Amo Development, LLC

Nima Khatibzadeh

Hong Fu

Alireza Malek Tabrizi

James E Hill

Harvey I Liu

Deepali Mehta-Hurt

Andrew Voorhees

Cynthia Villanueva

Alisyn Facemire

Li Chen

Griffith E Altmann

Li Bing

Pavel Vodkin

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

Lasik flap cutting patterns including intrastromal pocket for bubble management

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

Lasik flap cutting patterns including bubble barrier layer in side cut for bubble management

An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using 'fast-scan-slow-sweep' scanning scheme. A high frequency scanner forms a fast scan line, which is placed tangential to a parallel of latitude of the surface of the lenticule and then then moved in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, with the orientation of the scan line rotated between successive sweeps. To generate tissue bridge free incisions without leaving laser-induced marks in the eye, a laser pulse energy between 40 nJ to 70 nJ is used, and the sweeping speed is controlled such that the scan line step (the distance between the centers of consecutive scan lines) is between 1.7 μm and 2.3 μm.

Corneal lenticular incision using a femtosecond laser with optimized pulse energy and scan line steps

In laser-assisted corneal lenticule extraction procedures, the lenticule incision profile includes anterior and posterior lenticule incisions, with one or more of the following features: plano transition zone outside the optical zone, to improve mating of anterior and posterior incision surfaces after lenticule extraction; shallow arcuate incisions above the anterior incision and near the lenticule edge, to improve surface mating; separate ring cut intersecting the anterior and posterior incisions in the transition zone, to reduce tissue bridges and minimize tear at the lenticule edges and facilitate easy lenticule extraction; larger posterior incision, which includes a pocket zone outside the lenticule edge, for better surface mating and bubble management during cutting; and a separate ring shaped pocket cut intersecting the pocket zone of the posterior incision, for bubble management. An entry cut can intersect either the pocket zone of the posterior incision or an entry extension zone of the anterior incision.

Corneal lenticular incisions with transition zones in laser-assisted ophthalmic procedures

An ophthalmic surgical laser system and method for forming a lenticule in a subject's eye using 'fast-scan-slow-sweep' scanning scheme. A high frequency scanner forms a fast scan line, which is placed by the XY and Z scanners at a location tangential to a parallel of latitude of the surface of the lenticule. The XY and Z scanners then move the scan line in a slow sweep trajectory along a meridian of longitude of the surface of the lenticule in one sweep. Multiple sweeps are performed along different meridians to form the entire lenticule surface, and a prism is used to change the orientation of the scan line of the high frequency scanner between successive sweeps. In each sweep, the sweeping speed along the meridian is variable, being the slowest at the edge of the lenticule and the fastest near the apex.

High speed corneal lenticular incision using a femtosecond laser

An ophthalmic laser procedure for forming a lenticule in a cornea and extracting the lenticule from the cornea to accomplish vision correction. An ophthalmic laser system is used to form top and bottom lenticule incisions defining a lenticule in between, and further to form top and/or bottom entry cuts that respectively end unambiguously near the top or bottom lenticule surface. The bottom entry cut intersects both the top and bottom lenticule incisions but ends near the bottom lenticule incision. The entry cuts allow the surgeon to insert a surgical tool which reaches the intended top or bottom lenticule surface without ambiguity. The lenticule has an optical zone in the center that defines the optical power of the lenticule, and a transition zone in the periphery, where the end points of the entry cuts are located in the transition zone.

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San Jose, CA, United States of America

Nima Khatibzadeh