Leland Stanford Junior University

Amo Development, LLC

Medtronic Advanced Energy LLC

Optimedica Corporation

Peak Surgical, Inc.

Alexander B Vankov

Daniel V Palanker

Georg Schuele

Phillip Gooding

David A Dewey

Jenny Wang

Michael W Wiltberger

Richard A Hofer

Philip Huie, Jr

Tianheng Wang

Paul O Davison

Thomas W Chalberg, Jr

Dan E Andersen

Mark S Blumenkranz

Javier G Gonzalez

Mihai State

Michele P Calos

Harvey Abraham Fishman

Ralph I McNall, Iii

John Tighe

Michael F Marmor

Phillip H Gooding

Daniel J Andersen

A system for laser ophthalmic surgery includes: a single laser source, under the operative control of a controller, configured to alternatively deliver a first treatment laser beam and a second treatment laser beam. The first treatment laser beam has a pulse energy of 10 to 500 μJ. The second pulsed laser beam has a second pulse energy of about 0.1 to 10 μJ, lower than the first treatment laser beam. An optical system focuses the first treatment laser beam to a first focal spot and directs the first focal spot in a first treatment pattern into a first intraocular target. The optical system also focuses the second treatment laser beam to a second focal spot and direct the second focal spot in a second treatment pattern into a second intraocular target. The first intraocular target and second intraocular target are different.

Sub-nanosecond laser surgery system utilizing multiple pulsed laser beams

A full depth ophthalmic surgical system includes a femtosecond laser source and an optical coherence tomographer. The system is capable of performing surgical procedures along the entire length of the eye from the cornea to the retina. The optical system of the ophthalmic surgical system is optimized to focus the laser beam and imaging light in the vitreous humor of the eye. In some embodiments, the system includes a video camera with a tunable lens before it to image the entire length of the eye. For procedures performed posterior to the lens, a method for calibrating the full depth ophthalmic surgical system is also provided. The system can be used to perform treatment in the vitreous humor, including treating floaters and liquification of the vitreous humor.

Full depth laser ophthalmic surgical system, methods of calibrating the surgical system and treatment methods using the same

Methods and related apparatus for real-time process monitoring during laser-based refractive index modification of an intraocular lens. During in situ laser treatment of the IOL to modify the refractive index of the IOL material, a signal from the IOL is measured to determine the processing effect of the refractive index modification, and based on the determination, to adjust the laser system parameters to achieve intended processing result. The signal measured from the IOL may be a fluorescent signal induced by the treatment laser, a fluorescent signal induced by an external illumination source, a temporary photodarkening effect, a color change, or a refractive index change directly measured by phase stabilized OCT.

Process monitoring and control during laser-based refractive index modification of intraocular lenses in patients

The XYZ beam position of an ophthalmic laser system is calibrated by measuring a fluorescent signal induced by the focused laser beam in a thin glass coverslip via multiphoton absorption. A video camera measures the XY position and intensity of the fluorescent signal as the focused laser beam strikes the coverslip. The Z position of the focus is determined by scanning the targeted z position and identifying the Z scanner position of peak fluorescence. An OCT system measures the real space Z location of the coverslip, which is correlated with the Z scanner position. Other laser system parameters are assessed by repeatedly scanning a lower energy laser beam in a piece of IOL material, and observing damage (scattering voids) formation in the IOL material. Based on the rate of damage formation, laser system parameters such as beam quality, numerical aperture, pulse energy, and pulse duration, etc. can be assessed.

Calibration process for femtosecond laser intraocular lens modification system using video and OCT targeting

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

Methods and systems for laser ophthalmic surgery that provide for iris exposures below a predetermined exposure limit

A laser scanning method for forming a Fresnel type gradient index lens in an intraocular lens IOL. The radial profile of the desired optical pathlength (OPL) difference to be achieved in the IOL has multiple zones, each zone ramping from unchanged OPL to one wave, and stepping down to zero. To form a zone of a predefined OPL difference profile, the laser beam is scanned in multiple passes; in each pass, the laser beam is scanned in concentric circles of varying radii covering all or a part of the zone, with laser energy ramping up (along the radius) to a maximum allowed energy and staying at that energy. The ramp up region, which is dependent on the predefined OPL difference profile and the maximum allowed energy, is short, and most part of the pass is scanned at the maximum allowed energy.

Optimized writing of refractive index structures in IOLs using variable passes

A method of altering a refractive property of a crosslinked acrylic polymer material by irradiating the material with a high energy pulsed laser beam to change its refractive index. The method is used to alter the refractive property, and hence the optical power, of an implantable intraocular lens after implantation in the patient's eye. In some examples, the wavelength of the laser beam is in the far red and near IR range and the light is absorbed by the crosslinked acrylic polymer via two-photon absorption at high laser pulse energy. The method also includes designing laser beam scan patterns that compensate for effects of multiphone absorption such as a shift in the depth of the laser pulse absorption location, and compensate for effects caused by high laser pulse energy such as thermal lensing. The method can be used to form a Fresnel lens in the optical zone.

Methods and systems for changing a refractive property of an implantable intraocular lens

A full depth ophthalmic surgical system includes a femtosecond laser source and an optical coherence tomographer. The system is capable of performing surgical procedures along the entire length of the eye from the cornea to the retina. The optical system of the ophthalmic surgical system is optimized to focus the laser beam and imaging light in the vitreous humor of the eye. In some embodiments, the illumination light source and the scanning mirrors are imaged by the system's objective lens and the patient interface lens to locations near the pupil, to increase the volume of the vitreous humor reachable by the illumination light and laser beam. For procedures performed posterior to the lens, a method for calibrating the full depth ophthalmic surgical system is also provided. The system can be used to perform treatment in the vitreous humor, including treating floaters and liquification of the vitreous humor.

A system for laser ophthalmic surgery includes: a single laser source, under the operative control of a controller, configured to alternatively deliver a first treatment laser beam and a second treatment laser beam. The first treatment laser beam has a pulse energy of 10 to 500 &#x3bc;J. The second pulsed laser beam has a second pulse energy of about 0.1 to 10 &#x3bc;J, lower than the first treatment laser beam. An optical system focuses the first treatment laser beam to a first focal spot and directs the first focal spot in a first treatment pattern into a first intraocular target. The optical system also focuses the second treatment laser beam to a second focal spot and direct the second focal spot in a second treatment pattern into a second intraocular target. The first intraocular target and second intraocular target are different.

Systems and methods for fragmenting a lens by a laser cataract surgery system includes a sub-nanosecond laser source generating a treatment beam that includes a plurality of laser beam pulses. An optical delivery system is coupled to the sub-nanosecond laser source to receive and direct the treatment beam. A processor is coupled to the sub-nanosecond laser source and the optical delivery system. The processor includes a tangible non-volatile computer readable medium comprising instructions to determine a lens cut pattern for lens fragmentation and determine a plurality of energies of the treatment beam as a linear function of a depth of the lens cut pattern. The treatment beam is output according to the lens cut pattern and the determined energies.

Sub-nanosecond laser cataract surgery system

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

A laser eye surgery system used to treat vitreous bodies includes a laser source, a ranging subsystem, an integrated optical subsystem, and a patient interface assembly. The laser source produces a treatment beam that includes a plurality of laser pulses. The ranging subsystem produces a source beam used to locate one or more structures of an eye. In some embodiments, the ranging subsystem includes an optical coherence tomography (OCT) pickoff assembly that includes a first optical wedge and a second optical wedge separated from the first optical wedge. The OCT pickoff assembly is configured to divide an OCT source beam into a sample beam and a reference beam. The integrated optical subsystem is used to scan the treatment beam and the sample beam. In other embodiments, Purkinje imaging, Scheimpflug imaging, confocal or nonlinear optical microscopy, ultrasound, stereo imaging, fluorescence imaging, or other medical imaging technique may be used.

Growing community of inventors

Menlo Park, CA, United States of America

Alexander B Vankov