Visualization and treatment of media opacities in the eye

Abstract

A system for treating a media opacity in the vitreous media of an eye includes a visualization module adapted to provide visualization data of a portion of the eye via one or more observation beams. The system includes a laser module adapted to selectively generate a treatment beam directed at the media opacity so as to disrupt the media opacity. The laser module and the visualization module have a shared aperture for directing the treatment beam and the one or more observation beams toward the eye, the shared aperture centered on a central axis. A controller is configured to acquire one or more defining parameters of the media opacity and determine when the media opacity is within a predefined target region of a real-time observation window. The media opacity is treated with the treatment beam when the media opacity is within the predefined target region.

Description

Technical Field

[0001] This disclosure generally relates to the visualization and treatment of one or more medial opacities in the eye. Background Technology

[0002] Humans possess five basic senses: sight, hearing, smell, taste, and touch. Vision gives us the ability to see the world around us and connect with our environment. Many people worldwide suffer from visual quality problems. One condition affecting visual quality is the presence of vitreous opacities in the eye, sometimes called floaters. These opacities can manifest as spots or shadows of various shapes that appear to float in the patient's field of vision and scatter light entering the eye. The cause of these opacities may be microscopic collagen fibers within the vitreous fluid. Treatment for these opacities can include vitrectomy or laser vitreolysis. Because the vitreous cavity and retina are deeper than anterior tissues such as the cornea and lens, effective visualization and therapeutic delivery of these opacities are often challenging. Summary of the Invention

[0003] This document discloses a system for treating vitreous opacities in the eye. The system includes a visualization module adapted to provide visualization data of a portion of the eye via one or more observation beams. The system also includes a laser module adapted to selectively generate a therapeutic beam directed towards the vitreous opacity to cut, vaporize, or otherwise destroy it. The laser module and the visualization module have a shared aperture, centered on a central axis, for guiding the therapeutic beam and the one or more observation beams into the eye.

[0004] The controller communicates with the visualization module and the laser module, and has a processor and a tangible non-transitory memory thereon storing instructions. The processor executes the instructions such that the controller acquires one or more defined parameters of the medium turbidity, at least in part, based on the visualization data. These defined parameters include the shape and size of the medium turbidity. The controller is configured to determine, at least in part, when a threshold portion of the medium turbidity is within a predefined target area of ​​a real-time observation window, based on the one or more defined parameters. In some embodiments, the defined parameters include the depth of the medium turbidity. When a threshold portion of the medium turbidity is within the predefined target area, the treatment beam is directed towards the medium turbidity.

[0005] In some embodiments, the sensor communicates with the controller and is configured to detect patient movement. The controller is configured to disable the treatment beam when the sensor detects patient movement. The controller may be configured to obtain a speckle pattern of scattered light originating from the treatment beam, the size of which is approximately the wavelength of the treatment beam. In some embodiments, the system may include a joystick unit that communicates with the controller and is configured to enable depth selection for the visualization module.

[0006] The treatment beam may include multiple ultrashort laser pulses. The multiple ultrashort laser pulses may be defined with corresponding durations between about one femtosecond and about 50 picoseconds. The treatment beam may propagate in a direction parallel to the central axis. In some embodiments, the treatment beam may propagate at an off-axis angle deviating from the central axis, the off-axis angle being equal to or greater than 25 degrees.

[0007] In some embodiments, the corneal docking member may be positioned adjacent to the cornea of ​​the eye, and the corneal docking member is configured to reduce the depth of field of the treatment beam. The visualization module may be configured to employ electromagnetic radiation reflected from one or more optics before it reaches the eye, the one or more optics being positioned such that only oblique light rays reach the eye while central light rays are blocked.

[0008] In some embodiments, the visualization module includes a light source, a mirror unit, a first polarizer, and a second polarizer, the second polarizer being oriented at 90 degrees relative to the first polarizer. The first polarizer is adapted to polarize at least one incident light beam from the light source to produce a linearly polarized light wave. The mirror unit is adapted to direct the linearly polarized light wave onto the eye. The second polarizer is positioned such that a reflected light beam exiting the eye is projected onto the second polarizer. The visualization module may further include a birefringent prism configured to intercept the linearly polarized light wave before it reaches the eye. The birefringent prism is also configured to intercept the reflected light beam before it is projected onto the second polarizer.

[0009] In some embodiments, the visualization module includes an electrically controlled liquid lens with a response time between 1 ms and 5 ms. The system may include a wavefront sensor configured to determine visual aberrations in the one or more observation beams exiting the eye. A deformable mirror is configured to shape the wavefront of the therapeutic beam in part based on the visual aberrations determined by the wavefront sensor. The system may include a spatial light modulator adapted to shape at least one of a corresponding phase and a corresponding amplitude of the one or more observation beams. The spatial light modulator may be positioned coaxial with the central axis. The spatial light modulator may be rotatable off-axis relative to the central axis.

[0010] This document discloses a method for treating medial opacities in the eye using a system having a visualization module, a laser module, and a controller, the controller having a processor and a tangible non-transitory memory thereon recording instructions. The method includes adjusting the laser module to selectively generate a therapeutic beam directed at the medial opacity, and obtaining visualization data of the eye via the visualization module. The method includes acquiring and storing one or more defined parameters of the medial opacity based at least in part on the visualization data. The defined parameters include the shape and size of the medial opacity. The method further includes determining, via the controller, at least in part on the one or more defined parameters, when a threshold portion of the medial opacity is within a predefined target region. When the threshold portion of the medial opacity is within the predefined target region, the therapeutic beam is directed at the medial opacity via the laser module to disrupt the medial opacity.

[0011] The above-described features and advantages, as well as other features and advantages, of this disclosure will become apparent from the following detailed description of the best mode for carrying out this disclosure, taken in conjunction with the accompanying drawings. Attached Figure Description

[0012] Figure 1 This is a schematic diagram of a system for treating medial opacities in the eye, the system having a controller, a visualization module, and a laser module;

[0013] Figure 2 yes Figure 1 A schematic diagram of a part of the system;

[0014] Figure 3 According to another embodiment, it can be Figure 1 A schematic fragment of the visualization module used in the system;

[0015] Figure 4 It can be Figure 1 A schematic fragment of an example spatial light modulator used in the system;

[0016] Figure 5 It is possible to be Figure 1 A schematic flowchart of the method executed by the controller;

[0017] Figure 6 It is by Figure 1 A schematic diagram illustrating a real-time observation window as an example of system implementation;

[0018] Figure 7 According to yet another embodiment, it can be Figure 1 A schematic fragment of the visualization module used in the system; and

[0019] Figure 8 It can be Figure 1 A schematic segment of the corneal docking component used in the system. Detailed Implementation

[0020] Referring to the accompanying drawings, where the same reference numerals refer to the same parts, Figure 1 A system 10, comprising a visualization module 12, a laser module 14, and a surgical camera 15, is schematically shown. As described below, the visualization module 12 is a stereoscopic optical visualization system. The system 10 is configured to image and treat a target site. In the illustrated embodiment, the target site is the eye 16 of the patient 18. (Reference) Figure 1 The visualization module 12 and the laser module 14 are at least partially located in the head unit 20 of the housing assembly 22, wherein the head unit 20 is configured to at least partially point towards the eyes 16. The head unit 20 can be configured to accommodate various postures of the patient 18. For example, during eye surgery, the patient 18 can be in an upright sitting position. (Reference) Figure 1 Selector 24 can be mounted on head unit 20 for selecting specific features, such as magnification or zoom, focus, and other features.

[0021] Now for reference Figure 2 A schematic diagram of a portion of system 10 is shown. System 10 is configured to treat at least one medium turbidity 26 in the eye 16, such as Figure 2 As shown. The medium turbidity 26 can be located at various positions within the vitreous medium 28, as indicated by the first medium turbidity 26A, the second medium turbidity 26B, and the third medium turbidity 26C (see [reference]). Figure 2 As described below, system 10 utilizes visualization data and beam delivery parameters to optimize the treatment of the medium turbidity 26. System 10 incorporates a shared aperture 30 for simultaneous visualization, imaging, and treatment delivery of the medium turbidity 26.

[0022] refer to Figure 2The laser module 14 is configured to selectively generate at least one treatment beam 32 directed toward the medium turbidity 26 via a laser source 34. In some embodiments, the treatment beam 32 comprises a plurality of ultrashort laser pulses, each ultrashort laser pulse having a duration of about one femtosecond (10⁻¹⁰). -15 From 50 picoseconds to approximately 50 picoseconds (50 × 10⁻⁶ seconds) -12 Between seconds. The treatment beam 32 is optimized to at least partially cut, vaporize, destroy, decompose, or otherwise reduce the turbidity of the medium 26.

[0023] refer to Figure 1 and Figure 2 System 10 includes a controller C having at least one processor P and at least one memory M (or a non-transitory tangible computer-readable storage medium) on which instructions for performing method 300, which is referred to below, can be recorded. Figure 5 The diagram illustrates and describes that memory M can store a set of controller-executable instructions, and processor P can execute the set of controller-executable instructions stored in memory M.

[0024] The visualization module 12 guides the surgeon in diagnosis, target site selection, and laser vitreous ablation energy. The visualization module 12 is adapted to acquire visual data of the eye 16. As described below, the visualization module 12 can employ various techniques to generate contrast, including digitally programmable incident illumination microscopy using a spatial light modulator 200, such as... Figure 4 As shown. Reference Figure 1 The controller C can be configured to process signals from the visualization module 12 for playback on the display 36. The display 36 may include, but is not limited to, a high-definition television, an ultra-high-definition television, smart glasses, a projector, one or more computer screens, a laptop computer, a tablet computer, and may include a touchscreen.

[0025] refer to Figure 1 The controller C can be configured to process signals to and from the user interface 38, which can be operated by the surgeon or other members of the surgical team. In one example, the user interface 38 is a joystick unit 38. In one embodiment, the visualization module 12 is a stereoscopic optical microscope with depth selection controllable via the joystick unit 38. Precise depth control is used to protect the lens 40 and retina 42 of the eye, such as... Figure 2 As shown.

[0026] The visualization module 12 and the laser module 14 may include an integrated processor or device controller that communicates with the controller C. For example, see reference... Figure 1The visualization module 12 may include a module processor 44, and the laser module 14 may include a laser processor 46. The module processor 44 and the laser processor 46 may be separate modules communicating with the controller C. Alternatively, the module processor 44 and the laser processor 46 may be embedded within the controller C.

[0027] The surgical camera 15 can be communicatively coupled to the controller C and other components of the system 10, such as the display 36. The surgical camera 15 may include an integrated control unit 48 with a processor, memory, and image processing unit. (Reference) Figure 1 Visible light source 49 can be used as the illumination source for surgical camera 15. Visible light source 49 may include a xenon source, a white LED light source, or any other suitable visible light source. Surgical camera 15 may include one or more sensors configured to detect light reflected from eye 16 and send a signal corresponding to the detected light to controller C or integrated control unit 48. The sensors may be complementary metal-oxide-semiconductor (CMOS) sensors, charge-coupled device (CCD) sensors, or other sensors available to those skilled in the art. A digital image of eye 16 may be displayed on display 36. Surgical camera 15 may be a digital camera, an HDR camera, a 3D camera, or any combination thereof. Surgical camera 15 may be a monochrome camera or a color camera. Surgical camera 15 may utilize appropriate components (not shown) available to those skilled in the art for optical-mechanical focusing, zoom adjustment, and adjustment of the working distance of surgical camera 15.

[0028] refer to Figure 1 System 10 may include a motion sensor 50, which communicates with controller C and is configured to detect movement of patient 18. In one example, motion sensor 50 contacts a structural member 52 (such as a headrest) supporting patient 18. In another example, motion sensor 50 contacts patient 18's forehead. Controller C may be configured to disable treatment beam 32 when sensor 50 detects movement of patient 18.

[0029] Various components of system 10 can be configured to communicate via network 54, such as Figure 1 As shown. Network 54 can be a bidirectional bus implemented in various ways, such as a serial communication bus in the form of a local area network (LAN). The LAN can include, but is not limited to, a control area network (CAN), a control area network with flexible data rates (CAN-FD), Ethernet, Bluetooth, WIFI, and other forms of data. Other types of connections can be used. System 10 may further include a communication interface 56 for transmitting and receiving information from a remote server and / or cloud unit.

[0030] Visualization module 12 is adapted to be viewed via one or more observation beams V (see Figure 1 This provides visualization data for the eye 16. As described below, the visualization module 12 is configured to use electromagnetic radiation reflected from one or more optics before it reaches the eye 16. Although in Figure 1 An example embodiment of the visualization module 12 is shown, but it should be understood that the visualization module 12 may include other types of imaging devices available to those skilled in the art. References Figure 1 The visualization module 12 includes a light source 60 that emits light within the visible range of the electromagnetic spectrum. For example... Figure 1 As shown, the first observation beam B1 and the second observation beam B2 originate from the light source 60 and can pass through the collimation unit 62. The collimation unit 62 may include various field-of-view and aperture stops, as well as other optical devices available to those skilled in the art.

[0031] A first observation beam B1 and a second observation beam B2 are directed toward the eye 16 via a first reflector 64 and a second reflector 66, respectively. The first reflector 64 and the second reflector 66 can be placed at a selected distance and are configured to selectively reflect light of a specific desired wavelength. The first reflector 64 and the second reflector 66 can be mirrors, corner prisms, or spatial light modulators 200, as described below. The reflected light from the first reflector 64 and the second reflector 66 propagates toward a first curved mirror 68 and a second curved mirror 70, respectively. (Reference) Figure 1 The first curved mirror 68 and the second curved mirror 70 guide the first observation beam B1 and the second observation beam B2 onto a portion of the eye 16 at an oblique incident angle, respectively, as the first oblique ray O1 and the second oblique ray O2. Figure 1 In the illustrated embodiment, the central light that typically passes through and surrounds the target area is blocked, and only oblique light rays from each direction can illuminate the target area, i.e., the eye 16. This ring illumination removes zero-order or non-scattered light, resulting in an image formed by the higher-order diffraction intensities scattered by the eye 16. Therefore, the imaged portion of the eye 16 appears bright compared to the dark background.

[0032] refer to Figure 1 The first oblique ray O1 and the second oblique ray O2 can be constructed from corresponding hollow light cones. The first oblique ray O1 and the second oblique ray O2 illuminate the eye 16. Vitreous visualization is similar to reflection microscopy (spot illumination) because the light source and imaging / visualization optics are on the same side of the target area. However, vitreous visualization / imaging differs in that the source of the visualization data is light reflected from the retina 42 and / or sclera 71 through a phase object (such as medium turbidity 26) in the vitreous medium 28. Essentially, the light source is behind the target area. (Reference) Figure 1The reflected beam R (from the retina 42 and / or sclera 71) is turbid by the medium in the vitreous medium 28 26 (see Figure 2 Diffraction, reflection, and / or refraction. The reflected beam R propagates back through objective lens 72 and tube lens 74.

[0033] refer to Figure 1 At least one of the objective lens 72 and the tube lens 74 may be an electrically controlled liquid lens. In some embodiments, the electrically controlled liquid lens may include a core containing optical fluid, the core being sealed with a flexible outer diaphragm. The focal length of the electrically controlled liquid lens can be changed by altering the curvature of the fluid in the flexible outer diaphragm, for example, by controlling a voice coil via an electric current. In one example, the electrically controlled liquid lens has a response time of 1 millisecond.

[0034] The reflected beam R encodes the positions of multiple reflection points in the eye 16 relative to a known reference point or relative to each other. Reference Figure 1 The encoding can be captured by detector 76 and processed via module processor 44 and / or controller C. In one example, detector 76 includes a photosensor coupled to an electrical device. However, it should be understood that detector 76 may include other types of sensor devices available to those skilled in the art. In some embodiments, optical fibers may be employed to transmit and / or guide the first observation beam B1 and the second observation beam B2, directing them to fall on the appropriate region of interest in the eye 16. Various beams may be transmitted and / or guided within system 10 using other methods available to those skilled in the art. Additionally, system 10 may include both optical observation and electronic visualization.

[0035] refer to Figure 1 The visualization module 12 may include a steering unit 78 for steering the first observation beam B1 and / or the second observation beam B2. In one embodiment, the steering unit 78 includes a multi-axis galvanometer or a single-axis galvanometer. A single-axis galvanometer is a small, lightweight mirror that can be electrically controlled to oscillate back and forth on an axis, thereby changing the direction of reflection of light reflected along one axis.

[0036] The first reflective device 64 and the second reflective device 66 may include a spatial light modulator 200, an example of which is... Figure 4 As shown in the image. (Reference) Figure 4 The spatial light modulator 200 may include a capping layer 202 adjacent to the zero-voltage electrode layer 204. The capping layer 202 may be made of silicone, glass, or other suitable materials. The liquid crystal modulator 206 is located between the zero-voltage electrode layer 204 and the pixel electrode array 208, which includes first to fourth pixel electrodes E1, E2, E3, and E4.

[0037] The spatial light modulator 200 is adapted to shape at least one of the corresponding phase and corresponding amplitude of the incident light 210 on a pixel-by-pixel basis. (Reference) Figure 4 Each of the pixel electrode arrays 208 can be configured to apply a different potential difference relative to the zero-voltage electrode layer 204. The potential difference of the pixel electrodes 208 can be selected directly or indirectly by the controller C. Therefore, the reflected light 212 (which includes a first wavefront portion W1, a second wavefront portion W2, a third wavefront portion W3, and a fourth wavefront portion W4) can be formed with variable amplitude and / or phase in the spatial dimension. The spatial light modulator 200 can include phase-only, amplitude-only, or combined phase and amplitude modulation modes. In the example shown, the highest potential difference is applied by the third pixel electrode E3. To reduce diffraction losses, a dielectric mirror 214 can be positioned between the liquid crystal modulator 206 and the pixel electrode array 208.

[0038] Better visualization of the medium opacity 26 is crucial for precise and effective laser vitrectomy. The spatial light modulator 200 provides programmable phase and / or amplitude offsets at each pixel, enabling the generation of a custom-designed wavefront entering the eye 16. By selectively controlling the phase and / or amplitude of light in space, the boundary or edge of the medium opacity 26 relative to the surrounding vitreous medium 28 can be more accurately identified and visualized. Therefore, the spatial light modulator 200 results in an overall improvement in the treatment of the patient 18. The spatial light modulator 200 can be tilted or coaxial with the central axis A. The spatial light modulator 200 can be located in the illumination path and / or observation path. The system 10 can employ various other optical mechanisms and optics to translate minute changes in local phase (e.g., due to differences in optical path length and / or local refractive index) into corresponding changes in brightness, which can be visualized as differences in image contrast.

[0039] According to an alternative embodiment, the visualization module 112 in Figure 3 As shown in the diagram. The visualization module 112 includes polarization devices, such as a first polarizer 165 and a second polarizer 175. (Reference) Figure 3 The first incident beam I1 and the second incident beam I2 originate from the light source 160 and can pass through the collimating unit 162. The first incident beam I1 and the second incident beam I2 can be polarized by the first polarizer 165 before being guided into the objective lens 172 by the reflecting mirror unit 164. The linearly polarized light wave is focused onto the eye 16 and reflected back to the objective lens 172. On the path returning from the eye 16, the first reflected beam R1 and the second reflected beam R2 encounter the second polarizer 175, which is oriented at 90 degrees relative to the first polarizer 165. Only the depolarized wavefront can pass through the second polarizer 175 to reach the tube lens 174 and the detector 176, thereby improving contrast.

[0040] Optionally, refer to Figure 3 In addition to the first polarizer 165 and the second polarizer 175, the visualization module 112 may also include a birefringent prism 185 (shown in dashed lines). The birefringent prism 185 is positioned above the objective lens 172 and is configured to produce lateral displacement in the region of surface undulation where the eye 16 is present. The birefringent prism 185 splits the polarized wavefront (which has already passed through the first polarizer 165) into two orthogonally polarized beams on its way to the eye 16. This allows for the visualization of minute height differences on the surface. If the contour illuminated by either the first incident beam I1 or the second incident beam I2 is completely flat, no feature is observed. If the contour includes surface variations, one of the first incident beam I1 or the second incident beam I2 must travel a longer path and is assigned that path difference.

[0041] refer to Figure 3 On the return path after passing through objective lens 172 and birefringent prism 185, the first reflected beam R1 and the second reflected beam R2 pass through the second polarizer 175 (before encountering tube lens 174 and detector 176) to produce an intermediate image. Detector 176 may include a photosensor and other electronic components for converting the path difference into discernible contrast in the image. Visualization module 112 may include additional components, accessories, and circuitry not shown.

[0042] Now for reference Figure 2 The corneal docking member 80 can be positioned near the eye 16. The corneal docking member 80 is adapted to eliminate corneal asphericity, which may be due to previous corneal surgery of the patient 18. By reducing the depth of field of laser transmission, the corneal docking member 80 highly converges the treatment beam 32 and achieves high spatial coherence. The corneal docking member 80 can take the form of a planar contact lens worn directly on the cornea 82 of the eye 16. The corneal docking member 80 can also take the form of a planar contact lens supported by a transmission unit 500, an example of which is... Figure 8 As shown in the image. (Reference) Figure 8 The transfer unit 500 may include a hollow frame 502 supporting the corneal docking member 80 at a first end 504. A lens 506 may be positioned at the opposite end 508 of the transfer unit 500. In some embodiments, the corneal docking member 80 is surface-treated with a high-viscosity thixotropic contact fluid to increase friction. The corneal docking member 80 may be configured to reduce saccade speed by combining the high-viscosity thixotropic contact fluid with a large surface area having minimal contact force.

[0043] refer to Figures 1 to 2The laser source 34 can be a femtosecond laser or a picosecond laser and can emit light with a wavelength of about 1,050 nm. A non-limiting example of a laser setup is 10 millijoules. In one example, the laser source 34 is configured to deliver infrared radiation, i.e., a wavelength between about 700 nm and 1220 nm. The laser module 14 is configured to precisely target multiple ultrashort laser pulses in the treatment beam 32 towards the medium turbidity 26. In one embodiment, the laser source 34 is constructed as a master oscillator power amplifier (MOPA) configuration, wherein the ytterbium-doped single-mode fiber laser is passively mode-locked by a semiconductor saturable absorber mirror (SESAM). The laser source 34 can be constructed using a femtosecond fiber laser, which offers technological advantages in terms of cost, size, robustness, and stability. In one embodiment, the laser module 14 can include a MOPA architecture using photonic crystal fiber and SESAM. Fiber-based femtosecond lasers using MOPA have a kHz-MHz repetition rate, enabling surgeons to perform continuous operations instead of using infrequent, short pulses (as provided by YAG lasers).

[0044] refer to Figure 2 The direction of the treatment beam 32 can be varied depending on the application at hand. For example, the first treatment beam 32A can propagate in a direction parallel to the central axis A defined by the shared aperture 30. (See reference) Figure 2 The shared aperture 30 is centered on and perpendicular to the central axis A. (Reference) Figure 2 The second treatment beam 32B points off-axis at an off-axis angle 84 between the treatment beam 32B and the reference line 83. The reference line 83 is parallel to the central axis A. In some embodiments, the off-axis angle 84 is equal to or greater than 25 degrees. The off-axis angle 84 can be equal to or greater than 45 degrees. In some embodiments, the laser module 14 can rotate relative to the central axis A. Although the laser source 34 of the laser module 14 is in Figure 1 In the example, the laser source 34 is shown not coaxial with the light source 60 of the visualization module 12; however, it should be understood that the position of the laser source 34 relative to the light source 60 can vary. For example, the position and orientation of the laser source 34 can be changed to be coaxial with the light source 60.

[0045] refer to Figure 2 The treatment beam 32 can interact with the modulator 86 for various beam modification purposes. For example, the modulator 86 can be configured to modulate the phase of the treatment beam 32 emitted by the laser source 34. The modulator 86 can be configured to distribute the energy of the treatment beam 32 to produce multiple impact points in its focal plane. The modulator 86 can be positioned coaxially with the central axis A. In some embodiments, the modulator 86 can be rotated off-axis relative to the central axis A.

[0046] In some embodiments, the modulation device 86 is a deformable reflector 88, such as Figure 2 As shown. The surface of the deformable mirror 88 can be deformed or bent by the actuator array 90 in order to correct optical aberrations.

[0047] The deformable mirror 88 can be used with the wavefront sensor 92 (see...) Figure 2 This method is used in combination. It is beneficial for reducing defocus and aberrations in patients with multifocal and extended depth-of-focus intraocular lenses. Wavefront sensor 92 is configured to determine the reflected beam R exiting the eye 16 (see...). Figure 1 Visual aberrations in ) . In one example, wavefront sensor 92 is a Shack-Hartmann wavefront sensor with a small lens array coupled to an integrated detector. The small lens array focuses light spots onto the detector, and the positions of these spots can be calculated and compared with the position of a reference spot from a reference beam. First observation beam B1 and second observation beam B2 (see Figure 1 The wavefront can be used as a reference beam for the wavefront sensor 92. The controller C is configured to obtain a local phase error in the wavefront of the reflected beam R via the wavefront sensor 92 and to numerically reconstruct the wavefront using the phase error, which can then be used to correct the local phase error via the modulation device 86. As those skilled in the art will understand, the controller C can correct the wavefront error via open-loop or closed-loop correction.

[0048] Now for reference Figure 5 This shows that it can be generated by Figure 1 The flowchart illustrates method 300 executed by controller C. Method 300 does not need to be applied in the specific order listed herein, and some boxes may be omitted. Memory M may store a set of controller executable instructions, and processor P may execute the set of controller executable instructions stored in memory M.

[0049] according to Figure 5 In block 302, controller C is configured to acquire visualization data of eye 16 via visualization module 12. The image stream from visualization module 12 can be sent to module processor 44 and / or controller C, which can be configured to prepare the image stream. Controller C can be configured to store video and / or stereoscopic video signals into a video file and into memory M.

[0050] according to Figure 5In block 304, controller C is configured to acquire one or more definition parameters of the media turbidity 26, partially based on the visualization data in block 302. The definition parameters include the corresponding shape and size of each of the media turbidities 26. In other words, controller C is configured to extract structural features of the media turbidity 26, such as shape and size. Each media turbidity 26 includes a separate set of definition parameters. In some embodiments, the definition parameters may include the depth d of the media turbidity 26 from a pre-selected reference plane along the central axis A (see [reference]). Figure 2 Furthermore, according to box 304, controller C is configured to store definition parameters related to the multiple media turbidity 26.

[0051] according to Figure 5 In box 306, controller C is configured to determine when a threshold portion of the medium turbidity 26 is within a predefined target area 350 of the real-time observation window 352. Figure 6 This is a schematic example of a real-time observation window 352 and a predefined target region 350. The real-time observation window 352 is configured to reflect the visualization data from the visualization module 12 in real time. In one example, the threshold portion is 50%. Controller C performs this identification partly based on the parameters defined in box 304. The corresponding shapes of the real-time observation window 352 and the predefined target region 350 can be rectangular or circular and can be varied as needed.

[0052] refer to Figure 6 The real-time observation window 352 may include a cross laser line 354 to help focus and improve visibility near transparent tissue. In one example, the cross laser line 354 emits green. In some embodiments, the controller C does not track the real-time location of the media turbidity 26 and relies only on the detection of a threshold portion of the media turbidity 26 within a predefined target region 350.

[0053] If the medium turbidity 26 is within the predefined target area 350, method 300 proceeds to block 308, in which the treatment beam 32 is directed at the medium turbidity 26 to cut it. The controller C can be configured to send a signal to the laser module 14 to precisely aim the focus of the treatment beam 32 at the medium turbidity 26. If the medium turbidity 26 is not within the predefined target area, method 300 loops back to block 306.

[0054] Laser pulses from treatment beam 32 can be uniformly targeted at a specific treatment volume, which can be smaller or larger than the medial turbidity 26. Treatment beam 32 can be delivered in various patterns depending on the application at hand. For example, treatment beam 32 can be delivered as a linearly distributed array of dots in a single plane. For some types of medial turbidity 26 (e.g., Weiss ring), treatment beam 32 can be delivered as a small-angle pattern or a circular pattern. Laser setup can include single-pulse, multi-pulse, or continuous delivery. As described above, laser module 14 can include a MOPA architecture using photonic crystal fiber and SESAM. From a surgeon's perspective, the pulse rate in the kHz range of the MOPA architecture is continuous. Laser pulse energy, the location of the point of impact, and the treatment volume can be optimized to achieve maximum efficiency in breaking the medial turbidity 26 while minimizing various factors such as bubble formation and diffusion, laser exposure, proximity to the back of the eye 16, and surgical time.

[0055] Method 300 proceeds from box 308 to box 310 to evaluate whether one or more exit conditions have been met. An example exit condition could be that the medium turbidity 26 has reached the minimum acceptable size. If the exit conditions have been met, method 300 terminates. If the exit conditions have not been met, method 300 loops back to box 302.

[0056] In some embodiments, controller C can be configured to obtain a speckle pattern of scattered light originating from treatment beam 32, wherein the size of the scattered light is approximately the wavelength of treatment beam 32. The turbid medium 26 scatters the light when treatment beam 32 is directed at it. The scattered light originates from different positions within eye 16 and propagates over different lengths, resulting in constructive and destructive interference. The interference varies randomly in space, producing a randomly varying intensity pattern called speckle. In other words, speckle is caused by interference between coherent light rays scattered with different phases and amplitudes. The scattered light causes material irregularities, the size of which can be approximately the wavelength of the laser irradiating the scattering material.

[0057] Laser module 14 may include other operating modes. For example, laser module 14 may include a manual mode in which the surgeon manually identifies the pitch, yaw, and depth of the media opacity 26, presses a trigger to capture an image of the media opacity 26 via visualization module 12, and activates laser module 14. If no movement of the media opacity 26 or eye 16 is detected, laser module 14 is activated. Manual mode may include closed-loop tracking.

[0058] In an alternative embodiment, visualization module 12 may be combined with a slit-based confocal imaging module that uses infrared light with a rolling shutter instead of an optomechanical slit. Slit confocal imaging requires less light than a confocal source. Confocal imaging reduces the depth of field beneficial for vitreous visualization and reduces scattered light, thereby improving the signal-to-noise ratio. System 10 may include a slit-scanning confocal stereo visualization option with a spatial light modulator 200 using reflected light. In some embodiments, visualization module 12 may employ a ring phased array 3D ultrasound unit available to those skilled in the art.

[0059] refer to Figure 7 The diagram illustrates a visualization module 412 according to yet another embodiment. The visualization module 412 includes a coaxial illumination unit 420 with a slit lamp 422 that generates a corresponding light beam interacting with a first reflector 424 and a second reflector 426. At least one of the first reflector 424 and the second reflector 426 includes a spatial light modulator 200 (e.g., ...). Figure 4 (As shown). The first reflector 424 and the second reflector 426 can be coupled with... Figure 1 The central axis A is coaxial. (Reference) Figure 7 The visualization module 412 includes an angled illumination unit 430 with a slit lamp 432 that generates a corresponding beam of light that interacts with a reflector 434. The reflector 434 includes a spatial light modulator 200 (e.g., Figure 4 (As shown). The tilting illumination unit 430 can be rotated relative to the target area or eye 16 via a rotating arm 438 attached to the housing 428. In other words, the reflector 434 can be rotated off-axis relative to the central axis A. The coaxial illumination unit 420 and the tilting illumination unit 430 may include various lenses 420, 422 for optical focusing, as well as other accessories (not shown) for magnification and steering.

[0060] It should be understood that the different features described in one embodiment can be used independently of each other, or can be combined with one or more desired features from other embodiments. For example, the spatial light modulator 200 can be used in adaptive optics methods for visualization-only applications (without laser vitreous ablation). The spatial light modulator 200 can be used with or without the corneal docking member 80. The spatial light modulator 200 can be used for coaxial or tilted illumination paths and / or stereoscopic / optical surgical visualization paths.

[0061] Figure 1 The controller C may be an integral part of other controllers integrated with the laser module 14 and visualization modules 12, 112, or a separate module operatively connected to the other controllers. Figure 1The controller C includes a computer-readable medium (also called a processor-readable medium) that includes a non-transitory (e.g., tangible) medium involved in providing data (e.g., instructions) that can be read by a computer (e.g., by the computer's processor). Such a medium can take many forms, including but not limited to non-volatile and volatile media. Non-volatile media can include, for example, optical discs or magnetic disks, and other persistent storage. Volatile media can include, for example, dynamic random access memory (DRAM), which can constitute main memory. Such instructions can be transmitted via one or more transmission media, including coaxial cables, copper wires, and optical fibers, including lines containing a system bus coupled to the computer's processor. Some forms of computer-readable media include, for example, floppy disks, floppy disks, hard disks, magnetic tape, other magnetic media, CD-ROMs, DVDs, other optical media, punched cards, paper tape, other physical media with a perforated pattern, RAM, PROM, EPROM, FLASH-EEPROM, other memory chips or cartridges, or other media that can be read by a computer.

[0062] The lookup tables, databases, data repositories, or other data storage devices described herein can include various mechanisms for storing, accessing, and retrieving various types of data, including hierarchical databases, a set of files in a file system, application databases in proprietary formats, relational database management systems (RDBMS), etc. Each such data storage device can be included within a computing device employing one of the aforementioned computer operating systems and can be accessed via a network in one or more of various ways. File systems can be accessed from the computer operating system and can include files stored in various formats. RDBMS can employ Structured Query Language (SQL) and languages ​​for creating, storing, editing, and executing stored procedures, such as the PL / SQL language mentioned above.

[0063] The detailed descriptions and accompanying drawings are supportive and descriptive of this disclosure, but the scope of this disclosure is defined only by the claims. While some best modes and other embodiments for implementing the claimed disclosure have been described in detail, various alternative designs and embodiments exist to practice the disclosure as defined in the appended claims. Furthermore, the features of the embodiments shown in the drawings or the various embodiments mentioned in this specification are not necessarily to be construed as embodiments independent of each other. Rather, each feature described in one example of an embodiment may be combined with one or more other desired features from other embodiments to produce other embodiments not described in words or with reference to the drawings. Therefore, such other embodiments fall within the scope of the appended claims.

Claims

1. A system for treating vitreous turbidity in the eye, the system comprising: A visualization module adapted to provide visualization data of a portion of the eye via one or more observation beams; A laser module adapted to generate a therapeutic beam directed at the medium turbidity in order to disrupt the medium turbidity; The laser module and the visualization module have a shared aperture for guiding the treatment beam and the one or more observation beams to the eye, the shared aperture being centered on a central axis; and A controller, which communicates with the visualization module and the laser module, has a processor and a tangible non-transitory memory, on which instructions are recorded; and Wherein, the processor executes the instructions to cause the controller to: One or more defining parameters of the medium turbidity are obtained, at least in part, based on the visualization data, the one or more defining parameters including the shape and size of the medium turbidity; The threshold portion of the medium turbidity is determined, at least in part, based on one or more defined parameters, when it falls within a predefined target area of ​​the real-time observation window of the visualization module, the real-time observation window being configured to reflect visualization data from the visualization module in real time; and When the threshold portion of the medium turbidity is within the predefined target area, the treatment beam is directed towards the medium turbidity.

2. The system as claimed in claim 1, wherein, The one or more defined parameters include the depth of turbidity in the medium.

3. The system of claim 1, further comprising: A sensor, which communicates with the controller and is configured to detect the patient's movements; and The controller is configured to disable the treatment beam when the sensor detects movement of the patient.

4. The system as claimed in claim 1, wherein, The controller is configured to obtain a speckle pattern of scattered light originating from the treatment beam, the size of which is approximately the wavelength of the treatment beam.

5. The system as claimed in claim 1, wherein, The treatment beam comprises multiple ultrashort laser pulses, wherein the multiple ultrashort laser pulses define corresponding durations between one femtosecond and 50 picoseconds.

6. The system of claim 1, wherein, The therapeutic beam propagates in a direction parallel to the central axis.

7. The system as claimed in claim 1, wherein, The therapeutic beam propagates at an off-axis angle deviating from the central axis, the off-axis angle being equal to or greater than 25 degrees.

8. The system of claim 1, further comprising: A corneal docking member, the corneal docking member being positioned adjacent to the cornea of ​​the eye, the corneal docking member being configured to reduce the depth of field of the treatment beam.

9. The system of claim 1, wherein: The visualization module is configured to use electromagnetic radiation reflected from one or more optical elements before it reaches the eye, the one or more optical elements being positioned such that only oblique light rays reach the eye while central light rays are blocked.

10. The system of claim 1, wherein: The visualization module includes a light source, a mirror unit, a first polarizer and a second polarizer, wherein the second polarizer is oriented at 90 degrees relative to the first polarizer. The first polarizer is adapted to polarize at least one incident beam from the light source to generate a linearly polarized light wave; and The reflector unit is adapted to direct the linearly polarized light wave toward the eye; and The second polarizer is positioned such that the reflected light beam leaving the eye is projected onto the second polarizer. The visualization module further includes a birefringent prism configured to intercept the linearly polarized light wave before it reaches the eye, and the birefringent prism is also configured to intercept the reflected light beam before it is projected onto the second polarizer.

11. The system of claim 1, wherein, The visualization module includes an electrically controlled liquid lens with a response time between 1 millisecond and 5 milliseconds.

12. The system of claim 1, further comprising: A wavefront sensor configured to determine visual aberrations in one or more beams of observation exiting the eye; as well as A deformable mirror configured to shape the wavefront of the therapeutic beam in part based on the visual aberrations determined by the wavefront sensor.

13. The system of claim 1, further comprising: A spatial light modulator adapted to shape at least one of the corresponding phase and corresponding amplitude of the one or more observation beams, the spatial light modulator being positioned coaxial with the central axis.

14. The system of claim 1, further comprising: A spatial light modulator adapted to shape at least one of the corresponding phase and corresponding amplitude of one or more observation beams, the spatial light modulator being capable of off-axis rotation relative to the central axis.

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