Laser system with orientation analysis system for measuring patient orientation

Abstract

The present disclosure relates to a guide configured to allow movement of at least a portion of a light beam delivery system to adjust an orientation of the at least movable portion to different orientations of a patient's head measured about an axis of an eye to be treated. The system has an orientation analysis system for acquiring orientation related data using one or more body parts of the patient. The ophthalmic laser system allows a user and / or controller to move the movable portion of the light beam delivery system using the orientation related data such that during laser treatment, the movable portion has an orientation about the axis of the eye and relative to the patient's head that corresponds to or substantially corresponds to a predetermined target orientation; or the orientation is at or substantially within a predetermined target range.

Description

Technical Field

[0001] This invention relates to a system for performing laser treatments, such as treatments that create incisions in the cornea or lens. The invention also relates to systems for ablating portions of the corneal surface, such as in photorefractive keratotomy (PRK) and laser-assisted in situ keratomileusis (LASIK) treatments. Background Technology

[0002] Cataract surgery is one of the most common ophthalmic surgeries. The main goal of cataract surgery is to remove the aging lens and replace it with an artificial lens or intraocular lens (IOL) to restore some of the optical properties of the aging lens.

[0003] The main steps of cataract surgery include: making a corneal incision to access the anterior chamber of the eye, and making an incision to correct astigmatism (limbal laxity incision, abbreviated as LRI or astigmatic keratotomy, abbreviated as AK), cutting and opening the lens capsule to access the lens (capsular incision), fragmenting the lens and removing the fragmented lens through phacoemulsification, irrigation and aspiration, and in most cases, implanting an artificial lens into the eye.

[0004] Therefore, femtosecond laser-assisted cataract surgery is a multi-stage process, including femtosecond laser surgery (LRI, AK, corneal incision, capsulotomy and lens fragmentation), phacoemulsification (emulsification, liquefaction and aspiration of the lens), and manual surgery (implantation of an artificial lens).

[0005] However, with conventional femtosecond laser systems, this typically requires transferring the patient from the standard patient bed to a separate, fixed patient support device, which is part of the femtosecond laser system and specifically designed for performing laser surgical procedures. This patient transfer procedure, however, complicates the clinical workflow and causes patient discomfort.

[0006] Furthermore, to reduce footprint and cost, it is desirable to configure the femtosecond laser system used for cataract surgery to also be used for creating corneal flaps in laser-assisted in situ keratomileusis (LASIK). However, the femtosecond laser used for creating the LASIK flap should be located close to the excimer laser system to facilitate patient movement from one system to another. On the other hand, the femtosecond laser used for cataract surgery should be located in a sterile operating room where phacoemulsification and IOL implantation are performed.

[0007] In view of the above, there is a need to provide a laser system that allows for efficient clinical workflows. Summary of the Invention

[0008] Embodiments of this disclosure relate to an ophthalmic laser system configured to perform laser treatment on a patient's eye using a therapeutic laser beam. The laser system includes a beam delivery system for focusing the therapeutic laser beam such that the beam travels toward the eye to be treated. The laser system also includes a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea. The laser system also includes a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least a movable portion to different orientations of the patient's head measured about an axis around the eye to be treated. The laser system also includes an orientation analysis system for acquiring orientation-related data using: (a) one or more body parts of the patient; and / or (b) one or more objects, each object having a fixed position and / or orientation relative to a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about the eye axis. The ophthalmic laser system is configured to allow the user and / or controller to move a movable part of the beam delivery system using orientation-related data, such that during laser treatment, the movable part is oriented about the eye axis and relative to the patient's head, the orientation (i) corresponding to or substantially corresponding to a predetermined target orientation; or (ii) within or substantially within a predetermined target range.

[0009] As used herein, the term "axis of the eye" can refer to the visual axis or the optical axis of the eye. As used herein, the term "optical axis of the eye" can refer to the axis that is perpendicular to the anterior surface of the cornea and has the smallest distance from the center of curvature of all other refractive surfaces of the eye. As used herein, the term "visual axis of the eye" (also known as "line of sight") can refer to the straight line that extends from the object being seen, through the center of the pupil, and to the macula of the retina.

[0010] At least one of one or more objects may cover and / or contact, in particular directly contact the corresponding body part, with the object having a fixed (i.e. unchanging) position and / or orientation relative to that body part.

[0011] Each body part analyzed, whether directly or using one or more objects, can represent a structural and / or anatomical part of the patient's head, such as at least a portion of the patient's eyes, ears, and / or nose. Therefore, body parts can serve as indicators of the patient's head position and / or orientation.

[0012] The controller may include a data processing system. The data processing system may include a computer system having one or more processors and memory for storing instructions that can be processed by the processors. The one or more processors may execute an operating system. The data analysis system may also include a user interface configured to allow a user to receive data from and / or provide data to the data processing system. The user interface may include a graphical user interface. The ophthalmic laser system may include a pointing device, such as a computer mouse. The graphical user interface may be configured to receive user input via the pointing device.

[0013] The guide may include one or more rotary guides and / or linear guides. Each linear guide may be configured as a straight or curved linear guide. In a configuration that adjusts the position and / or orientation of a movable portion of the beam delivery system relative to the patient to perform laser treatment, the axis of rotation of the guide may extend in a vertical or substantially vertical direction. During laser treatment, the patient's eye may dock to the movable portion of the beam delivery system via a contact element of the patient interface, wherein the contact element contacts the anterior corneal surface of the patient's eye, and the treatment laser passes through the contact element after exiting the beam delivery system.

[0014] The guide can be configured for electrically adjusting the position and / or orientation of movable parts of the beam delivery system, particularly for electrically adjusting the orientation around the axis of the eye to be treated.

[0015] The guide can be configured to provide one, two, or three rotational degrees of freedom for positioning a movable portion of the beam delivery system relative to the patient's eye. For example, the guide may include one, two, or three rotary bearings and / or a ball bearing. The axes of rotation of the rotary bearings may be non-parallel to each other.

[0016] Additionally or alternatively, the guides may be configured to provide one, two, or three translational degrees of freedom. Specifically, the guides may include one, two, or three linear guides that are non-parallel to each other. Each linear guide may be configured as a straight or curved linear guide.

[0017] An ophthalmic laser system can be configured such that movement of a movable portion using orientation-related data can be at least partially performed manually by a user based on data provided to the user via the ophthalmic laser system's user interface. For example, this data could indicate the current orientation angle of the patient's head relative to the movable portion of the beam delivery system. This data can be determined by a controller using the orientation-related data. Additionally or alternatively, the ophthalmic laser system may include a drive system for moving the movable portion of the beam delivery system. A controller can be operatively coupled to the drive system. The controller can be configured to control the drive system based on the orientation-related data to perform movement of the movable portion of the beam delivery system.

[0018] The beam delivery system may include an objective lens system for focusing a therapeutic laser beam into the eye. At least a portion of the objective lens system may be part of a movable portion of the beam delivery system.

[0019] The beam delivery system may include a scanning system operatively coupled to a controller. The scanning system can provide three degrees of freedom for focusing the laser beam at different locations within the eye or on the anterior surface of the cornea. One of these three degrees of freedom can be provided by an axial scanning system. The remaining two degrees of freedom can be provided by a beam deflection scanning system.

[0020] An axial scanning system can be configured to scan the laser focus along the axis of the laser beam. A beam deflection scanning system can be configured to scan the laser beam by deflecting the laser beam. The axial scanning system can be located in the laser beam path between the laser source of the laser system and the beam deflection scanning system. The scanning system can be located in the therapeutic laser beam path between the laser source and the focusing optics system.

[0021] In addition to scanning the laser focus along the laser beam axis, the axial scanning system can also cause laser beam deflection, allowing the laser focus to move laterally while moving axially. The lateral movement of the laser focus can be less than its axial movement. Laser beam deflection performed using a beam deflection scanning system can adjust the lateral position of the laser focus relative to the optical axis of the beam delivery system.

[0022] An axial scanning system can be configured to scan the focal point of a laser beam axially by varying the divergence or convergence angle of the laser beam. The divergence or convergence can be measured at a location along the axis of the laser beam from which it exits the axial scanning system. As used herein, the terms "divergence" or "convergence" can be defined as an angular measure representing whether the beam diameter increases or decreases with distance.

[0023] An axial scanning system may include one or more movable lenses located in the optical path of a therapeutic laser beam. The axial scanning system may be configured such that the one or more movable lenses can be controlled to move in a direction parallel or substantially parallel to the optical axis of the one or more movable lenses. The ophthalmic laser system may include a controller that communicates with actuator signals of the axial scanning system. The actuator may be configured to move the one or more movable lenses based on signals received from the controller.

[0024] An axial scanning system may include a first optical system with negative optical power and a second optical system with positive optical power. The second optical system may be located in the laser beam path between the first optical system and the deflection scanning system. The axial scanning system may be further configured such that the distance between the first and second optical systems is controllable and variable.

[0025] The ophthalmic laser system may also include an imaging system for acquiring a frontal image of at least a portion of the eye to be treated, at least with the eye docked or substantially docked to the ophthalmic laser system. The imaging system may include an image sensor and an imaging optics system for imaging that portion of the eye onto the image sensor. The image sensor may include a two-dimensional ordered or disordered array of pixels. The image sensor may be sensitive to one or more wavelengths in the range of 380 nm to 950 nm or in the range of 380 nm to 1400 nm.

[0026] The optical path of the eye imaging system can pass through a contact element of the patient interface. The contact element can contact the anterior corneal surface of the eye to be treated. At least a portion of the imaging optical path of the eye imaging system can pass through at least a portion of a movable portion of the beam delivery system. The optical elements of the movable portion of the beam delivery system may include optical elements of a focusing optics system for focusing a therapeutic laser beam within the eye and / or an exit optics system through which the therapeutic laser beam exits from the beam delivery system toward the contact element of the patient interface. The imaging optical path of the eye imaging system may be external to a scanning system through which the therapeutic laser beam passes.

[0027] A beam delivery system, particularly a movable portion thereof, may include a beam combiner located in the laser beam path between the scanning system and the eye. The beam combiner can be configured to combine the optical path of the therapeutic laser beam with that of the imaging system. The beam combiner can be configured to deflect the therapeutic laser beam toward or substantially toward the eye. The beam combiner may include mirrors and / or prisms. The beam combiner can be configured as a dichroic beam combiner. The beam combiner can be located downstream of, within, or upstream of the focusing optics system in the therapeutic laser beam path. Downstream of the beam combiner, the therapeutic laser beam can extend vertically or substantially vertically.

[0028] The controller can be configured to use images from an imaging system to determine the pupil center of the eye to be treated. The controller can be further configured to align laser positioning data (e.g., a scanning pattern used to scan the focal point of a therapeutic laser beam within the eye) with the axis of the eye to be treated using the determined pupil center. The controller can be further configured to use images from an eye imaging system to determine the orientation of the laser positioning data around the axis of the eye to be treated. For example, the controller can execute image analysis algorithms to extract the location and / or orientation of anatomical landmarks and / or features of the eye to be treated and compare the images with images acquired using diagnostic equipment. For example, diagnostic equipment includes wavefront analysis systems and / or OCT systems. This allows laser positioning data to be determined based on measurements from the diagnostic equipment. Examples of anatomical landmarks include, but are not limited to, structural features of the iris and conjunctival vessels.

[0029] The movable portion of the beam delivery system may include at least a portion of: (a) an axial scanning system, (b) a deflection scanning system, (c) an eye imaging system and / or a focusing optics system for generating a focal point of the therapeutic laser beam within the eye to be treated.

[0030] According to one embodiment, at least one body part is located outside the eyeball of the eye to be treated. The at least one body part may not only be located outside the eyeball of the eye to be treated, but also outside one or more of the following: (a) the upper and / or lower eyelids, (b) eyelashes, (c) the lacrimal duct, (d) the lacrimal punctum, and (e) the caruncle of the eye to be treated.

[0031] According to one embodiment, the guide includes a rotation guide configured to allow a movable portion of the beam delivery system to rotate about a rotation axis.

[0032] The axis of rotation can be parallel to or aligned with the optical axis of the movable portion of the beam delivery system. The rotating guide can have a single degree of freedom of motion. Therefore, different orientations of the patient's head around the axis of the eye to be treated can be performed by rotating the movable portion of the beam delivery system about the axis of rotation of the rotating guide. However, it is also conceivable to use multiple rotating guides to adjust the orientation of the movable beam delivery system around the axis of treatment.

[0033] According to one embodiment, the laser system is configured such that during laser treatment, the axis of rotation of the rotating guide is parallel to or aligned with the optical axis of a movable portion of the beam delivery system. The optical axis may be defined by one or more exiting optics of the beam delivery system through which the therapeutic laser beam exits the beam delivery system and travels toward the patient interface. During treatment, the optical axis of the movable portion of the beam delivery system may be aligned with or substantially aligned with the axis of the eye to be treated.

[0034] According to one embodiment, the controller is configured to automatically or using user input determine one or more parameters based on orientation-related data, which (a) indicate or (b) are related to one or more orientation parameters of the patient’s head around the axis of the eye to be treated.

[0035] An ophthalmic laser system can be configured to output graphical and / or textual information to a user using the ophthalmic laser system's user interface, which is generated by the controller using one or more parameters.

[0036] Embodiments of the present invention relate to an ophthalmic laser system configured to perform laser treatment on a patient's eye using a therapeutic laser beam. The laser system includes a beam delivery system for focusing the therapeutic laser beam such that the beam travels toward the eye to be treated. The laser system also includes a controller operatively coupled to the beam delivery system and configured to control the beam delivery system based on laser positioning data to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea, the laser positioning data indicating or relating to the location to be treated within the eye. The laser system also includes a orientation analysis system for acquiring orientation-related data using (a) one or more body parts of the patient and / or (b) one or more objects. Each object is in a fixed position and / or orientation relative to a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about the eye axis. At least one body part is external to the eyeball of the eye to be treated. The controller may be further configured to determine, based on the orientation-related data: (i) one or more parameters of the laser positioning data; and / or (ii) whether the exiting optics of the beam delivery system are positioned anterior to the patient's left or right anterior eye. The emitting optical element can be an optical element of the delivery system through which the therapeutic laser beam is emitted from the beam delivery system toward the patient interface and / or the eye to be treated.

[0037] Laser positioning data may include one or more scanning paths for scanning the focal point of the therapeutic laser beam within the eye. Examples of such scanning paths include, but are not limited to: scanning paths within the cornea, scanning paths for performing anterior capsular incision (i.e., creating a flap or opening in the lens capsule), scanning paths for posterior capsular incision (i.e., creating an opening in the posterior lens capsule), and / or scanning paths for lens fragmentation.

[0038] Examples of intracorneal scanning pathways include those used to form anterior lamellar flaps (e.g., LASIK flaps), stromal lamellar flaps (e.g., in SMILE and FLEx procedures), or posterior lamellar flaps (e.g., in endothelial keratoplasty). SMILE stands for "small incision lenticule extraction," FLEx for "femtosecond laser lenticule extraction," and LASIK for "laser-assisted in situ keratomileusis." Another example is the scanning pathway used to form limbal laxity incisions (LRI) and cataract incisions (for access to the anterior chamber during cataract surgery).

[0039] Determining laser positioning data based on orientation-related data can include determining the orientation of the laser positioning data around the eye axis based on one or more parameters that indicate the orientation of the patient's head around the axis of the eye to be treated.

[0040] According to yet another embodiment, the controller is configured to determine one or more parameters, either automatically or using user input, based on orientation-related data. These parameters indicate or are related to one or more orientation parameters of the patient's head.

[0041] The orientation of the patient’s head can be measured (a) relative to a movable part of the beam delivery system, or (b) relative to a fixed coordinate system or relative to the base of the ophthalmic laser system (which supports the support arm and / or houses the laser source).

[0042] According to yet another embodiment, one or more parameters of patient head orientation are measured about the axis of the eye to be treated. Additionally or alternatively, one or more parameters of patient head orientation are (i) measured relative to a movable portion of the beam delivery system; or (ii) measured relative to a fixed coordinate system.

[0043] A directional analysis system configured to measure one or more parameters relative to a movable part can be mounted such that at least a portion of the directional analysis system is fixed in position and / or oriented relative to the movable part of the beam delivery system. A directional analysis system configured to measure one or more parameters relative to a fixed coordinate system can be mounted such that at least a portion of the directional analysis system is fixed in position and / or oriented relative to the laser system base or relative to a fixed object in the environment (e.g., the wall or ceiling of the room where the laser system is located, such as an operating room).

[0044] According to one embodiment, determining the one or more parameters includes: automatically or based on user input, determining one or more angular position parameters of the anatomical features and / or anatomical landmarks relative to the eye axis. Additionally or alternatively, the determination includes: automatically or based on user input, determining one or more orientation parameters of the anatomical features and / or anatomical landmarks in a plane perpendicular to the eye axis.

[0045] As used in this article, the term "angular position" can be understood as referring to an azimuth angle in a cylindrical coordinate system. Therefore, the angular position of anatomical landmarks relative to the eye axis involves an azimuth angle in a cylindrical coordinate system, where the eye axis corresponds to the cylindrical axis of the coordinate system.

[0046] Anatomical features and / or anatomical landmarks may include, or at least partially, those defined by one or more body parts, particularly those defined by one or more body parts of the patient's face. Examples of anatomical features include, but are not limited to, the patient's body axes, particularly the body axes of the patient's head, such as the interpupillary axis and / or the longitudinal axis of the patient's head. Another example of a body axis is the longitudinal axis of the patient's body. The longitudinal axis of the patient's body may be defined by the patient's trunk, legs, and / or head. Examples of landmarks include, but are not limited to, the pupillary opening, the pupillary center, and the tip of the nose.

[0047] According to yet another embodiment, the directional analysis system includes a detector system configured to detect electromagnetic radiation emitted from a region comprising one or more body parts and / or objects.

[0048] The radiation may be emitted from the one or more body parts and / or objects in response to illuminating the one or more body parts and / or objects with illumination radiation. The illumination radiation may be generated using the illumination system of an ophthalmic laser system. The illumination system may include a light source configured to illuminate the one or more body parts and / or objects. The illumination system may also include an optical system located in the illumination optical path between the light source and the one or more body parts and / or objects. The illumination source may simultaneously illuminate the one or more body parts and / or objects, or may include a scanner for scanning the illumination beam across the one or more body parts and / or objects.

[0049] For example, the emitted electromagnetic radiation could be scattered and / or reflected illumination radiation. It is also conceivable that the emitted radiation could include fluorescence and / or phosphorescence radiation excited by illumination radiation.

[0050] Alternatively, the emitted radiation can be generated by body parts and / or objects without being illuminated by a lighting system.

[0051] The illumination system can be configured such that the illumination of one or more body parts and / or objects is uniform or substantially uniform. Alternatively, the illumination system can be configured to generate structured light illumination of one or more body parts and / or objects. Structured light illumination can be generated using light in the visible wavelength range, particularly wavelengths between 380 nm and 780 nm. Additionally or alternatively, structured light illumination can be generated using light in the infrared wavelength range, particularly between 780 nm and 1,400 nm. For example, structured light illumination can be generated using one or more masks. Alternatively, the orientation analysis system can include a scanner for scanning a laser beam or collimated incoherent light across the one or more body parts and / or objects. Structured light illumination can be generated by a scanning laser beam or by scanning collimated incoherent light. The structured light illumination can be configured such that images acquired from the one or more body parts and / or objects using the imaging optics of the orientation analysis system allow for the reconstruction of the surface topography of the body parts and / or objects.

[0052] According to yet another embodiment, the detector system is configured to detect electromagnetic radiation in a spatially resolved manner. For example, the orientation analysis system includes an image sensor sensitive to the electromagnetic radiation. Additionally or alternatively, the orientation analysis system may include a scanner for sequentially receiving electromagnetic radiation from different portions of the object field and directing the received electromagnetic radiation to the detector.

[0053] According to one embodiment, the frequency of the electromagnetic radiation is in the range of 10 GHz and 800 THz, and / or the wavelength is in the range of 10 micrometers and 10 millimeters, particularly in the range of 100 micrometers and 1 millimeter.

[0054] According to yet another embodiment, the orientation analysis system is configured to use a static magnetic field and / or electrostatic field extending between a part of the ophthalmic laser system (particularly a movable part of the beam delivery system) and the one or more objects to acquire orientation-related data.

[0055] The orientation analysis system may include one or more magnets and one or more magnetic field sensors. The one or more magnets may be or constitute part of an object having a fixed position and / or orientation relative to a body part, and the magnetic field sensors may be part of an ophthalmic laser system. Alternatively, the one or more magnetic field sensors may be or constitute part of the one or more objects, and the magnets are part of an ophthalmic laser system.

[0056] Examples of objects that include magnets or magnetic field sensors include, but are not limited to: eye fixation devices, such as suction rings, and objects, such as rings, that can be placed on a patient’s untreated eye or attached to a surgeon’s finger.

[0057] Additionally or alternatively, the orientation analysis system may include one or more coils, such as Helmholtz coils, configured to generate a magnetic field at the location of one or more sensors of the orientation analysis system. The sensors may represent or constitute part of objects that have a fixed orientation and / or position relative to corresponding body parts.

[0058] For example, a orientation analysis system may include at least two Helmholtz coils, each configured to generate a unidirectional magnetic field at a sensor location. The magnetic field sensor may include one or more Hall effect sensors. For example, the orientation analysis system may include three pairs of Helmholtz coils. Each pair of coils may be arranged coaxially about a spatial axis, and these axes are not parallel to each other. The orientation analysis system also includes an object having three Hall effect sensors for measuring the components of the static magnetic field generated by the Helmholtz coils along the three non-parallel axes.

[0059] According to yet another embodiment, the orientation analysis system can be configured to detect the capacitance between one or more electrodes provided at a movable portion of the beam delivery system and one or more electrodes provided at the one or more objects. For example, each of a plurality of electrodes may be provided at a corresponding object, and the orientation analysis system can be configured to detect a corresponding distance from each electrode to one of a plurality of additional electrodes provided at the movable portion of the beam delivery system. The controller can be configured to determine one or more parameters based on the detected distances, these parameters (a) indicating or (b) relating to one or more orientation parameters of the patient's head around the axis of the eye to be treated.

[0060] According to yet another embodiment, the orientation analysis system includes an imaging system for acquiring two-dimensional images of the one or more body parts and / or objects. Additionally or alternatively, the orientation analysis system includes a surface topography acquisition system. Additionally or alternatively, the orientation analysis system includes a 3D imaging system.

[0061] A surface topography acquisition system may include a LIDAR scanning system for acquiring the surface topography of the one or more body parts and / or objects. LIDAR is an acronym for "light detection and ranging." A LIDAR scanning system may include a laser that forms a point-cross-sectional laser beam and a scanner. The laser may be configured to generate a pulsed laser beam for measuring time-of-flight (ToF LIDAR), amplitude-modulated continuous-wave (AMCW) laser beam, or frequency-modulated continuous-wave (FMCW) laser beam. The scanner may be configured to deflect the laser beam in two dimensions. The scanner may be configured to scan the surface including the surface of the one or more body parts and / or objects.

[0062] Additionally or alternatively, the surface topography analysis system may include a 3D time-of-flight camera system. The 3D time-of-flight camera system may include a light source and a 3D image sensor. The light source may be configured as a laser and / or an LED. The light source may be a non-scanning light source. The light emitted by the light source may be pulsed, amplitude-modulated, or may be a stroboscopic light source that generates square waves.

[0063] Additionally or alternatively, the surface topography acquisition system may include at least one RF (radio frequency) detector and at least one RF tag. The RF tag may be an object or may be attached to an object. The RF detector may include one or more antennas for detecting signals emitted from the RF tag. Based on the relative intensity and / or phase difference of the RF signals emitted from the RF tag and detected by the RF detector, the controller may determine one or more parameters of the position and / or orientation of the RF tag relative to the RF detector.

[0064] Additionally or alternatively, the surface topography acquisition system may include an optical coherence tomography system and / or a confocal microscope.

[0065] The 3D imaging system can be configured as a stereo 3D camera.

[0066] According to yet another embodiment, the ophthalmic laser system includes one or more tiltmeters and / or accelerometers. The controller can be configured to reduce or eliminate degradation of orientation-related data caused by movement of movable portions of the beam delivery system relative to the patient's head.

[0067] Degradation of orientation-related data may be caused by a support arm that movably supports a movable portion of the beam delivery system and / or one or more guides that support the movable portion of the beam delivery system. Movement of the support arm may be caused by external forces, such as user input via a finger on a touchscreen.

[0068] According to one embodiment, the optical path of the directional analysis system passes through one or more optical elements of the beam delivery system, particularly one or more optical elements of a movable portion of the beam delivery system. Additionally or alternatively, the optical path passes through optical elements, particularly a patient interface arranged in the optical path of the therapeutic laser beam between the beam delivery system and the eye to be treated.

[0069] The optical path can be the imaging optical path of an imaging system that acquires a frontal image of the eye to be treated, particularly an image of the region surrounding the optical axis of the beam delivery system within the anterior segment of the eye. For example, the imaging region may include the pupil and / or at least a portion of the iris of the eye to be treated. The imaging optical path may extend through one or more optical elements of the patient interface, particularly through the contact element of the patient interface that contacts the anterior surface of the cornea.

[0070] Additionally or alternatively, the optical path of the directional analysis system through one or more optical elements of the movable portion of the delivery system and / or the patient interface can be the optical path of the measuring arm of an optical coherence tomography (OCT) and / or confocal microscope. The OCT system and / or confocal microscope can be configured to acquire one or more cross-sectional images of the cornea and / or at least a portion of the lens of the eye. The image planes of the cross-sectional images may not be parallel to each other. The ophthalmic laser system can be configured to allow the user and / or controller to use images with non-parallel image planes to align the axis of the eye to be treated with the optical axis of the movable portion of the beam delivery system.

[0071] According to one embodiment, orientation-related data includes graphics, symbols, and / or topographic representations and / or 3D images containing one or more body parts and / or objects. The ophthalmic laser system may include a display device operatively coupled to a controller. The controller may be configured to control the display device to present graphics, symbols, and / or topographic representations and / or 3D images to a user. The graphic representation may be an image.

[0072] According to one embodiment, the controller is configured to automatically or using user input determine the position and / or orientation of the one or more body parts and / or objects in the representation and / or 3D image.

[0073] Ophthalmic laser systems may include a user interface configured to receive user input for semi-automatically identifying one or more locations and / or image regions within graphics, symbols, and / or topographic representations and / or 3D images. For example, a graphical user interface may be configured to receive user input via a pointing device (e.g., a computer mouse), where the user input identifies the location and / or boundaries of the one or more regions.

[0074] These areas can correspond to a body part and / or an object.

[0075] According to one embodiment, the laser system is configured to display a graphic representation on a display device, the graphic representation indicating or relating to the position and / or orientation of a movable portion of the beam delivery system relative to a part of the patient's body (particularly relative to the patient's head).

[0076] This graphical representation can help surgeons position the movable part of the beam delivery system relative to the patient's head manually or semi-automatically (i.e., using a controller and user input). This avoids unwanted collisions between the patient's head and the movable part of the beam delivery system.

[0077] According to one embodiment, the laser system is configured to determine one or more parameters for positioning movement of a movable portion of the beam delivery system based on orientation correlation data. The determined parameters may include one or more parameters for adjusting the orientation of the movable portion of the beam delivery system relative to the patient's head around the axis of the eye to be treated. These parameters may indicate one, two, or three translational degrees of freedom of the movable portion. Additionally or alternatively, these parameters may indicate one, two, or three rotational degrees of freedom of the movable portion. These parameters may specify movement relative to the ophthalmic laser system base. These parameters may relate to the path used to move the laser applicator between the patient's eyes to perform laser treatment on each eye. The controller of the ophthalmic laser system may be configured to determine parameters indicating positioning movement of six degrees of freedom based on surface topography data acquired using an orientation analysis system.

[0078] According to one embodiment, at least one body part includes at least a portion of the patient's head, particularly (a) at least a portion of the untreated eye or (b) at least a portion of the eye to be treated.

[0079] According to one embodiment, at least one body part includes at least a portion of the periorbital anatomy of at least one eye of the patient, particularly the lacrimal punctum and / or caruncle.

[0080] According to one embodiment, the orientation analysis system includes at least two imaging systems. A first imaging system may be configured to image (i) at least a portion of the eye to be treated; and / or (ii) an optical element, particularly at least a portion of a patient interface, located in the optical path of a treatment laser beam between a beam delivery system and the patient's eye. A second imaging system may be configured to image at least a portion of an untreated eye and / or at least a portion of an object that contacts and / or covers at least a portion of the untreated eye.

[0081] According to one embodiment, the orientation analysis system includes an imaging system configured to image (i) at least a portion of the eye to be treated; and / or (ii) an optical element, particularly at least a portion of a patient interface, located in the optical path of a treatment laser beam between a beam delivery system and the patient's eye. The orientation analysis system may further include a system for acquiring a 3D image and / or topographic representation of at least a portion of an untreated eye and / or an object that contacts and / or covers at least a portion of the untreated eye.

[0082] According to one embodiment, one of the objects is at least a portion of the eye fixation device, particularly at least a portion of the suction ring.

[0083] A portion of the contact eye fixation device can be positioned aligned with or substantially aligned with the pupil of the eye. The eye fixation device can have a visually asymmetrical shape relative to the axis of the contact eye fixation device portion. For example, the eye fixation device may include a handle used by the surgeon to position the eye fixation device relative to the patient's eye. The handle can visually indicate to the surgeon the orientation of the eye fixation device about the eye's axis. When attached to the eye to be treated, the handle can also limit the angular range of the eye fixation device's orientation relative to the patient's head. Due to the limited angular range, the orientation indication of the eye fixation device is, or at least related to, the orientation of the patient's head in a plane perpendicular to the axis of the eye to be treated. Furthermore, using an orientation analysis system to determine the surface morphology of the eye fixation device allows adjustment of the tilt of the laser applicator relative to the tilt of the eye fixation device. This avoids unwanted shear forces during the docking process.

[0084] According to one embodiment, the controller is configured to automatically determine the position and / or orientation of the eye fixation device, particularly the position and / or orientation of one or more markers (especially infrared markers) on the eye fixation device, based on orientation-related data or user input. The one or more infrared markers may be infrared-absorbing or infrared-reflecting markers.

[0085] The orientation analysis system may include an imaging system for imaging at least a portion of the eye fixation device onto an image sensor of the imaging system when the eye fixation device is attached to the patient's eye. The imaging optical path of the imaging system may pass through one or more optical elements of a beam delivery system (particularly its movable portion).

[0086] According to one embodiment, the orientation analysis system includes an aiming system for aiming at one or more body parts and / or objects along an aiming direction.

[0087] The aiming system can be configured to target one or more body parts of the patient, such as the patient's feet, head, one or both eyes, mouth, or feet. The aiming system can be configured to simultaneously target two separate body parts (e.g., the patient's eyes), or to align the aiming system with the longitudinal shape of the body part (e.g., the longitudinal shape of the mouth).

[0088] According to one embodiment, the aiming system includes a light source for generating an aiming beam extending along the aiming direction. Additionally or alternatively, the aiming system includes a mechanical indicator that visually indicates the aiming direction. Additionally or alternatively, the aiming system includes a circumferentially arranged array of light sources, wherein the aiming system is configured such that one or more active light sources in the array indicate the aiming direction.

[0089] According to one embodiment, the aiming system is configured such that the aiming direction can be adjusted by a user and / or a controller.

[0090] Embodiments of this disclosure relate to an ophthalmic laser system having a beam delivery system. The laser system is configured to perform laser treatment on a patient's eye using a therapeutic laser beam. The laser system includes a beam delivery system for focusing the therapeutic laser beam such that the beam travels toward the patient's eye. The laser system also includes a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea. The laser system also includes a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least the movable portion to different orientations of the patient's head measured about an axis around the eye to be treated. The laser system also includes an orientation indicating system configured to indicate to a user a relative orientation between: (a) the orientation of a patient's body part and / or an object that contacts and / or covers at least a portion of the body part; and (b) the orientation of the movable portion of the beam delivery system, wherein the relative orientation is relative to the axis of the eye to be treated.

[0091] The orientation system can be configured to indicate whether the movable part has an orientation around the eye axis and relative to the patient's head, the orientation (i) corresponding to or substantially corresponding to a predetermined target orientation; or (ii) being within or substantially within a predetermined target range.

[0092] According to one embodiment, the orientation indicating system includes a light source. The position and / or orientation of the light-emitting surface of the light source can indicate or be related to the orientation of a movable portion of the beam delivery system. Additionally or alternatively, the direction of light emitted by the light source can indicate or be related to the orientation of the movable portion of the beam delivery system. The direction of the light can have a fixed orientation relative to the movable portion of the beam delivery system. This orientation can be measured in a plane perpendicular to the axis of the eye to be treated.

[0093] According to one embodiment, the light source is a laser, particularly a line laser.

[0094] According to yet another embodiment, the orientation system includes an aiming system for targeting one or more predefined body parts of a patient.

[0095] According to yet another embodiment, the orientation indicating system includes a light source. The orientation indicating system can be configured such that light emitted from the light source produces a visible mark on the patient's body or on an object attached to and / or covering at least a portion of the patient's body.

[0096] According to yet another embodiment, the position and / or orientation of the visible marker indicate relative orientation or are related to it.

[0097] According to another embodiment, the orientation indication system includes a mechanical orientation indicator, wherein the indicated direction is related to the orientation of a movable portion of the beam delivery system. The mechanical orientation indicator may be a protrusion extending from the laser applicator housing. The mechanical orientation indicator may be configured as a protrusion in the form of a tab. However, other shapes of the mechanical orientation indicator are also conceivable. The protrusion may be in the form of a tab. The mechanical orientation indicator may have a fixed orientation relative to the movable portion of the beam delivery system. This orientation can be measured in a plane perpendicular to the axis of the eye to be treated.

[0098] According to yet another embodiment, the ophthalmic laser system includes a support arm, wherein at least this portion of the beam delivery system is movably supported by a free end of the support arm, or a portion thereof.

[0099] According to yet another embodiment, a second end of the support arm, opposite to the free end, is connected to a laser system base that supports the support arm. Additionally or alternatively, the second end includes an interface for connecting the support arm to another component at the second end of the support arm.

[0100] According to yet another embodiment, the laser system includes a laser source for generating a therapeutic laser beam. A second end of the support arm, opposite the free end, can be connected to a laser system base that supports the support arm. The base can accommodate at least a portion of the laser source.

[0101] According to yet another embodiment, the support arm includes one or more sensors operatively coupled to a controller, and includes one or more of the following: (a) a linear and / or angular position sensor; and / or (b) a tiltmeter and / or accelerometer. The controller may be configured to determine one or more parameters of the position and / or orientation of the laser applicator based on the output of the one or more sensors. The determined position and / or orientation may be determined relative to the ophthalmic laser system base.

[0102] According to yet another embodiment, the support arm includes one or more linear and / or angular position sensors operatively coupled to a controller. The controller can be configured to determine one or more parameters of the position and / or orientation of the laser applicator based on the outputs of the one or more linear and / or angular sensors.

[0103] Embodiments of this disclosure relate to a method of operating an ophthalmic laser system having a beam delivery system for performing laser treatment on a patient's eye using a therapeutic laser beam. The laser system includes a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated. The laser system also includes a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea. The laser system also includes a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least a movable portion to different orientations of the patient's head measured about an axis around the eye to be treated. The method includes: using an orientation analysis system to acquire orientation-related data using one or more body parts and / or one or more objects of the patient, each object being in a fixed position and / or orientation relative to a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about the eye axis. The method further includes: using orientation-related data, a user and / or the controller of the laser system, moving a movable portion of the beam delivery system such that, during laser treatment, the movable portion has an orientation around the eye axis and relative to the patient's head that corresponds to or substantially corresponds to a predetermined target orientation, or is within or substantially within a predetermined target range.

[0104] Embodiments of this disclosure relate to a method of operating an ophthalmic laser system having a beam delivery system for performing laser treatment on a patient's eye using a therapeutic laser beam. The laser system includes a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated. The laser system also includes a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea. The method includes: using a orientation analysis system to acquire orientation-related data using one or more body parts and / or one or more objects of the patient, each object contacting and / or covering a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about an eye axis. At least one body part and / or object is external to the eye to be treated. The controller is further configured to determine, based on the orientation-related data: (i) one or more parameters of the laser positioning data; and / or (ii) whether the exiting optics of the beam delivery system are positioned anterior to the patient's left or right anterior eye.

[0105] According to one embodiment, the method further includes: using a user and / or ophthalmic laser system, placing at least one object such that the object contacts and / or covers a part of the patient's body. The method may also include acquiring orientation-related data from at least a portion of the placed object. The body part may be a predefined body part, particularly an anatomically and / or functionally predefined body part.

[0106] According to one embodiment, placing an object includes placing the object on another object, particularly a portion of tissue that contacts and / or covers a body part.

[0107] According to yet another embodiment, the object being placed is an anatomical part of the surgeon's hand, particularly the fingers or fingertips of the surgeon's hand.

[0108] Embodiments of this disclosure relate to an ophthalmic laser system for performing laser treatment on the eye using a therapeutic laser beam. The laser system includes a laser applicator comprising an optical system through which the therapeutic laser beam exits the laser applicator in a direction toward the patient's eye. The laser system also includes a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated. The laser system also includes a support arm. The free end of the support arm includes or movably supports the laser applicator. The laser system also includes a controller operatively coupled to the beam delivery system. The controller is configured to control the beam delivery system based on laser positioning data to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea, the laser positioning data indicating or relating to the location to be treated within the eye. The laser system also includes a gigahertz-terahertz imaging system for acquiring image data from (a) one or more body parts of a patient; and / or (b) one or more objects, each object having a fixed position and / or orientation relative to a corresponding body part. The gigahertz-terahertz imaging system is configured to use electromagnetic radiation in the frequency range of 10 GHz to 100 THz. The laser system is further configured to: (a) allow the user and / or controller to adjust the relative position and / or orientation of the laser applicator relative to the patient's head using image data; and / or (b) use the controller to determine laser positioning data based on the image data.

[0109] According to yet another embodiment, the radiation source is configured to generate electromagnetic radiation with frequencies in the range of 30 GHz to 50 THz.

[0110] According to yet another embodiment, the terahertz and / or gigahertz imaging system includes a scanner for scanning an electromagnetic radiation beam across the one or more body parts and / or objects.

[0111] According to yet another embodiment, the controller is configured to determine the external contour of at least a portion of the patient's body based on image data. This external contour may be the contour of at least a portion of the patient's skull, jaw, torso, and / or legs.

[0112] According to yet another embodiment, the free end of the support arm includes or movably supports at least a portion of the gigahertz-terahertz imaging system.

[0113] Embodiments of this disclosure relate to an ophthalmic laser system for performing laser treatment on the eye. The laser system includes a laser applicator comprising an optical system through which a therapeutic laser beam exits the laser applicator in a direction toward the patient's eye. The laser system also includes a support arm, wherein a free end of the support arm includes or movably supports the laser applicator. The laser system also includes a controller. The support arm includes a controllable visual indicator, wherein the controller is operatively connected to the visual indicator to control the generation of a visual signal. The visual indicator includes (a) a curved surface from which signal light of the visual signal is emitted, wherein the curved surface forms at least a circumferential portion of the outer peripheral surface of the support arm; and / or (b) a plurality of surfaces from which signal light of the visual signal is emitted, wherein the plurality of surfaces are distributed at least around the circumferential portion of the outer peripheral surface of the support arm.

[0114] Visual signals can indicate information. This information can be encoded in changes in intensity, color, and / or variations in a subset of the plurality of surfaces emitting the visual signal. According to another embodiment, the support arm includes at least one arm segment, wherein a visual indicator is disposed at a support structure of the support arm, which supports the arm segment. The support structure may include at least a portion of a rotation guide for pivoting the arm segment about a horizontal axis. The laser system can be configured such that the support structure is movably mounted on a base of the ophthalmic laser system. For example, the support structure can be connected to the base via one or more additional arm segments. The support structure can be configured to connect joints of two consecutive arm segments. Alternatively, the support structure can be fixedly connected to the base. Additionally or alternatively, the laser system can be configured such that the support structure can be translated in a controlled manner relative to the base. For example, the ophthalmic laser system may include a positioning stage mounted on the base. The support structure can be mounted on the positioning stage such that the support structure can be translated relative to the base in at least two horizontal dimensions.

[0115] The arm segment may be the most distal of all rotatable arm segments of the support arm. The support arm may be configured such that the arm segment is rotatable about a horizontal axis and / or about a vertical axis. The arm segment may form part of a multi-link mechanism of the support arm. The multi-link mechanism may be configured such that the orientation of the first end of the multi-link mechanism relative to the second end is maintained when the first end moves relative to the second end. The multi-link mechanism may be a parallel linkage and / or a four-bar linkage. The multi-link mechanism may be balanced to provide at least partial gravitational balance for the laser applicator. The multi-link mechanism may be the only component of the support arm rotatable about a horizontal axis, and / or may be the most distal rotatable component of the support arm about a horizontal axis.

[0116] It should be understood that this disclosure is not limited to visual indicators arranged at joints and / or the support structure of the support arm. It is also conceivable that visual indicators be mounted on or part of a segment or multi-link mechanism of the support arm. This segment or multi-link mechanism may be the distal segment or distal multi-link mechanism of the support arm. This segment or multi-link mechanism can rotate about a horizontal axis. Furthermore, this segment or multi-link mechanism can also rotate about a vertical axis. The orientation of the horizontal axis of rotation in the horizontal plane can be adjusted by the support arm.

[0117] According to yet another embodiment, the support arm includes two arm segments connected by one or more joints. A visual indicator may be positioned at one or more of these joints.

[0118] According to another embodiment, the outer peripheral surface has a horizontal or substantially horizontal circumference. The circumferential direction of the circumferential surface can be horizontally oriented or substantially horizontally oriented. In other words, the axis of the circumferential surface can be vertically oriented or substantially vertically oriented.

[0119] A circumferential surface can have a cylindrical outer perimeter. However, other outer shapes for a circumferential surface are also conceivable, such as elliptical, rectangular, rhomboid, and polygonal outer shapes. A polygonal outer shape can have three or more straight sides.

[0120] According to another embodiment, the first of the two arm segments can rotate about a vertical or substantially vertical axis, and the second of the two arm segments can rotate about a horizontal or substantially horizontal axis.

[0121] According to another embodiment, the second arm segment can also be rotated about a vertical axis in order to adjust the orientation of the second arm segment relative to the first arm segment.

[0122] According to yet another embodiment, the first arm segment is connected to the laser applicator via the second arm segment.

[0123] According to yet another embodiment, the controller is configured such that visual signals indicate stages of laser treatment. The controller may be configured to use visual indicators to indicate stages of laser treatment with a predefined temporal correlation, particularly in sync with the progress time of the ophthalmic laser system.

[0124] According to yet another embodiment, the controller is configured such that visual signals indicate the operational status of laser treatment performed using an ophthalmic laser system. The controller may be configured to use visual indicators to indicate the operational status of the laser treatment with a predefined temporal correlation, particularly synchronized with the progress time of the ophthalmic laser system.

[0125] According to yet another embodiment, the controller and the visual indicator are configured such that the visual indicator shows a warning message to the user.

[0126] According to yet another embodiment, the support arm is configured such that the laser applicator can be positioned relative to the base in three dimensions.

[0127] According to one embodiment, the visual indicator includes one or more light-emitting diodes (LEDs). The visual indicator may include a plurality of LEDs arranged circumferentially around at least the circumferential portion.

[0128] Additionally or alternatively, the visual indicator may include an optically diffused fiber. The fiber axis of the optically diffused fiber may be arranged at least partially around a circumferential surface to form one or more windings.

[0129] According to one embodiment, the visual indicator includes one or more light-emitting diodes (LEDs). The plurality of LEDs can be arranged on a carrier structure. The carrier structure can be in the form of a plate or substantially a plate. At least a portion of the carrier structure can be configured as a circuit board. The plate can be planar or substantially planar in shape. Alternatively, the plate can be curved, with the LEDs mounted on an outward circumferential surface of the plate. The carrier structure can be in the form of a circumferential portion of at least one ring or substantially therein.

[0130] According to yet another embodiment, the visual indicator includes a plurality of light sources, wherein each light source includes or is covered by one of the surfaces from which signal light is emitted, and these surfaces are distributed around at least the circumferential portion.

[0131] According to one embodiment, the visual indicator includes a light reflector illuminated by one or more light sources of the visual indicator. The reflector may be configured to perform specular or diffuse reflection of signal light emitted from the one or more light sources of the visual indicator. The reflector and / or a light diffuser may be located in the optical path of the signal light between the one or more light sources and a cover of the visual indicator, the cover covering the reflector. The cover may also cover the one or more light sources of the visual indicator. At least a portion of the cover may be made of a light-diffusing material and / or be transparent to one or more wavelengths emitted from the one or more light sources of the visual indicator.

[0132] Embodiments of the present invention relate to an ophthalmic laser system for performing laser treatment on the eye. The laser system includes a base housing at least a portion of a laser source of the laser system, wherein the laser source is configured to generate a therapeutic laser beam for performing laser treatment. The laser system also includes a laser applicator comprising an optical system through which the therapeutic laser beam exits the laser applicator in a direction toward the patient's eye. The laser system also includes a support arm and a controller. The support arm is connected at a first end to the laser applicator. A second end of the support arm may be connected to the base, and / or additionally or alternatively, the support arm includes an interface for connecting the support arm to another component at the second end of the support arm. The support arm may be configured such that the laser applicator is positionable relative to the base in three dimensions. The laser applicator may be positionable while maintaining a vertical orientation. The laser system may also include a motorized triaxial positioning system operatively coupled to the controller for positioning the laser applicator relative to at least a portion of the support arm or relative to the entire support arm. The positioning system may be configured such that the laser applicator is positionable in three dimensions.

[0133] The laser system may include an articulated beamguide. At least a portion of the articulated beamguide may extend between a first position where the therapeutic laser beam exits from the base or support arm and a second position where the therapeutic laser beam enters the support arm or laser applicator. The laser system may include coupling means for coupling the articulated beamguide to the support arm along one or more positions of the beamguide between the first and second positions.

[0134] The support arm can be connected to the laser applicator at one end. The second end of the support arm can be connected to a base, and / or another component can be connected at the second end of the support arm. This other component can be external to the ophthalmic laser system. For example, this other component can be a second base, or it can be a wall, ceiling, or floor of a building.

[0135] The base of the laser system can be configured as a movable base that can move across a floor surface. The movable base may include multiple wheels, such as four wheels, for moving the base across the floor surface. The movable base can be configured such that the entire laser surgical system can be moved across the floor by a single person. The support arms and laser applicator can be supported solely by the base.

[0136] The laser source can be an infrared laser source. An infrared laser source can be configured as a femtosecond laser source. The pulse energy of the laser pulse can be greater than 1 nanojoule, or greater than 10 nanojoules, or greater than 50 nanojoules. The pulse energy can be less than 20 microjoules, or less than 15 microjoules, or less than 10 microjoules. The pulse duration of the pulsed laser beam can be less than 800 femtoseconds, or less than 500 femtoseconds, or less than 300 femtoseconds, or less than 150 femtoseconds, or less than 100 femtoseconds. The pulse duration can be greater than 10 femtoseconds or greater than 50 femtoseconds. The repetition rate of the pulsed laser beam can be greater than 50 kHz or greater than 80 kHz. The repetition rate of the pulsed laser beam can be less than 10 MHz or less than 1 MHz. The center wavelength of the pulsed laser beam incident on the eye can be between 800 nm and 1400 nm, or between 900 nm and 1400 nm, or between 1000 nm and 1100 nm, or between 1010 nm and 1050 nm.

[0137] An infrared laser source can be configured to give the laser pulses pulse energy such that the laser beam induces photo-rupture within the corneal tissue or the lens of the patient's eye. Photo-rupture may be caused by laser-induced optical breakdown. Alternatively, the pulse energy of the laser pulses can be below a threshold that induces laser-induced optical breakdown. For example, multiple pulses (with pulse energies below the threshold for laser-induced optical breakdown) can overlap in a manner that induces tissue separation within the cornea.

[0138] Infrared laser sources may include pre-compensators for at least partially pre-compensating for variations in the group delay dispersion (GDD) of the laser pulse caused by components of the laser optics system (located downstream of the laser source in the laser beam path). If the laser pulse has positive GDD, longer wavelengths of the laser pulse propagate faster than shorter wavelengths. Therefore, positive GDD corresponds to material dispersion, which is typical in transparent media because red light wavelengths experience a lower refractive index than blue light wavelengths. The pre-compensator can be configured to reduce the GDD. For example, the reduced GDD produced by the pre-compensator can have a lower positive GDD or a more negative GDD.

[0139] The lateral diameter of the focal point of the therapeutic laser beam from an infrared laser source within the cornea or lens can be less than 10 micrometers, or less than 6 micrometers. This diameter can also be greater than 3 micrometers. The lateral diameter can be measured in a direction perpendicular to the optical axis of the laser optical system. The lateral diameter can be measured as the 80% circumferential energy diameter.

[0140] Alternatively, the laser source can be configured as an excimer laser source. The laser system can be configured to generate a laser beam focused on the anterior surface of the eye. The wavelength of the therapeutic laser beam generated by the excimer laser source can be greater than 150 nm or greater than 190 nm. Alternatively, the wavelength can be less than 400 nm or less than 200 nm. The pulse duration of the therapeutic laser beam generated by the excimer laser source can be less than 100 ns or less than 50 ns. Alternatively, the pulse duration can be greater than 1 ns or greater than 3 ns.

[0141] The controller may include a data processing system. The data processing system may include a computer system having a processor and memory for storing instructions that can be processed by the processor. The processor may execute an operating system. The data analysis system may also include a user interface configured to allow users to receive data from and / or provide data to the data processing system. The user interface may include a graphical user interface.

[0142] The controller can be configured to determine the scanning path of a pulsed laser beam used to scan the laser focus on or inside the cornea or lens of a patient's eye. The controller can also be configured to determine the scanning path based on patient-specific data.

[0143] The controller can be configured to generate scanning patterns such that the laser pulses may overlap or not. The lateral displacement between adjacent laser pulses can be less than 30 micrometers, less than 20 micrometers, or less than 10 micrometers. This displacement can be greater than 0.5 micrometers or greater than 1 micrometer.

[0144] The laser source may include an oscillator laser configured to generate low-energy ultrashort pulse trains. The pulse energy of the low-energy ultrashort pulses may be below 100 nJ, below 20 nJ, or below 10 nJ. The pulse energy may be greater than 1 pJ or greater than 100 pJ. The laser source may also include amplifiers, such as regenerative amplifiers or fiber amplifiers, for amplifying at least a portion of the low-energy ultrashort pulses.

[0145] The base of the laser system can house a portion of the laser source. For example, an oscillator laser can be arranged in the base, and an amplifier and / or a pre-compensator for the laser source (configured to reduce the group delay dispersion of the therapeutic laser beam) can be arranged in the laser applicator. Alternatively, the base can house the entire laser source, such as the oscillator laser, amplifier, and pre-compensator.

[0146] The base may include one or more housings. Each housing may house a portion of the laser source. For example, the first housing of the base may house the seed laser of the laser source, and the second housing of the base may house the amplifier of the laser source, particularly a regenerative amplifier or fiber amplifier.

[0147] A support arm may include one or more arm segments. A support arm may include multiple arm segments connected in series. Adjacent arm segments of a support arm may be connected by one or more joints. An arm segment may be defined as a component of the support arm that provides a non-hinged connection between a first end and a second end of the arm segment. An arm segment may provide a rigid or telescopic coupling between its first and second ends. At one or both ends of the arm segment, the arm segment may be attached to or integrally connected to a joint. The term "integral connection" is intended to indicate that a first element / feature extends or transitions from a second element / feature in a continuous manner, rather than as two separate and distinguishable elements.

[0148] The support arm may include at least one arm segment that forms part of a multi-link mechanism of the support arm. The multi-link mechanism may be configured such that the orientation of the first end of the multi-link mechanism relative to the second end of the multi-link mechanism is maintained when the first end moves relative to the second end. The multi-link mechanism may be a parallel linkage and / or a four-bar linkage. The multi-link mechanism may be balanced to provide at least partial gravitational balance for the laser applicator.

[0149] Arm segments can be connected in series via rotary joints. Each rotary joint can be configured such that the orientation of adjacent arm segments relative to each other is adjustable. Each rotary joint can have one or two axes of rotation. The support arm can include at least one multi-axis joint having two or more axes of rotation. Each axis of rotation can be oriented substantially orthogonal to each other. One of the two axes of rotation can be oriented substantially vertically or perpendicular to the vertical direction.

[0150] The support arm can be configured such that the distance between the laser applicator measuring in the horizontal direction and the position where the support arm is connected to the base is adjustable. The maximum horizontal distance between the base and the applicator head can be greater than 50 cm or greater than 10 cm. This distance can be less than 5 m or less than 3 m.

[0151] The support arm can be further configured such that the laser applicator can move along a circular or substantially circular arc-shaped travel path. This arc can lie in a horizontal or substantially horizontal plane. The radius of the arc can be greater than 10 cm or greater than 50 cm. The radius can be less than 5 m or less than 3 m. This radius can be defined by the longitudinal extension length of a segment of the support arm, wherein the support arm is configured such that the segment can rotate about a vertical or substantially vertical axis. Additionally or alternatively, the support arm can be configured such that the segment can rotate about a horizontal or substantially horizontal axis of rotation. The segment can be part of a multi-link mechanism, particularly a four-bar or parallel-bar mechanism. Additionally or alternatively, the segment can be balanced to provide at least partial gravitational balance for the laser applicator.

[0152] The positioning system may include guides, particularly linear guides, for each of the three axes. The axes of the positioning system may be perpendicular to each other. The positioning system may be configured as an XYZ positioning system, where the Z-axis is a vertical or substantially vertical axis. For each guide, the corresponding guide may be configured as a sliding guide and / or a roller guide. Each guide may include two mating guide members. The first guide member may be configured as a guide rail, which may form a guide track and / or define a guide path. The second guide member may be configured as a carriage and / or be movable along the guide path and / or guide track. The carriage may be a sliding carriage and / or a roller carriage.

[0153] For each of the three axes of the positioning system, the range of motion can be less than 500 mm or less than 150 mm. The range of motion can be at least 1 mm or at least 3 mm.

[0154] For each of the three axes of the positioning mechanism, the positioning accuracy can be worse than 1 micrometer or worse than 10 micrometers. The positioning accuracy can be better than 500 micrometers or better than 100 micrometers.

[0155] For one or more axes or each axis, the positioning speed can be adjusted by the user in a continuous or stepwise manner. The laser system can be configured to receive user input for adjusting the positioning speed of one or more axes or each axis of the positioning system.

[0156] The positioning system can be positioned between the support arm and the laser applicator. However, it is also conceivable that the positioning system is part of the support arm.

[0157] According to one embodiment, the laser applicator includes a manually operable control unit operatively coupled to a controller for performing positioning of the laser applicator relative to at least said portion of a support arm based on user input received via a control element. The manually operable control unit can be configured for directional control, particularly for three-dimensional directional control. For example, the manually operable control unit may include a joystick and / or may include one or more buttons. Each button may correspond to a direction of travel.

[0158] According to yet another embodiment, the laser applicator includes an imaging system for acquiring a frontal image of at least a portion of a patient's eye during at least a portion of the time during which the laser applicator is positioned relative to at least a portion of a support arm.

[0159] The controller of the laser system may include an image processing algorithm for determining whether at least a portion of the frontal image is in focus. Additionally or alternatively, the image processing algorithm may be configured to determine one or more parameters that depend on or indicate the focus level of at least a portion of the image. The image processing algorithm may include a segmentation algorithm for segmenting the frontal image. The image processing algorithm may determine one or more parameters that depend on or indicate the focus level of one or more segmented image regions.

[0160] The imaging system may include an image sensor. The image sensor may include a two-dimensional ordered or disordered array of pixels. The image sensor may be sensitive to one or more wavelengths in the range of 380 nm to 950 nm or 380 nm to 1400 nm. The imaging system may include an imaging optics system for imaging tissue portions disposed in the object plane of the imaging optics system onto the image sensor. At least a portion of the imaging optics system may be provided by a portion of a focusing optics system for focusing a therapeutic laser beam into the patient's eye.

[0161] According to yet another embodiment, the laser applicator includes a beam combiner for combining the imaging optical path of the imaging system with the optical path of the therapeutic laser beam.

[0162] The beam combiner can be configured to deflect the therapeutic laser beam in a direction toward or substantially toward the eye. The beam combiner may include a mirror and / or a prism. The beam combiner can be configured as a dichroic beam combiner. The beam combiner can be located downstream of, within, or upstream of the focusing optics system in the laser beam path.

[0163] The distance between the object plane of the imaging system and the laser applicator can be configured or adjusted such that the distance substantially corresponds to the distance between the laser applicator and the patient's cornea during laser treatment.

[0164] According to one embodiment, the laser applicator includes a display device for displaying a frontal image during at least a portion of the laser applicator's positioning relative to a support arm. The display device may be mounted on or integrated into the housing of the laser applicator. The display is visible to the user during operation of manually operated control elements.

[0165] According to yet another embodiment, the laser applicator includes an interaction measurement unit for generating an output signal that depends on at least one parameter of the mechanical interaction between the patient's eye and the laser applicator.

[0166] The interaction measurement unit may include multiple interaction measurement sensors. These sensors may be circumferentially distributed around the optical axis of the laser applicator. Alternatively, these sensors may be arranged at the same or substantially the same radial distance from the optical axis of the laser applicator.

[0167] The measured mechanical interaction parameters may depend on the force or the directional component of the force, or may be the force or the directional component of the force. This force may be present between the patient's eye and the laser applicator. Additionally or alternatively, the measured mechanical interaction may depend on the time-varying force, or the time-varying force between the patient's eye and the laser applicator.

[0168] The interaction measurement unit may include multiple interaction measurement sensors. One or more interaction measurement sensors may include force sensors, piezoelectric sensors, and / or strain gauges.

[0169] The interaction measurement unit can be configured to measure the magnitude of the projection of the force vector onto the optical axis of the laser applicator (i.e., the portion of the optical axis at the location where the therapeutic laser beam exits from the laser applicator toward the patient's eye) and / or the magnitude of the projection of the force vector onto a plane perpendicular to the optical axis.

[0170] Strain gauges can be configured to measure strain in a sensing material caused by force. The strain can be compressive or tensile. Strain gauges can be configured as foil strain gauges, semiconductor strain gauges (utilizing the piezoresistive effect), or capacitive strain gauges. Piezoelectric sensors can utilize the piezoelectric effect in piezoelectric materials (e.g., quartz). Piezoelectric sensors can measure compressive, tensile, and / or shear forces acting on the piezoelectric sensor. Force sensors can also include interferometric strain sensors or measure forces acting on birefringent materials. Fiber optic force sensors can also be envisioned.

[0171] Force sensors can be placed in the force path between the patient's eye and the optical system that focuses the therapeutic laser beam into the patient's eye.

[0172] According to yet another embodiment, the laser applicator includes a display device. The controller may be configured to generate data representing graphic and / or textual information using an output signal generated by the interaction measurement unit. Additionally or alternatively, the controller may be configured to display the graphic and / or textual information on the display device during at least a portion of the time the laser applicator is positioned relative to at least said portion of the support arm.

[0173] The graphical and / or textual information generated using the output signal of the interaction measurement unit can depend on the magnitude and direction of the force between the laser applicator and the eye, which can be determined using the interaction measurement unit.

[0174] Additionally or alternatively, graphical and / or textual information may depend on the magnitude and / or rate of change of the measured force.

[0175] According to one embodiment, the coupling device includes a tension transmission connection. The tension transmission connection may include a tension spring for transmitting tension.

[0176] According to another embodiment, the coupling device includes a guide. This guide can be configured as a lateral guide. The lateral guide can be configured to limit lateral movement of the coupling member of the coupling device relative to the longitudinal axis of the support arm segment. The coupling member can be rigidly attached to or integrally connected to a hinged beamguide.

[0177] The lateral guide can guide the movement of the coupling member in a direction parallel or substantially parallel to the longitudinal axis of the support arm segment. This guide can be configured to limit changes in the vertical orientation of the plane defined by the continuous arm segment of the articulated beam guide during laser applicator movement.

[0178] According to yet another embodiment, the laser applicator includes an optical coherence tomography (OCT) system configured to acquire cross-sectional images of at least a portion of the eye.

[0179] The center wavelength of the OCT measurement arm can be in the range of 750 to 1400 nanometers. The optical coherence tomography (OCT) system can be configured to acquire cross-sectional images of at least a portion of the cornea and / or the lens of the eye. The OCT system may include a scanner. The scanner of the OCT system may be separate from the scanner of the optical system used to scan the therapeutic laser beam.

[0180] According to yet another embodiment, the laser applicator includes a beam combiner for combining the optical path of the measuring arm of the OCT system with the optical path of the therapeutic laser beam.

[0181] A beam combiner for combining the optical path of a therapeutic laser beam with the optical path of a measuring arm of an OCT system can be configured as a dichroic beam combiner. At least a portion of the beam combiner for combining the optical path of a measuring arm of an OCT system with the therapeutic laser beam can be provided by at least a portion of the beam combiner for combining the optical path of an imaging system with the optical path of a therapeutic laser beam.

[0182] According to one embodiment, the support arm includes an arm segment rotatable about a horizontal or substantially horizontal axis. According to another embodiment, the arm segment is part of a multi-link mechanism, particularly a four-bar linkage, such as a parallel linkage. The multi-link mechanism can be configured such that the vertical orientation of the laser applicator is maintained during rotation of the arm segment about a horizontal axis.

[0183] According to another embodiment, the support arm includes a first arm segment and a second arm segment, which are connected in series via an intermediate joint. The first arm segment is rotatable about a vertical or substantially vertical axis, and the second arm segment is rotatable about a horizontal or substantially horizontal axis.

[0184] According to another embodiment, the intermediate joint system is configured to allow the second arm segment to rotate (a) about a horizontal or substantially horizontal axis and (b) about a vertical or substantially vertical axis. The intermediate joint system may include two joints rigidly attached to or integrally connected to each other. The first of the two joints has a vertically or substantially vertically oriented axis of rotation, and the second of the two joints has a horizontally or substantially horizontally oriented axis of rotation. The first joint may be attached to or integrally connected to the first arm segment, and the second joint may be attached to or integrally connected to the second arm segment.

[0185] According to yet another embodiment, the second arm segment is part of a multi-bar linkage, particularly a four-bar linkage, such as a parallel linkage.

[0186] According to yet another embodiment, the support arm includes a balancing mechanism to provide at least partial gravity balance for the applicator head.

[0187] According to yet another embodiment, the balancing mechanism includes one or more springs. Each spring may be configured as a gas spring or a mechanical spring.

[0188] According to yet another embodiment, the support arm includes a braking and / or locking system for preventing movement of the second end of the support arm relative to the first end of the support arm. The braking and / or locking system may include one or more lockable joints and / or brakes for braking movement of the joint portions relative to each other. The locking mechanism of the lockable joint may lock based on the shape of the joint components (which would otherwise be movable relative to each other).

[0189] According to yet another embodiment, the laser applicator includes a manually operable control unit for selectively activating and deactivating the braking and / or locking system based on user input received via the control unit.

[0190] According to another embodiment, the laser system includes an interaction measurement unit configured to generate an output signal dependent on the mechanical interaction between the patient's eye and the laser applicator. A controller may be operatively connected to the interaction measurement unit and an braking and / or locking system. The controller is configured to receive the output signal generated by the interaction measurement unit and determine, based on the received output signal, whether to deactivate the braking and / or locking system.

[0191] An articulated beamguide may include one or more joints, each joint connecting an adjacent longitudinal segment. Each segment may define a linear laser beam path extending along the longitudinal axis of the segment. For each segment, the corresponding segment may be rigid or extendable along the longitudinal axis of the corresponding tube element.

[0192] Each joint of the articulated beamguide may include a mirror system. The mirror system may include one or more mirrors. The mirror system may be configured to deflect a therapeutic laser beam emitted from a first adjacent tube element connected to the joint to a second adjacent tube element.

[0193] According to yet another embodiment, the support arm or laser applicator has a rotary joint having a vertically extending axis of rotation for rotating the laser applicator about the vertical axis and relative to at least a portion of the support arm.

[0194] According to yet another embodiment, the laser system includes a locking system configured to lock a rotary joint having a vertically extending axis of rotation.

[0195] According to yet another embodiment, the laser applicator includes: a focusing optics system for focusing a therapeutic laser beam into the eye and / or an axial scanning system for scanning the laser focal point along the laser beam axis; and / or a beam deflection scanning system for scanning the laser beam by deflecting the laser beam.

[0196] Another embodiment of this disclosure relates to a method for positioning a laser applicator of an ophthalmic laser system relative to a patient's eye. The method includes positioning the laser applicator relative to the patient's eye using a support arm. The support arm may be connected to the laser applicator at a first end. A second end (a) of the support arm may be connected to a base and / or (b) may include an interface for connecting the support arm to another component at the second end. The laser system may be configured to generate a therapeutic laser beam for performing laser therapy. The support arm may be configured such that the laser applicator can be positioned relative to the base while maintaining the vertical orientation of the laser applicator. The method may further include positioning the laser applicator relative to the support arm using a motorized triaxial positioning system.

[0197] According to yet another embodiment, the method includes acquiring a frontal image of the eye using an imaging system with a laser applicator. The method may further include displaying the frontal image on a display device of the laser system during at least a portion of positioning of the laser applicator relative to a support arm. The displayed frontal image may be a real-time image.

[0198] According to yet another embodiment, during this partial positioning, the distance between the focal plane and the laser applicator substantially corresponds to a predetermined distance between the laser applicator and the patient's eye, particularly from the patient's cornea.

[0199] According to another embodiment, the method further includes: generating an output signal by an interaction measurement unit, the output signal depending on the mechanical interaction between the patient's eye and the laser applicator. The method may also include determining text and / or graphic information based on the output signal using a controller of the laser system. The method may further include displaying the text and / or graphic information during at least a portion of the laser applicator's positioning.

[0200] The time period for displaying the frontal image and the time period for displaying text and / or graphic information based on the output signal of the interaction unit can be the same, overlap, or not overlap.

[0201] According to another embodiment, the method includes: generating an output signal by an interaction measurement unit, the output signal depending on the mechanical interaction between the patient's eye and the laser applicator. The method may further include using a controller of the laser system and determining, based on the output signal, whether to deactivate a brake on the support arm that prevents movement of the second end of the support arm relative to the first end of the support arm. Attached Figure Description

[0202] Figure 1 This is a perspective view of a laser system according to an exemplary embodiment.

[0203] Figure 1A This is a schematic cross-sectional view of the lower portion of the laser applicator and the contact element of a first and second variant of a laser system according to an exemplary embodiment;

[0204] Figure 1B These are schematic illustrations of windows of the graphical user interface of the first and second variant laser systems according to exemplary embodiments.

[0205] Figure 1C This is a schematic illustration of a sterile drape used to perform laser therapy using a laser system according to an exemplary embodiment;

[0206] Figure 1D and Figure 1E This is another schematic illustration of a window of a graphical user interface for a first and second variant of a laser system according to an exemplary embodiment;

[0207] Figure 1F This is a schematic cross-sectional view of the lower portion of the laser applicator and the contact element of a third variant of a laser system according to an exemplary embodiment;

[0208] Figure 1G This is a schematic illustration of anatomical landmarks and features used to determine orientation-related data by a third variant of a laser system according to an exemplary embodiment;

[0209] Figure 1HThis is a schematic diagram illustrating the installation location of the directional analysis system of a third variant of the laser system according to an exemplary embodiment:

[0210] Figure 1I This is a schematic cross-sectional view of the lower portion of the laser applicator and the contact element of a fourth variant of a laser system according to an exemplary embodiment;

[0211] Figure 1J and Figure 1K This is a schematic illustration of a directional analysis system of a fifth variant of a laser system according to an exemplary embodiment;

[0212] Figure 1L This is a schematic illustration of a directional analysis system of a sixth variant of a laser system according to an exemplary embodiment;

[0213] Figure 1M This is a schematic illustration of a directional analysis system of a seventh variant of a laser system according to an exemplary embodiment;

[0214] Figure 1N This is a schematic illustration of a directional analysis system of an eighth variant of a laser system according to an exemplary embodiment;

[0215] Figure 2 It is based on such Figure 1 A second perspective view of the laser system of the exemplary embodiment shown, wherein the support arm is in a stationary position.

[0216] Figure 3 It is based on such Figure 1 A schematic diagram of a laser system according to an exemplary embodiment is shown, illustrating the laser system based on, as described above. Figure 1 The extent of lateral movement of the laser applicator in the laser system of the exemplary embodiment shown;

[0217] Figure 4 It is based on such Figure 1 Another schematic top view of the laser system of the exemplary embodiment shown;

[0218] Figure 5 It is based on such Figure 1 A schematic side view of the support arm and laser applicator of the laser system shown in the exemplary embodiment;

[0219] Figure 6 It is based on such Figure 1 A schematic diagram showing information displayed on a display device of the laser applicator of the laser system of the exemplary embodiment shown;

[0220] Figure 7 It is based on such Figure 1 A schematic diagram of an imaging system, an OCT system, and a beam combiner arranged in the laser applicator of an exemplary laser system shown.

[0221] Figure 8A and Figure 8B Schematic illustration based on, for example Figure 1 The interaction measurement unit of the laser applicator in the laser system shown in the exemplary embodiment;

[0222] Figure 9 It is based on such Figure 1 A schematic diagram showing information displayed on a display device of the laser applicator of the laser system of the exemplary embodiment shown;

[0223] Figure 10 It is based on such Figure 1 A schematic diagram of the parallel linkage mechanism and balancing mechanism of the support arm of the laser system shown in the exemplary embodiment; and

[0224] Figures 11A to 11C It is a side view of the support arm and the articulated beam guide tube of the laser system, as well as the coupling device for coupling the articulated beam guide tube to the support arm of the laser system according to an exemplary embodiment.

[0225] Figure 12 This is a schematic diagram illustrating the possible orientation range of the laser applicator relative to the patient's head;

[0226] Figure 13 This is a schematic illustration of the image area of ​​the patient's untreated eye in the image of the first imaging system;

[0227] Figure 14 This is a schematic illustration of a portion of a support arm of an ophthalmic laser system according to an exemplary embodiment, which includes a controllable visual indicator.

[0228] Figure 15A This is a schematic perspective view of a portion of the intermediate joint of the support arm of an ophthalmic laser system according to an exemplary embodiment, wherein the curved surface has been removed from the intermediate joint; and

[0229] Figure 15B yes Figure 15A A schematic cross-sectional view of a portion of the intermediate joint shown. Detailed Implementation

[0230] To facilitate understanding of the invention, exemplary embodiments of ophthalmic laser systems configured to perform treatments on the eye are referenced in the text, and only some of these embodiments are described herein. It should be understood that by describing these exemplary embodiments, it is not intended to limit the scope of the invention. Inclusion of additional elements may be apparent to those skilled in the art. The specific elements disclosed herein should not be construed as limiting, but rather serve as the basis for the claims and as a representative basis for teaching those skilled in the art to employ the invention in virtually any suitably detailed device or manner.

[0231] The terms “substantially” or “approximately” as used herein may be used to modify any quantitative representation that may vary without altering its underlying function.

[0232] Figure 1 This is a schematic illustration of an ophthalmic laser system 1 for performing laser treatments on the eye, according to an exemplary embodiment. These treatments may include, but are not limited to, flap formation for laser-assisted in situ keratomileusis (LASIK), formation of corneal incisions and limbal laxity incisions (LRI, AK), capsular incision (particularly anterior capsular incision), and lens fragmentation.

[0233] The laser system 1 includes a laser source configured to generate a therapeutic laser beam for performing laser therapy. At least a portion of the laser source is mounted within a housing 2 of the base 3. Another portion of the laser source may be disposed within a laser applicator 6 supported by a hinged support arm 4 and / or within the support arm 4 supporting the laser applicator 6. It is also conceivable that the base 3 includes more than one housing, each housing a portion of the laser source. For example, a first housing of the base 3 houses the oscillator laser of the laser source, and a second housing of the base houses the amplifier and / or pre-compensator of the laser source.

[0234] Laser system 1 includes a laser optical system configured to direct a laser beam toward a patient lying on a bed or support device. Figure 1(Not shown) The patient's eye is positioned on a laser source. A therapeutic laser beam is generated, which is guided by a laser optics system through a portion of a support arm 4, a hinged beamguide 5, and a laser applicator 6. The hinged beamguide 5 extends at least between a first position where the laser beam exits the support arm 4 and a second position where the laser beam enters the laser applicator 6. However, this disclosure is not limited to this configuration for guiding a therapeutic laser beam from the base 3 to the patient's eye. For example, the laser beam may be guided through the entire support arm. In particular, the laser system may be configured such that it does not include a beamguide. It is also contemplated that the hinged beamguide 5 extends at least between a first position where the therapeutic laser beam exits the base 3 and a second position where the therapeutic laser beam enters the support arm 4 or the laser applicator 6. A portion of the hinged beamguide may be disposed within the base 3, within the support arm 4, and / or within the laser applicator 6.

[0235] exist Figure 1 In the exemplary embodiment shown, the laser source is configured to emit a pulsed laser beam with pulse energy and pulse duration sufficient to induce laser-induced optical breakdown (LIOB) within the cornea, lens, or lens capsule of the patient's eye. The LIOB generated by the laser pulses results in photo-rupture, causing a series of consecutive, overlapping, or closely positioned laser pulses to create incisions in the corneal tissue, lens, or lens capsule. Photo-rupture is a non-thermal process. The laser optics system includes a scanning system configured to scan the focal point of the pulsed laser beam within the eye to form perforated or continuous (i.e., non-perforated) incisions. Figure 1 In the exemplary embodiment shown, the scanning system is arranged within the laser applicator 6. However, it is also conceivable that at least a portion of the scanning system is arranged within the base 3 and / or the support arm 4.

[0236] It should be noted that this disclosure is not limited to the laser treatments and laser systems described above. Specifically, the laser system can be configured to controllably ablate corneal tissue without causing significant damage to adjacent and / or deep tissues of the eye. The laser system can emit light with a wavelength greater than 150 nm or greater than 190 nm. This wavelength can be less than 400 nm or less than 200 nm. For example, the laser source can be configured as an excimer laser source. The laser system can be an argon-fluorine (ArF) excimer laser that generates laser pulses with a wavelength of essentially 193 nm. The laser ablation process can be used to reshape the cornea. Such ablation treatments can include, but are not limited to, photorefractive keratomileusis (PRK), laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK), and phototherapeutic keratomileusis (PTK). In each of these procedures, a laser beam can be used to remove a predetermined amount of corneal stroma located beneath the corneal epithelium and Bowman's membrane to form a reshaped surface portion.

[0237] exist Figure 1 In the exemplary embodiment shown, the laser source is arranged in the base. However, it is also conceivable that only a portion of the laser source is arranged in the base, with a second portion arranged in the laser applicator 6 or the support arm 4. For example, the oscillator laser of the laser source can be arranged in the base, and the regenerative amplifier and / or the pre-compensator of the laser source can be arranged in the laser applicator and / or the support arm.

[0238] Using the support arm 4, the laser applicator 6 can be positioned in three dimensions. The support arm 4 can be configured to allow manual positioning of the laser applicator 6 in three dimensions. However, it is also contemplated that the support arm may include one or more motors, such that at least a portion of the movement that can be performed using the support arm 4 is electrified. A three-axis electric positioning system 9 is arranged between the support arm 4 and the laser applicator 6. The positioning system 9 can be configured to position the laser applicator 6 relative to the support arm 4. It is also contemplated that the positioning system 9 is part of the support arm 4, such that the laser applicator and a portion of the support arm 4 are positionable relative to another portion of the support arm 4. For example, the positioning system 9 can be arranged between two arm segments, or it can be part of an arm segment of the support arm 4.

[0239] For example, as described in more detail below, the positioning system 9 is used to perform a fine positioning procedure after the laser applicator 6 has been positioned in the coarse positioning procedure using the support arm 4.

[0240] Positioning system 9 can be operatively coupled to the controller ( Figure 1 (Not shown in the image). The controller may be housed within the base 3. However, it is also conceivable that the controller be housed in a housing independent of both the base 3 and the laser applicator 6. The controller may be connected to the components of the base 3, the positioning system 9, and / or the laser applicator 6 via wired or wireless connections.

[0241] The laser applicator 6 may also include a manually operable control unit 10 operably coupled to the controller for performing positioning of the laser applicator 6 relative to said portion or the entire support arm 4 using the positioning system 9. The manually operable control unit 10 may be configured for directional control. For example, the control unit 10 may be configured as a joystick (e.g.,...) Figure 1 (As shown). However, this disclosure is not limited to such a control element. It is also conceivable that the control element includes one or more buttons, each button representing a direction of travel of the laser applicator 6.

[0242] The configuration of the ophthalmic laser system according to the exemplary embodiment allows for positioning of the laser applicator relative to the patient, enabling the patient to remain on their regular patient bed where they received preoperative treatment. This avoids the need for patient transfer, which would otherwise require moving the patient from their regular patient bed to a separate, fixed patient support unit that is part of the laser system and specifically designed for laser surgical procedures.

[0243] Therefore, the surgical laser system according to this disclosure not only improves the efficiency of clinical workflows but also reduces the floor space required for operating rooms, as it eliminates the need for space dedicated to fixed patient support devices for performing laser surgery. Furthermore, the portable laser surgical system facilitates the cleaning and sterilization of the operating room.

[0244] Furthermore, to reduce footprint and cost, it is desirable to configure a femtosecond laser system used for cataract surgery that can also be used to create corneal flaps for laser-assisted in situ keratomileusis (LASIK). However, the femtosecond laser used for LASIK flap creation should be located close to the excimer laser system to facilitate patient movement from one system to another. On the other hand, the femtosecond laser used for cataract surgery should be located in a sterile operating room where phacoemulsification equipment is used to emulsify the lens and implant the intraocular lens. The laser system according to the exemplary embodiment is a mobile laser system that can be easily moved between different locations within the hospital. Moreover, the articulated support arm allows surgeons greater flexibility in arranging the laser system within the operating room, which contains many other devices such as surgical microscopes, phacoemulsification systems, and operating room trolleys, and requires sufficient space for one or more surgeons and other medical staff.

[0245] like Figure 1 as well as Figure 4 Schematic top view and Figure 5 As shown in the schematic side view, the support arm 4 can be configured as a hinged support arm having two or more arm segments connected in series. The support arm 4 may include a first arm segment 8 and a second arm segment 11. The first arm segment 8 can be rotatably supported by a base 3 such that the first arm segment 8 can rotate about a first vertical axis A1. The first vertical axis A1 can have a fixed position and orientation relative to the base 3. Additionally or alternatively, the base can be configured such that the position of the first arm segment 8 relative to the base 3, particularly its height and / or orientation (rotation), is adjustable. For example, the base 3 can be configured such that the first arm segment is supported by a rotary bearing assembly (…). Figure 1 (Not shown) A support is provided for rotatably supporting the first arm segment 8 on the first vertical axis A1. The base 3 can be configured such that the height of the rotary bearing assembly relative to the rest of the base 3 is adjustable, for example, using an electric height adjustment mechanism.

[0246] The first arm segment 8 can be connected to the second arm segment 11 via an intermediate joint 12. The intermediate joint 12 can be configured such that the orientation of the second arm segment 11 relative to the first arm segment 8 can be adjusted in two dimensions. For example, the intermediate joint 12 can be configured such that the second arm segment can rotate about a vertical axis A2 and also about a horizontal axis A3.

[0247] The support arm 4 is configured such that the laser applicator 6 has the same vertical orientation before and after rotation of the second arm segment 11 about the horizontal axis A3. In an exemplary embodiment, the rotation of the second arm segment 11 about the horizontal axis A3 is coupled with the orientation of the laser applicator 6 relative to the second arm segment. This coupling is a mechanical coupling, achieved through a multi-link mechanism of the support arm 4, which can be configured as a parallel linkage mechanism. Two or more parallel links of the parallel linkage mechanism can form the second arm segment 11. However, it is also contemplated that the second arm segment 11 and / or the laser applicator 6 include tilt sensors for measuring the tilt of the second arm segment 11 and / or the laser applicator 6 relative to the horizontal plane. A controller can be provided that receives output signals from one or more tilt sensors and controls the adjustment of the vertical orientation of the laser applicator 6 based on the measured tilt. The adjustment of the vertical orientation can be performed using a motor that drives a rotary joint. It is also contemplated that the connection between the second arm segment 11 and the laser applicator 6 is configured such that the vertical orientation of the laser applicator 6 is maintained by gravity acting on the laser applicator 6.

[0248] The parallel linkage can be configured such that the distal end of the parallel linkage (i.e., the distal end relative to the base 3) maintains its vertical orientation, regardless of the orientation of the second arm segment 11 relative to the horizontal plane. An example of the parallel linkage is referred to below. Figure 10 describe.

[0249] from Figure 1 , 4 As can be seen from Figures 5 and 6, the laser applicator 6 can rotate relative to the support arm 4 about a vertical axis of rotation A6. The vertical axis of rotation A6 can extend through the laser applicator 6, specifically through the housing 22 of the laser applicator 6. However, it is also conceivable that the vertical axis of rotation A6 does not extend through the laser applicator 6. Rotating the laser applicator about the vertical axis of rotation A6 changes the orientation of the laser applicator 6 relative to the support arm 4.

[0250] Rotation of at least a portion of the laser applicator 6 relative to the support arm 4 allows the surgeon to adjust the orientation of the laser applicator 6 during a rough positioning procedure, ensuring that the positioning of the laser applicator 6 relative to the patient's eye is not spatially limited by the patient's anatomy. Additionally or alternatively, the laser system may be configured such that the laser applicator 6 can rotate relative to at least a portion of the support arm about a horizontal axis. Figure 4 and Figure 5(Not shown in the image). In addition to the laser applicator 6 being rotatable about a horizontal axis, the laser system can also be configured such that the laser applicator 6 is rotatable about a roll axis, which is fixed relative to the laser applicator 6, i.e., fixed for different rotational positions of the laser applicator 6 obtained by rotating about a vertical and / or horizontal axis. Figure 4 and Figure 5 (Not shown in the image). This provides greater flexibility in adjusting the orientation of the laser applicator 6 relative to the patient.

[0251] The support arm 4 of the laser applicator 6 of the laser system includes a rotation guide 60 having a vertical rotation axis A6, which is parallel or substantially parallel to the optical axis OA of the beam delivery system within the laser applicator 6, located at the contact element of the treatment laser beam exiting the laser applicator 6 toward the patient interface. Figure 7 The position marked as 28) indicates the travel position. The rotary guide can have a single rotational degree of freedom. From... Figure 1 and Figure 5 As can be seen, in the exemplary embodiment, the rotation guide 60 causes the laser applicator 6 and the motorized triaxial positioning system 9 to rotate about the vertical axis A6. However, it is also conceivable that the rotation guide 60 is arranged between the motorized triaxial positioning system and the laser applicator 6, such that the rotation axis A6 has a fixed position relative to the optical axis OA of the beam delivery system. This allows the vertical rotation axis A6 to be aligned with the optical axis OA, enabling the laser applicator to rotate about the optical axis OA.

[0252] The rotation guide 60 allows movement of the laser applicator 6 to adjust its orientation about a vertical axis to different orientations of the patient's head as measured about the axis of the eye to be treated. This movement can be performed manually by the user or automatically by the controller of the ophthalmic laser system, which controls a drive system configured to rotate the laser applicator 6 about a rotation axis A6. Figure 1 (Not shown in the image).

[0253] Figure 1 Unlike prior art devices, the ophthalmic laser system of the exemplary embodiment does not have an integrated patient support device, i.e., a patient support device with a predefined position and / or orientation relative to the laser system. Instead, the laser system of the exemplary embodiment has a support arm 4, which allows laser treatment to be performed while the patient is lying on a conventional operating table. However, due to this flexibility, the orientation of the laser applicator 6 relative to the patient's head around the axis of the eye to be treated is unknown after the surgeon has positioned the laser applicator close to the patient using the positioning arm. Furthermore, when the surgeon manually performs a coarse positioning procedure using the support arm 4, a handle provided at the laser applicator is typically used. Therefore, the orientation of the laser applicator often changes to an unknown orientation during the coarse positioning procedure.

[0254] However, due to the anatomical shape of the patient's head and the shape of the outer surface of the laser applicator 6 housing, the laser applicator can only dock to the patient's eye in a specific orientation relative to the patient's head. This can make the docking process to the patient's eye laborious and time-consuming.

[0255] The inventors have demonstrated that this drawback can be overcome by providing a orientation analysis system (which acquires orientation-related data) or by providing an orientation indication system (which instructs the user on the relative orientation of the laser applicator relative to the patient's head). Orientation-related data can also be used to determine the scanning path of the therapeutic laser beam focus within the patient's eye or on the anterior surface of the cornea.

[0256] Orientation-related data are obtained using one or more body parts of the patient and / or one or more objects having a fixed position and / or orientation relative to the patient's body parts. It has been shown that this allows for effective avoidance of collisions between the laser applicator and the patient's head.

[0257] As will be explained in more detail below, orientation-related data obtained from one or more body parts and / or objects allows the controller of the ophthalmic laser system ( Figure 1 (Not shown) Positioning the laser applicator such that, during laser treatment, the laser applicator has an orientation about the axis of the eye to be treated, which (i) corresponds to or substantially corresponds to a predetermined target orientation; or (ii) is within or substantially within a predetermined target range. The target orientation and / or target range may depend on the external shape of the laser applicator housing.

[0258] It should be noted that, given the shape of the outer surface of the laser applicator 6 housing, a relatively wide predetermined target area is sufficient. For the same reason, it is sufficient to determine only one or more (i.e., not all) parameters that indicate the orientation of the patient's head. It may even be sufficient to determine only one or more parameters related to orientation.

[0259] As explained in more detail in the following paragraphs, in the first and second variations of the directional analysis system of the exemplary embodiments, the ophthalmic laser system includes one or more 2D imaging systems. The 2D imaging systems can be configured to image one or more body parts and / or objects onto the image sensor of the imaging system.

[0260] Figure 1A It is the lower part 66 of the laser applicator 6 (also shown in Figure 1A schematic cross-sectional view of the contact element 28 of the patient interface through which the beam delivery system delivers the therapeutic laser beam 27 to the patient's eye 29 to be treated. The laser applicator 6 includes a first imaging system 64. The first imaging system 64 includes an imaging optics system 67 configured to image one or more body parts and / or objects (located within an object field 68 of the first imaging system 64) onto an image sensor 65. As further explained below, based on the image from this first imaging system, the orientation of the laser applicator 6 relative to the patient's head around the axis of the eye to be treated can be determined.

[0261] The laser applicator 6 also includes a second imaging system 34 configured to acquire a frontal image of the central portion of the eye to be treated (e.g., at least a portion of the pupillary opening and iris) by imaging the central portion onto the image sensor 105 of the second imaging system. Figure 1A It can be seen, and as referenced Figure 7 In more detail, the imaging optical path of the second imaging system 34 passes through a portion 30b of the beam delivery system.

[0262] The image acquired using the second imaging system 34 can be used to align the optical axis OA of the beam delivery system 6 with the axis AE of the eye to be treated. This is described below. Figure 1B To explain in more detail, specifically, in order to acquire orientation-related data, the first imaging system 64 can acquire one or more images when the optical axis OA of the beam delivery system is aligned with the axis AE of the eye to be treated. On the other hand, the inventors have shown that if the images from the first imaging system 64 are used but the optical axis OA of the beam delivery system is not aligned with the axis AE of the eye to be treated, sufficient accuracy can be obtained in orientation determination.

[0263] Additionally or alternatively, in the ophthalmic laser system of the exemplary embodiment, images acquired using the second imaging system 34 can be used to determine the pupil center of the eye to be treated, so as to center the scanning pattern used in laser treatment. Additionally or alternatively, the controller of the ophthalmic laser system can be configured to compare images acquired using the second imaging system with one or more images acquired using diagnostic equipment (e.g., a wavefront analysis system or an OCT system). This allows the determination of the scanning path for performing laser treatment based on measurements from the diagnostic equipment. This comparison may include iris registration and / or limbal vessel registration.

[0264] Figure 1B This is a schematic illustration of window 83 of a graphical user interface of an ophthalmic laser system according to an exemplary embodiment. On the left side of window 83, the graphical user interface displays the use of a second imaging system 34 (shown in…). Figure 1AImage 72 was acquired. Image 72 shows the central portion of the eye to be treated. The central portion of the image includes at least a portion of the pupillary opening 70 and the iris 88. Figure 1A As can be seen, the imaging optical path 33 of the second imaging system 34 extends through a portion 30b of the beam delivery system and the contact element 28 of the patient interface. The imaging optical path 33 of the second imaging system 34 uses the beam combiner 26 to combine the optical path of the therapeutic laser beam 27.

[0265] Image 72 also shows eight purchin reflective inner rings 86, which are generated by a ring-shaped LED light source ( Figure 1A The light shown in Figure 72 (labeled 98) is produced by the reflection of light at the anterior surface of the cornea. The schematic illustration of Figure 72 also shows an outer ring 85 of eight reflections produced by the light from the LED light source, these reflections being generated by the light reflecting off the contact surface of the contact element 28. Figure 1A The reflection is generated at point 87 (marked in the center). If contact element 28 comes into contact with the cornea, the inner ring 86 of the Purkinje reflection disappears.

[0266] The inner reflective ring 86 and the outer reflective ring 85 can be used in a triaxial positioning system 9 for ophthalmic laser systems (combined with the above). Figure 1 (Description) Aligning the optical axis OA of the laser applicator 6 with the axis AE of the eye to be treated 29, this triaxial positioning system allows the laser applicator 6 to be positioned relative to the support arm 4. Specifically, based on the position of the inner purchin reflector ring 86 relative to the outer reflector ring 85, the user can use the manually operable control unit 10 (shown in...) Figure 1 and Figure 1A ) Control electric three-axis positioning system 9 (shown in Figure 1 and Figure 5 ), until the two rings 85 and 86 are concentric, such as Figure 1B As shown. If the two rings 85 and 86 are concentric or substantially concentric, the optical axis OA of the laser applicator is aligned or substantially aligned with the axis AE of the eye to be treated.

[0267] Therefore, since the inner and outer rings 85 and 86 of the circular reflection are concentric in image 72 and the inner ring 86 of the Purkinje reflection is visible, this indicates that the optical axis of the beam delivery system is aligned with the axis of the eye, and the contact element of the patient interface is not in complete contact with the anterior corneal surface. Figure 1B In the image 72 of the eye to be treated, for example, the distance between the contact surface 87 of the contact element 28 and the anterior surface of the cornea may be between 10 mm on one hand and 0 mm on the other (i.e., in contact with the cornea) or substantially 0 mm. This distance may be measured along the optical axis.

[0268] In reference Figure 1B In a first variant of the described exemplary embodiment, the controller uses the optical axis of the laser applicator ( Figure 1AThe alignment, or substantially alignment, between the laser applicator (marked OA) and the axis AE of the eye to be treated determines one or more parameters for the orientation of the laser applicator relative to the patient's head. Figure 1B The right side of window 83 shown displays a graphical user interface generated by the first imaging system 64 (shown in...). Figure 1A At least a portion of the generated image is shown, with the two axes aligned as indicated by the frontal image 72 of the eye to be treated, as shown in the left portion of window 83. Due to the alignment between the two axes, the position 90 of the pupil center of the eye to be treated relative to the image 89 of the first imaging device is known. This is because the first imaging system 64 (shown in…) Figure 1A The optical axis OA of the beam delivery system has a fixed position and orientation. Therefore, the orientation of the laser applicator relative to the axis of the patient's head around the eye to be treated can be determined based on the determined position of the pupil center 91 of the untreated eye in the first imaging device image 89. The pupil center 91 is therefore an anatomical landmark based on which the interpupillary axis can be determined, i.e., an anatomical feature of the patient's body.

[0269] It should be noted that, although in Figure 1B In the image 89, the center of the pupil of the eye to be treated is located within the image 89, but it is also possible to imagine that the center of the pupil of the eye to be treated is located outside the image 89.

[0270] The graphical user interface of the first variant of the ophthalmic laser system is configured to receive user input via a pointing device (e.g., a computer mouse), wherein the user input identifies one or more locations in an image 89 of the first imaging system that correspond to, substantially correspond to, indicate, or substantially indicate the pupil center 91 of the untreated eye. For example, the user can use the pointing device to position a pointer 84 at a location in the image 89 of the first imaging device that corresponds to or substantially corresponds to the pupil center 91 of the untreated eye 73. It is also conceivable that the graphical user interface is configured such that, using the pointing device, the user can specify a boundary in the image 89 of the first imaging device that corresponds to or substantially corresponds to the pupil edge 92. The specified image region indicates or substantially indicates the pupil center 91 of the untreated eye 73. The controller can be configured to determine the location in image 89 corresponding to the pupil center based on the user input specifying the pupil edge. Furthermore, it is conceivable that the user specifies a location within the pupil opening 82 of the untreated eye, and the controller executes an image processing algorithm, such as by using an edge detection filter, to determine the image region corresponding to the pupil opening. Based on the determined pupil opening, the controller determines the pupil center of the untreated eye.

[0271] Based on the external shape of the laser applicator housing, it can be envisioned that any point within the pupil opening 82 (i.e., without needing to determine the pupil center 91 of the untreated eye) can be used to determine the rotation angle of the laser applicator with sufficient accuracy.

[0272] Based on the position of the pupil center 91 of the untreated eye in the first imaging device image 89 and the known position 90 of the pupil center of the eye to be treated relative to image 89, the controller can determine the interpupillary axis IA of the patient's head, which corresponds to a lateral axis (i.e., the left-right axis) of the head. Therefore, two anatomical landmarks (i.e., two pupil centers) are used to determine an anatomical feature of the human body (i.e., the interpupillary axis IA).

[0273] The controller is further configured to determine one or more parameters, such as the orientation of the interpupillary axis IA of the head relative to the image 89 of the first imaging device. Figure 1B The angle α shown corresponds to the orientation of the laser applicator relative to the patient's head around the axis of the eye to be treated, as measured. The controller is further configured to generate data representing graphic and / or textual information using one or more determined parameters. The controller may be further configured to output this graphic and / or textual information to a user using the user interface of the ophthalmic laser system. The user interface may include a display and / or a graphical user interface. For example, the controller may output a value indicating the orientation of the interpupillary axis IA relative to image 89 on the display of the ophthalmic laser system.

[0274] In a second variation of the exemplary embodiment, the controller automatically or based on user input determines the orientation of the laser applicator relative to the patient's head without changing the optical axis OA of the beam delivery system. Figure 1A Align the axis marked OA with the axis AE of the eye to be treated.

[0275] For example, in a second variation of the exemplary embodiment, the controller executes an algorithm configured to automatically or based on user input determine the orientation of the untreated eye 73 in the image 89 acquired by the first imaging system. It is also conceivable to determine the orientation of the eye to be treated.

[0276] For example, the controller can execute an image processing algorithm configured to determine the boundaries of the upper and lower eyelids 94, 95 in the first imaging device image 89, such as using an edge detection filter. The controller can be further configured to determine the orientation of the interpupillary axis IA of the patient's head based on the detected boundaries of the upper and lower eyelids 94, 95. For example, the controller can be configured to use an anatomical model that provides the correlation between the orientation of the interpupillary axis IA and the horizontal axis E of the eye between the inner and outer canthi defined by the upper and lower eyelids 95.

[0277] The inventors have demonstrated that the orientation angle produced by this method of determining the orientation of the laser applicator relative to the patient's head has sufficient accuracy.

[0278] Based on the determined orientation, the user and / or controller can adjust the rotation axis A6 of the laser applicator around the laser applicator (shown in...). Figure 1 The orientation of the target is such that it corresponds to or substantially corresponds to the target orientation, or is within or substantially within the predetermined target range.

[0279] The ophthalmic laser system can be configured such that, using relative orientation, a user can manually rotate the laser applicator about the rotation axis of rotation of the rotation guide 60. The ophthalmic laser system may include a braking and / or locking system to prevent rotational movement of the laser applicator using the rotation guide 60 about the rotation axis A6. The ophthalmic laser system may include a rotational position sensor (not shown) for measuring the rotational position of the laser applicator relative to the distal end of the support arm. The rotational position sensor may include an encoder, such as a mechanical, optical, magnetic, and / or electromagnetic induction encoder. The ophthalmic laser system can be further configured to use the output of the rotational position sensor and, further, the determined orientation-related data, to indicate to the user when the orientation of the laser applicator relative to the patient's head corresponds to or substantially corresponds to a predetermined target orientation, or is within or substantially within a predetermined target range.

[0280] Additionally or alternatively, the ophthalmic laser system may include a drive system (not shown) for rotating the applicator about a rotation axis A6 using a rotation guide 60. A controller may be operatively coupled to the drive system to control the rotation based on the determined orientation of the laser applicator relative to the patient's head. The controller may also be coupled to a rotational position sensor for measuring the orientation of the laser applicator relative to the distal end of the support arm.

[0281] As mentioned above Figure 1 The rotation axis A6 and optical axis OA of the laser applicator are parallel but misaligned. Therefore, rotating the laser applicator to have a predetermined target orientation or within a predetermined target range will cause the optical axis OA of the laser applicator to shift relative to the axis AE of the eye to be treated.

[0282] This displacement can be achieved using a triaxial positioning system. Figure 1 Adjustments are made as indicated by 9. Since the rotation guide 60 is connected to the laser applicator 6 via the triaxial positioning system 9, displacement of the laser applicator 6 using the triaxial positioning system 9 does not change the adjusted orientation of the laser applicator 6 relative to the patient's head.

[0283] As explained in the following paragraphs, the first and second variants of the ophthalmic laser system are further configured to determine the orientation of the laser applicator relative to the patient's head even during surgical treatment when the first imaging system is unable to image the untreated eye (because it is covered by a drape or other medical covering used in the operating room, for example, to prevent infection). Figure 1C As shown, during cataract surgery, the patient's head is typically covered by a sterile drape 61 with an opening 81 that exposes only the eye 62 to be treated.

[0284] from Figure 1D As can be seen from the schematic illustration of window 83 of the graphical user interface, the untreated eye is not visible in the image 89 of the first imaging system due to the sterile drape 61. However, the ophthalmic laser systems of the first and second variations can be configured such that the orientation of the laser applicator relative to the patient's head can be determined additionally or alternatively based on an object having a fixed position and / or orientation relative to the patient's body part. This object can be attached to the patient's body and / or the sterile drape, or it can be loosely placed in a fixed position and / or orientation relative to the body part.

[0285] For example, from Figure 1D As can be seen from the images of the first imaging system 89, a surgeon can place an object, such as his or her finger 78, on a sterile drape 61, such that the position and / or orientation of the finger 78 serves as an indicator of the position and / or orientation of a patient's body part (e.g., an untreated eye 73) covered by the drape 61. By using his or her finger, the surgeon can also verify the correct position of the finger 78 by palpating the untreated eye under the drape 61. Other objects, particularly non-body objects, can also be envisioned for indicating the position and / or orientation of one or more body parts of the patient. These objects can be attached to or loosely placed on the drape 61. For example, it is possible that an ophthalmic laser system includes objects with one or more markers. An image processing algorithm executed by the controller can be configured to detect the position and / or orientation of one or more markers. It is also envisioned that multiple markers are provided at the object, and the controller is configured to determine all directional degrees of freedom of the object based on 2D images of these markers. For example, markers are placed at an eye fixation device, and 2D images of the eye fixation device are used to determine all directional degrees of freedom of the suction ring.

[0286] The one or more markers can indicate the location and / or orientation of a patient's body parts. The markers can also assist the user in indicating the location and / or orientation of an object in an image using the cursor 84 of the indicating device. The markers can be infrared markers, particularly infrared-absorbing or reflective markers. Such markers are independent of the patient's skin color and ambient lighting conditions. One or more markers can be provided at an eye fixation device, which serves as one of the objects for acquiring orientation-related data.

[0287] It should be noted that even if the patient's head or body is not covered by the drape 61, an object can still be used to indicate the location and / or orientation of the patient's body parts. Specifically, the object, particularly the markings provided at the object, can facilitate automatic or user-based detection of the object's location and / or orientation within the image 89 of the first imaging device.

[0288] Back Figure 1D As illustrated in the example, the ophthalmic laser system of the exemplary embodiment can be configured to automatically or based on user input determine the position and / or orientation of an object (e.g., a surgeon's finger 78) in an image 89 acquired by a first imaging system. For example, the controller can be configured to execute an image processing algorithm that identifies one or more features of the object, such as the boundary 79 corresponding to an image portion of the object (e.g., the surgeon's finger 78). For example, the image algorithm can perform segmentation on at least a portion of the image 89. The controller can be further configured to determine an image region corresponding to the distal portion of the surgeon's finger 78, such as the distal phalanx of the finger. The controller can be configured to use a typical anatomical value of the distal phalanx length. Additionally or alternatively, the controller can be configured to determine the orientation of the surgeon's finger in a plane perpendicular to the axis of the eye to be treated.

[0289] Additionally or alternatively, the ophthalmic laser system may be configured to allow a user to use the cursor 84 of a pointing device (such as a computer mouse) to identify at least a portion of the boundary 79 of a surgeon's finger 78 in an image.

[0290] like Figure 1E As illustrated, to assist surgeons in verifying the location of an untreated eye, determined automatically or based on user input, an ophthalmic laser system can be configured to generate an overlay image 89 on top of a first imaging system image based on the determined location of the untreated eye. This overlay image includes symbolic representations of one or more eye features, such as eyebrows, upper and lower eyelids, and pupillary margins. The inventors have demonstrated that this symbolic representation of the patient's facial features makes it easier for surgeons to check whether the determined orientation of the patient's head relative to the laser applicator has the required accuracy.

[0291] In each variation of the exemplary embodiments described above, it is conceivable that the controller executes an algorithm generated using machine learning techniques to determine the position and / or orientation of one or more body parts and / or objects in an image.

[0292] In a variation of the above exemplary embodiments, the first and second imaging systems (in) Figure 1A The images labeled 64 and 34 may include image sensors that are sensitive to electromagnetic radiation in the visible and / or infrared wavelength range. In the infrared wavelength range, or for wavelengths in the 700 nm to 2,500 nm range, the pupil reflects almost all the infrared light it receives back to the camera along its path, producing the so-called "bright pupil effect." If the light is shone outside the camera's optical axis, the pupil appears dark because the reflected light does not enter the camera lens. This produces the so-called dark pupil effect. Therefore, using infrared light, the pupil center can be determined with greater precision in the images of the first and second imaging systems 64 and 34.

[0293] Additionally or alternatively, based on images acquired in the visible and / or infrared wavelength range, the controller of the ophthalmic laser system may be configured to determine at least a portion of the external contour of the imaged patient's head. The controller may be configured to automatically or based on user input, determining the orientation of the applicator relative to the patient's head based on the determined portion of the external contour. It is also conceivable that the controller executes an algorithm generated using machine learning techniques to interpret the image data from the infrared images.

[0294] Figure 1F A third variation of the exemplary embodiment is schematically illustrated. In this third variation of the exemplary embodiment, the rotational analysis system includes a gigahertz-terahertz imaging system 99 that uses gigahertz and / or terahertz radiation in the frequency range of 10 GHz to 100 THz, particularly in the range of 30 GHz to 50 THz, to image at least a portion of the patient's head.

[0295] The gigahertz-terahertz imaging system 99 includes a radiation source 100 for generating a collimated gigahertz and / or terahertz radiation beam, a focusing mirror system 108, and a scanning mirror 106 for scanning the beam across the surface of a body part and / or object. Figure 1F (Illustrated by the double arrow 110). For example... Figure 1FAs further shown, gigahertz and / or terahertz radiation emitted from the scanned body part and / or object in response to irradiation is reflected by scanning mirror 106, passes through focusing mirror system 108, is reflected by beam combiner 109, and is detected by detector system 107. A system similar to the above is disclosed in the article “A Review of Active Millimeter-Wave Imaging Technologies for Personnel Security” by Zhongmin Wang et al., published in IEEE Access, Vol. 7, pp. 148336-148350. The entire contents of that document are incorporated herein by reference for all purposes. It should be understood that this disclosure is not limited to such gigahertz-terahertz imaging systems. Specifically, gigahertz-terahertz imaging systems may include image sensors. Such image sensors are described in the article “A Novel Real-Time Asia-Pacific Hertz Security Human Scanner” by Gombo Tzydynzhapov et al., published in the Journal of Infrared, Millimeter and Terahertz Waves, 41(2), March 2020. The entire contents of that document are incorporated herein by reference for all purposes.

[0296] The aforementioned gigahertz-terahertz imaging system is an active imaging system, i.e., an imaging system including a radiation source 100 that generates radiation with frequencies in the gigahertz and / or terahertz frequency range. However, it is also conceivable that the gigahertz-terahertz imaging system is a passive imaging system, i.e., an imaging system that does not include a radiation source, but instead acquires images of radiation emitted by the body in the gigahertz and / or terahertz frequency range. The radiation emitted by the patient's body can be imaged onto an image sensor by an imaging optics system, the image sensor including multiple detector elements, each detector element being sensitive to multiple frequencies in the gigahertz and / or terahertz frequency range. The detector elements can be arranged in an array or substantially in an array. Alternatively, a passive imaging system can include a scanner and an optical system for imaging a portion of an object field onto a single detector element or an array of detector elements. The scanner can be configured to sequentially image portions of the object field to image one or more body parts and / or objects.

[0297] The inventors have demonstrated that electromagnetic radiation emitted from a patient's body in the terahertz and / or gigahertz wavelength range can penetrate sterile drapes or other sheet-like medical coverings, thereby enabling the identification of features of the patient's head with sufficient precision to determine the orientation of the laser applicator relative to the patient's head. For example, such as Figure 1GAs shown, using a gigahertz-terahertz imaging system, the external contours of patient body parts can be identified, such as the contours of the skull 111, chin 112, neck 113, and patient shoulders 114. The gigahertz-terahertz images can also display image features related to the patient's eyes. Because these image features are symmetrical about the longitudinal axis LA of the patient's head, an estimate of the orientation of the longitudinal axis LA within the gigahertz-terahertz image can be derived from these features, for example... Figure 1G The orientation angle β is shown. It is also conceivable to use the contours of other body parts, such as the contours of arm 115 and leg 116, to determine the estimate of the orientation of the head's longitudinal axis LA.

[0298] It is also conceivable that the determination of the orientation of the laser applicator relative to the patient's head can be performed in a manner similar to that described in the first variant in conjunction with the exemplary embodiment. Specifically, as referred to Figure 1B The second imaging device 34 (shown in) is used. Figure 1A This allows the optical axis of the laser applicator to be aligned with the axis of the eye to be treated. This enables the determination of the laser applicator's orientation relative to the patient's head by identifying the location corresponding to the patient's untreated eye in an image acquired using a gigahertz-terahertz imaging system.

[0299] like Figure 1H As shown, a gigahertz-terahertz imaging system can also be envisioned (in...). Figure 1F At least a portion of the laser (marked as 99) is arranged in other parts of the ophthalmic laser system, such as mounting positions 117 and 118 at the first arm segment 8 and the second arm segment 11 of the support arm 4. Since it may be sufficient to determine only a rough estimate of the orientation of the patient's head relative to the laser applicator based on the external shape of the housing of the laser applicator 6, it is not necessary to require the imaging direction of the orientation analysis system to be precisely parallel to the axis of the eye to be treated.

[0300] Furthermore, the inventors have demonstrated that the gigahertz-terahertz imaging system can be used for purposes other than determining the orientation of a laser applicator relative to a patient's head. For example, such as... Figure 1C As shown, because in some surgical procedures, the main part of the patient's head is covered by a drape or other medical covering used in the operating room, such as to prevent infection, GHz and terahertz imaging systems can be used to determine the position of the patient's head relative to the laser applicator and / or relative to the base of the ophthalmic laser system. The GHz-terahertz imaging system used to determine the position of the patient's head can be the same as the GHz-terahertz system used to determine the orientation of the patient's head relative to the laser applicator, or an additional GHz-terahertz system.

[0301] For example, installed at position 119 on the base (shown in) Figure 1HA gigahertz-terahertz imaging system can be used to acquire images indicating the height of the patient's head relative to the floor. Therefore, a gigahertz-terahertz imaging system can be used to adjust the height of the laser applicator and / or the patient bed. The height of the laser applicator can be determined by a motorized triaxial positioning system (in...). Figure 1H Adjustments are made by moving the positioning arm (manually or using one or more drive systems). (Note 9 in the original text)

[0302] Figure 1I This is a schematic illustration of a fourth variant of the exemplary embodiment. The directional analysis system of the fourth variant includes a LIDAR scanning system 119. The LIDAR scanning system includes a laser 120 that forms a laser beam having a point-like or substantially point-like cross-section. The LIDAR scanning system 119 also includes a scanner 121 for scanning the laser beam across a surface including a body part and / or an object surface. The LIDAR scanning system also includes a detector 122 for detecting the light of the laser beam reflected from the surface. The laser 120 may be configured to generate a pulsed laser beam to measure time-of-flight (ToF LIDAR), amplitude-modulated continuous-wave (AMCW) laser beam, or frequency-modulated continuous-wave (FMCW) laser beam. The scanner 121 may be configured to deflect the laser beam in two dimensions.

[0303] The controller of the ophthalmic laser system can be configured to generate surface topography data from one or more body parts and / or objects using orientation-related data acquired using a LIDAR scanning system. The controller can be configured to identify the location and / or orientation of one or more anatomical features and / or landmarks of the patient's body based on the surface topography data, such as the location and / or orientation of one or both eyes, one or both ears, nose, and / or chin. The controller can also be configured to determine the contour of the chin and / or at least a portion of the head contour based on the topography data. This contour may involve or substantially involve the projection of the topography data onto a reference plane (i.e., a plane corresponding to a constant height). Furthermore, if the patient's head is covered with a sterile drape, such as... Figure 1C As shown, the controller can be configured to automatically or based on user input identify portions of surface topography data corresponding to the patient's nose. The controller can be further configured to determine the orientation of the nose based on the topography data in order to determine the orientation of the laser applicator relative to the patient's head.

[0304] In addition, the controller can be configured to use height information from surface topography data to adjust the height of the laser applicator relative to the patient's head.

[0305] Additionally or alternatively, the surface topography analysis system may include a 3D time-of-flight camera system. The 3D time-of-flight camera system may include a light source and a 3D image sensor. The light source may be configured as a laser and / or an LED. The light source may be a non-scanning light source. The light emitted by the light source may be pulsed, amplitude-modulated, or may be a stroboscopic light source that generates square waves.

[0306] Additionally or alternatively, the surface topography analysis system may include a stereo 3D camera. Using a 3D camera as a orientation analysis system, surface topography data can be acquired from one or more objects marked with one or more markers. Specifically, the 3D camera may be sensitive to infrared radiation, and the one or more objects may be illuminated with infrared light. This can improve the accuracy of determining the orientation of the laser applicator relative to the patient's head. The controller can use the 3D images acquired through infrared illumination to perform iris registration to determine the rotation angle of the eye to be treated. Furthermore, the controller can use these images for pupil and / or iris tracking.

[0307] Figure 1J This is a schematic illustration of a directional analysis system for a fifth variant of an exemplary ophthalmic laser system. The fifth variant's directional analysis system includes an aiming system 101 for use along the aiming direction (in... Figure 1J (Illustrated by arrow d) Aiming at one or more body parts and / or objects.

[0308] The aiming system 101 includes a light source (not shown) for generating an aiming beam 97 extending along the aiming direction d. In an exemplary embodiment, the aiming beam 97 is a laser beam, particularly a line laser beam. However, the light source may also be an incoherent light source. The orientation analysis system may include an optical system that generates a rectangular or fan-shaped aiming beam from light from an incoherent light source.

[0309] like Figure 1J As shown, the orientation analysis system 101 is configured to determine the orientation of the laser applicator 6 relative to the patient's head without aligning the optical axis OA of the laser applicator 6 with the axis AE of the eye to be treated. Specifically, the aiming beam 97 can be adjusted such that the beam intersects the pupil center of the treated eye 29 and the pupil center of the untreated eye 73. The aiming system 101 includes a sensor (not shown) that measures the orientation angle γ of the aiming direction d relative to the laser applicator about the optical axis OA of the laser applicator 6. For example, the light source and focusing optics of the aiming system 101 are rotatably supported by the laser applicator 6, allowing the aiming system to rotate about the optical axis OA of the laser applicator 6.

[0310] After adjusting the aiming direction d of the aiming system 101 and measuring the orientation angle γ, the laser applicator 6 can be positioned in a plane perpendicular to the axis of the eye to be treated, so that the optical axis OA of the laser applicator 6 is aligned with the axis of the eye 29 to be treated.

[0311] Additionally or alternatively, in a manner similar to that described above in conjunction with the first variant, the aiming system 101 of the fifth variant can be configured such that, after the optical axis of the laser applicator has been aligned with the axis of the eye to be treated, the orientation of the laser applicator relative to the patient's head around the axis of the eye to be treated can be adjusted. Specifically, from Figure 1K As can be seen, after the optical axis OA of the laser applicator is aligned with the axis of the eye to be treated, the aiming direction of the aiming system 101 is adjustable, so that the aiming beam intersects with the pupil center 71 of the untreated eye 73. Due to the alignment of the optical axis OA of the laser applicator 6 with the axis of the eye to be treated (using reference...), Figure 1B The interpretation of the Pulchin image (86) can be performed with relatively high precision, which leads to a more accurate determination of the orientation angle γ.

[0312] Due to the rotation axis of the laser applicator 6 (in) Figure 1 The laser applicator 6 is deviated from the optical axis OA of the laser applicator 6 (marked as A6 in the middle). The orientation of the laser applicator 6 is adjusted (from...). Figure 1K The initial configuration shown will cause the optical axis OA of the laser applicator 6 to deviate from the axis of the eye to be treated. However, after adjusting the rotation of the laser applicator, a motorized triaxial positioning system can be used (in... Figure 1 (9) Align the optical axis of the laser applicator with the axis of the eye again.

[0313] In the description of the fifth variation above, the aiming system is used to aim at one or both of the patient's eyes. However, it is conceivable that the aiming system could be configured to aim at other body parts, such as the mouth, nose, or one or both of the patient's feet. For example, by aiming at one of the patient's feet, the aiming direction of the aiming system can be adjusted to be parallel or substantially parallel to the longitudinal axis of the patient's body. The longitudinal axis of the body indicates, or at least is an estimate of, the longitudinal axis of the patient's head.

[0314] Figure 1LThis is a schematic illustration of a directional analysis system for a sixth variant of an ophthalmic laser system. The sixth variant's directional analysis system includes an aiming system 101 comprising a light source array 102, the light sources of which are arranged circumferentially on the laser applicator. For example, the light source can be provided by an LED light source. However, this disclosure is not limited to such a light source. In the sixth variant, the aiming direction d is indicated by an activated light source (labeled 103) pointing towards the aiming direction d. Therefore, by changing the activated light source, the aiming direction d of the aiming system 101 can be changed. The directional analysis system of the sixth variant of the ophthalmic laser system can be described with reference to the above... Figure 1J and Figure 1K The same method described in the fifth variation is used to determine the orientation angle of the laser applicator 6 relative to the patient's head. Specifically, the orientation angle can be determined when the optical axis of the laser applicator is aligned with the axis of the eye to be treated. Alternatively, the orientation angle can be determined when the optical axis of the laser applicator is not aligned with the axis of the eye to be treated.

[0315] This disclosure is not limited to aiming systems using light. For example... Figure 1M As shown, the seventh variant of the ophthalmic laser system includes a mechanical indicator 127 that visually indicates the aiming direction d. For example, the mechanical indicator 127 may be a protrusion extending from the laser applicator housing. Figure 1M As shown, the mechanical indicator 127 of the seventh variant is a protrusion in the form of a tab. However, other shapes of the mechanical indicator 127 are also conceivable. In the seventh variant, the mechanical indicator 127 is rotatably supported by the laser applicator 6, such that the aiming direction d of the mechanical indicator 127 can be adjusted relative to the laser applicator 6 about the optical axis OA. The aiming system 101 of the seventh variant also includes a sensor (not shown) that measures the orientation angle γ of the aiming direction d relative to the laser applicator 6 about the optical axis OA of the laser applicator 6.

[0316] Figure 1N This is a schematic illustration of an eighth variant of an ophthalmic laser system. The eighth variant of the ophthalmic laser system includes a direction indication system that indicates the orientation of the laser applicator 6 relative to the patient's head. The direction indication system is configured as an aiming system 101. The aiming system 101 is configured to emit an aiming beam 97. However, other configurations of the aiming system are also contemplated, as described above in conjunction with the fifth to seventh variants of exemplary laser systems. The aiming beam can be a laser beam, particularly a line laser beam. However, it is also contemplated that the light source used to generate the aiming beam 97 is an incoherent light source. The direction analysis system may include an optical system that generates a rectangular or fan-shaped beam from the incoherent light. Figure 1MIn the exemplary embodiment shown, the aiming system is configured to emit an aiming beam 97 along direction d, which has a fixed orientation relative to the laser applicator 6 in a plane perpendicular to the axis of the eye to be treated. Therefore, changing the orientation of the laser applicator 6 relative to the patient's head (schematically shown by arrow 104) results in a corresponding change in the aiming direction d of the aiming beam 97 (schematically shown by double arrow 123). Additionally or alternatively, the orientation indicating system may include a mechanical indicator, which may be a protrusion extending from the laser applicator housing. The mechanical indicator may be configured as a protrusion. This protrusion may be in the form of a tab. However, other shapes of the mechanical indicator are also contemplated. The mechanical indicator may have a fixed orientation relative to the laser applicator in a plane perpendicular to the axis of the eye to be treated.

[0317] To position the laser applicator in the desired orientation relative to the patient's head (measured around the axis of the eye to be treated), the user and / or controller can rotate the laser applicator 6 until the beam 97 of the aiming system intersects the center of the pupils of both eyes. After adjusting the rotation of the laser applicator 6, the user and / or controller can use a motorized triaxial positioning system (in... Figure 1 (9) Adjust the position of the laser applicator 6 relative to the patient's hand.

[0318] An ophthalmic laser system according to any of the aforementioned variations 1 to 7 can be configured such that the controller uses one or more parameters of the determined orientation of the laser applicator 6 relative to the patient's head to determine positioning data, which indicates or relates to the position of the laser focal point within the eye to be treated. The positioning data may include parameters for one or more scanning paths used to perform laser treatment.

[0319] For example, the controller can use the determined rotation angle of the laser applicator relative to the patient's head to determine the angular position of the arcuate keratotomy incision, limbal laxity incision, phacoemulsification incision, and / or the orientation of the flap hinge measured around the axis of the eye to be treated.

[0320] Additionally or alternatively, in the exemplary laser system of any of the aforementioned variations 1 to 7, the controller of the ophthalmic laser system can be configured to determine, based on orientation-related data, whether the emitting optics of the laser applicator are positioned in front of the patient's left or right anterior end. Thus, the controller can verify that the laser applicator is positioned in front of the eye intended for treatment. For example, for Figure 1B The first variant of the ophthalmic laser system shown, due to the external shape of the laser applicator housing, is... Figure 1B In the location represented by the image shown (i.e., in the location of the laser applicator where the first imaging system image is acquired), the possible orientation range of the laser applicator relative to the patient's head is limited to an angle range of approximately 90 degrees (see image). Figure 12 ).like Figure 13 As schematically shown, there exists an image region 124 in which the patient's untreated eye appears in the image of the first imaging system. Due to the limited angular range of the orientation of the laser applicator 6 described above, region 124 can be divided into two non-overlapping regions 125 and 126. If the image portion corresponding to the untreated eye appears in region 125, then by the second imaging system 34 (shown in...) Figure 1A The eye imaged by the second imaging system 34 is the patient's right eye. On the other hand, if the image portion corresponding to the untreated eye appears in region 126, the eye imaged by the second imaging system 34 is the patient's left eye.

[0321] The laser system according to an exemplary embodiment includes a braking and / or locking system for preventing movement of the second end of the support arm relative to the first end of the support arm. Specifically, this allows the surgeon to perform a coarse positioning procedure by manually positioning the laser applicator 6 close to the patient's head. After the coarse positioning procedure, the surgeon activates the braking and / or locking system of the support arm such that, in the locked state, the surgeon can use the positioning system 9 to perform a fine positioning procedure.

[0322] In an exemplary embodiment, the laser applicator 6 includes one or more manually operable control elements 18a, 18b (shown in...). Figure 4 This allows the surgeon to activate the braking and / or locking system, enabling the applicator head to be positioned in different locations using the support arm 4. In an exemplary embodiment, the laser applicator includes two handles 17a, 17b (shown in...). Figure 4 The surgeon can hold both handles with both hands. Each handle has release buttons 18a and 18b. If the surgeon presses both release buttons simultaneously, the braking and / or locking system is deactivated, and the surgeon can position the laser applicator 6 in three dimensions. For simplified illustration, in... Figure 1 and Figure 2 Handles 17a and 17b and release buttons 18a and 18b are not shown.

[0323] According to an exemplary embodiment, the laser system is configured to allow the laser applicator to be positioned relative to the patient's head by performing a coarse positioning procedure in which the laser applicator 6 is adjusted relative to the patient's head using a support arm 4. Then, in a subsequent fine positioning procedure using a triaxial positioning system 9, the laser applicator 6 is positioned relative to the patient's head to its final position where laser treatment is performed.

[0324] The coarse positioning procedure using support arm 4 allows surgeons to perform rapid and effective coarse positioning relative to the patient's head. Manual adjustability also provides greater patient safety, as the surgeon can quickly move the laser applicator 6 away from the patient's head if needed. However, it is conceivable that one or more joints of the support arm are electrically powered, allowing coarse positioning to be performed entirely or partially (i.e., using manual positioning) by motors.

[0325] As explained in more detail below, the fine positioning procedure can be performed based on images from an imaging system that is part of the laser applicator 6 and / or on measurements from an interaction measurement unit that measures the mechanical interaction (e.g., force) between the laser applicator 6 and the patient's eye.

[0326] Figure 6 The information displayed on the display device 19 of the laser applicator 6 during the coarse positioning procedure is shown schematically. From Figure 6 As can be seen, the surgeon sees an image generated by an imaging system located within the laser applicator 6 on the display device 19. The imaging system acquires a frontal image 20 of the patient's eye using a constant object plane distance. The object plane distance is adjusted so that it corresponds to a desired predetermined distance between the laser applicator and the patient's eye. Therefore, using the frontal image of the eye, the surgeon can control the lateral position of the laser applicator using a three-axis positioning system, such that the center of the crosshair 24 is located at the center of the pupil of the eye. Furthermore, by adjusting the vertical position of the laser applicator 6 using the positioning system 9 until a focused image appears on the display device 19, the surgeon can adjust the height of the laser applicator so that the distance between the laser applicator 6 and the patient's eye corresponds to the desired predetermined distance.

[0327] The above rough positioning procedure can be applied to suction rings and contact elements (see below). Figure 7 and Figure 8A (Description) This is performed while attached to the eye. The laser applicator 6 and the contact element can be configured such that the iris and limbus are displayed in the frontal image 20. For example, a surgeon determines whether the frontal image 20 is in focus based on some or all of these features.

[0328] The controller of the laser system may include image processing algorithms for determining whether at least a portion of the frontal image 20 is in focus, and / or configured to determine one or more parameters that depend on or indicate the focus level of at least a portion of the frontal image 20. For example, this portion of the frontal image 20 may be the iris of an eye. The image processing algorithm may include a segmentation algorithm for segmenting the frontal image. The image processing algorithm may determine one or more parameters that depend on or indicate the focus level of one or more segmented image regions. For example, the segmented image regions may represent the iris of a patient's eye.

[0329] The controller can be configured to display graphical and / or textual information based on determined parameters on the display device 19.

[0330] The arrangement of the imaging system within the laser applicator 6 is described below. Figure 7 Description. The laser applicator 6 includes a beam combiner 26. The beam combiner 26 is located in the scanning system ( Figure 7 The treatment laser beam 27 is located between the contact element 28 (not shown) and the patient interface. The contact element 28 includes a concave contact surface that contacts the anterior surface of the cornea during treatment. It should be noted that... Figure 7 The concave shape of the contact element 28 shown is merely an example, and it can be imagined that the contact surface of the contact element 28 is either flat or convex toward the eye.

[0331] Beam combiner 26 can be located in the optical path of therapeutic laser beam 27 between the two components 30a and 30b of focusing optics system 36, such as Figure 7 As shown. A focusing optics system 36 is also arranged within the laser applicator 6. It is also conceivable that the laser applicator includes at least a portion of a scanning system for three-dimensionally scanning the focal point of the therapeutic laser beam within the eye. The scanning system may include an axial scanning system for scanning the laser focal point along the laser beam axis and / or a beam deflection scanning system for scanning the laser beam by deflecting it.

[0332] Each of components 30a and 30b may include one or more optical elements, such as lenses. However, this disclosure is not limited to such a configuration. It is also conceivable that the beam combiner 26 is located either in the optical path of the therapeutic laser beam 27 between the scanning system and the focusing optics system, or in the optical path of the therapeutic laser beam 27 between the focusing optics system and the contact element 28.

[0333] The beam combiner 26 may include a translucent mirror and / or a prism. The translucent mirror may be a dichroic mirror and / or the prism may be a dichroic prism. For example... Figure 7 As schematically shown, beam combiner 26 can be configured to combine the optical path of laser beam 27 with the measurement optical path 31 of optical coherence tomography (OCT) system 32 and the imaging optical path 33 of imaging system 34 on the other hand. The imaging system can have a two-dimensional photosensitive imaging sensor. The photosensitive imaging sensor can have a two-dimensional photosensitive pixel array. The optical coherence imaging system can be configured to acquire cross-sectional images of the cornea and / or the lens of the eye. The imaging system with the imaging sensor can be configured to acquire a two-dimensional frontal image of the eye.

[0334] In the eye treatment system according to an exemplary embodiment, the measurement optical path 31 of the optical coherence tomography system 32 and the imaging optical path 33 of the imaging system 34 are combined using a second beam combiner 35 located outside the optical path of the treatment laser beam 27. The second beam combiner 35 may include a mirror and / or a prism. The mirror may be a dichroic mirror and / or the prism may be a dichroic prism.

[0335] The cross-sectional images of the OCT system 32 can be used during fine positioning procedures to observe whether the anterior surface of the cornea has come into contact with the contact element 28.

[0336] As described below with reference to FIG8, during the fine positioning procedure, the position of the laser applicator relative to the patient's eye is monitored based on signals from an interaction measurement unit that generates an output signal that depends on the mechanical interaction between the patient's eye and the laser applicator.

[0337] Figure 8A The contact element 28 and other components for coupling the contact element 28, one side relative to the laser optics system and the other side relative to the patient's eye 29, are shown schematically in an exploded view. The laser system includes a coupling portion 37, which can be rigidly connected to the laser optics system or can be movably supported in a direction parallel to the optical axis of the laser optics system. The contact element 28 and the coupling portion 37 are configured such that the contact element 28 is detachably coupled to the coupling portion 37. In the coupled state, the contact element 28 can be in a substantially predefined position relative to the laser optics system and can have a predefined tilt relative to the optical axis OA of the laser optics system. Alternatively, in an embodiment where the contact element 28 is movably supported in a direction parallel to the optical axis of the laser optics system, in the coupled state, the contact element 28 is in a predefined radial position relative to the optical axis and has a predefined tilt relative to the optical axis. The contact element 28 is attached to the coupling portion 37 using a suction mechanism including a suction source 38.

[0338] The laser system also includes a suction ring 39, which can be secured to the eye 29, and a contact element 28 can be rigidly attached to the suction ring. The suction ring 39 includes a skirt that forms a groove that defines a suction channel between the skirt and the front surface of the eye 29. A vacuum is generated in the vacuum path using a vacuum source 40, thus securing the suction ring 39 to the front surface of the eye 29.

[0339] The suction ring 39 is rigidly attached to or integrally formed with the clamping mechanism 41 as a single piece. The clamping mechanism 41 is used to secure the contact element 28 to the suction ring 39. An example of such a clamping mechanism 41 is disclosed in document US2007 / 0093795A1, the contents of which are incorporated herein by reference for all purposes. However, the invention is not limited to the configuration in which the clamping mechanism is used to secure the contact element 28 to the suction ring 39. In particular, it is conceivable that the contact element 28 and the suction ring 39 are integrally formed, for example, as a single piece or integrated into a one-piece assembly.

[0340] from Figure 8A And from Figure 8B ( Figure 8B As can be seen from the top view of coupling portion 37 and eye 29, coupling portion 37 includes a coupling ring 42 for coupling coupling portion 37 to the rest of the laser applicator. Furthermore, coupling portion 37 includes a plurality of extension arms 43a, 43b, 43c, 43d, each extension arm connecting the coupling ring 42 to the lower portion 44 of coupling portion 37.

[0341] When the coupling portion 37 is mounted to the remainder of the laser applicator, the coupling portion 37 contacts a plurality of force sensors 45a, 45b, 45c, and 45d. The force sensors 45a, 45b, 45c, and 45d are arranged in a plane perpendicular to the optical axis OA of the laser applicator, and therefore parallel to the plane of the mounting ring 42. Figure 8B As can be seen, the force sensors are circumferentially distributed at equal angles around the optical axis OA of the laser applicator and at the same distance from the optical axis OA. For example, each of force sensors 45a, 45b, 45c, and 45d includes a piezoelectric sensor that measures the tensile and / or compressive forces acting on the piezoelectric sensor. Additionally or alternatively, strain gauges are arranged on one or more extension arms.

[0342] from Figure 8A The cross-sectional view shows that each force sensor 45a, 45b, 45c, and 45d is arranged at the patient's eye 29 and the focusing optical system 36 (shown in...). Figure 7 In the force path between the laser applicator and the eye, the focusing optical system focuses the therapeutic laser beam within the patient's eye 29 and is part of the laser applicator. Therefore, the magnitude of the force measured by each corresponding force sensor, and the difference between the magnitudes of the forces measured by different force sensors, can be used to determine the magnitude and direction of the force between the laser applicator and the eye.

[0343] Therefore, monitoring the output signals of force sensors 45a, 45b, 45c, and 45d allows the laser system to be docked to the eye with a circumferentially uniform force, ensuring that the eye does not tilt during laser treatment. The uniform force measured by the force sensors is particularly important in capsular incision and lens fragmentation surgeries, where a "soft docking" technique is used.

[0344] To perform the "soft docking" technique, contact element 28 (shown in...) is used. Figure 8A It has a concave contact surface for contacting the anterior surface of the cornea. The force between the patient's eye and the laser applicator is kept at a low level, such that in the mating state, there is a thin layer of saline solution between the contact surface of the contact element and the anterior surface of the cornea.

[0345] Using the output signal of a force sensor to perform a "soft docking" technique ensures that the vertical force component does not exceed a predefined level, resulting in minimal corneal deformation and avoiding posterior corneal folds. Posterior corneal folds can deflect the treatment laser beam, leading to "stamp-shaped" incisions. Furthermore, by ensuring that the lateral component of the force does not exceed a predefined level, the eye is prevented from tilting, thus improving the precision of laser treatment.

[0346] Figure 9 This is a schematic illustration of the information displayed on display device 19 during the fine positioning procedure. The display device shows OCT images 46 acquired during the docking procedure, as well as information based on force sensors 45a, 45b, 45c, and 45d (shown in...). Figure 8A and Figure 8B The output signal of the OCT image is shown in Figure 47. The OCT image can be a real-time OCT image.

[0347] In an exemplary embodiment, Figure 47 has three concentric rings with indicators arranged in the center, each ring having eight indicators. After the controller processes the output signal from the interaction measurement sensor, one of the indicators is highlighted, for example... Figure 9 The indicator 48 is highlighted. The ring containing the highlighted indicator indicates the magnitude of the measured force, with a larger ring diameter indicating a higher force measured by the force sensor. Specifically, the two inner rings indicate acceptable force levels, while the outer ring indicates unacceptable force levels. If the force level is unacceptable, the surgeon uses the positioning system 9 (shown in [location not specified]), which can be controlled by the control unit 10. Figure 1 Move the laser applicator away from the patient, i.e., raise the laser applicator. Adjust the laser applicator so that the vertical force level is below the predefined level to ensure that corneal folds are avoided.

[0348] The highlighted indicator's circumferential position indicates the direction of the lateral component of the force measured using a force sensor. Figure 9 In the image, a highlighted indicator on the right instructs the surgeon to move the laser applicator in the negative x-direction to minimize lateral force. Minimizing lateral force prevents the eye from tilting relative to the optical axis of the laser applicator.

[0349] Additionally or alternatively, the controller may be configured to determine a parameter that indicates or depends on the magnitude of at least one component of the force between the laser applicator and the patient's eye. The controller may be configured to display this parameter on a display device. The force component may be a component along the optical axis of the laser applicator, or a component in a plane perpendicular to the optical axis of the laser applicator.

[0350] Therefore, the use of force sensors and triaxial positioning systems allows surgeons to perform docking procedures that ensure high-quality surgical procedures.

[0351] In the laser system according to an exemplary embodiment, the output signal of the interaction measurement unit is used to determine whether to deactivate the braking and / or locking system based on the output signal of the interaction measurement unit. Thus, if the patient moves their head during laser treatment, injury to the patient's eyes can be prevented. For example, if the projection of the force vector onto the optical axis of the laser applicator exceeds a predetermined threshold, the laser source and the braking and / or locking system are deactivated.

[0352] Figure 10 This is a cross-sectional view of a parallel linkage mechanism, which includes... Figure 1 The second arm segment 11 is shown in the laser system according to an exemplary embodiment. The second arm segment 11 includes two links 52 and 53 of a four-bar linkage configured as a parallel linkage mechanism, having links 52 and 53 of the second arm segment oriented parallel to each other, and having four joints 53a, 53b, 53c and 53d, each joint having a horizontal axis of rotation.

[0353] The parallel linkage mechanism also includes a balancing mechanism for providing at least partial counterbalancing of the action on the laser applicator. Figure 10 The balancing force is the force of gravity G on the (not shown). In an exemplary embodiment, the balancing mechanism includes a compression spring 54 disposed within a first rod 53 and applying tension to a toothed belt 55, which extends via two toothed pulleys 56, 57 into a second rod 52. Within the second rod 52, the end of the toothed belt 55 is secured using a fastening member 58.

[0354] Back Figure 1 According to an exemplary embodiment, the laser system includes a coupling mechanism for coupling a hinged beam guide tube 5 to a second arm segment 11 of a support arm 4. This coupling mechanism 16... Figures 11A to 11C It is shown in more detail in the side view.

[0355] from Figures 11A to 11CAs can be seen, the coupling mechanism 16 includes a first coupling member 58, which is rigidly attached to or integrally connected to the hinged beam guide tube 5. Furthermore, the coupling mechanism includes a second coupling member 59, which is a coupling member corresponding to the first coupling member 58 and is attached to or integrally connected to the second arm segment 11. In an exemplary embodiment, the first and second coupling members 58, 59 are configured as lateral guides, which limit the lateral movement of the first coupling member 59 relative to a direction parallel to the longitudinal axis of the second arm segment 11. In an exemplary embodiment, the coupling mechanism 16 has the effect that the plane defined by adjacent segments 13 and 14 of the hinged beam guide tube 5 has a substantially vertical orientation for different positions of the laser applicator 6 presented by the movement of the first and second arm segments 8 and 11 of the support arm 4. This ensures that the hinged beam guide tube 5 does not collide with the support arm 4 during operation of the laser system 1. Such a collision could damage the hinged beam guide tube 5 and / or the support arm 4, or could obstruct the positioning of the laser applicator 6 using the support arm 4.

[0356] Specifically, Figures 11A to 11C The diagram schematically illustrates how the first and second coupling members 58, 59 are positioned relative to each other for each of three different configurations of the support arm 4. For different inclinations of the second arm segment 11, the joint between the first and second arm segments 13 and 14 of the articulated beam guide 5 remains coupled to the second arm segment 11 of the support arm 1. Furthermore, because the articulated beam guide extends between the laser applicator 6 and the position where the therapeutic laser beam exits from the first arm segment 8 of the support arm 4, the articulated beam guide 5 can remain engaged with the linear guide even when the second arm segment rotates about the vertical axis A2. However, it should be noted that if the lateral guide has sufficient clearance, the articulated beam guide 5 can be coupled to the second arm segment 11 even when it extends from the position where the therapeutic laser beam exits from the base 3.

[0357] Alternatively or additionally, the coupling device may also be conceived to include a tension transmission connection.

[0358] Figure 14 This is a schematic illustration of a portion of a support arm 4 of an ophthalmic laser system according to an exemplary embodiment, which includes a controllable visual indicator 128 operatively connected to a controller of the laser system (not shown in FIG. 15). The controller controls the visual indicator 128 to generate a visual signal. This visual signal can assist the surgeon in performing laser surgical procedures and / or indicate warning signals to ensure successful laser treatment.

[0359] As mentioned above Figure 1 , Figure 4 and Figure 5The support arm includes a first arm segment 8, which is connected to a second arm segment 11 via an intermediate joint 12. Therefore, the intermediate joint 12 represents a support structure for the second arm segment 11. The intermediate joint 12 can be configured such that the orientation of the second arm segment 11 relative to the first arm segment is adjustable in two rotational degrees of freedom. Specifically, the intermediate joint 12 can be configured such that the second arm segment 11 can rotate about a vertical axis A2 and also about a horizontal axis A3. Specifically, from... Figure 14 It can be seen that the proximal portion 130 of the second arm segment 11 forms part of the first rotational joint 131 of the intermediate joint 12, wherein the axis of the first rotational joint 131 is the horizontal axis A3. In addition, the distal portion 132 of the first arm segment 8 forms part of the second rotational joint 133 of the intermediate joint 12, wherein the axis of the second rotational joint 133 is the vertical axis A2.

[0360] It should be understood that this disclosure is not limited to a visual indicator arranged at the intermediate joint of the support arm. It is also conceivable that the visual indicator is mounted on or becomes part of the arm segment of the support arm.

[0361] The intermediate joint 12 includes a visual indicator 128. The visual indicator 128 includes a curved surface 129 from which visual signal light generated by the visual indicator 128 is emitted. The curved surface 129 forms the outer peripheral surface of the support arm. Therefore, in the exemplary embodiment, the curved surface completely surrounds a portion of the support arm 4. However, it is also conceivable that the curved surface emitting the visual signal light forms only a circumferential portion of the outer peripheral surface of the support arm. For example, this circumferential portion may represent more than 50%, more than 70%, or more than 80% of the circumferential surface.

[0362] Because the visual signal light is emitted from the curved surface forming the circumferential portion of the support arm, the visual signal is easily visible from different viewing directions. This ensures that the visual signal is visible to all surgeons and surgical personnel in the operating room.

[0363] The curved surface 129 emitting visual signal light can be formed by a cylindrical or substantially cylindrical cover that covers one or more light sources of the visual indicator. The cover can be made of a transparent material, particularly a light-diffusing material.

[0364] Additionally or alternatively, the visual indicator may include multiple surfaces from which visual signal light is emitted. These multiple surfaces are distributed at least around a circumferential portion of the outer peripheral surface of the support arm. For example, each surface may be a surface of a light source (e.g., an LED light source).

[0365] from Figure 14 It can be further observed that the axis of the circumferential portion is vertically oriented or substantially vertically oriented. Therefore, the visual signal can be seen from different viewing directions within the operating room.

[0366] The controller can be configured to cause visual signals to indicate the stage of laser treatment. The stage of laser treatment can be indicated with a predetermined time correlation or synchronously with the progress of laser treatment. For example, the visual signals can indicate the progress of laser treatment to the user. For example, the indicated progress can indicate or be correlated with a percentage value between 0% and 100%. For example, the controller can be configured to use the frequency of intensity changes and / or the color of the visual signals to indicate or be correlated with that percentage value.

[0367] Additionally or alternatively, the controller may be configured to cause a visual signal to indicate the operating status of the ophthalmic laser system. The controller may be configured to indicate the operating status of the ophthalmic laser system in a time-dependent or time-synchronous manner with changes in the operating status of the ophthalmic laser system. Examples of operating statuses of the therapeutic laser indicated to the user include, but are not limited to, "laser standby," "laser ready," and "laser firing." Each of these states may correspond to a predefined visual signal of the visual indicator, for example, defined by the frequency of intensity changes and / or the color of the visual signal.

[0368] Additionally or alternatively, the controller and visual indicator may be configured to cause the visual indicator to display a warning message to the user. Examples of warning messages include, but are not limited to: "Laser beam energy too low," "Laser beam energy too high," and "Force out of range." The force can be referenced above. Figure 9 The interaction measurement unit measures the interaction. Each of these warning messages may correspond to a predefined visual signal of a visual indicator, for example, defined by the frequency of intensity changes and / or the color of the visual signal.

[0369] Figure 15A It is a schematic perspective view. Figure 15B It is the intermediate joint 12 (also shown in) Figure 14 A schematic cross-sectional view of a portion of ( ). Figure 15A In the middle, this part of the joint is curved (in) Figure 14 and Figure 15BThe state of the surface 129 (marked 129) removed from the intermediate joint 12 is shown. In the laser system of the exemplary embodiment, the curved surface 129 is a cover that covers one or more light sources 134, which may be configured as light-emitting diodes (LEDs). The cover also covers a light diffuser 135 and a reflector 136, which is configured to perform specular or diffuse reflection of signal light emitted from the one or more light sources 134. The light diffuser 135 is made of a light-diffusing material, such as a light-diffusing synthetic plastic material. At least a portion of the cover 129 may be made of a light-diffusing material and / or a material that is transparent to one or more wavelengths of light emitted from the one or more light sources 134. In the ophthalmic laser system of the exemplary embodiment, one or more light sources 134 are mounted on a carrier structure 133, which, in the exemplary embodiment, is configured as a circuit board. In the ophthalmic laser system of the exemplary embodiment, the carrier structure 133 is formed by two plates 133a, 133b, each plate being semi-annular in shape and having a planar or substantially planar shape. However, it is also contemplated that the carrier structure 133 is formed by a single plate that only partially surrounds the circumference. Alternatively, the carrier structure can be conceived as being formed by three or more plates, which together completely or partially surround a circumference. Signal light emitted from one or more light sources 134 passes through a light diffuser 135, is reflected by a reflector 136 via diffuse or specular reflection, and then passes through a cover 129. This allows for a relatively large cover from which the signal light is emitted, making the visual signal sufficiently clear to all surgeons and medical personnel in the operating room.

[0370] The embodiments described above are merely illustrative and not intended to limit the technical methods of the present invention. Although the present invention has been described in detail with reference to preferred embodiments, those skilled in the art will understand that modifications or equivalent substitutions can be made to the technical methods of the present invention without departing from the scope of the claims. In the claims, the word "comprising" does not exclude other elements or steps, and the indefinite articles "a" or "an" do not exclude a plurality. Any reference numerals in the claims should not be construed as limiting the scope.

[0371] Before we proceed with the claims, we first list the following terms to describe some of the prominent features of certain embodiments of this disclosure.

[0372] Item 1: An ophthalmic laser system configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated; a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea; a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least a movable portion to different orientations of the patient's head measured about an axis around the eye to be treated; and an orientation analysis system for acquiring orientation-related data using (a) one or more body parts of the patient; and / or (b) one or more objects, each object having a fixed position and / or orientation relative to a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about the eye axis; wherein the ophthalmic laser system is configured to allow the user and / or the controller to move the movable portion of the beam delivery system using the orientation-related data such that, during laser treatment, the movable portion has an orientation about the eye axis and relative to the patient's head, the orientation (i) corresponding to or substantially corresponding to a predetermined target orientation; or (ii) being within or substantially within a predetermined target range.

[0373] Item 2: The ophthalmic laser system according to Item 1, wherein at least one body part is outside the eyeball of the eye to be treated.

[0374] Item 3: An ophthalmic laser system according to Item 1 or 2, wherein the guide includes a rotary guide configured to allow a movable portion of the beam delivery system to rotate about a rotation axis.

[0375] Item 4: The ophthalmic laser system according to Item 3, wherein the laser system is configured such that during laser treatment, the axis of rotation of the rotating guide is parallel to or aligned with the optical axis of a movable portion of the beam delivery system.

[0376] Item 5: An ophthalmic laser system according to any of the preceding items, wherein the controller is configured to automatically or by using user input determine one or more parameters based on orientation-related data, which (a) indicate or (b) are related to one or more or all orientation parameters of the patient’s head around the axis of the eye to be treated.

[0377] Item 6: An ophthalmic laser system configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated; a controller operatively coupled to the beam delivery system and configured to control the beam delivery system based on laser positioning data to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea, the laser positioning data indicating or relating to the location to be treated within the eye; and a orientation analysis system for acquiring orientation-related data using (a) one or more body parts of the patient and / or (b) one or more objects, each object being in a fixed position and / or orientation relative to a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about an eye axis; wherein at least one body part is external to the eyeball of the eye to be treated; wherein the controller is further configured to determine, based on the orientation-related data: (i) one or more parameters of the laser positioning data; and / or (ii) whether the emitting optics of the beam delivery system are positioned anterior to the patient's left or right anterior anterior anus.

[0378] Item 7: An ophthalmic laser system according to Item 6, wherein the controller is configured to automatically or by using user input determine one or more parameters based on orientation-related data, which indicate or are related to one or more or all orientation parameters of the patient's head.

[0379] Item 8: An ophthalmic laser system according to Item 7, wherein (a) one or more parameters of patient head orientation are measured about an axis around the eye to be treated; and / or (b) one or more parameters of patient head orientation are (i) measured relative to a movable part of the beam delivery system; or (ii) measured relative to a fixed coordinate system.

[0380] Item 9: An ophthalmic laser system according to Items 5, 7 or 8, wherein determining the one or more parameters comprises: (a) automatically or based on user input, determining one or more or all angular position parameters of the patient's anatomical features and / or anatomical landmarks relative to the eye axis; and / or (b) automatically or based on user input, determining one or more or all orientation parameters of the anatomical features and / or anatomical landmarks in a plane perpendicular to the eye axis.

[0381] Item 10: An ophthalmic laser system according to any of the preceding items, wherein the directional analysis system includes a detector system configured to detect electromagnetic radiation emitted from a region comprising one or more body parts and / or objects.

[0382] Item 11: The ophthalmic laser system according to Item 10, wherein the detector system is configured to detect electromagnetic radiation in a spatially resolved manner.

[0383] Item 12: An ophthalmic laser system according to Item 10 or 11, wherein the frequency of the electromagnetic radiation is in the range of 10 GHz and 800 THz, and / or the wavelength is in the range of 10 micrometers and 10 millimeters, particularly in the range of 100 micrometers and 1 millimeter.

[0384] Item 13: An ophthalmic laser system according to any of the preceding items, wherein orientation data is acquired using one or more objects; wherein the orientation analysis system is configured to acquire orientation-related data using a static magnetic field and / or electrostatic field extending between a movable part of the ophthalmic laser system, particularly a beam delivery system, and the one or more objects.

[0385] Item 14: An ophthalmic laser system according to any of the preceding claims, wherein the orientation analysis system comprises: (a) a 2D imaging system for acquiring two-dimensional images of the one or more body parts and / or objects; and / or (b) a surface topography acquisition system; and / or (c) a 3D imaging system.

[0386] Item 15: An ophthalmic laser system according to any of the preceding items, wherein the ophthalmic laser system includes one or more tiltmeters and / or accelerometers, wherein the controller is configured to reduce or eliminate degradation of orientation-related data caused by movement of a movable portion of the beam delivery system relative to the patient's head.

[0387] Item 16: An ophthalmic laser system according to any of the preceding items, wherein the optical path of the directional analysis system passes through one or more optical elements of (a) the beam delivery system and / or (b) an optical element, particularly a patient interface, which is arranged in the optical path of the therapeutic laser beam between the beam delivery system and the eye to be treated.

[0388] Item 17: An ophthalmic laser system according to any of the preceding items, wherein the orientation-related data includes graphics, symbols and / or morphological representations and / or 3D images containing one or more body parts and / or objects.

[0389] Item 18: An ophthalmic laser system according to Item 17, wherein the controller is configured to automatically or by using user input determine the position and / or orientation of the one or more body parts and / or objects in the representation and / or 3D image.

[0390] Item 19: An ophthalmic laser system according to any of the preceding claims, wherein the laser system is configured to display graphics, symbols and / or topographic representations and / or 3D images on a display device, the graphics, symbols and / or topographic representations and / or 3D images indicating the position and / or orientation of a movable portion of the beam delivery system relative to a patient's body part, particularly relative to the patient's head.

[0391] Item 20: An ophthalmic laser system according to any of the preceding items, wherein the laser system is configured to determine one or more parameters for the positioning movement of a movable portion of the beam delivery system based on orientation correlation data.

[0392] Item 21: An ophthalmic laser system according to any of the preceding items, wherein at least one body part includes at least a portion of the patient’s head, particularly (a) at least a portion of the eyeball of the untreated eye and / or (b) at least a portion of the eyeball of the eye to be treated.

[0393] Item 22: An ophthalmic laser system according to any of the preceding items, wherein at least one body part includes at least a portion of the periorbital anatomy of at least one eye of the patient, particularly the lacrimal punctum and / or caruncle.

[0394] Item 23: An ophthalmic laser system according to any of the preceding items, wherein orientation-related data is acquired using at least one object, wherein (a) at least one object contacts and / or covers at least a portion of an untreated eye, and / or (b) at least one object contacts and / or covers at least a portion of an eye to be treated.

[0395] Item 24: An ophthalmic laser system according to any of the preceding claims, wherein the directional analysis system comprises at least two imaging systems; wherein a first imaging system is configured to image (i) at least a portion of the eye to be treated; and / or (ii) an optical element, particularly at least a portion of a patient interface, the optical element being located in the optical path of a treatment laser beam between the beam delivery system and the patient's eye; and wherein a second imaging system is configured to image at least a portion of an untreated eye and / or at least a portion of an object, the object contacting and / or covering at least a portion of the untreated eye.

[0396] Item 25: An ophthalmic laser system according to any of the preceding claims, wherein the orientation analysis system includes an imaging system configured to image (i) at least a portion of the eye to be treated; and / or (ii) an optical element, particularly at least a portion of a patient interface, the optical element being located in the optical path of a treatment laser beam between the beam delivery system and the patient's eye; wherein the orientation analysis system further includes a system for acquiring a 3D image and / or morphological representation of at least a portion of the untreated eye and / or an object that contacts and / or covers at least a portion of the untreated eye.

[0397] Item 26: An ophthalmic laser system according to any of the preceding items, wherein one of the objects is at least a portion of an eye fixation device, particularly at least a portion of a suction ring.

[0398] Item 27: An ophthalmic laser system according to Item 26, wherein the controller is configured to automatically determine the position and / or orientation of an eye fixation device, particularly the position and / or orientation of one or more markers (particularly infrared markers) of the eye fixation device, based on orientation-related data or user input.

[0399] Item 28: An ophthalmic laser system according to any of the preceding items, wherein the orientation analysis system includes an aiming system for aiming at one or more body parts and / or objects along an aiming direction.

[0400] Item 29: An ophthalmic laser system according to Item 28, wherein (a) the aiming system includes a light source for generating an aiming beam extending along the aiming direction; and / or (b) the aiming system includes a mechanical indicator that visually indicates the aiming direction; and / or (c) the aiming system includes a circumferentially arranged array of light sources, wherein the aiming system is configured such that one or more active light sources in the array of light sources indicate the aiming direction.

[0401] Item 30: An ophthalmic laser system according to Item 28 or 29, wherein the aiming system is configured such that the aiming direction can be adjusted by the user and / or the controller.

[0402] Item 31: An ophthalmic laser system having a beam delivery system, wherein the laser system is configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the patient's eye; a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea; a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least a movable portion to different orientations of the patient's head as measured about an axis around the eye to be treated; and an orientation indicating system configured to indicate to a user a relative orientation between: (a) the orientation of a patient's body part and / or an object that contacts and / or covers at least a portion of the body part; and (b) the orientation of the movable portion of the beam delivery system, wherein the relative orientation is relative to the axis of the eye to be treated.

[0403] Item 32: The laser system according to Item 31, wherein the orientation indication system includes a light source, wherein (a) the position and / or orientation of the light-emitting surface of the light source; and / or (b) the direction indication of the light emitted by the light source or related to the orientation of a movable part of the beam delivery system.

[0404] Item 33: The laser system according to Item 32, wherein the light source is a laser, particularly a line laser.

[0405] Item 34: A laser system according to any one of items 31 to 33, wherein the orientation pointing system includes an aiming system for aiming at one or more predefined body parts of a patient.

[0406] Item 35: A laser system according to any one of items 31 to 34, wherein the orientation indicator system includes a light source, wherein light emitted from the light source produces a visible mark on the patient's body or on an object attached to and / or covering at least a portion of the patient's body.

[0407] Item 36: The laser system according to Item 35, wherein the position and / or orientation of the visible markings indicate relative orientation or are related to relative orientation.

[0408] Item 37: A laser system according to any one of items 31 to 36, wherein the orientation indication system includes a mechanical orientation indicator, wherein the indicated orientation is related to the orientation of a movable part of the beam delivery system.

[0409] Item 38: An ophthalmic laser system according to any of the preceding items further includes a support arm, wherein at least this portion of the beam delivery system is movably supported by a free end of the support arm, or a portion thereof.

[0410] Item 39: An ophthalmic laser system according to Item 38, wherein a second end of the support arm opposite to the free end: (a) is connected to a laser system base supporting the support arm; and / or (b) includes an interface for connecting the support arm to another component at the second end of the support arm.

[0411] Item 40: The ophthalmic laser system according to Item 38 or 39 further includes a laser source for generating a therapeutic laser beam; wherein a second end of the support arm opposite to the free end is connected to a laser system base supporting the support arm; and wherein the base houses at least a portion of the laser source.

[0412] Item 41: An ophthalmic laser system according to any one of items 38 to 40, wherein the support arm includes one or more sensors operatively coupled to a controller, and the sensors include one or more of the following: (a) a linear and / or angular position sensor; and / or (b) a tilt meter and / or accelerometer; wherein the controller is configured to determine one or more parameters of the position and / or orientation of the laser applicator based on the output of the one or more linear and / or angular sensors.

[0413] Item 42: A method of operating an ophthalmic laser system having a beam delivery system for performing laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated; a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea; and a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least a movable portion to different orientations of the patient's head as measured about an axis around the eye to be treated; wherein the method comprises: using an orientation analysis system to acquire orientation-related data using one or more body parts and / or one or more objects of the patient, each object having a fixed position and / or orientation relative to a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts about the eye axis; and, by a user and / or the controller of the laser system, using the orientation-related data, moving the movable portion of the beam delivery system such that, during laser treatment, the movable portion has an orientation about the eye axis and relative to the patient's head, the orientation corresponding to or substantially corresponding to a predetermined target orientation, or within or substantially within a predetermined target range.

[0414] Item 43: A method of operating an ophthalmic laser system having a beam delivery system for performing laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated; a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea; the method comprising: using a orientation analysis system to acquire orientation-related data using one or more body parts and / or one or more objects of the patient, each object contacting and / or covering a corresponding body part such that the orientation-related data depends on the orientation of the one or more body parts about an eye axis; wherein at least one body part and / or object is external to the eye to be treated; wherein the controller is further configured to determine, based on the orientation-related data: (i) one or more parameters of the laser positioning data; and / or (ii) whether the emitting optics of the beam delivery system are positioned anterior to the patient's left or right anterior anterior anus.

[0415] Item 44: The method according to Item 42 or 43, wherein the orientation-related data is determined using one or more objects, wherein the method further comprises: using a user and / or an ophthalmic laser system, placing at least one object such that the object contacts and / or covers a part of the patient's body; and obtaining orientation-related data from at least a portion of the placed object.

[0416] Item 45: The method according to Item 44, wherein placing an object includes placing the object on another object, particularly on a portion of tissue that contacts and / or covers a body part.

[0417] Item 46: According to the method of Item 44 or 45, the object placed is an anatomical part of the surgeon, in particular the fingers or fingertips of the surgeon's hand.

[0418] Item 47: A method of operating an ophthalmic laser system having a beam delivery system, wherein the laser system is configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the patient's eye; a controller operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea; and a guide configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least the movable portion to different orientations of the patient's head measured about an axis around the eye to be treated; wherein the method includes: using an orientation indicator system to indicate to a user (a) the relative orientation between (a) the orientation of a part of the patient's body and / or object and (b) the orientation of the movable portion of the beam delivery system, wherein the orientation is relative to the axis of the eye to be treated.

[0419] Item 48: An ophthalmic laser system according to any one of items 1 to 30 and 38 to 41, wherein the directional analysis system includes a gigahertz-terahertz imaging system for acquiring image data from one or more body parts and / or objects; wherein the gigahertz-terahertz imaging system is configured to use electromagnetic radiation in the frequency range of 10 GHz to 100 THz.

[0420] Item 49: An ophthalmic laser system for performing laser treatment on an eye using a therapeutic laser beam, the laser system comprising: a laser applicator including an optical system through which the therapeutic laser beam exits the laser applicator in a direction toward a patient's eye; a beam delivery system for focusing the therapeutic laser beam such that the therapeutic laser beam travels toward the eye to be treated; a support arm, wherein a free end of the support arm includes or movably supports the laser applicator; and a controller operatively coupled to the beam delivery system and configured to control the beam delivery system based on laser positioning data to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea, the laser positioning data being... The laser system is configured to: indicate or relate to the location of treatment within the eye; a gigahertz-terahertz imaging system for acquiring image data from (a) one or more body parts of a patient; and / or (b) one or more objects, each object having a fixed position and / or orientation relative to the corresponding body part; wherein the gigahertz-terahertz imaging system is configured to use electromagnetic radiation with frequencies in the range of 10 GHz to 100 THz; wherein the laser system is further configured to: (a) allow the user and / or controller to adjust the relative position and / or orientation of the laser applicator relative to the patient's head using the image data; and / or (b) use the controller to determine laser positioning data based on the image data.

[0421] Item 50: Ophthalmic laser systems according to Items 48 or 49, wherein the frequency of electromagnetic radiation is in the range of 30 GHz to 50 THz.

[0422] Item 51: An ophthalmic laser system according to any one of items 48 to 50, wherein the terahertz and / or gigahertz imaging system includes a scanner for scanning an electromagnetic radiation beam across the one or more body parts and / or objects.

[0423] Item 52: An ophthalmic laser system according to any one of items 48 to 51, wherein the controller is configured to determine the external contour of at least a portion of a patient's body based on image data.

[0424] Item 53: An ophthalmic laser system according to any one of items 48 to 52, wherein the free end of the support arm includes or movably supports at least a portion of the gigahertz-terahertz imaging system.

[0425] Item 54: An ophthalmic laser system according to any one of items 48 to 53, wherein the controller is configured to automatically or by using user input determine one or more parameters based on image data, which (a) indicate or (b) relate to one or more or all orientation parameters of the patient’s head about the axis of the eye to be treated.

[0426] Item 55: An ophthalmic laser system according to any one of items 48 to 54 further includes: a drive system for driving the movement of a positioning arm to displace a laser applicator; wherein a controller is operatively coupled to the drive system for controlling the movement of the positioning arm based on image data.

[0427] Item 56: An ophthalmic laser system according to any one of items 48 to 55, wherein the second end of the support arm opposite the free end is: (a) connected to a laser system base supporting the support arm; and / or (b) includes an interface for connecting the support arm to another component at the second end of the support arm.

[0428] Item 57: The ophthalmic laser system according to Item 56 further includes a laser source for generating a therapeutic laser beam; wherein a second end of the support arm opposite to the free end is connected to a laser system base supporting the support arm; and wherein the base houses at least a portion of the laser source.

[0429] Item 58: An ophthalmic laser system according to any one of items 48 to 57, wherein the therapeutic laser beam is a pulsed laser beam having a pulse duration between 1 femtosecond and 1,000 femtoseconds.

[0430] Item 59: An ophthalmic laser system for performing laser treatment on an eye, the laser system comprising: a laser applicator including an optical system through which a therapeutic laser beam exits the laser applicator in a direction toward a patient's eye; a support arm; and a controller; wherein a free end of the support arm includes the laser applicator or movably supports the laser applicator; wherein the support arm includes a controllable visual indicator operatively connected to the controller to control the generation of a visual signal; wherein the visual indicator includes: (a) a surface from which signal light of the visual signal is emitted, wherein the surface forms at least one circumferential portion of an outer peripheral surface of the support arm; and / or (b) a plurality of surfaces from which signal light of the visual signal is emitted, wherein the plurality of surfaces are distributed at least around the circumferential portion of the outer peripheral surface of the support arm.

[0431] Item 60: An ophthalmic laser system according to Item 59, wherein the circumferential surface has a horizontal or substantially horizontal circumference.

[0432] Item 61: An ophthalmic laser system according to Item 59 or 60, wherein the support arm comprises two arm segments connected by one or more joints, wherein a visual indicator is disposed at one or more joints.

[0433] Item 62: An ophthalmic laser system according to Item 61, wherein the first of two arm segments is rotatable about a vertical or substantially vertical axis, and the second of two arm segments is rotatable about a horizontal or substantially horizontal axis.

[0434] Item 63: An ophthalmic laser system according to Item 61 or 62, wherein the second arm segment is rotatable about a vertical axis in order to adjust the orientation of the second arm segment relative to the first arm segment.

[0435] Item 64: An ophthalmic laser system according to any one of Items 62 or 63, wherein a first arm segment is connected to a laser applicator via a second arm segment.

[0436] Item 65: An ophthalmic laser system according to any one of items 59 to 64, wherein the controller is configured such that a visual signal light indicates a stage of laser treatment.

[0437] Item 66: An ophthalmic laser system according to any one of items 59 to 65, wherein the controller is configured such that a visual signal indicates the operating status of the ophthalmic laser system.

[0438] Item 67: An ophthalmic laser system according to any one of items 59 to 66, wherein the controller and visual indicator are configured to cause the visual signal to indicate a warning message to the user.

[0439] Item 68: An ophthalmic laser system according to any one of items 59 to 67, wherein the support arm is configured such that the laser applicator can be positioned relative to the base in three dimensions.

[0440] Item 69: An ophthalmic laser system according to any one of items 59 to 68, wherein the visual indicator includes one or more light-emitting diodes (LEDs).

[0441] Item 70: An ophthalmic laser system according to any one of items 59 to 69, wherein the visual indicator includes a plurality of light sources, wherein each light source includes or is covered by one of the surfaces from which signal light is emitted, and these surfaces are distributed around at least the circumferential portion.

[0442] Item 71: An ophthalmic laser system according to any one of items 59 to 70, wherein the visual indicator includes a light reflector illuminated by one or more light sources of the visual indicator, and the light reflector is configured to perform specular or diffuse reflection of signal light emitted from the one or more light sources.

[0443] Item 72: An ophthalmic laser system according to any one of items 1 to 41 and 48 to 71, wherein the laser system comprises: a base housing at least a portion of a laser source of the laser system, wherein the laser source is configured to generate a therapeutic laser beam for performing laser treatment; a laser applicator including an optical system through which the therapeutic laser beam exits the laser applicator in a direction toward the patient's eye; a support arm; and a controller; wherein the support arm is connected to the laser applicator at a first end, and wherein a second end of the support arm (a) is connected to the base and / or (b) includes an interface for connecting the support arm to another component at the second end of the support arm; wherein the support arm is configured such that the laser applicator can be positioned relative to the base in three dimensions while maintaining the vertical orientation of the laser applicator; and wherein the laser system further comprises a motorized triaxial positioning system operatively coupled to the controller for positioning the laser applicator relative to at least a portion of the support arm in three dimensions.

[0444] Item 73: The laser system according to Item 72, wherein the laser applicator includes a manually operable control unit operatively coupled to a controller for performing positioning of the laser applicator relative to a support arm based on user input received via a control element.

[0445] Item 74: The laser system according to Item 72 or 73, wherein the laser applicator includes an imaging system for acquiring a frontal image of at least a portion of the patient's eye during at least a portion of positioning of the laser applicator relative to the support arm.

[0446] Item 75: The laser system according to Item 74, wherein the laser applicator includes a display device for displaying the frontal image during at least a portion of the time the laser applicator is positioned relative to the support arm.

[0447] Item 76: A laser system according to any one of items 72 to 75 above, wherein the laser applicator includes an interaction measurement unit for generating an output signal that depends on parameters of the mechanical interaction between the patient's eye and the laser applicator.

[0448] Item 77: The laser system according to Item 76, wherein the output signal depends on the force between the patient's eye and the laser applicator; and / or the interaction determining unit includes a force sensor, a strain gauge sensor and / or a piezoelectric element.

[0449] Item 78: A laser system according to Item 76 or 77, wherein the laser applicator includes a display device, wherein the controller is configured to generate data representing graphic and / or textual information using an output signal generated by an interaction measurement unit; and to display the graphic and / or textual information on the display device during at least a portion of the laser applicator being positioned relative to the support arm.

[0450] Item 79: A laser system according to any one of items 1 to 41 and 48 to 78 above, wherein the laser applicator includes an optical coherence tomography (OCT) system configured to acquire a cross-sectional image of at least a portion of the eye.

[0451] Item 80: The laser system according to Item 79, wherein the laser applicator includes a beam combiner for combining the optical path of the measuring arm of the OCT system with the optical path of the therapeutic laser beam.

[0452] Item 81: A laser system according to any one of items 1 to 41 and 48 to 80 above, wherein the support arm includes an arm segment rotatable about a horizontal or substantially horizontal axis.

[0453] Item 82: The laser system according to Item 81, wherein the arm segment includes a parallel linkage mechanism.

[0454] Item 83: A laser system according to any one of items 1 to 41 and 48 to 82 above, wherein the support arm includes a first arm segment and a second arm segment connected in series by an intermediate joint; wherein the first arm segment is rotatable about a vertical or substantially vertical axis and the second arm segment is rotatable about a horizontal or substantially horizontal axis.

[0455] Item 84: The laser system according to Item 83, wherein the intermediate joint is configured to allow the second arm segment to rotate about a horizontal or substantially horizontal axis and about a vertical or substantially vertical axis.

[0456] Item 85: The laser system according to Item 83 or 84, wherein the second arm segment includes a parallel linkage mechanism.

[0457] Item 86: A laser system according to any one of items 1 to 41 and 48 to 85 above, wherein the support arm includes a balancing mechanism for providing gravity balance for the applicator head.

[0458] Item 87: The laser system according to Item 86, wherein the support arm includes one or more springs, wherein the support arm is configured to provide at least a portion of the gravitational balance using the one or more springs.

[0459] Item 88: A laser system according to any one of items 1 to 41 and 48 to 87 above, wherein the support arm includes a braking and / or locking system for preventing movement of the second end of the support arm relative to the first end of the support arm.

[0460] Item 89: The laser system according to Item 88, wherein the laser applicator includes a manually operable control unit for selectively activating and deactivating the braking and / or locking system based on user input received via the control unit.

[0461] Item 90: A laser system according to Item 88 or 89, wherein the laser system includes an interaction measurement unit configured to generate an output signal that depends on the mechanical interaction between the patient's eye and the laser applicator; wherein a controller is operatively connected to the interaction measurement unit and a braking and / or locking system; wherein the controller is configured to receive the output signal generated by the interaction measurement unit and determine, based on the received output signal, whether to deactivate the braking and / or locking system.

[0462] Item 91: The laser system according to any one of items 1 to 41 and 48 to 90 above further includes an articulated beam guide tube, wherein at least a portion of the articulated beam guide tube extends between a first position on or within a base or support arm segment and a second position on or within a laser applicator.

[0463] Item 92: A laser system according to any one of items 1 to 41 and 48 to 91 above, wherein the support arm has a rotary joint having a vertically extending axis of rotation for rotating the laser applicator about an axis extending through the laser applicator.

[0464] Item 93: The laser system according to Item 92, wherein the laser system includes a locking system configured to lock a rotary joint having a rotational axis extending through the laser applicator.

[0465] Item 94: A laser system according to any one of items 1 to 41 and 48 to 93 above, wherein the laser applicator comprises: an objective lens for focusing a therapeutic laser beam into the eye and / or an axial scanning system for scanning the laser focus along the laser beam axis; and / or a beam deflection scanning system for scanning the laser beam by deflecting the laser beam.

[0466] Item 1A: An ophthalmic laser system for performing laser treatment on an eye, the laser system comprising: a base housing at least a portion of a laser source of the laser system, wherein the laser source is configured to generate a therapeutic laser beam for performing laser treatment; a laser applicator including an optical system through which the therapeutic laser beam exits the laser applicator in a direction toward a patient's eye; a support arm; and a controller; wherein the support arm is connected to the laser applicator at a first end, and wherein a second end of the support arm (a) is connected to the base and / or (b) includes an interface for connecting the support arm to another component at the second end of the support arm; wherein the support arm is configured such that the laser applicator can be positioned relative to the base in three dimensions while maintaining the vertical orientation of the laser applicator; and wherein the laser system further includes a motorized triaxial positioning system operatively coupled to the controller for positioning the laser applicator relative to at least a portion of the support arm in three dimensions.

[0467] Item 2A: A laser system according to Item 1A, wherein the laser applicator includes a manually operable control unit operatively coupled to a controller for performing positioning of the laser applicator relative to a support arm based on user input received via a control element.

[0468] Item 3A: A laser system according to Item 1A or 2A, wherein the laser applicator includes an imaging system for acquiring a frontal image of at least a portion of the patient's eye during at least a portion of positioning of the laser applicator relative to the support arm.

[0469] Item 4A: The laser system according to Item 3A, wherein the laser applicator includes a display device for displaying the frontal image during at least a portion of the period during which the laser applicator is positioned relative to the support arm.

[0470] Item 5A: A laser system according to any one of items 1A to 4A above, wherein the laser applicator includes an interaction measurement unit for generating an output signal that depends on parameters of the mechanical interaction between the patient's eye and the laser applicator.

[0471] Item 6A: A laser system according to Item 5A, wherein the output signal depends on the force between the patient's eye and the laser applicator; and / or the interaction determining unit includes a force sensor, a strain gauge sensor and / or a piezoelectric element.

[0472] Item 7A: A laser system according to Item 5A or 6A, wherein the laser applicator includes a display device, wherein the controller is configured to generate data representing graphic and / or textual information using an output signal generated by an interaction measurement unit; and to display the graphic and / or textual information on the display device during at least a portion of the laser applicator being positioned relative to a support arm.

[0473] Item 8A: An ophthalmic laser system for performing laser treatment on an eye, the laser system comprising: a base housing at least a portion of a laser source of the laser system, wherein the laser source is configured to generate a therapeutic laser beam for performing laser treatment; a laser applicator including an optical system through which the therapeutic laser beam exits the laser applicator toward a patient's eye; a support arm connected at a first end to the laser applicator, wherein the support arm (a) is connected to the base and / or (b) includes an interface for connecting the support arm to another component at a second end; an articulated beamguide, wherein at least a portion of the articulated beamguide extends between a first position where the therapeutic laser beam exits from the base or the support arm and a second position where the therapeutic laser beam enters the support arm or the laser applicator; wherein the laser system includes a coupling means for coupling the articulated beamguide to the support arm along one or more positions of the beamguide between the first and second positions.

[0474] Item 9A: The laser system according to Item 8A, wherein the coupling device includes a tension transmission connection.

[0475] Item 10A: The laser system according to Item 9A, wherein the tension transmission connection includes a tension spring for transmitting tension.

[0476] Item 11A: A laser system according to any one of items 8A to 10A, wherein the coupling device includes a guide, particularly a lateral guide.

[0477] Item 12A: A laser system according to Item 11A, wherein the guide is configured to limit the change in the vertical orientation of a plane defined by a continuous arm segment of an articulated beam guide during movement of the laser applicator.

[0478] Item 13A: A laser system according to any one of items 1A to 12A above, wherein the laser applicator includes an optical coherence tomography (OCT) system configured to acquire a cross-sectional image of at least a portion of the eye.

[0479] Item 14A: A laser system according to Item 13A, wherein the laser applicator includes a beam combiner for combining the optical path of the measuring arm of the OCT system with the optical path of the therapeutic laser beam.

[0480] Item 15A: A laser system according to any one of items 1A to 14A above, wherein the support arm includes an arm segment that can rotate about a horizontal or substantially horizontal axis.

[0481] Item 16A: The laser system according to Item 15A, wherein the arm segment includes a parallel linkage mechanism.

[0482] Item 17A: A laser system according to any one of items 1A to 16A above, wherein the support arm includes a first arm segment and a second arm segment connected in series with each other by an intermediate joint; wherein the first arm segment is rotatable about a vertical or substantially vertical axis and the second arm segment is rotatable about a horizontal or substantially horizontal axis.

[0483] Item 18A: A laser system according to Item 17A, wherein the intermediate joint is configured to allow the second arm segment to rotate about a horizontal or substantially horizontal axis and about a vertical or substantially vertical axis.

[0484] Item 19A: A laser system according to Item 17A or 18A, wherein the second arm segment includes a parallel linkage mechanism.

[0485] Item 20A: A laser system according to any one of items 1A to 19A above, wherein the support arm includes a balancing mechanism for providing gravity balance for the applicator head.

[0486] Item 21A: A laser system according to Item 20A, wherein the support arm includes one or more springs, wherein the support arm is configured to provide at least a portion of the gravitational balance using the one or more springs.

[0487] Item 22A: A laser system according to any one of items 1A to 21A above, wherein the support arm includes a braking and / or locking system for preventing movement of the second end of the support arm relative to the first end of the support arm.

[0488] Item 23A: A laser system according to Item 22A, wherein the laser applicator includes a manually operable control unit for selectively activating and deactivating the braking and / or locking system based on user input received via the control unit.

[0489] Item 24A: A laser system according to Item 22A or 23A, wherein the laser system includes an interaction measurement unit configured to generate an output signal that depends on the mechanical interaction between the patient's eye and the laser applicator; wherein a controller is operatively connected to the interaction measurement unit and the actuator; wherein the controller is configured to receive the output signal generated by the interaction measurement unit and determine, based on the received output signal, whether to deactivate the braking and / or locking system.

[0490] Item 25A: The laser system according to any one of items 1A to 24A further includes an articulated beam guide tube, wherein at least a portion of the articulated beam guide tube extends between a first position on or within a base or support arm segment and a second position on or within a laser applicator.

[0491] Item 26A: A laser system according to any one of items 1A to 25A above, wherein the support arm has a rotary joint having a vertically extending axis of rotation for rotating the laser applicator about an axis extending through the laser applicator.

[0492] Item 27A: A laser system according to Item 25A or 26A, wherein the laser system includes a locking system configured to lock a rotary joint having a rotational axis extending through the laser applicator.

[0493] Item 28A: A laser system according to any one of items 1A to 27A above, wherein the laser applicator includes: an objective lens for focusing a therapeutic laser beam into the eye and / or an axial scanning system for scanning the laser focus along the laser beam axis; and / or a beam deflection scanning system for scanning the laser beam by deflecting the laser beam.

[0494] Item 29A: A method for positioning a laser applicator of an ophthalmic laser system relative to a patient's eye, the method comprising: positioning the laser applicator relative to the patient's eye using a support arm, wherein the support arm is connected at a first end to a base of the ophthalmic laser system; and wherein the support arm is connected to the base and / or is connectable to a fixing member at a second end of the support arm; wherein the base houses at least a portion of a laser source of the laser system, wherein the laser source is configured to generate a therapeutic laser beam for performing laser therapy; wherein the support arm is configured such that the laser applicator can be positioned relative to the base while maintaining the vertical orientation of the laser applicator; and positioning the laser applicator relative to at least a portion of the support arm using a motorized triaxial positioning system.

[0495] Item 30A: The method according to Item 29A further includes: acquiring a frontal image of the eye using an imaging system with a laser applicator; and displaying the frontal image on a display device of the laser system during at least a portion of the time during which the laser applicator is positioned relative to the support arm.

[0496] Item 31A: According to the method of Item 30A, wherein during the positioning of this part, the distance of the focal plane from the laser applicator substantially corresponds to the predetermined distance of the laser applicator from the patient's eye.

[0497] Item 32A: The method according to any one of items 29A to 31A further includes: generating an output signal by an interaction measurement unit, the output signal depending on the mechanical interaction between the patient's eye and the laser applicator; determining text and / or graphic information based on the output signal using a controller of the laser system; and displaying the text and / or graphic information during at least a portion of the positioning of the laser applicator relative to the support arm.

[0498] Item 33A: The method according to any one of items 29A to 32A further includes: generating an output signal by an interaction measurement unit, the output signal depending on the mechanical interaction between the patient's eye and the laser applicator; using a controller of the laser system and based on the output signal to determine whether to deactivate a brake on the support arm, the brake preventing the second end of the support arm from moving relative to the first end of the support arm.

[0499] Item 34A: The method according to any one of items 29A to 33A, wherein the output signal depends on the force between the patient's eye and the laser applicator; and / or the interaction determination unit includes a force sensor and / or a strain gauge sensor.

[0500] Item 35A: A laser system according to any one of items 1A to 7A further includes an articulated beamguide, wherein at least a portion of the articulated beamguide extends between a first position where the therapeutic laser beam exits from the base or support arm and a second position where the therapeutic laser beam enters the support arm or laser applicator; wherein the laser system includes a coupling means for coupling the articulated beamguide to the support arm along one or more positions of the beamguide between the first and second positions.

[0501] Item 36A: The laser system according to Item 35A, wherein the coupling device includes a tension transmission connection.

[0502] Item 37A: The laser system according to Item 36A, wherein the tension transmission connection includes a tension spring for transmitting tension.

[0503] Item 38A: A laser system according to any one of items 35A to 37A, wherein the coupling device includes a guide, particularly a lateral guide.

[0504] Item 39A: A laser system according to Item 38A, wherein the guide is configured to limit the change in the vertical orientation of a plane defined by a continuous arm segment of an articulated beam guide during laser applicator movement.

Claims

1. An ophthalmic laser system configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: A beam delivery system for focusing the therapeutic laser beam so that it travels toward the eye to be treated; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye; a guide, configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least the movable portion to different orientations of the patient's head as measured about an axis around the eye to be treated. The orientation analysis system is used to obtain orientation-related data using the following: (a) one or more body parts of the patient; and / or (b) One or more objects, each having a fixed position and / or orientation relative to a corresponding body part. This makes the orientation-related data dependent on the orientation of the one or more body parts around the axis of the eye; The ophthalmic laser system is configured to allow a user and / or the controller to move the movable portion of the beam delivery system using the orientation-related data, such that during the laser treatment, the movable portion has an orientation about the axis of the eye and relative to the patient's head, the orientation... (i) Corresponds to or substantially corresponds to a predetermined target orientation; or (ii) Within or substantially within the predetermined target range.

2. The ophthalmic laser system of claim 1, wherein at least one of the body parts is located outside the eyeball of the eye to be treated.

3. The ophthalmic laser system of claim 1 or 2, wherein the guide includes a rotation guide configured to allow the movable portion of the beam delivery system to rotate about a rotation axis.

4. The ophthalmic laser system of claim 3, wherein the laser system is configured such that during laser treatment, the axis of rotation of the rotating guide is parallel to or aligned with the optical axis of the movable portion of the beam delivery system.

5. The ophthalmic laser system according to any one of the preceding claims, wherein the controller is configured to automatically or by user input determine one or more parameters based on the orientation-related data, the parameters (a) indicating or (b) relating to one or more or all orientation parameters of the patient’s head around the axis of the eye to be treated.

6. An ophthalmic laser system configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: A beam delivery system for focusing the therapeutic laser beam so that it travels toward the eye to be treated; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system based on laser positioning data to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye, the laser positioning data indicating or relating to the location to be treated within the eye; The orientation analysis system is used to obtain orientation-related data using the following: (a) one or more body parts of the patient and / or (b) One or more objects, each in a fixed position and / or orientation relative to a corresponding body part. This makes the orientation-related data dependent on the orientation of the one or more body parts around the axis of the eye; At least one of the body parts is located outside the eyeball of the eye to be treated; The controller is further configured to determine, based on the orientation correlation data: (i) one or more parameters of the laser positioning data; and / or (ii) Whether the outgoing optical element of the beam delivery system is positioned in front of the patient's left or right anterior eye.

7. The ophthalmic laser system of claim 6, wherein the controller is configured to automatically or by user input determine one or more parameters based on the orientation-related data, the parameters indicating or relating to one or more or all orientation parameters of the patient's head.

8. The ophthalmic laser system according to claim 7, wherein... (a) The one or more parameters of the patient's head orientation are measured about the axis around the eye to be treated; and / or (b) The one or more parameters of patient head orientation are (i) Measured relative to the movable portion of the beam delivery system; or (ii) Measured relative to a fixed coordinate system.

9. The ophthalmic laser system according to claim 5, 7 or 8, wherein determining the one or more parameters includes: (a) Automatically or based on user input, determine one or more or all angular position parameters of the patient's anatomical features and / or anatomical landmarks relative to the axis of the eye; and / or (b) Automatically or based on user input, determine one or more or all orientation parameters of the anatomical features and / or anatomical landmarks in a plane perpendicular to the axis of the eye.

10. The ophthalmic laser system according to any one of the preceding claims, wherein the directional analysis system includes a detector system configured to detect electromagnetic radiation emitted from a region comprising one or more of the body parts and / or objects.

11. The ophthalmic laser system of claim 10, wherein the detector system is configured to detect the electromagnetic radiation in a spatially resolved manner.

12. The ophthalmic laser system of claim 10 or 11, wherein the frequency of the electromagnetic radiation is in the range of 10 GHz and 800 THz, and / or the wavelength is in the range of 10 micrometers and 10 millimeters, particularly in the range of 100 micrometers and 1 millimeter.

13. The ophthalmic laser system according to any one of the preceding claims, wherein the orientation data is acquired using the one or more objects; wherein the orientation analysis system is configured to acquire the orientation-related data using a static magnetic field and / or electrostatic field extending between a portion of the ophthalmic laser system, particularly between the movable portion of the beam delivery system and the one or more objects.

14. The ophthalmic laser system according to any one of the preceding claims, wherein the directional analysis system comprises: (a) A 2D imaging system for acquiring two-dimensional images of the one or more body parts and / or objects; and / or (b) a surface topography acquisition system; and / or (c) a 3D imaging system.

15. The ophthalmic laser system according to any one of the preceding claims, wherein the ophthalmic laser system includes one or more tiltmeters and / or accelerometers, wherein the controller is configured to reduce or eliminate the degradation of the orientation-related data caused by movement of the movable portion of the beam delivery system relative to the patient's head.

16. The ophthalmic laser system according to any one of the preceding claims, wherein the optical path of the directional analysis system passes through (a) one or more optical elements of the beam delivery system and / or (b) optical elements in the optical path of the therapeutic laser beam arranged between the beam delivery system and the eye to be treated, particularly a patient interface.

17. The ophthalmic laser system according to any of the preceding claims, wherein the orientation-related data includes graphics, symbols and / or topographic representations and / or 3D images, which contain one or more of the body parts and / or objects.

18. The ophthalmic laser system of claim 17, wherein the controller is configured to automatically or using user input determine the position and / or orientation of the one or more body parts and / or objects in the representation and / or 3D image.

19. The ophthalmic laser system according to any one of the preceding claims, wherein the laser system is configured to display graphics, symbols and / or topographic representations and / or 3D images on a display device, the graphics, symbols and / or topographic representations and / or 3D images indicating the position and / or orientation of the movable portion of the beam delivery system relative to a patient's body portion, particularly relative to the patient's head.

20. The ophthalmic laser system according to any of the preceding claims, wherein the laser system is configured to determine one or more parameters for positioning movement of the movable portion of the beam delivery system based on the orientation correlation data.

21. The ophthalmic laser system according to any one of the preceding claims, wherein at least one of the body parts includes at least a portion of the patient's head, particularly (a) At least a portion of the eyeball of an untreated eye and / or (b) At least a portion of the eyeball of the eye to be treated.

22. The ophthalmic laser system according to any of the preceding claims, wherein at least one of the body parts comprises at least a portion of the periorbital anatomy of at least one eye of the patient, particularly the lacrimal punctum and / or caruncle.

23. The ophthalmic laser system according to any one of the preceding claims, wherein the orientation-related data is acquired using at least one of the objects, wherein (a) at least one of the objects contacts and / or covers at least a portion of the untreated eye, and / or (b) at least one of the objects contacts and / or covers at least a portion of the eye to be treated.

24. The ophthalmic laser system according to any one of the preceding claims, wherein the directional analysis system comprises at least two imaging systems; The first imaging system is configured for imaging. (i) at least a portion of the eye to be treated; and / or (ii) An optical element, particularly at least a portion of the patient interface, said optical element being located in the optical path of the therapeutic laser beam between the beam delivery system and the patient's eye; and The second imaging system is configured to image at least a portion of the untreated eye and / or at least a portion of an object, wherein the object contacts and / or covers at least a portion of the untreated eye.

25. The ophthalmic laser system according to any one of the preceding claims, wherein the directional analysis system includes an imaging system configured to image... (i) at least a portion of the eye to be treated; and / or (ii) An optical element, particularly at least a portion of the patient interface, said optical element being located in the optical path of the therapeutic laser beam between the beam delivery system and the patient's eye; The orientation analysis system further includes a system for acquiring a 3D image and / or topographic representation of at least a portion of the untreated eye and / or an object that contacts and / or covers at least a portion of the untreated eye.

26. The ophthalmic laser system according to any one of the preceding claims, wherein one of the objects is at least a portion of an eye fixation device, particularly at least a portion of a suction ring.

27. The ophthalmic laser system of claim 26, wherein the controller is configured to automatically or based on the orientation-related data determine the position and / or orientation of the eye fixation device, particularly one or more markers of the eye fixation device, especially infrared markers.

28. The ophthalmic laser system according to any one of the preceding claims, wherein the directional analysis system includes an aiming system for aiming at one or more of the body parts and / or objects along an aiming direction.

29. The ophthalmic laser system according to claim 28, wherein... (a) The aiming system includes a light source for generating an aiming beam extending along the aiming direction; and / or (b) The aiming system includes a mechanical indicator that visually indicates the aiming direction; and / or (c) The aiming system includes a circumferentially arranged array of light sources, wherein the aiming system is configured such that one or more active light sources in the array of light sources indicate the aiming direction.

30. The ophthalmic laser system of claim 28 or 29, wherein the aiming system is configured such that the aiming direction can be adjusted by the user and / or the controller.

31. An ophthalmic laser system having a beam delivery system, wherein the laser system is configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: A beam delivery system for focusing the therapeutic laser beam so that the therapeutic laser beam travels toward the patient's eye; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye; A guide, configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least the movable portion to different orientations of the patient's head as measured about an axis around the eye to be treated; A direction indication system configured to indicate to the user a relative orientation between the following two: (a) The orientation of the patient’s body parts and / or the object, wherein the object is in contact with and / or covers at least a portion of the body parts; and (b) Orientation of the movable portion of the beam delivery system, wherein the relative orientation is relative to the axis of the eye to be treated.

32. The laser system of claim 31, wherein the orientation indicating system comprises a light source, in (a) The position and / or orientation of the light-emitting surface of the light source; and / or (b) The direction of the light emitted by the light source The orientation is indicated or related to the movable portion of the beam delivery system.

33. The laser system according to claim 32, wherein the light source is a laser, particularly a line laser.

34. The laser system according to any one of claims 31 to 33, wherein the orientation indication system includes an aiming system for aiming at one or more predefined body parts of the patient.

35. The laser system according to any one of claims 31 to 34, wherein the orientation indicating system includes a light source, wherein light emitted from the light source produces a visible mark on the patient's body or on an object attached to and / or covering at least a portion of the patient's body.

36. The laser system of claim 35, wherein the position and / or orientation of the visible mark indicates or is related to the relative orientation.

37. The laser system according to any one of claims 31 to 36, wherein the orientation indication system includes a mechanical orientation indicator, wherein the indicated direction indicates or is related to the orientation of the movable portion of the beam delivery system.

38. The ophthalmic laser system according to any one of the preceding claims further includes a support arm, wherein at least the portion of the beam delivery system is movably supported by a free end of the support arm, or a portion of the free end.

39. The ophthalmic laser system of claim 38, wherein the second end of the support arm opposite the free end is: (a) connected to a base of the laser system supporting the support arm; and / or (b) includes an interface for connecting the support arm to another component at the second end of the support arm.

40. The ophthalmic laser system of claim 38 or 39, further comprising a laser source for generating the therapeutic laser beam; wherein a second end of the support arm opposite to the free end is connected to a base of the laser system supporting the support arm; and wherein the base houses at least a portion of the laser source.

41. The ophthalmic laser system according to any one of claims 38 to 40, The support arm includes one or more sensors operatively coupled to the controller, and the sensors include one or more of the following: (a) Linear and / or angular position sensors; and / or (b) Inclinometer and / or accelerometer; The controller is configured to determine one or more parameters of the position and / or orientation of the laser applicator based on the output of the one or more linear and / or angular sensors.

42. A method of operating an ophthalmic laser system having a beam delivery system for performing laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: A beam delivery system for focusing the therapeutic laser beam so that it travels toward the eye to be treated; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye; A guide, configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least the movable portion to different orientations of the patient's head as measured about an axis around the eye to be treated; The method includes: Using an orientation analysis system, orientation-related data are acquired from one or more body parts and / or one or more objects of the patient, each object having a fixed position and / or orientation relative to a corresponding body part. This makes the orientation-related data dependent on the orientation of the one or more body parts around the axis of the eye; The movable portion of the beam delivery system is moved by the user and / or the controller of the laser system using the orientation-related data, such that during the laser treatment, the movable portion has an orientation about the axis of the eye and relative to the patient's head, the orientation corresponding to or substantially corresponding to a predetermined target orientation, or within or substantially within a predetermined target range.

43. A method of operating an ophthalmic laser system having a beam delivery system for performing laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: A beam delivery system for focusing the therapeutic laser beam so that it travels toward the eye to be treated; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye; The method includes: Using an orientation analysis system, orientation-related data is acquired using one or more body parts and / or one or more objects of the patient, each object contacting and / or covering a corresponding body part, such that the orientation-related data depends on the orientation of the one or more body parts around the axis of the eye; At least one of the body parts and / or objects is outside the eye to be treated; The controller is further configured to determine, based on the orientation-related data: (i) one or more parameters of the laser positioning data; and / or (ii) whether the outgoing optics of the beam delivery system are positioned in front of the patient's left or right anterior eye.

44. The method of claim 42 or 43, wherein the orientation-related data is determined using one or more of the objects, and wherein the method further comprises: Using the user and / or the ophthalmic laser system, at least one of the objects is placed such that the object contacts and / or covers a part of the patient's body; and the orientation-related data is obtained from at least a portion of the placed object.

45. The method of claim 44, wherein placing the object comprises placing the object on another object, particularly on a portion of tissue, the tissue being in contact with and / or covering the body part.

46. ​​The method of claim 44 or 45, wherein the object placed is an anatomical part of the surgeon, particularly the fingers or fingertips of the surgeon's hand.

47. A method of operating an ophthalmic laser system having a beam delivery system, wherein the laser system is configured to perform laser treatment on a patient's eye using a therapeutic laser beam, the laser system comprising: A beam delivery system for focusing the therapeutic laser beam so that the therapeutic laser beam travels toward the patient's eye; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye; A guide, configured to allow movement of at least a portion of the beam delivery system to adjust the orientation of at least the movable portion to different orientations of the patient's head as measured about an axis around the eye to be treated; The method includes: Using a directional indication system, the user is indicated to (a) the orientation of the patient's body parts and / or object and (b) the orientation of the movable part of the beam delivery system, wherein the orientation is relative to the axis of the eye to be treated.

48. The ophthalmic laser system according to any one of claims 1 to 30 and 38 to 41, wherein the directional analysis system includes a gigahertz-terahertz imaging system for acquiring image data from the one or more body parts and / or objects; wherein the gigahertz-terahertz imaging system is configured to use electromagnetic radiation in the frequency range of 10 GHz to 100 THz.

49. An ophthalmic laser system for performing laser treatment on an eye using a therapeutic laser beam, the laser system comprising: A laser applicator, the laser applicator including an optical system through which a therapeutic laser beam exits the laser applicator in a direction toward the patient's eye; A beam delivery system for focusing the therapeutic laser beam so that it travels toward the eye to be treated; A support arm, wherein the free end of the support arm includes or movably supports the laser applicator; A controller, operatively coupled to the beam delivery system and configured to control the beam delivery system based on laser positioning data to position the focal point of the laser beam at different locations within the eye or on the anterior surface of the cornea of ​​the eye, the laser positioning data indicating or relating to the location to be treated within the eye; A gigahertz-terahertz imaging system for acquiring image data from: (a) one or more body parts of the patient; and / or (b) One or more objects, each having a fixed position and / or orientation relative to a corresponding body part; wherein the gigahertz-terahertz imaging system is configured to use electromagnetic radiation in the frequency range of 10 GHz to 100 THz; The laser system is further configured to: (a) allow a user and / or the controller to adjust the relative position and / or orientation of the laser applicator relative to the patient's head using the image data; and / or (b) use the controller to determine the laser positioning data based on the image data.

50. The ophthalmic laser system according to claim 48 or 49, wherein the frequency of the electromagnetic radiation is in the range of 30 GHz to 50 THz.

51. The ophthalmic laser system according to any one of claims 48 to 50, wherein the terahertz and / or gigahertz imaging system includes a scanner for scanning an electromagnetic radiation beam across the one or more body parts and / or objects.

52. The ophthalmic laser system according to any one of claims 48 to 51, wherein the controller is configured to determine the external contour of at least a portion of the patient's body based on the image data.

53. The ophthalmic laser system according to any one of claims 48 to 52, wherein the free end of the support arm includes or movably supports at least a portion of the gigahertz-terahertz imaging system.

54. The ophthalmic laser system according to any one of claims 48 to 53, wherein the controller is configured to automatically or by user input determine one or more parameters based on the image data, the parameters (a) indicating or (b) relating to one or more or all of the orientation parameters of the patient’s head about the axis of the eye to be treated.

55. The ophthalmic laser system according to any one of claims 48 to 54, further comprising: A drive system for driving the movement of the positioning arm to displace the laser applicator; The controller is operatively coupled to the drive system for controlling the movement of the positioning arm based on the image data.

56. The ophthalmic laser system according to any one of claims 48 to 55, wherein the second end of the support arm opposite to the free end: (a) A base of the laser system connected to the supporting arm; and / or (b) Includes an interface for connecting the support arm to another component at the second end of the support arm.

57. The ophthalmic laser system of claim 56, further comprising a laser source for generating the therapeutic laser beam; wherein a second end of the support arm opposite to the free end is connected to a base of the laser system supporting the support arm; and wherein the base houses at least a portion of the laser source.

58. The ophthalmic laser system according to any one of claims 48 to 57, wherein the therapeutic laser beam is a pulsed laser beam having a pulse duration between 1 femtosecond and 1,000 femtoseconds.

59. An ophthalmic laser system for performing laser treatment on the eye, the laser system comprising: A laser applicator, the laser applicator including an optical system through which a therapeutic laser beam exits the laser applicator in a direction toward the patient's eye; Support arm; and Controller; wherein the free end of the support arm includes the laser applicator or movably supports the laser applicator; The support arm includes a controllable visual indicator, which is operatively connected to the controller to control the generation of visual signals; The visual indicator includes: (a) A curved surface from which the signal light of the visual signal is emitted, wherein the curved surface forms at least one circumferential portion of the outer peripheral surface of the support arm; and / or (b) A plurality of surfaces from which the signal light of the visual signal is emitted, wherein the plurality of surfaces are distributed at least around the circumferential portion of the outer peripheral surface of the support arm.

60. The ophthalmic laser system of claim 59, wherein the circumferential surface has a horizontal or substantially horizontal circumference.

61. The ophthalmic laser system of claim 59 or 60, wherein the support arm comprises two arm segments connected by one or more joints, and wherein the visual indicator is disposed at one or more joints.

62. The ophthalmic laser system of claim 61, wherein the first arm segment of the two arm segments is rotatable about a vertical or substantially vertical axis, and the second arm segment of the two arm segments is rotatable about a horizontal or substantially horizontal axis.

63. The ophthalmic laser system of claim 61 or 62, wherein the second arm segment is rotatable about a vertical axis to adjust the orientation of the second arm segment relative to the first arm segment.

64. The ophthalmic laser system according to any one of claims 62 or 63, wherein the first arm segment is connected to the laser applicator via the second arm segment.

65. The ophthalmic laser system according to any one of claims 59 to 64, wherein the controller is configured such that the visual signal light indicates the stage of the laser treatment.

66. The ophthalmic laser system according to any one of claims 59 to 65, wherein the controller is configured such that the visual signal indicates the operating state of the ophthalmic laser system.

67. The ophthalmic laser system according to any one of claims 59 to 66, wherein the controller and the visual indicator are configured such that the visual signal indicates a warning message to the user.

68. The ophthalmic laser system according to any one of claims 59 to 67, wherein the support arm is configured such that the laser applicator can be positioned relative to the base in three dimensions.

69. The ophthalmic laser system according to any one of claims 59 to 68, wherein the visual indicator comprises one or more light-emitting diodes (LEDs).

70. The ophthalmic laser system of any one of claims 59 to 69, wherein the visual indicator comprises a plurality of light sources, wherein each of the light sources comprises or is covered by one of the surfaces from which signal light is emitted, and the surfaces are distributed around at least the circumferential portion.

71. The ophthalmic laser system according to any one of claims 59 to 70, wherein the visual indicator includes a light reflector, the light reflector being illuminated by one or more light sources of the visual indicator, and configured to perform specular or diffuse reflection of the signal light emitted from the one or more light sources.

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