System for aligning an eye with a patient interface of an ophthalmic laser device

Abstract

In certain embodiments, a system for aligning an eye with a patient interface of a laser device includes a camera, a display screen, and a computer. The camera records an image of the eye through the patient interface of the laser device. A liquid is disposed between and in contact with the patient interface and an outer surface of the eye. The image includes an outline of the liquid. The display screen displays the image of the eye. The computer aligns the eye with the patient interface by: identifying an outline of the liquid in the image received from the camera; determining misalignment of the eye based on the outline; and instructing the display screen to display a description of the misalignment.

Description

Technical Field

[0001] The present disclosure relates generally to ophthalmic laser devices and, more particularly, to aligning an eye with a patient interface of an ophthalmic laser device. Background Art

[0002] Some ophthalmic laser surgical systems have a laser device that generates a pulsed laser beam to perform surgery on the eye. In some procedures, the laser beam creates photodamage at specific points in the eye according to a treatment pattern. The laser beam should be properly aligned with the eye to create photodamage that precisely matches the pattern. A patient interface (PI) coupled to the laser device is typically used to align the laser beam with the eye during surgery. The patient interface is typically attached to the eye by a vacuum to secure the eye in place, thereby correctly positioning the eye relative to the treatment pattern.

[0003] Aligning the eye with the patient interface to couple the interface to the correct position on the eye (i.e., "docking" the interface to the eye) is not a simple matter. According to one known docking process, the patient is required to look at a fixed light that is concentric with the laser beam, and the surgeon then manually positions the interface on the eye. However, it is often difficult for the patient to look at the fixed light, especially once the interface is in contact with the eye, thereby reducing the accuracy of the alignment. According to another known docking process, the pupil of the eye can be imaged and used to align the patient interface with the eye. However, some types of patient interfaces may distort the pupil when the interface is placed on the eye, thereby reducing the accuracy of the alignment. These known processes may result in incorrect positioning of the interface on the eye, such that, for example, the laser beam is not centered on the eye and / or is angled with the axis of the eye. For some surgeries, misalignment may produce suboptimal results. For example, in a lenticulectomy procedure, the lenticule created with a misaligned laser beam may not be centered at the eye and / or be angled with the axis of the eye, thereby resulting in suboptimal vision correction. Summary of the Invention

[0004] In certain embodiments, a system for aligning an eye with a patient interface of a laser device includes a camera, a display screen, and a computer. The camera records an image of the eye through the patient interface of the laser device. A liquid is disposed between the patient interface and an outer surface of the eye. The liquid contacts the patient interface and the outer surface of the eye. The image includes an outline of the liquid. The display screen displays the image of the eye. The computer aligns the eye with the patient interface so as to align the eye with a laser beam of the laser device. The eye is aligned to perform surgery on the eye according to a treatment pattern. The computer aligns the eye with the patient interface by: identifying an outline of the liquid in an image received from the camera; determining misalignment of the eye based on the outline; and instructing the display screen to display a description of the misalignment.

[0005] An embodiment may not include the following features or may include one, some, or all of the following features:

[0006] The computer determines the misalignment of the eye from the outline by: recognizing that the shape of the outline is elliptical; and determining that the axis of the eye is at an angle to the z-axis of the laser device.

[0007] The computer determines misalignment of the eye from the contour by: determining that the centroid of the shape of the contour is not at the center point of the laser device; and determining that the eye is laterally displaced relative to the center point of the laser device.

[0008] The computer determines an adjustment to substantially compensate for the misalignment. For example, the computer determines the adjustment to substantially compensate for the misalignment by: identifying that the shape of the contour is an ellipse; determining, in response to identifying the shape, that the axis of the eye is angled relative to the z-axis of the laser device; and determining to rotate the eye to substantially compensate for the misalignment. For example, the computer determines the adjustment to substantially compensate for the misalignment by: determining that the centroid of the shape of the contour is not at a center point of the laser device; determining that the eye is laterally displaced a distance relative to the center point of the laser device; and determining that translating the eye toward the center point the determined distance substantially compensates for the misalignment. In some embodiments, the computer instructs the display screen to display a description of the adjustment. In some embodiments, the computer adjusts the patient interface or the eye based on the adjustment to compensate for the misalignment. In some embodiments, the computer adjusts the treatment pattern based on the adjustment to compensate for the misalignment.

[0009] The computer generates an alignment overlay indicating a desired position and a desired shape of a contour for aligning the eye with the patient interface, places the alignment overlay on an image, and instructs a display screen to display the image with the alignment overlay. In certain embodiments, the computer receives a description of a corneal topography of the eye, and determines the desired position and the desired shape of a contour for aligning the eye with the patient interface based on the corneal topography of the eye. In certain embodiments, the computer determines a plurality of alignment overlays, each corresponding to a specific distance between the eye and the patient interface, determines a distance between the eye and the patient interface, and generates the alignment overlay corresponding to the determined distance.

[0010] The computer determines a distance between the eye and the patient interface based on the size of the outline. In some embodiments, the computer instructs a display screen to display the distance between the eye and the patient interface. In some embodiments, the computer adjusts the distance between the eye and the patient interface in response to the determined distance between the eye and the patient interface.

[0011] The computer executes a liquid dispensing program to redistribute the liquid by: moving the patient interface away from the eye; and moving the patient interface closer to the eye.

[0012] The system further includes a dispenser configured to dispense an additional liquid onto the outer surface of the eye. The computer instructs the dispenser to dispense the additional liquid onto the outer surface of the eye. In some embodiments, the additional liquid includes a substance capable of changing the surface tension of the liquid. In some embodiments, the additional liquid includes a substance that enhances the visibility of the liquid.

[0013] The system further includes a vacuum device configured to remove at least a portion of the liquid from the outer surface of the eye.The computer instructs the vacuum device to remove at least a portion of the liquid from the outer surface of the eye. BRIEF DESCRIPTION OF THE DRAWINGS

[0014] Figure 1 An example of an ophthalmic surgical system configured to align an eye with a patient interface according to certain embodiments is shown;

[0015] Figure 2A and Figure 2B An example of a fluid placed between the eye and the patient interface is shown;

[0016] Figure 3 An example of the shape of the liquid's contour is shown;

[0017] Figure 4A and Figure 4B An example is shown of how a circular outline can indicate eye alignment with the patient interface;

[0018] Figure 5A and Figure 5B An example is shown of how an elliptical profile can indicate the tilt of the eye axis relative to the interface axis;

[0019] Figure 6A and Figure 6B An example showing how contouring can be used to correct for lateral misalignment is shown;

[0020] Figure 7A and Figure 7B Examples of deformed contours are shown;

[0021] Figure 8 Examples are shown of how a contoured alignment overlay can be used to correct for roll misalignment, lateral misalignment, and / or torsional misalignment;

[0022] Figure 9A 、 Figure 9B and Figure 9C Examples of graphical elements depicting misalignment and adjustments for correcting the misalignment are shown;

[0023] FIG. 10A to FIG. 10B Further examples of graphical elements depicting misalignment and adjustments for correcting the misalignment are shown;

[0024] Figures 11A to 11B An example of the relationship between the contour and the distance between the patient interface and the eye is shown;

[0025] Figure 12A 、 Figure 12B and Figure 12C Further examples of the relationship between the profile and the distance between the patient interface and the eye are presented;

[0026] Figure 13 Different alignment overlays are shown for different distances between the patient interface and the eye; and

[0027] Figure 14 Shows that it can be Figure 1 An example of a method performed by a system for aligning an eye with a patient interface. DETAILED DESCRIPTION

[0028] With reference now to the description and drawings, example embodiments of the disclosed apparatus, systems, and methods are shown in detail. The description and drawings are not intended to be exhaustive or otherwise limit the claims to the specific embodiments shown in the drawings and disclosed in the description. Although the drawings represent possible embodiments, they are not necessarily drawn to scale, and certain features may be simplified, exaggerated, removed, or partially cut away to better illustrate the embodiments.

[0029] In certain ophthalmic surgical procedures, the eye is coupled to the surgical system via a patient interface (PI) in order to properly align the eye with the treatment pattern. A problem that can arise is that aligning the eye with the patient interface to attach the patient interface to the eye can be difficult. Certain embodiments can address this issue.

[0030] Figure 1 An example of an ophthalmic surgical system 10 configured to align an eye 22 with a patient interface 20 according to certain embodiments is shown. In an embodiment, the system 10 images a liquid (not shown) disposed between the patient interface 20 and the eye 22. The contour of the liquid indicates the alignment of the eye 22 relative to the patient interface 20. The system 10 uses the contour of the liquid to align the eye 22 with the interface 20 during the docking process. Accordingly, the system 10 can solve the problem of attaching the patient interface 20 to the eye 22 so that the eye is aligned with the treatment pattern.

[0031] Generally speaking, aligning the eye 22 with the patient interface 20 refers to positioning the eye 22 relative to the patient interface 20 (or positioning the patient interface 20 relative to the eye 22) so that when the interface 20 is attached to the eye 22, the laser beam passing through the interface 20 strikes the eye 22 at the appropriate point and angle relative to the eye according to the treatment pattern. Note that "aligning the eye 22 with the patient interface 20" also includes aligning the patient interface 20 with the eye 22. In some embodiments, alignment can be described in terms of an xyz coordinate system of the laser device of the system 10, where the centered laser beam defines the z-axis and the abutting surface of the patient interface 20 defines an xy plane at z=0. In embodiments, the center point (x,y,z)=(0,0,0) and the center axis z=0 (or z-axis) of the patient interface 20 (and therefore the laser device 15) are aligned with the center point (e.g., the center of the pupil, the vertex of the eye, or the apex of the eye) and the center axis (e.g., the optical axis or visual axis) of the eye 22, respectively. However, any suitable feature of patient interface 20 may be aligned with any suitable feature of the eye so that the laser beam impinges on the appropriate portion of eye 22 according to the treatment pattern.

[0032] Misalignment can occur in a number of different ways: (1) the eye 22 can be laterally misaligned due to lateral displacement in the x and / or y directions; (2) the eye 22 can have a roll misalignment such that the axis of the eye 22 and the axis of the interface 20 are misaligned, i.e., the axes are at an angle greater than zero degrees (e.g., greater than three degrees) relative to each other; (3) the eye 22 can be torsional misaligned due to rotational displacement about the z-axis; and (4) the eye 22 can be longitudinally misaligned due to longitudinal displacement in the z-direction.

[0033] In the illustrated example, system 10 includes a laser device 15, a patient interface 20 (having an axis 25), a camera 38, a fluid dispenser / vacuum 40, and a control computer 30, coupled as shown. Laser device 15 includes controllable components, such as a laser source 12, a scanner 16, one or more optical elements 17, and / or a focusing lens 18, coupled as shown. Patient interface 20 includes a contact portion 24 (having an abutment surface 26) and a sleeve 28, coupled as shown. Computer 30 includes logic 31, memory 32 (which stores a computer program 34), and a display 36, coupled as shown. Eye 22 has an axis 27.

[0034] As an overview, system 10 aligns eye 22 with patient interface 20 according to the following operational example to allow the laser beam of laser device 15 to operate on eye 22 according to a treatment pattern. Camera 38 records an image of eye 22 through patient interface 20. Liquid (e.g., a tear film) is disposed between patient interface 20 and an outer surface of eye 22, wherein the liquid is in contact with patient interface 20 and the outer surface. The image includes an outline of the liquid. Display 36 displays the image of the eye. Computer 30 identifies the outline of the liquid in the image received from camera 38; determines misalignment of eye 22 based on the outline; and instructs display 36 to display a description of the misalignment.

[0035] Turning to the portion of system 10, a laser source 12 generates a laser beam having ultrashort pulses. An ultrashort pulse refers to a light pulse having a duration of less than a nanosecond (e.g., on the order of picoseconds, femtoseconds, or attoseconds). The laser beam can have any suitable wavelength, such as a wavelength in the range of 300 to 1500 nanometers (nm), for example, a wavelength in the range of 300 nm to 650 nm, 650 nm to 1050 nm, 1050 nm to 1250 nm, and / or 1250 nm to 1500 nm, such as 340 nm to 350 nm, for example, 347 nm ± 1 nm. The focus of the laser beam can create laser-induced optical breakdown (LIOB) in tissue (e.g., the cornea) to produce photodamage in the tissue. The laser beam can be precisely focused to produce precise photodamage, which can reduce or avoid unnecessary damage to other tissues.

[0036] The scanner 16 directs the focal point of the laser beam laterally and longitudinally. The longitudinal direction refers to the direction of laser beam propagation, also known as the z-direction. The lateral direction refers to the direction orthogonal to the beam propagation direction, also known as the xy plane. In some embodiments, the xyz coordinate system of the laser device 15 is defined such that the abutment surface 26 of the patient interface 20 is in the xy plane at z = 0, and the center of the abutment surface 26 is on the z-axis at (x, y) = (0, 0). Other suitable xyz coordinate systems may be used.

[0037] The scanner 16 can direct the laser beam laterally in any suitable manner. For example, the scanner 16 can include a pair of galvanometer-actuated scanner mirrors that can be tilted about mutually perpendicular axes. As another example, the scanner 16 can include an electro-optical crystal that can electro-optically steer the laser beam. The scanner 16 can direct the laser beam longitudinally in any suitable manner. For example, the scanner 16 can include a longitudinally adjustable lens, a lens of variable refractive power, or a deformable mirror that can control the z-position of the beam focus. The components of the scanner 16 can be arranged along the beam path in any suitable manner, for example, in the same or different modular units.

[0038] One (or more) optical elements 17 direct the laser beam toward a focusing objective 18. The optical element 17 can act on (e.g., transmit, reflect, refract, diffract, collimate, adjust, shape, focus, modulate, and / or otherwise act on) the laser beam. Examples of optical elements include lenses, prisms, mirrors, diffractive optical elements (DOEs), holographic optical elements (HOEs), and spatial light modulators (SLMs). In an example, the optical element 17 is a mirror. The focusing objective 18 focuses the focal point of the laser beam toward a point on the eye 22 through the patient interface 20. In an example, the focusing objective 18 is an objective lens, such as an f-theta objective lens.

[0039] The patient interface 20 interfaces with the cornea of the eye 22 to couple the eye 22 to the laser device 15. In an example, the patient interface 20 has a sleeve 28 coupled to the contact portion 24. The sleeve 28 is removably coupled to the focusing objective 18. The contact portion 24 can be translucent or transparent to the laser beam and has an abutment surface 26 that interfaces with the cornea. In some embodiments, the abutment surface 26 is planar and forms a planar area on the cornea, which can define an xy plane. In other embodiments, the abutment surface 26 need not be planar and, for example, can be convex or concave. In some embodiments, the patient interface 20 has rotational symmetry about an axis 25, which can be aligned with an axis 27 of the eye 22.

[0040] Camera 38 records images of eye 22 through patient interface 20. Examples of camera 38 include a video camera, an eye-tracking camera, or an optical coherence tomography (OCT) camera. Camera 38 transmits image data representing the recorded image of eye 22 to computer 30. Computer 30 performs image processing on the image data to identify the outline of the liquid disposed between patient interface 20 and eye 22. Image processing includes resolving the liquid in the recorded image, determining the outline of the liquid, and identifying the shape of the outline.

[0041] The liquid dispenser / vacuum 40 includes a dispenser and / or a vacuum device. The dispenser dispenses additional liquid onto the outer surface of the eye 22. The additional liquid can be any suitable substance, such as artificial tears. In some cases, the additional liquid can include a substance that changes the surface tension of the liquid between the eye 22 and the interface 20. For example, the surface tension can be reduced so that the liquid film spreads more easily on the interface 20. As another example, the surface tension can be increased to reduce the outline of the liquid. In some cases, the additional liquid can include a medication for the eye 22, for example, a substance that reduces discomfort or pain. In some cases, the additional liquid can include a substance that enhances the visibility of the outline. For example, the additional liquid can include a dye that changes the color of the liquid to a more visible color or a dye that includes a fluorescent tracer.

[0042] The vacuum device removes at least a portion of the liquid from the outer surface of the eye 22, typically using suction. The liquid dispenser / vacuum 40 can have nozzles 42 (42a, 42b) to dispense and / or remove liquid. In the illustrated example, nozzle 42a dispenses liquid, while nozzle 42b removes liquid.

[0043] Computer 30 controls the components of system 10 according to computer program 34. For example, computer 30 controls the components (e.g., laser source 12, scanner 16, optical element 17, and / or focusing objective 18) to focus the laser beam of laser device 15 on eye 22 and photodamage at least a portion of eye 22 according to a treatment pattern. To successfully treat eye 22, eye 22 must be properly aligned with the laser beam. To properly align with the laser beam, eye 22 must be properly attached to patient interface 20, which requires proper alignment of eye 22 and interface 20 during docking.

[0044] In some embodiments, the computer 30 receives images of the eye recorded by the camera 38 through the patient interface 20. A liquid (e.g., a tear film) is disposed between the patient interface 20 and the outer surface of the eye 22, wherein the liquid is in contact with the interface 20 and the outer surface. The liquid forms a contour imaged by the camera 38. (For examples of liquid between the eye 20 and the interface 20, see Figures 2A to 3 ).

[0045] In some embodiments, the computer 30 facilitates aligning the eye 22 with the patient interface 20 by identifying the shape of the liquid contour in the image received from the camera 38 and determining the misalignment of the eye 22 based on the contour. The computer 30 then instructs the display 36 to display a description of the misalignment. For example, the computer 30 may identify that the contour is elliptical and determine that the eye axis 27 is at an angle to the interface axis 25 (or the z-axis of the laser device 15). As another example, the computer 30 may determine that the centroid of the contour is not at the center point of the laser device 15 and, therefore, determine that the eye 22 is laterally displaced relative to the center point of the laser device 15. Figures 4A to 7B An example of the relationship between the contour of the liquid and the alignment of the eye 22 is described.

[0046] In some embodiments, the computer 30 determines an adjustment that substantially compensates for the misalignment. For example, if the eye axis 27 is angled relative to the interface axis 25 (or the z-axis of the laser device 15), the computer 30 may determine that rotating the eye 22 substantially compensates for the misalignment. As another example, if the eye 22 is laterally displaced a distance relative to the center point of the laser device 15, the computer 30 may determine that translating the patient interface; translating the eye; and / or translating the treatment pattern substantially compensates for the misalignment.

[0047] In some embodiments, the computer 30 may perform any suitable operation after determining the adjustment. For example, the computer 30 may instruct the display 36 to display a description of the adjustment. 9A to 10B An example of a description of an adjustment is described. As another example, the computer 30 may instruct the laser device 15 to adjust the patient interface 20 according to the adjustment to compensate for the misalignment. As another example, the computer 30 may instruct the automated bed to change the patient's position so that the eye 22 moves according to the adjustment to compensate for the misalignment. As another example, the computer 30 may adjust the treatment pattern according to the adjustment to compensate for the misalignment.

[0048] In certain embodiments, computer 30 facilitates aligning eye 22 with patient interface 20 by generating an alignment overlay that indicates the desired position and shape of a liquid profile that aligns eye 22 with patient interface 20, and placing the alignment overlay over the recorded image of eye 22. Computer 30 then directs display 36 to display the image with the alignment overlay.

[0049] In an embodiment, the alignment overlay indicates the desired position and / or desired shape of the contour when the eye 22 is aligned with the interface 22 (which may also be referred to as the "aligned position and / or aligned shape" or the "predicted position and / or predicted shape"). The alignment overlay may have any suitable shape or size that indicates the desired position and / or desired shape of the contour. For example, the alignment overlay may be one or more shapes that operate as a mark of the center of the contour of the liquid. To align the eye 22, the eye 22 may be moved relative to the interface 20 (or the interface 20 may be moved relative to the eye 22) until the center of the contour of the liquid is at the mark. As another example, the alignment overlay may be a plurality of marks, circles, or other shapes that define the desired contour of the liquid. To align the eye 22, the eye 22 may be moved relative to the interface 20 (or the interface 20 may be moved relative to the eye 22) until the contour of the liquid is defined by the overlay. Reference Figure 8 Examples of alignment coverings are described. In some embodiments, computer 30 determines the alignment covering based on a corneal topography of eye 22. Figure 13 An example of generating such an alignment overlay is described.

[0050] In some embodiments, computer 30 determines a plurality of alignment overlays, where each alignment overlay corresponds to a distance between eye 22 and patient interface 20. When the docking process reaches a distance, the alignment overlay corresponding to the determined distance is placed on the image. Figures 11A to 13 Examples of such coverings are described.

[0051] In some embodiments, the computer 30 determines the distance between the eye 22 and the patient interface 20 based on the size of the outline of the liquid. After determining the distance, the computer 30 may perform any suitable operation. For example, the computer 30 may instruct the display 36 to display the distance. As another example, the computer 30 may instruct the laser device 15 to adjust the actual distance in response to the determined distance. For example, the computer 30 may determine that the patient interface 20 is too close to the eye 22 and may instruct the laser device 15 to move the interface away from the eye 22. As another example, the computer 30 may place an alignment overlay on the image corresponding to the determined distance.

[0052] In some embodiments, the computer 30 executes a liquid dispensing program to redistribute the liquid. The computer 30 may execute the program in any suitable manner. For example, the computer 30 may instruct the user and / or the laser device 15 to move the patient interface toward and / or away from the eye 22. As another example, the computer 30 may instruct the liquid dispenser / vacuum 40 to dispense additional liquid onto the outer surface of the eye 22. As another example, the computer 30 may instruct the vacuum of the liquid dispenser / vacuum 40 to remove a portion of the liquid from the outer surface of the eye 22.

[0053] Figure 2A and Figure 2B An example of liquid 50 disposed between the eye 22 and the patient interface 20 is shown. Figure 2A The liquid 50 is shown disposed between the eye 22 and the patient interface 20. The liquid 50 is not in contact with the abutment surface 26 of the patient interface 20. The camera 38 records an image of the eye 22 through the contact portion 24 of the patient interface 20.

[0054] Figure 2B A liquid 50 is shown in contact with the abutment surface 26. The adhesion of the liquid 50 to the abutment surface 26 is stronger than the cohesive forces between water molecules (also known as "capillary action"), causing the liquid 50 to adhere to the abutment surface 26 and form a profile 52 that can be imaged by the camera 38. The shape of the profile 52 is affected by the alignment of the eye 22 with the patient interface 20, and therefore the shape can be indicative of the alignment of the eye 22 with the patient interface 20. The profile 52 can be formed on the abutment surface 26 before contact is made between the eye 22 itself and the abutment surface, so alignment of the eye 22 with the patient interface can begin before contact. Reference Figure 3 An example of the shape of the outline 52 is described.

[0055] Figure 3Examples of shapes of contours 52 (52a, 52b, 52c) are shown. Contour 52a has a circular shape, which may indicate that the eye 22 is aligned with the patient interface 20. Contour 52b has an elliptical shape, which may indicate that the eye axis 27 is tilted relative to the interface axis 25. Contour 52c has shapes that are neither circular nor elliptical, i.e., they are malformed shapes, which may indicate that the cornea of the eye 22 does not have a normal spherical shape, i.e., is irregular in shape. Figures 4A to 5B The relationship between the shape of the contour 52 and the alignment of the eye 22 with the patient interface 20 is described in more detail.

[0056] Figure 4A and Figure 4B An example is shown of how a circular outline 52a may indicate alignment of the eye 22 with the patient interface 20. The circular outline 52a indicates that the distance between the patient interface 20 and the eye 22 is approximately the same at most, if not all, points of the outline 52a, i.e., the patient interface 20 is aligned symmetrically about the center (e.g., the vertex) of the cornea such that the axis 27 of the eye 22 is aligned with the axis 25 of the patient interface 20.

[0057] Figure 5A and Figure 5B An example of how an elliptical profile 52b can indicate that the eye axis 27 is tilted relative to the interface axis 25 by an angle greater than zero degrees (e.g., greater than three degrees) is shown. The shape of the cornea is determined such that the elliptical profile 52b indicates that the patient interface 20 is aligned asymmetrically about the apex of the cornea, such that the eye axis 27 is not aligned with the interface axis 25, i.e., the eye 22 may have a roll misalignment. It should be noted that the shape of the eye 22 (e.g., prolate or oblate) can also affect the shape of the elliptical profile. Rotating the eye 22 relative to the patient interface 20 (or rotating the patient interface 20 relative to the eye 22) until the profile 52 has a circular shape can compensate for the roll misalignment.

[0058] Figure 6A and Figure 6B An example of how a profile 52 can be used to correct for lateral misalignment is shown. In some embodiments, the profile 52 has a center point 54 that should be aligned with (x,y)=(0,0) of the xyz coordinate system of the laser device 15, where the center 55 of the abutment surface 26 is (x,y)=(0,0). In some cases, the center point 54 can be the centroid of the profile 52, which is the arithmetic mean position of all points of the profile 52. In the example shown, the profile 52 is a circular profile 52a, so the center point 54 is the centroid, or center, of the circle of the profile 52a.

[0059] In the example shown, center point 54 is not located at abutment center 55, so patient interface 20 is laterally misaligned with eye 22. Eye 22 can be moved laterally relative to patient interface 20 (or patient interface 20 can be moved laterally relative to eye 22) to correct the lateral misalignment.

[0060] Figure 7A and Figure 7B An example of a deformed profile 52c is shown. The deformed profile 52c indicates that the cornea of the eye 22 has an irregular shape. In some embodiments, the computer 30 determines a desired profile 52 indicating when the patient interface 20 is aligned with the eye 22 based on a corneal topography of the eye 22. For example, the computer 30 may calculate a plurality of distances between points of the patient interface 20 and points of the cornea based on the corneal topography when the patient interface 20 and the eye 22 are aligned, and then determine a desired profile 52 for the fluid 50 based on these distances. In some embodiments, the computer 30 may determine different desired profiles 52 for different stages of docking, for example, when docking begins and the eye 22 is away from the patient interface 20, when docking is in progress and the eye 22 is close to the patient interface 20, and when docking is complete and the patient interface 20 is attached to the eye 22. This will be referred to Figure 13 Describe in more detail.

[0061] Figure 8 An example of how an alignment overlay 56 of profile 52c can be used to correct for roll misalignment, lateral misalignment, and / or torsional misalignment is shown. In some embodiments, the computer 30 can generate an alignment overlay 56 corresponding to the desired profile 50. The alignment overlay 56 can be displayed as an overlay on the recorded image, which can allow the camera 38 and / or the user to detect and / or correct misalignment. In some cases, the computer 30 adds a centering point 57 to the alignment overlay 56. The centering point 57 can be located at the center of the abutment surface 55 and can allow the camera 38 and / or the user to detect and / or correct lateral misalignment. In some cases, the alignment overlay 56 can have a shape that allows the camera 38 and / or the user to identify and / or correct torsional misalignment. If not, the computer 30 can add one or more markings to the alignment overlay 56 that allow the camera 38 and / or the user to detect and / or correct torsional misalignment.

[0062] 9A to 10BExamples of graphical elements 58, 59, 60 depicting misalignment and adjustments for correcting the misalignment are shown. In some embodiments, the computer 30 displays graphical elements 58 (58a-58c), 59 (59a-59c) depicting the alignment or misalignment of the eye 22 with the patient interface 20. The graphical elements 58, 59 can have any suitable size or shape that can indicate to a user the alignment or misalignment of the eye 22 with the patient interface 20. In the illustrated example, the graphical element 58 (58a-58c) depicts a side view of the eye 22 relative to the interface 20, and the graphical element 59 (59a-59c) depicts a top view of the outline 52 of the liquid 50 relative to the interface 20.

[0063] In some embodiments, the computer 30 displays graphical elements 60 (60a-60e) that depict adjustments for correcting misalignment or for continuing the docking process. The graphical elements 60 (60a-60e) can assist the user in aligning the eye 22 with the patient interface 20. The graphical elements 60 can have any suitable size or shape that can indicate to the user the movement of the patient interface 20 and / or eye 22. Examples of graphical elements 60 include: a pointer that indicates the direction of movement (e.g., an arrow, line, or triangle or other polygon); a curved pointer that indicates the direction of rotation; and / or text that describes the direction of movement and / or rotation.

[0064] Figure 9A Graphical element 60a is shown, which is a curved arrow representing rotational motion that rotates eye 22 to align eye axis 27 with interface axis 25 to correct roll misalignment. Figure 9B A graphical element 60 b is shown, which is an arrow representing a translational movement that moves the center point of the contour 52 towards the center 55 of the abutment surface. Figure 9C Graphical element 60c is shown, which is an arrow representing longitudinal motion to move eye 22 closer to patient interface 20.

[0065] Figure 10A Graphical elements 60d are shown indicating two types of motion. The straight arrows represent translational motion to move the center point 54 of the outline 52 towards the center point 57 of the alignment cover 56, and the curved arrows represent rotational motion in the xy plane to correct for torsional misalignment. Figure 10B A graphical element 60 e is shown, which is an arrow representing a translational motion that moves the center point 54 of the outline 52 toward the centering point 57 of the alignment cover 56 .

[0066] Figures 11A to 13Examples of the relationship between the contour 52 of the liquid 50 and the distance d between the patient interface 20 and the eye 22 are shown. In these examples, the patient interface 20 has a planar abutment surface. Patient interfaces 20 with differently shaped abutment surfaces can produce contours 52 of different shapes and / or sizes.

[0067] Figure 11A and Figure 11B The profile 52 is shown at distances d1 and d2, where d1>d2. The distance d can be measured in any suitable manner. For example, the distance d can be measured as the distance between the patient interface 20 (e.g., the abutment surface 16) and the base of the cornea (where the cornea meets the sclera) or other suitable portion of the cornea. Generally speaking, the profile 52 is smaller when the distance d is larger and becomes larger as the distance d decreases, that is, when the eye 22 and the interface 20 move closer relative to each other, the profile 52 becomes larger. In the example, the profile 52 is smaller at the distance d1 and larger at the distance d2. The size of the profile 52 can be measured in any suitable manner. For example, the size of the profile 52 can be calculated based on, for example, the area defined by the profile 52 or the diameter of the profile 52.

[0068] Figures 12A to 12C The profile 52 is shown at distances d1, d2, and d3, where d1>d2>d3. In an example, the profile 52 is smaller at distance d1, larger at distance d2, and even larger at distance d3. In an example, distance d1 may be the distance before contact between the eye 22 and the interface 20.

[0069] In some embodiments, computer 30 calculates distance d based on the size of contour 52. For example, computer 30 determines the relationship between the size of contour 52 and distance d. This relationship can be determined based on, for example, an average of previous measurements of size and distance or based on a corneal topography map of eye 22. Computer 30 then measures the size of the contour and determines the distance based on the size and relationship.

[0070] Figure 13 Different alignment covers 56 are shown for different distances d between the patient interface 20 and the eye 22. In some embodiments, the computer 30 determines a desired profile 52 (which indicates when the patient interface 20 is aligned with the eye 22) based on a corneal topography of the eye 22. The corneal topography of the eye 22 generally describes the anterior shape of the cornea. This shape can be converted into an xyz coordinate system for the laser device 15 so that the xy coordinates of the corneal surface can be determined for different z values. Using this information, the computer 30 predicts where the corneal surface will hit the abutment plate 26 because the abutment plate 26 applies pressure to the cornea during docking. The predicted profile 52 defines where the corneal surface will hit the abutment plate 26. The predicted profile can serve as the desired profile 52.

[0071] In some embodiments, the computer 30 may determine different expected profiles 52 for different stages of docking, e.g., when docking begins and the patient interface 20 is moved away from the eye 22, when docking progresses and the patient interface 20 moves closer to the eye 22, and when docking is complete and the patient interface 20 is attached to the eye 22. For example, the computer 30 may predict, for each distance d between the patient interface 20 and the eye 22, a profile 52 based on a corneal topography of the eye 22 that defines where the corneal surface meets the abutment plate 26.

[0072] The computer 30 may also display alignment overlays 56 (56a through 56d) corresponding to the desired profile 52 at each distance d during different stages of docking. In the illustrated example, alignment overlay 56a represents the desired profile 52 at distance d1, when the eye initially contacts the patient interface 20. Alignment overlay 56b represents the desired profile 52 at distance d2, when the eye moves closer to the patient interface 20. Alignment overlay 56c represents the desired profile 52 at distance d3, when the eye is in advanced applanation with the patient interface 20. Alignment overlay 56d represents the desired profile 52 at distance d4, when docking is complete.

[0073] In other examples, the contour 52 may be formed on the abutment surface 26 before contact is made between the eye 22 itself and the abutment surface. In these examples, the computer 30 determines the alignment overlay 56 corresponding to the desired contour 52 before contact, so alignment of the eye 22 with the patient interface 20 can begin before contact.

[0074] Figure 14 Shows that it can be Figure 1 An example of a method for aligning an eye 22 with a patient interface 20, as performed by the system 10, is provided. The method begins at step 100, where the camera 38 records an image of the eye 22 with the liquid 50 through the patient interface 20. The liquid (e.g., tear film) 50 is disposed between the patient interface 20 and the outer surface of the eye 22 and is in contact with the patient interface 20 and the outer surface. The image includes an outline 52 of the liquid 50.

[0075] At step 102, liquid 50 may be redistributed. For example, if outline 52 cannot be imaged by camera 38, liquid 50 may be redistributed. If liquid 50 is not to be redistributed, the method proceeds to step 106. If liquid 50 is to be redistributed, the method moves to step 104, where liquid 50 is redistributed. Computer 30 may execute a liquid dispensing program to redistribute liquid 50 in any suitable manner. For example, computer 30 may instruct the user and / or laser device 15 to move patient interface 20 toward and / or away from eye 22 one or more times. As another example, computer 30 may instruct the user and / or the dispenser of liquid dispenser / vacuum 40 to dispense additional liquid onto the outer surface of eye 22. As another example, computer 30 may instruct the user and / or the vacuum of liquid dispenser / vacuum 40 to remove a portion of the liquid from the outer surface of eye 22. After redistributing liquid 50, the method proceeds to step 106.

[0076] The computer 30 monitors an image of the eye 22 at step 106 and determines a distance d between the patient interface 20 and the eye 22 at step 108. In some embodiments, the computer 30 may determine the distance d based on the size of the outline 52. In some embodiments, the computer 30 may instruct the display screen 36 to display the distance d. In some embodiments, the computer 30 may adjust the distance d in response to the determined distance d.

[0077] The computer 30 generates an alignment cover 56 at step 110. In some embodiments, the computer 30 can generate an alignment cover 56 that represents the desired profile 52 of the liquid. In some embodiments, the computer 30 determines the alignment cover 56 based on a corneal topography map of the eye 22. In some embodiments, the computer 30 determines a plurality of alignment covers 56, each corresponding to a distance d between the eye 22 and the patient interface 20. When the docking process reaches a specific distance, the alignment cover 56 corresponding to that distance is placed on the image. The computer 30 instructs the display 36 to display an image of the eye 22 with the alignment cover 56 at step 112. At step 114, the eye 22 is moved toward the patient interface 20, or the patient interface 20 is moved toward the eye 22. The relative motion can be performed in any suitable manner. For example, the relative motion can be performed in the xy direction, the torsional direction, and / or the z direction in any suitable order.

[0078] At step 116, misalignment may exist. In some embodiments, computer 30 identifies outline 52 in the image and determines misalignment of eye 22 with outline 52. For example, computer 30 may identify outline 52 as elliptical and determine that eye axis 27 is angled with interface axis 25. As another example, computer 30 may determine that the centroid of outline 52 is not at the center point of laser device 15 and, therefore, determine that eye 22 is laterally displaced relative to the center point of laser device 15.

[0079] If there is no misalignment, the method proceeds to step 128, where applanation may be performed. If there is a misalignment, the computer 30 instructs the display 36 to display a description of the misalignment 58, 59 at step 118. The computer 30 determines an adjustment to compensate for the misalignment at step 120. In some embodiments, the computer 30 determines an adjustment to substantially compensate for the misalignment. For example, if the eye axis 27 is angled with the interface axis 25, the computer 30 may determine that rotating the eye 22 substantially compensates for the misalignment. As another example, if the eye 22 is laterally displaced a distance relative to the center point of the laser device 15, the computer 30 may determine that one or more of the following substantially compensates for the misalignment: translating the patient interface 20 a determined distance; translating the eye 22 toward the center point a determined distance; and / or translating the treatment pattern a determined distance.

[0080] The computer 30 displays a description of the adjustment 60 at step 124. The adjustment may be made at step 126 to compensate for the misalignment. For example, the computer 30 may instruct the laser device 15 to adjust the patient interface 20 based on the adjustment to compensate for the misalignment. As another example, the computer 30 may instruct the automated bed to reposition the patient so that the eye 22 moves based on the adjustment to compensate for the misalignment. As another example, the computer 30 may adjust the treatment pattern based on the adjustment to compensate for the misalignment.

[0081] At step 128, flattening may be complete. If flattening is not complete, the method returns to step 102, where liquid 50 may need to be dispensed. If flattening is complete, the method proceeds to step 130, where the docking procedure is completed. The method then ends.

[0082] The components (for example, computer 30) of system and equipment disclosed herein can include interface, logic and / or memory, any of which can include computer hardware and / or software.Interface (for example, display 36) can receive the input of components and / or send output from components, and is typically used for exchanging information between for example software, hardware, peripheral device, user and these combinations.User interface (for example, graphical user interface (GUI)) is the interface type that user can use to interact with computer.The example of user interface includes display screen, touch screen, keyboard, mouse, gesture sensor, microphone and loudspeaker.

[0083] Logic can perform the operations of a component. Logic can include one or more electronic devices that process data (e.g., execute instructions for generating outputs from inputs). Examples of such electronic devices include computers, processors, microprocessors (e.g., central processing units (CPUs)), and computer chips. Logic can include computer software that encodes instructions that can be executed by an electronic device to perform operations. Examples of computer software include computer programs, applications, and operating systems.

[0084] The memory can store information and can include tangible, computer-readable and / or computer-executable storage media. Examples of memory include computer memory (e.g., random access memory (RAM) or read-only memory (ROM)), mass storage media (e.g., hard disk), removable storage media (e.g., compact disk (CD) or digital video or versatile disk (DVD)), database, network storage device (e.g., server), and / or other computer-readable media. Particular embodiments may be directed to memory encoded with computer software.

[0085] Although the present disclosure has been described in terms of certain embodiments, it will be apparent to those skilled in the art that modifications (such as changes, substitutions, additions, omissions, and / or other modifications) of the embodiments may be made. Therefore, the embodiments may be modified without departing from the scope of the invention. For example, the systems and devices disclosed herein may be modified. It will be apparent to those skilled in the art that the components of the systems and devices may be integrated or separate, or that the operations of the systems and devices may be performed by more, fewer, or other components. As another example, the methods disclosed herein may be modified. These methods may include more, fewer, or other steps, and these steps may be performed in any suitable order.

[0086] To assist the Patent Office and readers in interpreting the claims, Applicants note that they do not intend for any claim or claim element to invoke 35 U.S.C. §112(f) unless the phrase “means for” or “step for” is expressly used in a particular claim. Applicants understand that the use of any other terms within the claims (e.g., “mechanism,” “module,” “device,” “unit,” “component,” “element,” “member,” “device,” “machine,” “system,” “processor,” or “controller”) refers to structures known to persons skilled in the relevant art and is not intended to invoke 35 U.S.C. §112(f).

Claims

1. A system for aligning an eye with a patient interface of a laser device, the system comprising: a camera configured to record a plurality of images of the eye through a patient interface of the laser device, a liquid disposed between the patient interface and an outer surface of the eye, the liquid in contact with the patient interface and the outer surface of the eye, the images including an outline of the liquid; a display screen configured to display an image of the eye; as well as a computer configured to align the eye with the patient interface to align the eye with the laser beam of the laser device, to align the eye to perform surgery on the eye according to a treatment pattern, the computer configured to align the eye with the patient interface by: identifying an outline of the liquid in an image received from the camera; determining a misalignment of the eye based on the contour; as well as The display screen is instructed to display a description of the misalignment.

2. The system of claim 1 , wherein the computer is configured to determine the misalignment of the eye from the contour by: identifying that the shape of the contour is elliptical; and Determine the angle between the axis of the eye and the z-axis of the laser device.

3. The system of claim 1 , wherein the computer is configured to determine the misalignment of the eye from the contour by: determining that the centroid of the shape of the contour is not at the center point of the laser device; and A lateral displacement of the eye relative to a center point of the laser device is determined.

4. The system of claim 1 , wherein the computer is configured to: An adjustment is determined that substantially compensates for the misalignment.

5. The system of claim 4, wherein the computer is configured to determine the adjustment that substantially compensates for the misalignment by: identifying that the shape of the contour is an ellipse; determining that an axis of the eye is angled with respect to a z-axis of the laser device in response to identifying the shape; and Determining to rotate the eye substantially compensates for the misalignment.

6. The system of claim 4, wherein the computer is configured to determine the adjustment that substantially compensates for the misalignment by: determining that the centroid of the shape of the contour is not at the center point of the laser device; and determining a distance by which the eye is laterally displaced relative to a center point of the laser device; and Determining to translate the eye toward the center point the determined distance substantially compensates for the misalignment.

7. The system of claim 4, wherein the computer is configured to: The display screen is instructed to display a description of the adjustment.

8. The system of claim 4, wherein the computer is configured to: The patient interface or the eye is adjusted according to the adjustment to compensate for the misalignment.

9. The system of claim 4, wherein the computer is configured to: The treatment pattern is adjusted based on the adjustment to compensate for the misalignment.

10. The system of claim 1, wherein the computer is configured to: generating an alignment overlay indicating a desired position and a desired shape of the contour for aligning the eye with the patient interface; placing the alignment overlay onto the image; as well as The display screen is instructed to display the image with the alignment overlay.

11. The system of claim 10, wherein the computer is configured to: receiving a description of corneal topography of the eye; and A desired position and a desired shape of the contour for aligning the eye with the patient interface are determined based on a corneal topography of the eye.

12. The system of claim 10, wherein the computer is configured to: determining a plurality of alignment overlays, each alignment overlay corresponding to a specific distance between the eye and the patient interface; determining a distance between the eye and the patient interface; and The alignment overlay is generated corresponding to the determined distance.

13. The system of claim 1 , wherein the computer is configured to: The distance between the eye and the patient interface is determined based on the size of the outline.

14. The system of claim 13, the computer configured to instruct the display screen to display the distance between the eye and the patient interface.

15. The system of claim 13, the computer configured to adjust a distance of the eye from the patient interface in response to the determined distance between the eye and the patient interface.

16. The system of claim 1, wherein the computer is configured to execute a liquid dispensing program to redistribute the liquid by: moving the patient interface away from the eye; and The patient interface is moved proximate to the eye.

17. The system of claim 1 : further comprising a dispenser configured to dispense additional liquid onto an outer surface of the eye; and The computer is configured to instruct the dispenser to dispense the additional liquid onto the outer surface of the eye.

18. The system of claim 17, wherein the additional liquid comprises a substance capable of changing the surface tension of the liquid.

19. The system of claim 17, wherein the additional liquid includes a substance that enhances visibility of the liquid.

20. The system of claim 1 : further comprising a vacuum device configured to remove at least a portion of the liquid from an outer surface of the eye; and The computer is configured to instruct the vacuum device to remove at least a portion of the liquid from the outer surface of the eye.

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