised to the Zernike circle.
The radius R of the Zernike circle corresponds on the eye to the radius of the pupil, and it should firstly be capable of being chosen freely. The radius may be adjusted, especially for use with the laser, in accordance with the optical zone being aimed at for the aberrometric characterisation. All the points of light that lie outside the width of the pupil corresponding to the Zernike circle radius R do not typically enter into the computation. So for the purpose of solving the equation system only measuring-points are permitted to be drawn upon for which the following holds:
√{square root over (xk2+yk2)}≦R (14)
The resultant vector C introduced into equation (11), which includes the coefficients C1, . . . , Cn, also holds only for the Zernike circle (unit circle). In order now to determine the actual wavefront, the normalised wavefront aberration has to be linearly scaled with the radius of the pupil. Lastly, for the representation of the results it is still sensible to specify the Zernike coefficients Cn in micrometres. In the example elucidated above on the basis of equations (1) to (7), the Zernike coefficients are obtained in millimetres.
From the Zernike coefficients, the spherical and the cylindrical refractions of the eye being examined can be determined directly:
with: φ=90° if C5<0, otherwise: φ=180° if C3<0, otherwise φ=0° (18).
The conditions stated in equation (18) are dependent on the range of values of the arctangent in the compiler that is being used for the computer program that has been developed for solving the equation systems. For the compilers that are used in the present case it holds that: −90°≦arctan≦+90°.
For the purpose of completing the representation of the sum decomposition introduced above in equation (8) by means of Zernike polynomials, in the following the use of the Zernike polynomials with regard to the ocular length (OL) is presented.
The Zernike polynomials are originally defined for cylindrical coordinates (r, φ) introduced in the plane of projection with respect to the point of intersection of the optical axis as follows:
In equation (19) the following holds for the quantities Rnk (r):
In this connection it holds for the variables that:
0≦N≦∞ and
0≦m≦n.
In Table 1 the Zernike polynomials, expressed in polar coordinates (r, φ), are compiled up to and including the 8th order (n=8), that is to say, the first 45 polynomials (N=0, 1, 2, . . . , 44), as obtained by algebraic evaluating of equations (19) and (20).
In Table 1 (fourth column) and in Table 4 (second column) the radical from equation (19) in front of the actual polynomial is denoted by the symbol F. Table 4 lists the Zernike polynomials expressed in Cartesian coordinates (x, y).
For the evaluation of the second pattern of dots 118 recorded by the recording device 60 a conversion of the Zernike polynomials into the Cartesian coordinates x and y defined in the plane of projection (second plane 54) becomes necessary. The conversion of polar coordinates (r, φ) (as utilised in Table 1) into Cartesian coordinates (x, y) is effected with the aid of the following known rules:
y=r sin φ, x=r cos φ and r2=x2+y2 (21)
The complicated trigonometric terms arising in the course of the conversion of the in Table 1, by the exponentiation of the polar coordinates r, can be simplified by using the summation formulae for trigonometric functions specified in Table 2. The powers of the trigonometric functions arising after the simplification can then be converted into Cartesian coordinates, and in this way the Zernike polynomials listed in Table 4 can be computed algebraically, expressed in Cartesian coordinates (x, y).
The results of the conversions of the first 45 Zernike polynomials from Table 1 into the Zernike polynomials expressed in Cartesian coordinates are summarised in Table 4.
Listed in Tables 5 and 6, lastly, are the first partial derivatives of the Zernike polynomials with respect to the coordinates x and y (i.e. the functions ∂W/∂x and ∂W/∂y), which have been computed algebraically from the Zernike polynomials specified in Table 4.
It is the partial derivatives of the Zernike polynomials, compiled in Tables 5 and 6, that are ultimately needed for solving the equation systems (11), taking as a basis the measured offsets of the individual points of light and the subsequent determination of the wavefront aberrations.
Since the mathematical foundations for the reconstruction of the improved wavefront aberrations have been described, in the following it will be now be described with reference to
In certain embodiments, further data may be obtained, e.g., the topography of the anterior corneal surface 174 and of the posterior corneal surface 176 as well as biometric data pertaining to the eye, inclusive of the corneal thickness (CT) 192, the anterior-chamber depth (ACD) 194, the lens thickness (LT) 196 and the ocular length (OL) 198, see in each instance
The basis for optical computations using an eye model is the possibility of tracking beams of light computationally using ray tracing. In the course of the ray tracing, the optical path of beams of light that pass through the eye is computed utilising Snell's known law of refraction. The dependence of the refractive index on the wavelength is taken into account in this case through a suitable choice of the refractive indices for the various optical media of the eye model.
In order that the simulated wavefront for the entire individualised, improved eye-specific eye model to be created now becomes identical with the actual wavefront 102 (see
The optimisation algorithm has to be performed in an iterative manner, because the points of intersection of the tracked beams of light through the surfaces to be optimised 182 and 184 are required in order to start the algorithm, even though the surfaces 182 and 184 are not yet known. For this reason, by way of initial formulation for the iteration the lens was modelled with mean-value data pertaining to an eye model taken from the literature. The lens surface, which in this process is not yet optimised, is still the lens shape according to the bibliographical references for the underlying initial eye model.
The objective of the intraocular optimisation is to adapt a refracting surface in such a way that a defined wavefront upstream of the surface to be optimised can be transformed, by virtue of the refraction on the surface, into a wavefront defined downstream of the surface. In a manner analogous to the principle used in a Hartmann-Shack wavefront sensor it will be assumed that the measured wavefront above the entrance pupil resembles the respective wavefront that leaves the eye, starting from the ideal focal point 189 on the model retina 210 in
As a result of the two iteratively performed optimisations indicated in
Since an improved, individualised eye-specific eye model 200 for the eye of a patient has been created, this model can be taken for various applications of treatment planning, inclusive of the planning or advance computation of an optimised ablation profile for the anterior surface of the cornea (see
In order to compute a laser ablation profile for the anterior corneal surface, the improved, individualised eye model 200 which has been created (see
The computation in stage 2 also has to be performed iteratively, because the points of intersection of the beams through the newly to be computed face 222 are not known initially.
An improved ablation profile 224 (see
Lastly, the process for computing an improved design of an intraocular lens (IOL) 230 to be inserted into the eye will be described in the following with reference to
In the course of the computation of the improved design for an intraocular lens 230 it is not the primary objective, but a possible future objective, to correct higher-order aberrations; this is rather the objective for the optimisation of the improved ablation profile 224 for the refraction correction in respect of the anterior corneal surface. Therefore, for purposes of the optimisation of the IOL 230, eye models with lower degrees or demands made of the individualisation can also be utilised.
In contrast to the optimisation of the anterior corneal surface, as described on the basis of
The actual optimisation of the front lens face then takes place, once again iteratively, by ray tracing, again starting from the ideal projection point 189 on the model retina 210. In the course of this ray tracing, the front face 232 of the intraocular lens 230 to be designed is now adapted, in order ultimately to generate, as well as possible, the wavefront 234 computed upstream of the improved front lens face 232.
15)r4 sin4φ
90r4 − 20r2 + 1
indicates data missing or illegible when filed
10(x2 + y2)2 − 12(x2 + y2) + 3]
indicates data missing or illegible when filed
40x2
6]
indicates data missing or illegible when filed
Filing Document | Filing Date | Country | Kind | 371c Date |
---|---|---|---|---|
PCT/EP2012/002906 | 7/10/2012 | WO | 00 | 11/17/2014 |