Device for laser treatment of cloudy eyes

Abstract

An apparatus for laser treatment of ocular opacities comprises a measurement system for acquiring depth information from the eye structure, a laser system, an eye-tracking unit, a display unit, and a control and operation unit. According to the invention, the control and operation unit is designed to determine the depth position of the eye structure relative to the laser focus from the depth profile, and particularly to determine blocking zones for laser treatment of the retina and capsule. Furthermore, the control and operation unit is designed to generate at least one marker for each blocking zone of the retina and capsule and the laser focus, the features of which correspond to the corresponding depth position in the eye, so that the markers are displayed on the display unit and superimposed on a real-time image. A partially automated treatment device for laser treatment of ocular opacities is proposed, wherein a 2D view of the eye is combined with a 3D recording of the measurement system.

Description

Technical Field

[0001] This invention relates to a device for laser treatment of cloudy eyes. Background Technology

[0002] The vitreous humor is a mostly transparent, gel-like substance located inside the eye, between the lens and the retina. In youth, the vitreous humor is completely transparent and in contact with the retina. With age, the vitreous humor liquefies and increasingly detaches from the retina, a process known as posterior vitreous detachment. This is a normal aging process that typically occurs after age 50. The detached portion of the vitreous shrinks inside the eye, and the structural material and density of the vitreous humor become visible to the patient. Because this structural material and density can move above the field of vision, it is also called floaters. Typically, floaters are caused by the membranous structure at the back of the vitreous humor after detachment, and sometimes even by residual blood if retinal injury occurs during detachment. In rare cases, floaters can also exist as crystalline deposits within the vitreous humor due to metabolic problems.

[0003] Even though floating objects usually have no pathological cause, they are not as harmless as commonly assumed, as they can sometimes severely impair the quality of life and work efficiency of those affected.

[0004] Especially against light-colored backgrounds, such as when working at a computer, reading, or observing a blue sky or snow, these imperfections can be perceived and interfere with vision. Floating objects that are tossed in and out of the central viewing area due to reading motions are particularly disturbing.

[0005] Because these floaters are typically shaped like "flying mosquitoes," they are described in French as the technical term "Mouches-Volantes" (fly hallucinations). However, turbidity can also take other forms, such as dendritic, annular, or star-shaped, or even as dot clouds. In the following text, the term "floaters" will be used in relation to the vitreous opacities to be treated, regardless of their type or shape.

[0006] Floaters typically don't disappear without treatment because the immune system doesn't recognize them as abnormal and therefore doesn't break them down. Affected individuals often find them difficult to ignore or disregard. Certain types of floaters, such as those caused by residual blood after a retinal hemorrhage, can be partially absorbed by the body, although this usually takes weeks or months.

[0007] In a so-called vitrectomy (core vitrectomy), after opening the eye with cutting instruments, the vitreous humor is partially or completely broken, aspirated, and removed. This intervention is typically performed in cases of retinal detachment or epiretinal membrane peeling, and is certainly considered disproportionate for eliminating localized vitreous opacities. Furthermore, vitrectomy is invasive, requires hospitalization, and carries risks associated with the surgical intervention, particularly frequent cataract induction, less common retinal detachment, and rare but possible endophthalmitis.

[0008] A low-risk alternative treatment is now available using so-called laser vitreolysis. Laser vitreolysis is a gentle, low-risk, and painless laser procedure that vaporizes or atomizes vitreous opacities without opening the eye.

[0009] In laser vitreolysis, short laser pulses are directed onto the vitreous opacities to achieve optical breakthrough or photo-rupture due to the high laser intensity in the focal region. The float and the surrounding vitreous absorb the laser energy, forming a cutting or expanding laser plasma, thereby vaporizing and / or breaking down the float and dissolving it. The treatment is painless and carries no risk of infection. Laser vitreolysis provides a safe method for the gentle treatment of disturbing vitreous opacities, provided that important and sensitive eye structures, such as the capsular bag, lens, or retinal area, and especially the macula, are not damaged by the laser.

[0010] Of course, the success of treatment depends on the type of floaters. Treatment is particularly successful in cases of so-called white rings. Tissue chains can be severed, and tissue compression responsible for the intrusive shadows can be eliminated.

[0011] YAG lasers (especially 1064nm Nd:YAG) have been used to treat floaters for over 30 years (Brasse, K., Schmitz-Valckenberg, S., Jünemann, A. et al. Ophthalmologist (2019) 116:73. https: / / doi.org / 10.1007 / s00347-018-0782-1). However, even with the advanced equipment available to date, treatment can only be precise and targeted safely to the very front of the vitreous. In the deeper vitreous regions, the laser is not precise enough. However, this is precisely where most vitreous opacities are located, as they are often a result of posterior vitreous detachment. YAG lasers are commonly used in ophthalmology for iridotomy in glaucoma and for post-cataract treatment, specifically to remove opacities on intraocular lens implants caused by cell overgrowth or even the posterior membrane of the cataract. Frequency-doubled YAG lasers with green laser radiation (532 nm) are also used for retinal coagulation, for example, in cases of hemorrhage or retinal detachment. More rarely, YAG lasers are also used for phacoemulsification in cataract surgery, i.e., the liquefaction of the cloudy and hardened natural lens. However, in this case, it is not the Er:YAG laser with a wavelength of 2940 nm, which has high absorption by water or tissue, that is used; the Er:YAG laser must then typically be laboriously introduced into the eye via endoscope-guided endoscopic laser insertion.

[0012] Based on known existing technologies, there are already many solutions for laser surgery on eye tissues, especially those in the vitreous humor.

[0013] Therefore, DE 10 2011 103 181 A1 describes an apparatus and method for femtosecond laser surgery on tissues, particularly the vitreous humor of the eye. The apparatus consists of an ultrashort pulse laser with a pulse length of approximately 10 fs to 1 ps, particularly approximately 300 fs, a pulse energy of approximately 5 nJ to 5 pJ, particularly approximately 1 to 2 pJ, and a pulse repetition rate of approximately 10 kHz to 10 MHz, particularly 500 kHz. The laser system is coupled to a scanner system that enables spatial variation of the focal point in three dimensions. In addition to this therapeutic laser scanner optics system, the apparatus also consists of a navigation system coupled thereto.

[0014] US 2006 / 195076 A1 describes a system and method for creating incisions in ocular tissue at different depths. This system and method can focus light in a pattern onto different focal points located at different depths within the ocular tissue. Multiple focal points can be created simultaneously using segmented lenses. Optimal incisions can be achieved by sequentially or simultaneously focusing light at different depths, producing a broadened plasma column and a beam with an extended tail. Furthermore, the techniques described herein can be used to perform new ophthalmic surgical methods or improve existing methods, including dissecting tissues in the posterior pole, such as floaters, membranes, and the retina.

[0015] US 2014 / 257257 A1 also describes a system and method for treating target tissue in the vitreous humor of the eye, comprising a laser unit for generating a laser beam and a detector for generating an image of the target tissue. The system also includes a computer defining a focal spot path for emulsifying the target tissue. A comparator connected to the computer then controls the laser unit to move the focus of the laser beam. This focus movement is performed to treat the target tissue while minimizing deviation of the focus from the defined focal path.

[0016] US 2015 / 342782 A1 also relates to systems and methods for performing partial vitrectomy of the eye using a computer-controlled laser system. First, an optical channel through the vitreous is defined surgically. Then, vitreous-like and suspended deposits (flocculents) in the optical channel are ablated, and in some cases, removed from the optical channel (e.g., aspirated). In some cases, a transparent liquid can be introduced into the optical channel to replace the ablated material, thereby establishing unobstructed transparency within the optical channel. Generally, the present invention relates to systems and methods for laser ophthalmic surgery. In particular, the present invention relates to systems and methods for removing so-called floaters using a pulsed laser beam.

[0017] US 2018 / 028354 A1 also describes methods and systems for ophthalmic interventions of the eye. Undesirable features are identified based on an image of at least a portion of the eye. Vitreous opacities that impair vision, such as floaters, are considered undesirable features within the vitreous cavity. After identification and localization of the floaters by an image processing system, and upon confirmation by a physician, the floaters are automatically “shot” away with laser pulses. The laser energy vaporizes at least a portion of the vitreous opacity. The process is repeated until the vitreous opacity is eliminated. The entire process is repeated for each vitreous opacity until the vitreous fluid is determined to be sufficiently clear.

[0018] The method described by ELLEX (Ellex Medical Pty Ltd. product brochure; "TangoReflex-Laser Floater Treatment"; PB0025B; 2018; (http: / / www.ellex.com)) proposes using pulsed nanosecond lasers (YAG) to break down vitreous opacities or eliminate them completely by converting them into gas. A guide laser beam is aimed at the target area (float), and then one or more therapeutic laser pulses are applied to it. Here, the guide laser beam and therapeutic laser pulses are manually triggered by the user. This manual laser treatment typically consists of two separate treatments, each lasting 20-60 minutes.

[0019] Unpublished applications DE 10 2019 007 147.6 and DE 10 2019 007 148.4 describe systems for laser vitreous dissolution of floating objects, based on a combination of a processing laser and an OCT or OCDR system to achieve safe and precise fragmentation. Here, an OCDR system (Optical Coherence Domain Reflectometer) is understood as a system for interferometric acquisition of a one-dimensional scattering profile, while OCT (Optical Coherence Tomography) represents two-dimensional or three-dimensional imaging. In both cases, variations with a recording sequence (i.e., a movie) should also be included. Here, a minimum distance from the sensitive eye structure is ensured, and preferably, the laser is activated only when the focal point of the processing laser and the floating object to be processed are positioned sufficiently precisely relative to each other.

[0020] Both approaches have disadvantages, namely that doctors must constantly combine the familiar 2D frontal view provided to them with the 3D recordings of the OCT or OCDR system while using their spatial imagination, which is very difficult in situations where time is tight or rapid interaction with the patient is required.

[0021] The use of laser energy in laser vitreolysis is non-invasive and avoids the disadvantages of surgery, but it is also associated with disadvantages and risks.

[0022] Therefore, aiming the laser can be difficult. Because doctors observe the vitreous humor along the light path, it becomes challenging to determine the depth of the retina, the depth of vitreous opacities, or other relevant features. Consequently, there is a risk of missing vitreous opacities and / or damaging the eye.

[0023] In particular, treatment of shifting, difficult-to-identify, and mostly transparent floaters has proven difficult, as these floaters, as phase objects, still cast interfering shadows on the retina.

[0024] The application of laser energy can also cause additional movement of vitreous opacities, making treatment more difficult. Therefore, it may be necessary for the doctor to realign the laser after each application of energy, which can be time-consuming. Thus, laser-based treatments are costly and stressful for both patients and doctors.

[0025] Another potential problem is incomplete vitreous detachment, which can lead to localized vitreous traction or even retinal detachment. Laser processing within the vitreous can alter the energy relationships within the vitreous due to the resulting propagating shock waves, and can cause, for example, tension in the retina.

[0026] Ultimately, treating floaters located near the eye's sensitive structures proved particularly difficult. Laser radiation in this case could cause damage to the retina, the lens of the eye, or the macula. Summary of the Invention

[0027] The objective of this invention is to develop a solution for laser treatment of eye opacities that overcomes the drawbacks of known technical solutions and provides the feasibility of combining a 2D view of the eye with a 3D recording of a measurement system in a simple manner, thereby simplifying the operator's process. Furthermore, the solution should be easy to implement and cost-effective, and enable simpler, faster, and primarily safer treatment of intrusive vitreous opacities via laser vitreolysis.

[0028] An apparatus for laser processing of eye opacities comprises a measurement system for obtaining depth information from the eye structure, a laser system having optical elements for coupling the measurement system and the laser system, an eye-tracking unit, a display unit, and a control and operation unit. This apparatus achieves the aforementioned objective by having the measurement system designed to provide depth information of the eye structure in the form of a depth profile; the laser system designed to break up eye opacities; the eye-tracking unit designed to detect axial eye movement; the display unit designed to display at least one 2D image of the eye as a real-time image; and the control and operation unit designed to determine the depth position of the eye structure relative to the laser focus from the depth profile, and specifically to determine blocking zones for laser processing for the retina and capsule. The control and operation unit is also designed to generate at least one marker for each blocking zone of the retina and capsule and for the laser focus, the features of which correspond to the corresponding depth positions in the eye, so that the markers are displayed on the display unit and superimposed on the real-time image.

[0029] Here, the deflection unit can be implemented via a known electromechanical deflection mirror (e.g., a galvanometer or MEMS scanner), or it can also be implemented by simple manual operation to deflect and / or displace the laser beam, for example by means of a handheld contact lens and a displaceable and pivotable laser slit lamp.

[0030] According to the invention, the control and operation unit is designed to locate the structure of the floater and the eye, and specifically to determine the blocking zones for laser processing of the retina and capsule. Furthermore, the control and operation unit is designed to generate markers for at least the blocking zones of the retina and capsule and the blocking zones of the laser point, the size of which corresponds to the corresponding depth information in the eye, so that the markers are displayed on a display unit and overlaid with real-time images and / or scans.

[0031] A first advantageous design relates to a measurement system for acquiring depth information of the eye, said measurement system being an OCDR or OCT system.

[0032] The second advantageous design involves an eye tracker unit that uses the anterior region of the eye, preferably the iris, capsule, the front or back of the lens or cornea, a contact lens, or a reference mark set in the vitreous body by laser processing as a reference.

[0033] The third advantageous design involves a display unit designed to display other images, particularly scans with eye depth information and / or an overview of the current settings and / or operational elements. Here, the display unit is particularly advantageously a touchscreen.

[0034] Other advantageous designs involve a control and operation unit that is also designed to locate retinal landmarks, particularly the fovea, macula, optic nerve head, or blood vessels, and to generate markers for additional display on a display unit for laser processing.

[0035] Here, the markers generated by the control and operation unit differ in color and / or structure. Particularly preferably, the markers generated for the laser point change their color and / or structure when the laser point approaches or enters one of the blocking areas or retinal landmarks.

[0036] The control and operation unit is also designed to shut down the laser system when the laser focus approaches or enters one of the blocking zones or retinal landmarks. Different tolerances can be assigned to the two blocking zones and the retinal landmarks for shutting down the laser system upon approach or entry.

[0037] According to a particularly advantageous design, a device for laser vitreous dissolution of vitreous opacity is integrated into the slit lamp.

[0038] This invention relates to an apparatus for laser treatment of eye opacities. A partially automated treatment device (system) is proposed, wherein a two-dimensional view of the eye is combined with depth information (depth profile) to simplify the operator's operation when locating floaters during treatment. Attached Figure Description

[0039] The invention will now be described in more detail with reference to embodiments. For this purpose, examples are shown.

[0040] Figure 1 A view showing a fundus image with overlaid markers.

[0041] Figure 2 Views showing fundus images with superimposed markers at different focal positions of the laser point, and

[0042] Figure 3 A view showing a scan with markings for blocking areas and laser points. Detailed Implementation

[0043] The proposed device for laser processing of eye opacities, namely, the device for laser vitreous dissolution of vitreous opacities, consists of a measurement system for acquiring depth information of the eye, a laser system with a deflection unit, optical elements for coupling the measurement system and the laser system, an eye tracking unit, a display unit, and a control and operation unit.

[0044] Specifically, the measurement system is designed to provide depth information of the eye in the form of a scan. Axial eye movement is detected and compensated by an eye-tracking unit. The display unit is designed to display at least one two-dimensional image of the eye as a real-time image. For the real-time image, an image refresh rate of 5Hz, preferably 10Hz, and particularly preferably 20Hz is used, along with a latency of <200ms, preferably <100ms, and particularly preferably <35ms.

[0045] According to the present invention, the control and operation unit is designed to determine the depth position of eye cloudiness relative to the depth position of the laser focus, generate a mark for the relative position of the eye cloudiness relative to the laser focus, and display the mark on the display unit.

[0046] In addition, the control and operation unit is designed to locate the structure of the eye in the scan provided by the measurement system, and in particular to identify blocking zones for laser processing of the retina and capsule.

[0047] Specifically, the control and operation unit is also designed to generate markers for at least the blocking areas of the retina and capsule, as well as laser points, the size of which corresponds to the corresponding depth information in the eye, so that the markers can be displayed on the display unit and overlaid with real-time images.

[0048] By determining the position of the laser focus relative to the eye structures to be protected, a blocking zone is created for these structures, providing physicians with the feasibility of manually treating floaters. The created blocking zone prevents the laser focus from entering and damaging the eye structures.

[0049] According to an advantageous design, the control and operation unit is also designed to determine the depth position of eye cloudiness relative to the laser focus depth position, generate a mark for the relative position of eye cloudiness relative to the laser focus, and display the mark on the display unit.

[0050] The feasibility of automatically treating floaters is obtained by additionally determining the position of the eye cloudiness (floaters) relative to the eye structure to be protected or relative to the blocking zone generated for said eye structure.

[0051] Similarly, feasible manual treatment is further simplified by allowing doctors to at least approximate the position of the laser focus relative to the floating object.

[0052] In the apparatus presented herein, an OCDR or OCT system is used as a measurement system for obtaining depth information of the eye, and the OCDR or OCT system is preferably combined with a YAG laser system having a deflection unit.

[0053] When using an OCDR system, an A-scan is recorded, and additionally, a fundus scan is recorded using another image recording unit, wherein the position of the OCDR measurement rays relative to the fundus is known through calibration. Here, the fundus recording is preferably performed under IR or NIR illumination between 780 nm and 1060 nm.

[0054] In contrast, when using an OCT system, a 3D volumetric scan is recorded, during which eye movement is detected and compensated by an eye-tracking unit. Eye movement compensation is necessary because the recording of the 3D volumetric scan lasts for up to 2 seconds, and eye movement can cause scan distortion.

[0055] While eye structures can be detected relatively easily in OCDR or OCT signals, the situation is different in the case of floating objects.

[0056] The identification is preferably implemented by first determining the scattering signal level of the vitreous body. The following structure is identified as a floating object:

[0057] - The signal value is 2dB higher than the average vitreous signal, preferably 5dB higher.

[0058] - Having a minimum axial dimension (e.g., >15 μm in tissue), or having an equivalent optical path assuming a refractive index of 1.36, where a signal still appears at the vitreous level afterwards, or

[0059] - Identify its signal characteristics, which correspond to floating objects stored in a database, using size or position ratios.

[0060] The eye-tracking unit is designed to detect and compensate for axial eye movement.

[0061] In particular, the anterior region of the eye, preferably the capsule, the front of the lens or the back of the cornea, is used as a reference.

[0062] Because the retina can be obscured by floating objects, it is generally not used as a reference. Therefore, the anterior region of the eye is preferred for tracking eye movement relative to the axis of the floating object.

[0063] However, it is also possible to use a contact lens or a reference mark set in the vitreous body via laser processing as a reference for the eye-tracking unit. If a contact lens is to be used as a reference, a reference in the form of a functional coating can be considered to achieve stable tracking.

[0064] According to the invention, the display unit is designed to display, in addition to the 2D image of the eye, other images, particularly scans containing depth information of the eye and / or an overview of the current settings and / or operating elements, as real-time images. Here, it is particularly advantageous that the display unit is a touchscreen.

[0065] According to the present invention, binoculars, a 3D monitor, an HMD, etc., are also provided as display units. Furthermore, the design of the control and operation unit is important to the present invention. Specifically, the control and operation unit generates markings for the capsular bag and the blocking area and laser point of the retina, so that the markings are displayed on the display unit and superimposed on real-time images and / or scans. In particular, the buoyant object itself can also be marked.

[0066] The control and operation units are further designed to locate retinal landmarks, particularly the fovea, macula, optic nerve head, or blood vessels, and each of them generates a marker so that they can also be displayed on the display unit and overlaid with real-time images and / or scans if necessary.

[0067] To avoid injury, laser processing can be interrupted when the laser beam is aimed at one of the retinal landmarks.

[0068] Furthermore, according to the present invention, local height position changes of the retina are monitored, and for this purpose, key local locations can be marked as described, so as to avoid stress that could cause retinal detachment during further laser processing.

[0069] According to the present invention, the marks generated by the control and operation unit are different in color and / or structure.

[0070] to this end, Figure 1 This view shows a fundus image with superimposed markings, where both the fundus image and the markings are actually colored. The markings from the outside in represent: 1. Capsule; 2. Anterior occlusion zone boundary; 3. Laser focus; 4. Float; 5. Posterior occlusion zone boundary; 6. Retina; and 7. Laser direction.

[0071] Furthermore, when the laser dot approaches one of the blocking areas or retinal landmarks, the markers generated for the laser dot by the control and operation unit change their color and / or structure.

[0072] It is also feasible to alert the operator or shut down the laser system acoustically and / or optically when the laser focus approaches or enters one of the blocking areas or retinal landmarks.

[0073] to this end, Figure 2 This view shows fundus images with superimposed markings at different focal positions of the laser point, where, in practice, both the fundus images and markings are colored. In the fundus images shown here, for better overview, markings are only present for the retina 6, laser focus 3, and capsule 1. Laser processing is possible in the two images above because laser focus 3 is located in the "safe" area between the retina 6 and capsule 1; conversely, laser processing is not possible in the two images below because laser focus 3 is too close to either the retina 6 or capsule 1 and is located within their respective (not shown together) blocking areas.

[0074] Figure 3 A scan with markings for the restricted areas and laser dots is shown. From the view of depth scan 9, the user can very quickly and reliably identify the depth of the laser focus 3 relative to the retina 6 and the lens 8 (or capsule 1). Additionally, the posterior blocking zone 5 and the anterior blocking zone 2 are also shown here.

[0075] In addition, the control and operation unit is designed to assign different tolerances to the two blocking zones and the retinal landmarks for proximity purposes.

[0076] In a particularly advantageous design, the device for laser vitreous dissolution of vitreous opacities is integrated into the slit lamp. However, the concept of laser vitreous dissolution presented here can also be used in a similar manner in surgical microscopes.

[0077] The proposed device is also suitable for displaying a treatment history, for example, by marking and storing the firing depth and design location. It can also progressively change the position of the float (as a trajectory) and the retinal segment (marking local elevation) during progressive laser firing.

[0078] The present invention provides an apparatus for laser treatment of eye opacities, which eliminates the drawbacks of known technical solutions and provides the feasibility of combining a 2D view of the eye with a 3D recording of a measurement system in a simple manner, thereby simplifying the operator's operation. Furthermore, the solution is easy to implement and cost-effective, and enables simpler, faster, and primarily safer treatment of intrusive vitreous opacities through laser vitreolysis.

[0079] According to the present invention, the information obtained from the OCDR or OCT system regarding the location of sensitive eye structures, laser focus, and depth of potentially moving, floaters to be processed is organized in such a way that it can be combined with a 2D view familiar to the physician in an intuitive manner.

Claims

1. An apparatus for laser processing of eye opacities, the apparatus comprising a measurement system for acquiring depth information from the eye structure, a laser system, an eye-tracking unit, a display unit, and a control and operation unit, the laser system having optical elements for coupling the measurement system and the laser system, characterized in that, The measurement system is designed to provide depth information of the eye structure in the form of a depth profile; the laser system is designed to break up eye opacities; the eye-tracking unit is designed to detect axial eye movement; the display unit is designed to display at least one 2D image of the eye as a real-time image; the control and operation unit is designed to determine the depth position of the eye structure from the depth profile relative to the depth position of the laser focus, and specifically for laser processing to determine blocking zones for the retina and capsule; and the control and operation unit is also designed to generate at least one marker for at least the blocking zones of the retina and capsule and the laser focus, respectively, the features of which correspond to the corresponding depth positions in the eye, so that the markers are displayed on the display unit and superimposed on the real-time image.

2. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to determine the depth position of eye cloudiness relative to the depth position of the laser focus, generate a mark for the relative position of the eye cloudiness relative to the laser focus, and display the mark on the display unit.

3. The apparatus according to claim 2, characterized in that, The control and operation unit is designed to change the characteristics of the marker to be generated in terms of numerical values ​​of color, shape, and depth position.

4. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to generate markers with dimensions relating to the depth position of the retina, capsule, lens, laser focus, and eye opacity, such that the markers are positioned around the lateral laser focus position.

5. The apparatus according to claim 1, characterized in that, The eye-tracking unit is designed to compensate for axial eye movement.

6. The apparatus according to claim 1, characterized in that, The 2D image is a frontal image of the rear eye segment, and the frontal image is displayed as a real-time image with an image refresh rate of 5Hz and a latency of <200ms.

7. The apparatus according to claim 1, characterized in that, The measurement system used to obtain depth information of the eye is an OCDR system.

8. The apparatus according to claim 1, characterized in that, The front eye region is used as the reference for the eye-tracking unit.

9. The apparatus according to claim 1, characterized in that, A reference mark set in the vitreous body by laser processing or a contact lens will be used as the reference for the eye tracking unit.

10. The apparatus according to any one of claims 1 and 6, characterized in that, The OCDR system is designed to record A-scans and additionally includes an image recording unit for recording the fundus, wherein the position of the ray relative to the fundus is measured by calibrating a known OCDR.

11. The apparatus according to any one of claims 1 and 6, characterized in that, The OCT system is designed to record 3D volumetric scans, and the eye-tracking unit is designed to compensate for detected eye movements during the recording of the 3D volumetric scans.

12. The apparatus according to claim 1, characterized in that, The display unit is designed to display other images, particularly scans with depth information of the eyes and / or an overview of the current settings and / or operating elements.

13. The apparatus according to claim 1, characterized in that, The display unit is a touch screen.

14. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to display the markings generated for the blocking areas of the retina and the capsule, as well as the laser focus, on the display unit and to overlay the markings with the scan.

15. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to locate retinal landmarks, particularly the fovea, macula, optic nerve head, or blood vessels, and to generate markers for these retinal landmarks.

16. The apparatus according to claim 2, characterized in that, The markers generated by the control and operation unit differ in color and / or structure.

17. The apparatus according to claim 1, characterized in that, When the laser point approaches one of the blocking areas or retinal landmarks, the color and / or structure of the marker generated by the control and operation unit for the laser point changes.

18. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to acoustically and / or optically warn the operator when the laser system approaches one of the blocking zones or retinal landmarks.

19. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to shut down the laser system when approaching or entering one of the blocking zones or retinal landmarks.

20. The apparatus according to claim 1, characterized in that, The control and operation unit is designed to assign different tolerances to the two blocking zones and the retinal landmark for the shutdown of the laser system in close proximity.

21. The apparatus according to claim 1, characterized in that, A device for laser vitreous dissolution of vitreous opacity is integrated into a slit lamp.

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