Amo Development, LLC

Optimedica Corporation

Insightful Instruments, Inc.

Biometric Imaging, Inc.

Onetta, Inc.

Topcon Medical Laser Systems, Inc.

Spectra Physics Laser Diode Systems

Phillip Gooding

Georg Schuele

Christine J Beltran

Michael W Wiltberger

Jonathan H Talamo

David A Dewey

Alexander B Vankov

Brent Eikanas

William Culbertson

Neil Friedman

Dan E Andersen

Bruce Robert Woodley

Michael A Campos

Barry S Seibel

Jenny Wang

David G Angeley

Robert Justice Shartle

Jan C Wysopal

Tianheng Wang

Rene Hugues

Javier G Gonzalez

Richard A Hofer

Christine Beltran Ardema

Noah Bareket

George R Marcellino

Raymond Woo

Mihai State

John Scot Hart

Katrina Bell Sheehy

Jeffrey A Golda

Thomas Teisseyre

Madeleine C O'Meara

Thomas Michael Baer

Gregory J Kintz

David F Head

Steven Scott Christensen

Michael J Simoneau

Carlos Castro

John L Cole

Kelly A Cox

Barry Siebel

Michael Brett

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

During a process of refractive index modification of an intraocular lens (IOL) using an ophthalmic laser system, optical position monitoring of the IOL is performed by a video camera system viewing the top surface of the IOL. Fiducials are incorporated into the IOL at manufacture, or created in-vivo with laser. The monitoring method employs a defined area of interest (AOI) to limit the number of pixels to be analyzed, to achieve adequately high acquisition speed. In one example, the AOI contains 5 camera scan line segments, each line segment having sufficient pixels to create a stable amplitude signature. Successive frames of the AOI are analyzed to detect movement of the fiducial and/or to determine whether the fiducial has been lost.

High speed tracking of IOL during refractive index modification

A system for incising tissue with a plasma comprises an elongate electrode configured to incise the tissue along a tissue incision profile and a tissue contact element configured to shape the tissue, which comprises one or more of a channel or a protrusion to form one or more of a corresponding protrusion or indentation in a tissue surface while the tissue is incised with the electrode along the incision profile. The tissue contact element shapes the tissue sufficiently to allow the tissue to form one or more complimentary features along the incision profile when the tissue relaxes to a free-standing configuration with removal of the tissue contact element. The complementary features may be incised into the tissue to provide increased mechanical stability between the separated tissue regions, such as with nominally interlocking protrusion(s) and indentation(s).

Methods for incising tissue

Apparatus to treat an eye with an ophthalmic laser system comprises a patient interface having an annular retention structure to couple to an anterior surface of the eye. The retention structure is coupled to a suction line to couple the retention structure to the eye with suction. Liquid is added above the eye to act as a transmissive medium. A coupling sensor is coupled to the suction line to determine coupling of the retention structure to the eye. A separate pressure monitoring circuit having a much smaller volume than the suction line is connected to the annular retention structure to measure suction pressure therein. A system processor coupled to the monitoring pressure sensor includes instructions to interrupt firing of a laser when the pressure measured with a monitoring pressure sensor rises above a threshold amount.

Vacuum loss detection during laser eye surgery

A patient interface includes an eye interface device, a scanner, a first support assembly, and a beam source. The eye interface device is configured to interface with an eye of a patient. The scanner is configured to be coupled with the eye interface device and operable to scan an electromagnetic radiation beam in at least two dimensions in an eye interfaced with the eye interface device. The scanner and the eye interface device move in conjunction with movement of the eye. The first support assembly supports the scanner so as to accommodate relative movement between the scanner and the first support assembly parallel so as to accommodate movement of the eye. The beam source generates the electromagnetic radiation beam. The electromagnetic radiation beam propagates from the beam source to the scanner along an optical path having an optical path length that varies in response to movement of the eye.

Free floating patient interface for laser surgery system

An elongate electrode is configured to flex and generate plasma to incise tissue. An electrical energy source operatively coupled to the electrode is configured to provide electrical energy to the electrode to generate the plasma. A tensioning element is operatively coupled to the elongate electrode. The tensioning element can be configured to provide tension to the elongate electrode to allow the elongate electrode to flex in response to the elongate electrode engaging the tissue and generating the plasma. The tensioning element operatively coupled to the flexible elongate electrode may allow for the use of a small diameter electrode, such as a 5 μm to 20 μm diameter electrode, which can allow narrow incisions to be formed with decreased tissue damage. In some embodiments, the tensioning of the electrode allows the electrode to more accurately incise tissue by decreasing variations in the position of the electrode along the incision path.

Systems for incising tissue

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

Apparatus to treat an eye comprises an annular retention structure to couple to an anterior surface of the eye. The retention structure is coupled to a suction line to couple the retention structure to the eye with suction. A coupling sensor is coupled to the retention structure or the suction line to determine coupling of the retention structure to the eye. A fluid collecting container can be coupled to the retention structure to receive and collect liquid or viscous material from the retention structure. A fluid stop comprising a porous structure can be coupled to an outlet of the fluid collecting container to inhibit passage of the liquid or viscous material when the container has received an amount of the liquid or viscous material. The coupling sensor can be coupled upstream of the porous structure to provide a rapid measurement of the coupling of the retention structure to the eye.

Liquid optical interface for laser eye surgery system

The patient interface may comprise an axis for alignment with an axis of the eye such as an optical axis of the eye. The interface may comprise a guide to allow the interface to move along the axis with the eye, which can inhibit increases in intraocular pressure when the patient is aligned with the laser. The interface may comprise a lock to hold the patient interface at a location along the axis, which can maintain alignment of the patient with the laser eye surgery system. The interface may comprise a plurality of transducers to measure forces to the eye during surgery. The laser eye surgery system can be configured in one or more of many ways to respond to the measured forces. For example, the system may offset the position of laser beam pulses to increase the accuracy of the placement of the beam pulses on the eye.

Interface force feedback in a laser eye surgery system

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 eye surgery system that has a patient interface between the eye and the laser system relying on suction to hold the interface to the eye, the patient interface using liquid used as a transmission medium for the laser. During a laser procedure sensors monitor the level of liquid within the patient interface and send a signal to control electronics if the level drops below a threshold value. The sensor may be mounted on the inside of the patient interface, within a fluid chamber. Alternatively, a gas flow meter may be added to a suction circuit for the patient interface that detects abnormal suction levels indicating low fluid level.

Liquid loss detection during laser eye surgery

A method and surgical system including a laser source for generating a pulsed laser beam, an imaging system including a detector, shared optics configured for directing the pulsed laser beam to an object to be sampled and confocally deflecting back-reflected light from the object to the detector, a patient interface, through which the pulsed laser beam is directed, the patient interface having, a cup with a large and small opening, and a notched ring inside the cup; and a controller operatively coupled to the laser source, the imaging system and the shared optics, the controller configured to align the eye for procedure.

Registration of LOI fiducials with camera

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Mountain View, CA, United States of America

Phillip Gooding