Laser surgical system and method for creating a mark in an eye

Abstract

In some embodiments, an ophthalmic surgical system for creating a mark in the cornea includes controllable components, a camera, and a computer. The controllable components include a laser source, a scanner, and an objective lens. The laser source generates a laser beam. The scanner guides the focal point of the laser beam laterally and longitudinally. The objective lens focuses the focal point toward the eye. The camera images movement of the eye. The computer creates the mark by instructing the scanner to guide the focal point toward a peripheral area of ​​the cornea and by instructing the controllable components to create the mark in that peripheral area. The computer also determines that movement of the mark is within an alarm range indicating unacceptable movement and provides a notification in response to determining that movement of the mark is within the alarm range.

Description

Technical Field

[0001] This disclosure generally relates to laser surgical systems and methods, and more specifically to laser surgical systems and methods for creating markings in the eye. Background Technology

[0002] Some ophthalmic laser surgery systems generate pulsed laser beams to perform surgical procedures on the eye. In some procedures, the laser beam creates optical destruction at specific points in the eye according to a treatment pattern. Throughout the procedure, the laser beam must be properly aligned with the eye to create optical destruction that precisely matches the pattern.

[0003] Patient interfaces (PIs) are typically used to hold the eye in the proper position during surgical procedures. They are typically attached to the eye via vacuum to secure it in place, aiding in proper alignment of the eye with the treatment pattern during the procedure. Summary of the Invention

[0004] In some embodiments, an ophthalmic surgical system for creating a mark in the cornea for a surgical procedure includes controllable components, a camera, and a computer. The controllable components include a laser source, a scanner, and an objective lens. The laser source generates a laser beam with ultrashort pulses. The scanner guides the focal point of the laser beam laterally and longitudinally. The objective lens focuses the focal point toward the eye via a patient interface. The camera images movement of the eye. The mark has a shape indicating rotational movement of the eye. The computer creates the mark by instructing the scanner to guide the focal point laterally and longitudinally toward a peripheral region of the cornea; and by instructing one or more controllable components to create the mark in the peripheral region of the cornea. The computer also determines that movement of the mark is within an alarm range indicating an unacceptable amount of movement, and provides one or more notifications in response to determining that movement of the mark is within the alarm range.

[0005] The embodiments may exclude the following features or may include one, some, or all of the following features:

[0006] * The shape of the mark is selected from one or more of the following: polygon, line, multiple lines, multiple lines intersecting at one point, multiple lines intersecting at multiple points, circle with lines, ellipse, and one or more alphanumeric characters.

[0007] * The computer identifies a marker corresponding to the surgical procedure and creates the identified marker in the cornea. In some embodiments, if the surgical procedure is a lenticule removal procedure, the computer identifies that the marker is outside and near the outer boundary of the lenticule to be removed, and creates the marker outside and near the outer boundary. In some embodiments, if the surgical procedure is a flap creation procedure, the computer identifies that the marker is outside and near the outer boundary of the flap to be created, and creates the marker outside and near the outer boundary. In some embodiments, if the surgical procedure is a cataract removal procedure, the computer identifies that the marker outlines the lens capsule of the eye, and creates the marker outlining the lens capsule of the eye.

[0008] * Notifications can be audio notifications.

[0009] * Notifications can be visual notifications.

[0010] * The alert range includes multiple non-overlapping subset alert ranges forming partitions. The computer provides multiple notifications. Each notification corresponds to a subset alert range, wherein a first notification for a first subset alert range differs from a second notification for a second subset alert range. In some embodiments, the first notification has a first visual feature different from a second visual feature of the second notification. In some embodiments, the first notification has a first audio feature different from a second audio feature of the second notification. In some embodiments, the subset alert range is a termination alert range, and the computer terminates the surgical procedure in response to determining that movement of the marker falls within the termination alert range. In some embodiments, the ophthalmic surgical system includes a display screen. The computer displays notification icons on the display screen that include alert levels, where alert levels correspond to subset alert ranges, and visually emphasizes the alert level in response to determining that movement of the marker falls within the corresponding subset alert range.

[0011] * The computer determines the alarm range corresponding to the surgical procedure. In some embodiments, if the surgical procedure is a lenticule extraction procedure, the alarm range has a maximum acceptable distance of 50 to 150 micrometers. In some embodiments, if the surgical procedure is a flap creation procedure, the alarm range has a maximum acceptable distance of 100 to 500 micrometers. In some embodiments, if the surgical procedure is a cataract removal procedure, the alarm range has a maximum acceptable distance of 100 to 500 micrometers.

[0012] In some embodiments, a method for creating a mark in the cornea of ​​an eye for a surgical procedure includes creating the mark in the cornea via a computer. The mark has a shape that can indicate rotational movement of the eye. The computer instructs a scanner to laterally and longitudinally direct the focus of a laser beam toward a peripheral region of the cornea, and instructs one or more of a set of controllable components to create the mark in the peripheral region of the cornea. The set of controllable components includes a laser source configured to generate the laser beam, a scanner configured to laterally and longitudinally direct the focus of the laser beam, and an objective lens configured to focus the focus toward the eye via a patient interface. The computer also determines that movement of the mark is within an alarm range indicating an unacceptable amount of movement of the mark, and provides one or more notifications in response to determining that movement of the mark is within the alarm range.

[0013] The embodiments may exclude the features described above regarding the system, or may include one, some, or all of the features described above regarding the system, and / or may exclude the following features, or may include one, some, or all of the following features:

[0014] *The method further includes identifying the marker corresponding to the surgical procedure and creating the identified marker in the cornea.

[0015] * The alarm range includes multiple non-overlapping subset alarm ranges forming the partitions of the alarm range. The method further includes: providing multiple notifications, each corresponding to a subset alarm range, wherein a first notification for a first subset alarm range differs from a second notification for a second subset alarm range; displaying notification icons on a display screen including multiple alarm levels, at least one alarm level corresponding to a subset alarm range; and visually emphasizing the alarm level in response to determining that movement of the marker falls within the corresponding subset alarm range. Attached Figure Description

[0016] Figure 1 Examples of ophthalmic surgical systems configured to create markers in the cornea of ​​the eye, according to certain embodiments, are shown;

[0017] Figure 2A and Figure 2B An example of a mark created in an eye is shown;

[0018] Figure 3 It displays a marker that includes a circle with lines;

[0019] Figure 4 It displays tags that include alphanumeric characters;

[0020] Figure 5 It displays markings including lines;

[0021] Figure 6 It displays markings including lines and circles;

[0022] Figure 7 It shows that it can be made by Figure 1 Example of a traffic light notification icon used by the system;

[0023] Figure 8 It shows that it can be made by Figure 1 Examples of instrument notification icons used by the system; and

[0024] Figure 9 It shows that it can be made by Figure 1 This is an example of a system-executed method for creating markers in the eye. Detailed Implementation

[0025] Example embodiments of the disclosed devices, systems, and methods are now shown in detail with reference to the specification and accompanying drawings. The specification 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 specification. Although the drawings illustrate possible embodiments, they are not necessarily drawn to scale, and certain features may be simplified, exaggerated, removed, or partially cut out to better illustrate the embodiments.

[0026] In some ophthalmic surgeries, the eye is attached to a surgical system with a patient interface (PI) to properly align the eye with the treatment pattern. A potential problem is that the eye may move relative to the PI, and therefore relative to the treatment pattern. For example, a nervous patient might violently move their eyes, creating a shear force strong enough to cause the eye to move relative to the PI, or even become disconnected from the interface. As another example, an inexperienced surgeon might inadvertently move the eye relative to the PI, or might fail to properly attach the eye to the PI, causing the eye to move relative to the interface. Movement of the eye relative to the PI can lead to misalignment between the eye and the treatment pattern. The embodiments described herein address this problem.

[0027] Figure 1 An example of an ophthalmic surgical system 10, configured to create markings in the cornea of ​​an eye 22 according to certain embodiments, is shown. In this embodiment, the system 10 creates markings in the cornea, tracks the movement of the markings, and provides a notification if the movement falls within an alarm range indicating movement of the eye relative to the patient interface. Accordingly, the system 10 can be used to address the problem of the eye 22 moving relative to the patient interface and becoming misaligned with the treatment pattern.

[0028] In the example shown, system 10 includes a laser device 15, a patient interface 20, a camera 38, and a control computer 30, all connected as shown. The 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, all connected as shown. The patient interface 20 includes a contact portion 24 (with an abutment surface 26) and a sleeve 28, all connected as shown. The computer 30 includes logic 31, a memory 32 (which stores computer programs 34), and a display 36, all connected as shown.

[0029] In summary, system 10 can create and track markers according to the following operational example: Laser source 12 generates a laser beam with ultrashort pulses. Scanner 16 controls the focus of the laser beam laterally and longitudinally. Objective lens 18 focuses the focus toward eye 22 via patient interface 20. Camera 38 images the movement of eye 22. Computer 30 creates a marker in the cornea by instructing scanner 12 to direct focus toward the peripheral region of the cornea and by instructing controllable components to create a marker in the peripheral region. Computer 30 then determines whether the movement of the marker is within an alarm range describing unacceptable movement of the marker. If so, computer 30 provides one or more notifications that the movement is within the alarm range.

[0030] In the steering system 10, the laser source 12 generates a laser beam with ultrashort pulses. An ultrashort pulse is a light pulse with a duration less than a nanosecond (e.g., on the order of picoseconds, femtoseconds, or attoseconds). The laser beam can have any suitable wavelength, such as in the range of 300 to 1500 nanometers (nm), for example, wavelengths in the range of 300 to 650, 650 to 1050, 1050 to 1250, and / or 1250 to 1500 nm, such as 340 to 350 nm, for example, 347 nm ± 1 nm. The focal point of the laser beam can create laser-induced optical breakdown (LIOB) in tissue (e.g., the cornea) to produce photodestruction within the tissue. The laser beam can be precisely focused to produce precise photodestruction, which can reduce or avoid unwanted damage to other tissues.

[0031] The scanner 16 controls the focus of the laser beam in both the lateral and longitudinal directions. The longitudinal direction refers to the direction in which the laser beam propagates, 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 contact surface 26 of the patient interface 20 is selected to be in the xy-plane at z=0.

[0032] Scanner 16 can guide the laser beam laterally in any suitable manner. For example, scanner 16 may include a pair of scanning mirrors actuated by current measurement, which may tilt about mutually perpendicular axes. As another example, scanner 16 may include an electro-optic crystal that can electro-optically manipulate the laser beam. Scanner 16 can also guide the laser beam longitudinally in any suitable manner. For example, scanner 16 may include a longitudinally adjustable lens, a variable refractive power lens, or a deformable mirror that can control the z-position of the beam focus. The components of scanner 16 can be arranged along the beam path in any suitable manner, for example, in the same or different modular units.

[0033] One or more optical elements 17 guide the laser beam toward a focusing objective 18. Optical elements 17 can act (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 optics (DOE), holographic optics (HOE), and spatial light modulators (SLM). In this example, optical element 17 is a mirror. The focusing objective 18 focuses the laser beam through the patient interface 20 toward the eye 22. In this example, focusing objective 18 is an objective lens, such as an f-θ objective lens.

[0034] The patient interface 20 connects to the corneal interface of the eye 22 to connect the eye 22 to the laser device 15. In this example, the patient interface 20 has a sleeve 28 that connects to a contact portion 24. The sleeve 28 is detachably connected to a focusing objective lens 18. The contact portion 24 may be translucent or transparent to the laser beam and has an abutment surface 26 that connects to the corneal interface. In some embodiments, the abutment surface 26 is planar and forms a planar region on the cornea that may define an xy-plane. In other embodiments, the abutment surface 26 does not need to be planar; for example, it may be convex or concave.

[0035] Camera 38 records images of the movement of eye 22 (including the movement of markers created within eye 22). Examples of cameras 38 include video, optical coherence tomography (OCT), or eye-tracking cameras. Camera 38 transmits image data representing the recorded images of eye 22 to computer 30. Computer 30 performs image processing on the image data to determine the movement of the markers. Image processing includes identifying the markers in the recorded images, determining the position of the markers, and comparing the positions of the markers imaged at different times to determine the movement of the markers.

[0036] Computer 30 controls controllable components (e.g., laser source 12, scanner 16, optical element 17, and / or focusing lens 18) according to computer program 34. Computer program 34 includes computer code instructing the controllable components to focus a laser beam onto an area of ​​the cornea and to photodegrade at least a portion of that area to create a mark in the cornea. The mark is temporary and disappears spontaneously. The mark will be referenced... Figures 2A to 6 To provide a more detailed description.

[0037] Figure 2A and Figure 2B An example of mark 50 (50a) created in eye 22 is shown. Figure 2A An eye 22 is shown, having a pupil 42, an iris 44, a lens (not shown), and a cornea 46 with a peripheral region 48. Generally, the iris 44 and the cornea 46 each have an outer diameter ranging from 10 to 13 millimeters (mm). The cornea 46 has a peripheral region 48, which is the annular region of the cornea 46 closest to its outer periphery. The peripheral region 48 may have an outer radius Rc and an inner radius Rc x q, where Rc represents the outer radius of the cornea 46, and q is any suitable percentage, for example, 50 to 60%, 60 to 70%, 70 to 80%, 80 to 90%, and / or 90 to 95 percent.

[0038] The inner radius can be determined based on the surgical procedure. In some cases, the inner radius can be a treatment area that ensures the peripheral region 48 does not interfere with the surgical procedure (e.g., outside of this treatment area). For example, a typical stromal lens diameter is approximately 5 to 7 mm, and a typical flap diameter is approximately 7 to 10 mm. The inner radius can be selected such that the peripheral region 48 is outside the stromal lens or flap area. In other cases, the inner radius can be such that the peripheral region 48 includes or forms the boundary of the surgical procedure. For example, a marker 50 can be used to delineate the lens capsule, which has a diameter of approximately 9 to 10 mm. The inner radius can be selected to be smaller than or match the radius of the lens capsule.

[0039] The marker 50 can have any suitable size and shape. In some embodiments, the marker 50 has a size and shape that can easily indicate translation and / or rotation of the eye 22. For example, the marker 50 is large enough that the camera 38 can easily detect movement of the marker 50, but small enough to minimize light disruption to the eye 22. As another example, the marker 50 has a shape that allows the camera 38 to detect translation and / or rotation of the marker 50.

[0040] The marker 50 can be located at any suitable position within the peripheral region 48. In some embodiments, the position of the marker 50 can be determined based on the surgical procedure, such as the treatment area and / or field of vision relative to the surgical procedure. For example, during lenticule removal, the diameter of the treatment area (i.e., the lenticule) can be up to about 8 millimeters (mm), and the diameter of the field of vision can be about 12 mm. The marker 50 can be outside and close to the outer boundary of the lenticule (e.g., within 0.010 to 2 mm, such as 0.015 mm), but within the field of vision. As another example, for flap creation, the marker 50 can be outside and close to the outer boundary of the flap. As yet another example, for cataract removal, the marker 50 can delineate the lens capsule of the eye.

[0041] Examples of shapes include: polygons (e.g., triangles or squares), lines, multiple lines (e.g., an equal sign), multiple lines intersecting at a single point (e.g., a plus sign, a cross, or an asterisk), multiple lines intersecting at multiple points (e.g., stars), circles with lines, ellipses, and one or more alphanumeric characters (e.g., text with letters, numbers, and / or symbols of any language). In the example shown, the shape of the mark 50a resembles an equal sign. Figure 2A The sign 50a is shown with zero rotation, such that the equal sign is horizontal. Figure 2B The mark 50a has been rotated by 5 degrees, causing the equal sign to tilt by an angle.

[0042] Figures 3 to 6 Different types of markers 50 are shown. Figure 3 The diagram shows a marker 50 including markers 50b (50b-1, 50b-2), where each marker 50b is a circle with a line. The line of marker 50b-1 is aligned with a vertical line passing through the center of eye 22 (e.g., the center of the pupil, the eye apex, or the eye vertex), and the line of marker 50b-2 is aligned with a horizontal line passing through the center.

[0043] Figure 4 The diagram shows a marker 50c that includes alphanumeric characters. In some embodiments, these characters can provide information, such as a timestamp, patient identifier, or company name.

[0044] Figure 5 Marker 50 is shown, including marks 50d (50d-1 to 50d-8). Each mark 50d is a line aligned with a line passing through the center of eye 22. For example, marks 50d-1 and 50d-5 are aligned with a vertical line passing through the center, and marks 50d-3 and 50d-7 are aligned with a horizontal line passing through the center.

[0045] Figure 6Marker 50 is shown, including markers 50d and 50e. Marker 50e is a circle that can provide boundaries for the treatment area, such as providing an outline for a stromal lens, flap, or lens capsule.

[0046] Back Figure 1 Referring back to the computer 30 instructing the controllable components of the laser device 15 to create a marker 50. In some embodiments, the computer 30 determines the type of marker 50 to be created by recognizing the marker 50 corresponding to a surgical procedure. In embodiments, specific characteristics of the marker 50 (e.g., size, shape, location, and / or positioning) may be more suitable for a particular surgical procedure. For example, the computer 30 may determine that: (1) for a lenticule removal procedure, the marker 50 may be outside and close to the outer boundary of the lenticule; (2) for a flap creation procedure, the marker 50 may be outside and close to the outer boundary of the flap; and / or (3) for a cataract removal procedure, the marker 50 may delineate the lens capsule of the eye.

[0047] It is also recalled that computer 30 determines when movement of marker 50 falls within the alarm range and provides a notification in response to that determination. The alarm range describes the amount of unacceptable movement of marker 50, which represents the amount of unacceptable movement of eye 22. Unacceptable movement can be movement that causes eye 22 to misalign with the treatment pattern, such that a notification should be provided and / or the surgical procedure should be terminated. The alarm range can be represented as movement of a distance d greater than the maximum acceptable distance Q, denoted by set notation {d|d>Q}, where Q is any suitable number, for example, 50 to 500 micrometers.

[0048] In some embodiments, the alarm range comprises multiple non-overlapping subset alarm ranges forming partitions of the alarm range. A partition of a set is a collection of disjoint subsets of that set, where the union of the subsets equals the set. For example, the alarm range {d|d>Q} can be partitioned into {d|Q1<d≤Q2, Q2<d≤Q3, ...,Qn<d}, where Q=Q1. A subset alarm range closer to the maximum acceptable distance Q indicates less misalignment than a subset alarm range farther from the maximum acceptable distance Q. Accordingly, movement within a subset alarm range closer to the maximum acceptable distance Q may not be as urgent as movement further away. In some embodiments, a subset alarm range may be a termination alarm range, which indicates unacceptable movement such that the surgical procedure should be terminated.

[0049] In some embodiments, computer 30 determines an alarm range corresponding to the surgical procedure. Some surgical procedures (e.g., creating a stromal lens) may require more precision than others (e.g., creating a skin flap). For example, a stromal lens has a shape with refractive properties, so the stromal lens incision should be precisely aligned with the treatment pattern. A skin flap typically has a flat bed-like incision without refractive properties, so the alignment does not need to be as precise. Accordingly, for surgical procedures requiring greater precision, the maximum acceptable distance Q of the alarm range may be more stringent. For example, for a stromal lens removal procedure, the maximum acceptable distance Q may be in the range of 50 to 150 micrometers. As another example, for a skin flap creation procedure, the maximum acceptable distance Q may be in the range of 100 to 500 micrometers. As another example, for a cataract removal procedure, the maximum acceptable distance Q may be in the range of 50 to 500 micrometers.

[0050] Computer 30 may provide any suitable notifications, such as audio and / or visual notifications. Examples of audio notifications include beeps and spoken words that may be provided via an interface such as an electronic speaker. Examples of visual notifications include lights and graphic icons that may be displayed on an interface such as display 36 (e.g., a monitor screen).

[0051] In some embodiments, computer 30 provides multiple notifications for multiple subset alarm ranges. In some cases, each notification corresponds to a specific subset alarm range, and computer 30 provides different notifications for different subset alarm ranges; for example, a first notification for a first subset alarm range differs from a second notification for a second subset alarm range. For example, the first notification may have a first visual feature different from a second visual feature of the second notification. As another example, the first notification may have a first audio feature different from a second audio feature of the second notification. In some embodiments, computer 30 terminates the surgical procedure in response to determining that movement of a marker is within a termination alarm range. (See reference...) Figure 7 and Figure 8 Examples of visual notification icons that describe multiple subsets of alert ranges.

[0052] Figure 7 It shows that it can be made by Figure 1 The system 10 uses an example of a traffic light notification icon 70 (70a). The notification icon 70 is a graphical element (which can be displayed via display 36) that provides notification when the movement of marker 50 enters an alarm range. In some embodiments, the notification icon 70 includes alarm levels 72 (72a, 72b, 72c). Alarm level 72 may correspond to a subset of alarm ranges. If the movement of marker 50 falls within a subset of alarm ranges, the icon 70 may visually emphasize (e.g., by lighting up, pointing, flashing, outlining, or otherwise emphasizing) the corresponding alarm level 72.

[0053] In the example shown, alarm level 72a is a green light, alarm level 72b is a yellow light, and alarm level 72c is a red light. When movement falls within a subset of alarm levels, icon 70 can emphasize the corresponding light (e.g., make it turn on or brighter). Green alarm level 72a can correspond to no movement or movement that has not reached the alarm level, i.e., the movement is within acceptable limits. Yellow alarm level 72b can correspond to the subset of alarm levels closest to the minimum alarm value, i.e., the movement is unacceptable but not to the point where the procedure needs to be terminated. Red alarm level 72c can correspond to the subset of alarm levels that serves as the termination alarm range, i.e., the movement requires the termination of the procedure.

[0054] Figure 8 It shows that it can be made by Figure 1 The system 10 uses an example of an instrument notification icon 70 (70b). Notification icon 70b includes alarm levels 72 (72a to 72e). In the example shown, alarm level 72a is green; alarm level 72b is yellow-green; alarm level 72c is yellow; 72d is orange; and alarm level 72e is red.

[0055] Certain alarm levels 72 may correspond to subset alarm ranges. When movement of marker 50 falls within a subset alarm range, icon 70 may emphasize (e.g., point to) the corresponding level 72. Green alarm level 72a may correspond to no movement of marker 50 or movement that does not reach an alarm level; that is, the movement is within acceptable limits. Yellow-green alarm level 72b may correspond to the subset alarm range closest to the minimum alarm value; that is, the movement is unacceptable but close to acceptable. Yellow alarm level 72c may correspond to the next closest subset alarm range; that is, the movement is unacceptable but not to the point where termination of the procedure is required. Orange alarm level 72d may correspond to the next closest subset alarm range; that is, the movement is unacceptable and close to the point where termination of the procedure is required. Red alarm level 72e may correspond to a subset alarm range that serves as a termination alarm range; that is, the movement requires termination of the procedure.

[0056] Figure 9 It shows that it can be made by Figure 1This is an example of a method executed by system 10 for creating a marker 50 in eye 22. In some embodiments, computer 30 executes the method by instructing components of system 10 to perform actions of the method. The marker 50 may be created during a surgical procedure (e.g., stromal lenticule removal, flap creation, or cataract removal). The method begins at step 100, where computer 30 receives a request to create a marker 50 in cornea 46 of eye 40. The marker 50 may have a shape that can indicate translational and / or rotational movement of eye 22. In some embodiments, the request may be received from a user of system 10 (e.g., a surgeon) or from computer program 34 for automating the surgical procedure.

[0057] In step 110, computer 30 identifies the requested marker 50. In some embodiments, computer 30 may identify the marker 50 corresponding to a surgical procedure. For example, a lenticule removal procedure may use a marker 50 located outside and near the outer boundary of the lenticule to be removed. As another example, a flap creation procedure may use a marker 50 located outside and near the outer boundary of the flap to be created. As yet another example, a cataract surgery procedure may use a marker 50 that outlines the lens capsule of the cataract lens.

[0058] In step 112, computer 30 determines an alarm range. In some embodiments, computer 30 may determine an alarm range corresponding to a surgical procedure. For example, a stromal lenticule removal procedure may use an alarm range with a maximum acceptable distance Q of 50 to 150 micrometers. As another example, a flap creation procedure may use an alarm range with a maximum acceptable distance Q of 100 to 500 micrometers. As yet another example, a cataract surgery procedure may use an alarm range with a maximum acceptable distance Q of 50 to 500 micrometers.

[0059] Computer 30 instructs laser source 12 to generate a laser beam and instructs scanner 16 to guide the focus of the beam toward the peripheral region 48 of cornea 46 in step 114. In step 116, controllable components create a mark 50 in the peripheral region 48. Computer 30 uses camera 38 to monitor the movement of the mark 50 in step 118.

[0060] The surgical procedure can be completed in step 120. If the surgical procedure has been completed, the method proceeds to step 128, where computer 30 terminates the surgical procedure. If the surgical procedure has not been completed, the method proceeds to step 122.

[0061] In step 122, computer 30 checks whether the movement of marker 50 is within the alarm range. If the movement is not within the alarm range, the method returns to step 118, where computer 30 continues to monitor the movement of marker 50. If the movement is within the alarm range, the method proceeds to step 124.

[0062] In step 124, the computer 30 checks whether the alarm range is a termination alarm range. A termination alarm range indicates when the surgical procedure should be terminated. For example, a termination range could indicate that the eye is so misaligned that the treatment will not be effective. If the alarm range is not a termination alarm range, the method proceeds to step 126.

[0063] In step 126, computer 30 provides a notification that movement is within an alarm range. In some embodiments, the alarm range has multiple non-overlapping subset alarm ranges forming partitions, and computer 30 provides a notification for each subset alarm range. In some cases, computer 30 provides different notifications for different subset ranges. For example, a first notification for a first subset alarm range may be different from a second notification for a second subset alarm range. These notifications may be visually different (e.g., the first notification has a first visual feature different from the second visual feature of the second notification) or auditorily different (e.g., the first notification has a first audio feature different from the second audio feature of the second notification). The method then returns to step 118, where computer 30 continues to monitor the movement of marker 50.

[0064] If the alarm range is terminated in step 124, the method proceeds to step 128, where computer 30 terminates the surgical procedure. The method then ends.

[0065] Components of the systems and devices disclosed herein (e.g., control computer 30) may include interfaces, logic, and / or memory, any of which may include computer hardware and / or software. Interfaces (e.g., display 36) may receive input to and / or send output from components, and are typically used to exchange information between, for example, software, hardware, peripherals, users, and combinations thereof. User interfaces (e.g., graphical user interfaces (GUIs)) are types of interfaces that a user can use to interact with a computer. Examples of interfaces include display screens, touchscreens, keyboards, mice, gesture sensors, microphones, and speakers.

[0066] Logic (e.g., logic 31) can perform operations on components. Logic may include one or more electronic devices that process data (e.g., execute instructions to generate outputs from inputs). Examples of such electronic devices include computers, processors, microprocessors (e.g., central processing units (CPUs)), and computer chips. Logic may include computer software that encodes instructions executable by electronic devices to perform operations. Examples of computer software include computer programs, applications, and operating systems.

[0067] Memory (e.g., memory 32) can store information and may 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., optical disc (CD) or digital video or universal disc (DVD)), databases, network storage devices (e.g., servers), and / or other computer-readable media. Specific embodiments may be directed to memory encoded with computer software.

[0068] Although this disclosure has been described with reference to certain embodiments, modifications to the embodiments (e.g., alterations, substitutions, additions, omissions, and / or other modifications) will be apparent to those skilled in the art. Therefore, modifications can be made to the embodiments without departing from the scope of the invention. For example, modifications can be made to the systems and devices disclosed herein. Components of the systems and devices may be integral or separate, or the operation of the systems and devices may be performed by more, fewer, or other components, as will be apparent to those skilled in the art. As another example, modifications can be made to the methods disclosed herein. These methods may include more, fewer, or other steps, and these steps may be performed in any suitable order, as will be apparent to those skilled in the art.

[0069] To assist the Patent Office and readers in interpreting the claims, the applicant notes that they do not intend for any claim or claim element to invoke 35 U.SC §112(f) unless the terms “means for…” or “steps for…” are expressly used in a particular claim. The applicant understands that the use of any other terms within the claims (e.g., “mechanism,” “module,” “device,” “unit,” “component,” “element,” “building block,” “device,” “machine,” “system,” “processor,” or “controller”) refers to structures known to a person skilled in the art and is not intended to invoke 35 U.SC §112(f).

Claims

1. An ophthalmic surgical system for creating markers in the cornea of ​​the eye for surgical procedures, comprising: Multiple controllable components, the multiple controllable components including: A laser source configured to generate a laser beam having multiple ultrashort pulses; A scanner configured to guide the focal point of the laser beam laterally and longitudinally; and An objective lens configured to focus the focal point through the patient interface toward the eye; A camera configured to image the movement of the eye; and Computer, the computer is configured to: Identify the marker corresponding to the surgical procedure, the marker having one or more features suitable for the surgical procedure; An identifiable marker having one or more of the aforementioned features is created in the cornea by means of the following method, wherein the marker has a shape capable of indicating rotational movement of the eye: The scanner is instructed to direct the focus laterally and vertically toward the peripheral region of the cornea; Instruct one or more of the controllable components to create the mark in the peripheral region of the cornea; Determine that the movement of the marker is within an alarm range, the alarm range indicating an unacceptable amount of movement of the marker; and One or more notifications are provided in response to determining that the movement of the marker is within the alarm range.

2. The ophthalmic surgical system of claim 1, wherein, The shape of the mark is selected from one or more of the following: polygon, line, multiple lines, multiple lines intersecting at one point, multiple lines intersecting at multiple points, circle with lines, ellipse, and one or more alphanumeric characters.

3. The ophthalmic surgical system as described in claim 1, wherein: The surgical procedure is the removal of the lenticule; and The computer is configured to: The mark is identified as being outside and close to the outer boundary of the matrix lens to be removed; as well as The mark is created outside and close to the outer boundary.

4. The ophthalmic surgical system as described in claim 1, wherein: The surgical procedure described is the flap creation process; and The computer is configured to: The marker is identified as being outside and close to the outer boundary of the flap to be created; as well as The mark is created outside and close to the outer boundary.

5. The ophthalmic surgical system as described in claim 1, wherein: The surgical procedure described is a cataract removal procedure; and The computer is configured to: Identify the markers that outline the lens capsule of the eye; and Create the markers that outline the lens capsule of the eye.

6. The ophthalmic surgical system of claim 1, wherein, The notification in the one or more notifications is an audio notification.

7. The ophthalmic surgical system of claim 1, wherein, The notification in the one or more notifications is a visual notification.

8. The ophthalmic surgical system of claim 1, wherein: The alarm range includes multiple non-overlapping subset alarm ranges of the partitions that form the alarm range; as well as The computer is configured to provide multiple notifications, each notification corresponding to a subset of alarm ranges, wherein a first notification for a first subset of alarm ranges differs from a second notification for a second subset of alarm ranges.

9. The ophthalmic surgical system of claim 8, wherein, The first notification has a first visual feature that is different from the second visual feature of the second notification.

10. The ophthalmic surgical system of claim 8, wherein, The first notification has a first audio feature that is different from the second audio feature of the second notification.

11. The ophthalmic surgical system of claim 8, wherein: One of the multiple subset alarm ranges is the termination alarm range; and The computer is configured to terminate the surgical procedure in response to determining that the movement of the marker is within the range of the termination alarm.

12. The ophthalmic surgical system of claim 8, wherein: The ophthalmic surgical system further includes a display screen; and The computer is configured to: The display screen shows notification icons that include multiple alarm levels, with at least one alarm level corresponding to a subset of alarm ranges; and In response to determining that the movement of the marker is within the corresponding subset of alarm range, the at least one alarm level is visually emphasized.

13. The ophthalmic surgical system of claim 1, wherein the computer is further configured to determine the alarm range corresponding to the surgical procedure.

14. The ophthalmic surgical system of claim 13, wherein: The surgical procedure is the removal of a lenticule; and The alarm range has a maximum acceptable distance of 50 to 150 micrometers.

15. The ophthalmic surgical system of claim 13, wherein: The surgical procedure described is a flap creation process; and The alarm range has a maximum acceptable distance of 100 to 500 micrometers.

16. The ophthalmic surgical system of claim 13, wherein: The surgical procedure described is a cataract removal procedure; and The alarm range has a maximum acceptable distance of 100 to 500 micrometers.

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