Corneal lenticule incision with transition zone in laser-assisted ophthalmic procedures
By creating a microlenticule incision design with a flat transition zone and a shallow arc-shaped incision in the cornea, the problem of improper cutting and fitting during corneal microlenticule removal surgery is solved, improving surgical results and surface compatibility.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- AMO DEVELOPMENT LLC
- Filing Date
- 2021-08-18
- Publication Date
- 2026-05-29
Smart Images
Figure CN116348071B_ABST
Abstract
Description
[0001] Cross-references to related applications
[0002] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 067818, filed August 19, 2020, pursuant to 35 U.S.SC §119(e), the entire contents of which are incorporated herein by reference. Background Technology Technical Field
[0004] The embodiments of the present invention relate generally to laser-assisted ophthalmology procedures, and more specifically to systems and methods for forming corneal microlentifoss incisions with transition zones and other features.
[0005] Related technologies
[0006] Visual impairments such as myopia (nearsightedness), hyperopia, and astigmatism can be corrected using eyeglasses or contact lenses. Alternatively, the cornea of the eye can be surgically reshaped to provide the desired optical correction. Eye surgery has become very common; some patients undergo it as an elective procedure to avoid using contact lenses or eyeglasses to correct refractive problems, while others undergo it to correct adverse conditions such as cataracts. Furthermore, with the recent development of laser technology, laser surgery is gradually becoming the preferred technique in ophthalmological procedures.
[0007] Different laser eye surgery systems use different types of laser beams for various procedures and indications. These include, for example, ultraviolet lasers, infrared lasers, and near-infrared ultrashort pulse lasers. Ultrashort pulse lasers emit radiation with pulse durations ranging from as short as 10 femtoseconds to as long as 3 nanoseconds and wavelengths between 300 nm and 3000 nm.
[0008] Previous surgical methods for reshaping the cornea include laser-assisted in situ keratomileusis (LASIK), refractive keratomileusis (PRK), and corneal microlens removal.
[0009] In the LASIK procedure, an ultrashort pulse laser is used to cut a corneal flap, exposing the corneal stroma for photoablation with an ultraviolet beam from an excimer laser. The photoablation of the corneal stroma reshapes the cornea and corrects refractive conditions such as myopia, hyperopia, and astigmatism. In the PRK procedure, which does not create a flap, the epithelium is first removed, followed by the removal of some stromal material using an excimer laser. The epithelium will grow back within a few days after the procedure.
[0010] In corneal lenticule removal procedures, instead of using an excimer laser to ablate corneal tissue after creating a corneal flap, the technique involves tissue resection through two intersecting femtosecond laser incisions to form a lenticule for removal. The removal of the lenticule alters the shape and power of the cornea to correct vision. Lens removal can be performed with or without a corneal flap. Using a flapless procedure, a refractive lenticule is created within an intact portion of the anterior cornea and removed through a small incision. Summary of the Invention
[0011] The present invention relates to a method and related apparatus for corneal microlenti incision, which substantially avoids one or more problems caused by the limitations and disadvantages of related technologies.
[0012] Additional features and advantages of the invention will be set forth in the description which follows, and will be apparent in part from that description, or may be learned by practice of the invention. The objects and other advantages of the invention will be realized and obtained by means of the structures particularly pointed out in the written description, its claims, and the accompanying drawings.
[0013] To achieve the above objectives, the present invention provides a method for forming a microlens in the cornea of a patient's eye using an ophthalmic surgical laser system, comprising: operating the ophthalmic surgical laser system to generate a focused laser beam; and scanning the laser beam in the cornea to form an anterior microlens incision and a posterior microlens incision in the cornea, wherein the anterior microlens incision includes a curved anterior optical region, an anterior transition region connected to and surrounding the anterior optical region, and an anterior edge region connected to and surrounding the anterior transition region, wherein the posterior microlens incision includes a curved posterior optical region, a posterior transition region connected to and surrounding the posterior optical region, and an anterior edge region connected to and surrounding the posterior transition region. And a posterior edge region connected to and surrounding the posterior transition region, wherein the anterior and posterior optical regions overlap each other in a direction parallel to the optical axis of the eye in a top view, the anterior and posterior transition regions overlap each other in the top view, and the anterior and posterior edge regions overlap each other in the top view, wherein the anterior and posterior microlens incisions form a microlens of corneal tissue between them, wherein the anterior and posterior edge regions intersect each other to form the outer edge of the microlens, and wherein the anterior and posterior transition regions are parallel to each other and form a flat transition region of the microlens between them.
[0014] In some embodiments, both the anterior and posterior transition zones are parallel to the anterior surface of the cornea. In other embodiments, both the anterior and posterior transition zones are inclined toward the anterior surface of the cornea as they extend radially outward.
[0015] In some embodiments, the method further includes scanning a laser beam in the cornea to form a plurality of arcuate incisions in the cornea from the anterior surface of the cornea, wherein the arcuate incisions have an arcuate shape and are located inside the outer edge of the microlens in a top view, and wherein the arcuate incisions are substantially perpendicular to the anterior surface of the cornea and extend toward the anterior microlens incision without intersecting with the anterior microlens incision.
[0016] In another aspect, the present invention provides a method for forming a microlens in the cornea of a patient's eye using an ophthalmic surgical laser system, the method comprising: operating the ophthalmic surgical laser system to generate a focused laser beam; and scanning the laser beam in the cornea to form an anterior microlens incision and a posterior microlens incision in the cornea, wherein the anterior microlens incision and the posterior microlens incision overlap each other in a direction parallel to the optical axis of the eye in a top view, wherein the anterior microlens incision and the posterior microlens incision form a microlens of corneal tissue therebetween, and wherein the anterior microlens incision and the posterior microlens incision intersect each other to form the outer edge of the microlens; and scanning the laser beam in the cornea to form a plurality of arcuate incisions in the cornea from the anterior surface of the cornea, wherein the arcuate incisions have an arcuate shape and are located inside the outer edge of the microlens in a top view, and wherein the arcuate incisions are substantially perpendicular to the anterior surface of the cornea and extend toward the anterior microlens incision without intersecting the anterior microlens incision.
[0017] On the other hand, the present invention provides a method for forming a microlens in the cornea of a patient's eye using an ophthalmic surgical laser system, the method comprising: operating the ophthalmic surgical laser system to generate a focused laser beam; and scanning the laser beam in the cornea to form an anterior microlens incision and a posterior microlens incision in the cornea, wherein the anterior microlens incision includes a curved anterior optical region and an anterior transition region connected to and surrounding the anterior optical region, wherein the posterior microlens incision includes a curved posterior optical region, a posterior transition region connected to and surrounding the posterior optical region, and a posterior pocket region connected to and surrounding the posterior transition region, wherein the anterior and posterior optical regions overlap each other in a direction parallel to the optical axis of the eye in a top view, and the anterior and posterior transition regions in the top view... The incisions overlap but do not intersect each other, and the posterior lenticule incision is larger than the anterior lenticule incision in the top view; a laser beam is scanned in the cornea to form an annular incision, wherein the annular incision extends along the entire circumference of the microlens and intersects both the anterior and posterior transition regions to form a microlens of corneal tissue defined by the anterior and posterior lenticule incisions and the annular incision; and a laser beam is scanned in the cornea to form an inlet incision, wherein the inlet incision extends in a direction inclined relative to the optical axis and extends from the anterior corneal surface to intersect the posterior lenticule incision, or the anterior lenticule incision, or both the posterior and anterior lenticule incisions, and wherein the inlet incision extends within a predefined angular range in the top view.
[0018] In some implementations, the rear microlens cutout, which includes the rear optical zone, the rear transition zone, and the rear pocket zone, is a spherical surface, and the annular portion of the front transition zone and the corresponding annular portion of the rear transition zone have matching curvatures and are separated from each other by a predefined distance.
[0019] In some implementations, the annular cut is perpendicular to both the front and rear transition zones at the corresponding intersection locations.
[0020] In some implementations, the front transition region and the rear transition region are not parallel to each other, wherein the distance between the front transition region and the rear transition region increases as the front transition region and the rear transition region extend away from the front optical region and the rear optical region, respectively.
[0021] In some implementations, the inlet cut intersects only with the posterior microlens cut in the posterior pocket area.
[0022] In some implementations, the anterior microlens cut also includes an inlet extension region extending outward from the anterior transition region, wherein the inlet extension region extends a predefined angular range in a top view, wherein the inlet cut intersects only with the anterior microlens cut in the anterior inlet extension region, and wherein the predefined angular range of the inlet cut is smaller than the angular range of the inlet extension region and is positioned together with the angular range of the inlet extension region.
[0023] In some embodiments, the method further includes scanning a laser beam in the cornea to form a pouch incision, wherein the pouch incision extends along the entire circumference of the posterior lenticule incision and intersects only with the posterior lenticule incision in the posterior pouch region. The pouch incision is formed first, followed by the posterior lenticule incision, then the annular incision, then the anterior lenticule incision, and then the inlet incision; or the posterior lenticule incision is formed first, followed by the pouch incision, then the annular incision, then the anterior lenticule incision, and then the inlet incision.
[0024] In another aspect, the present invention provides an ophthalmic surgical laser system comprising: a laser system configured to generate a pulsed laser beam; an optical delivery system configured to deliver the laser beam to the cornea of a patient's eye, the optical delivery system including a scanner system configured to scan the focal spot position of the pulsed laser beam within the cornea; and a controller configured to control the laser system and the scanner system to perform the above-described method.
[0025] It should be understood that the foregoing general description and the following detailed description are merely exemplary and illustrative, and are intended to provide further explanation of the claimed invention. Attached Figure Description
[0026] Figure 1A and Figure 1BThe diagram schematically illustrates the incision formed during a routine corneal microlens removal procedure.
[0027] Figure 1C The illustration shows the use of Figure 1A and Figure 1B The standard corneal microlens removal procedure shown in the image involves removing the microlens and then covering the bed with a cap for the intended coverage.
[0028] Figures 2A to 2C A corneal microlens incision with a flat transition zone is shown in the microlens removal procedure according to an embodiment of the present invention.
[0029] Figures 3A to 3B A corneal microlens incision with a flat transition zone is shown in another embodiment of the invention for a microlens removal procedure.
[0030] Figures 4A to 4C A corneal microlens incision with an additional shallow arcuate incision near the edge of the microlens is shown according to another embodiment of the invention.
[0031] Figures 5 to 14 The invention illustrates a corneal microlenticule incision having a transition zone, a pocket zone, an inlet extension zone, an annular incision, and / or a pocket incision in a microlenticule removal procedure.
[0032] Figure 15 A method is shown for making a cut in the top or bottom of a microlens along the longitude meridian of the microlens using a cutting kerf.
[0033] Figure 16A and Figure 16B Two exemplary ophthalmic surgical laser systems in which embodiments of the present invention can be implemented are schematically shown. Detailed Implementation
[0034] Ophthalmic surgical laser system configuration
[0035] Refer to the attached diagram. Figure 16A An ophthalmic surgical laser system 1 suitable for making incisions in target materials, such as the cornea of the eye, is shown. A laser source 2 (such as a femtosecond laser) provides a pulsed laser beam 2A, which can be used for optical procedures to treat the eye. The system 1 also includes, but is not limited to: a high-frequency scanner (such as a resonant scanner) 3 for scanning the pulsed laser beam to generate a scan line 12, a scan line rotator 4 for rotating the scan line 12, a beam expander 5, an objective lens 6 for focusing the laser beam, an XY scanning device 7 for deflecting or guiding the laser beam onto or within a target, a rapid Z scanning device 8, a patient interface 9, an automatic Z device 10, a controller 13, and a communication module 15.
[0036] The resonant scanner 3 scans the pulsed laser beam at a high resonant frequency (e.g., several kiloHz) to produce a scan line extending in a lateral orientation (i.e., perpendicular to the laser beam propagation direction Z) and having a desired length (e.g., between 1 mm and 2 mm). The length of the scan line can be adjustable. The scan line rotator 4 can be implemented by a Dove prism, a Pechan prism, a set of mirrors, etc., mounted on a rotating stage. By rotating the scan line rotator 4 about the Z-axis, the lateral orientation of the scan line 12 is rotated, allowing the scan line to be placed at any desired orientation in the XY plane (i.e., a lateral plane perpendicular to the laser beam propagation direction Z). The XY scanning device 7 can be a movable XY scanning stage on which a focusing objective lens 6 is mounted; the XY scanning device 7 carries the objective lens 6 and moves it relative to the patient interface device 9 so that the center of the scan line 12 moves relative to the patient's eye in the XY direction. The rapid Z-scanning device 8 changes the depth of the laser focal spot position in the eye (i.e., along the Z direction). Therefore, when the movable XY scanning stage 7 and the fast Z scanning device 8 move the center of the scan line in the X, Y, and Z directions, the scan line rotator 4 modifies the lateral orientation of the scan line 12. Because the scanning speed of the resonant scanner is generally much faster than that of the XY scanning stage and the fast Z scanning device, the scan line 12 can be referred to as a fast scan line, and the movement of the fast scan line in the X, Y, and Z directions can be referred to as a slow sweep.
[0037] The XY scanning stage 7 can be a motorized stage with two motors that drive its movement in the X and Y directions. Preferably, the XY scanning stage is a recoil-free stage configured to reduce or eliminate mechanical vibration. The rapid Z-scanning device 8 may include a voice coil actuator that drives a lens in the Z direction. The movement of the lens causes a change in the depth of focus. The z-scanning frequency can be between 50 Hz and 15,000 Hz.
[0038] The patient interface device 9 couples the patient's eye to the ophthalmic surgical laser system 1. The patient interface 9 may include a visualization beam splitter to reflect light from the eye along optical path 11 toward a video microscope or ophthalmic microscope 14, allowing the eye to be imaged by the microscope's image detector.
[0039] The automated Z-module 10 measures the distal surface of the lens of the patient interface coupled to the patient's eye and provides a depth reference for the rapid Z-scan device 8 of the ophthalmic laser system. The automated Z-module 10 may include, for example, a confocal detector.
[0040] Controller 13 (which may be implemented by a processor executing suitable machine-readable program code and data stored in non-volatile memory) is operatively coupled to various components of system 1, including laser 2, fast Z-scan device 8, resonant scanner 3, scan line rotator 4, XY stage 7, detector 14, and communication module 15. Controller 13 is configured to guide these components of the system to output a focal spot of a pulsed laser beam in the eye in a desired pattern for eye modification. Communication module 15 provides information at the system and / or remotely to the operator of laser system 1 via a wired or wireless data connection, and may include a display, user input devices such as a keyboard, mouse, joystick, etc. The ophthalmic surgical laser system may additionally include an OCT (Optical Coherence Tomography) device (…). Figure 16A (Not shown in the image), which can be used to measure the structure of a target (e.g., eye tissue).
[0041] Figure 16B An ophthalmic surgical laser system 20 suitable for making incisions in target materials, such as the cornea of the eye, is shown. System 20 includes, but is not limited to: a laser source (not shown) for generating an input pulsed laser beam 21; a fast Z-scanning device 22; a resonant scanner 23 for generating scan lines 30 of the pulsed laser beam 21; a scan line rotator 24 for rotating the lateral orientation of the scan lines 30; a beam expander 25; an objective lens (slow Z-scanner) 26 with an adjustable focusing mechanism; an XY scanning stage 27 for deflecting or guiding the pulsed laser beam 21 onto or within a target; a patient interface 28 that may include a beam splitter; a controller 31; an image detector 32 disposed on an optical path 29 defined by the beam splitter of the patient interface; and a communication module 33. The slow Z-scanner 26 can be used to set the laser focal spot at a desired depth of focus, which sets the Z-baseline of the scan pattern.
[0042] Figure 16B Implementation plan and Figure 16A One difference between the implementation plans is that, Figure 16A The XY scanning stage 7 carries both the objective lens 6 and other components, including the rapid Z-scanning device 8, the resonant scanner 3, the scan line rotator 4, and the beam expander 5. Figure 16B The XY scanning stage 27 carries the objective lens 26 but does not carry the other components mentioned above. It should be noted that... Figure 16A In the system, objective lens 6 may also be equipped with a slow Z-scanner (also indicated by reference numeral 6 in the attached figure).
[0043] The following jointly owned U.S. patent application numbers describe having Figure 16A and Figure 16BFurther details of the ophthalmic surgical laser system configured as shown are found in: 14 / 970898, filed December 16, 2015, entitled “Compact Ultra-Short Pulsed Laser Eye Surgery Workstation”; and 14 / 865396, filed September 25, 2015, entitled “Systems and Methods for Lenticular Laser Incision,” the entire contents of which are incorporated herein by reference.
[0044] In other embodiments, the ophthalmic surgical laser system may employ other types of scanners, such as two orthogonal scanning mirrors, for scanning the laser beam in the lateral (XY) direction. Many such systems are known, and their details are not described here.
[0045] Conventional corneal microlens removal method
[0046] Lenticule removal is a known procedure for treating refractive errors. Figure 1A (Side view section) and Figure 1B (Top view) This schematically illustrates the incision made during a routine corneal microlens removal procedure for myopia correction. As... Figure 1A and Figure 1B As shown, the lenticule incision in the cornea 100 includes a spherical or toric cap incision (anterior lenticule incision) 101, a spherical or toric bed incision (posterior lenticule incision) 102, and an annular side incision 103. The cap incision 101 is wider than the bed incision 102. The straight side incision 103, as seen in the side view, connects the bed incision and the cap incision to isolate the removable lenticule volume 105. An arcuate inlet incision 104 is formed on one side to allow for lenticule removal. (See top view...) Figure 1B As shown in the figure, the inlet cut 104 is an arc shape spanning a predefined angle range.
[0047] In corneal lenticule removal surgery, it is crucial to achieve a perfect fit between the anterior (cap) and posterior (bed) surfaces of the remaining cornea after lenticule removal. Properly covering the bed with the cap is important for reducing light scattering and minimizing postoperative wound healing response. However, due to differences in surface area between the cap and bed surfaces, as well as changes in tissue tension caused by the incision, achieving a proper fit or coverage of the cap on the bed can be challenging, often resulting in fourth-order spherical aberration. Figure 1CAs shown, after removing the microlens volume 105, the cap surface 101 bends around the lateral cut (as indicated by the arrow) to mate with the bed surface 102. This results in a bulge 106 on the anterior corneal surface 107 near the boundary region, forming a saddle-shaped or fourth-order spherical aberration. In this case, proper mating of the bed surface and the cap surface may only be achieved in the central region of the intended optical zone 108.
[0048] The first and second sets of embodiments of the present invention provide microlens cutting profiles that can reduce these problems.
[0049] Corneal microlens profile with a flat transition zone
[0050] To address issues of inappropriate surface fit and higher-order spherical aberrations, a first set of embodiments of the present invention provides a corneal microlens incision profile including a flat transition region outside the optical zone. The optical zone of the microlens is the central portion of the microlens, which has a shape that imparts the required optical power for refractive correction. The surrounding flat transition region has a uniform thickness and may be parallel to or inclined toward the anterior corneal surface to further facilitate fit between the bed surface and the cap surface within the optical zone. The inclination of the flat transition region toward the anterior corneal surface also allows for an increase in the area of the posterior microlens surface relative to the anterior microlens surface, making the area of each incision more equal in a non-flattened configuration. The formation of the flat transition region in the microlens reduces bulging of the anterior corneal surface near the edge of the microlens after removal, thus reducing fourth-order spherical aberrations.
[0051] Figure 2A (A side sectional view in a plane passing through the optical axis of the cornea) illustrates an incision formed during a corneal microlens removal procedure for correcting myopia, according to an embodiment of the invention. In this embodiment, when the incision is made, the cornea 200 is flattened by a patient interface device (not shown) having a flat contact lens surface that presses against the anterior corneal surface 203 during the procedure. Figure 2A As shown, the incisions in the cornea 200 include an anterior lenticule incision 201 and a posterior lenticule incision 202. The anterior lenticule incision 201 has a centrally located curved optical region 201A (anterior optical region), a transition region 201B smoothly connected to and surrounding the anterior optical region, and a marginal region 201C smoothly connected to and surrounding the transition region. Similarly, the posterior lenticule incision 202 has a curved optical region 202A (posterior optical region), a transition region 202B smoothly connected to and surrounding the posterior optical region, and a marginal region 202C smoothly connected to and surrounding the transition region. In the top view, the two optical regions, the two transition regions, and the two marginal regions overlap each other. The transition regions 201B and 202B, and the marginal regions 201C and 202C, are annular in the top view (see...). Figure 2CIn a preferred embodiment, the radius of the optical region is preferably about 5 mm to 7 mm, and the radial width of the transition region is preferably about 100 μm to 1000 μm.
[0052] Preferably, for myopia correction, each of the anterior optical zone 201A and the posterior optical zone 202A has a spherical or toric shape (i.e., it is part of a sphere) and is circular in a top view, and both are convex from the perspective of the microlens. In an alternative embodiment, the anterior optical zone 201A and the posterior optical zone 202A may have other curved shapes, such as elliptical shapes for correcting myopic astigmatism. The anterior optical zone 201A and the posterior optical zone 202A define the optical power of the microlens, and thus define the refractive power correction after the microlens is removed.
[0053] exist Figure 2A In the embodiments described, transition regions 201B and 202B are flat and parallel to each other, and both are parallel to the flattened anterior surface of the cornea. The annular volume defined between transition regions 201B and 202B is referred to as the flat transition region of the microlens because it has a substantially uniform thickness. In a preferred embodiment, the thickness of the transition region of the microlens is about 10 μm to 50 μm, or more preferably 15 μm to 40 μm. It should be noted that, in this disclosure, depending on the context, the term "region" may refer to a portion of the incision (2D surface) or a portion of the microlens (3D volume).
[0054] exist Figure 2A In the illustrated embodiment, in the flattened state, the anterior lenticule incision 201 and the posterior lenticule incision 202 are mirror-symmetrical with respect to an imaginary central plane 204 parallel to the flattened anterior corneal surface 203. Therefore, the anterior and posterior lenticule incisions provide uniform refractive power correction. In an alternative embodiment (not shown), the anterior and posterior lenticule incisions may have different curvatures and thus provide different corrective refractive powers, but the flattened transition zone may still have the same... Figure 2A The same shape as shown.
[0055] Edge regions 201C and 202C form a smooth edge profile that connects the outer edges of the two transition regions 201B and 202B. Edge regions 201C and 202C intersect each other and can extend beyond their intersection point. The edge regions have suitable radii of curvature, giving the edges of the microlens a rounded shape. The rounded shape of the microlens edges helps reduce stress concentration that may be caused by sharp corners.
[0056] Figure 2B This demonstrates the effect after the clear contact surface of the patient interface is removed and the cornea is no longer flattened. Figure 2AThe shape of the incision. The imaginary center line 204 remains approximately parallel to the now curved anterior corneal surface 203. It should be noted that due to corneal deformation that occurs when the contact lens is removed, the overall size (area) of the anterior surface of the microlens (anterior microlens incision 201) may become larger than the overall size of the posterior surface (posterior microlens incision 202).
[0057] Figure 3A (Side sectional view) illustrates an incision formed during a corneal microlens removal procedure for myopia correction according to another embodiment of the invention. Similar to... Figure 2A In the illustrated embodiment, the cornea 300 is flattened by the patient interface device (not shown). Figure 3A As shown, the incisions in the cornea 300 include an anterior lenticule incision 301 and a posterior lenticule incision 302. The anterior lenticule incision 301 has a centrally located curved optical region 301A, a transition region 301B connected to and surrounding the anterior optical region, and an edge region 301C connected to and surrounding the transition region. The posterior lenticule incision 302 has a curved optical region 302A, a transition region 302B connected to and surrounding the posterior optical region, and an edge region 302C connected to and surrounding the transition region. In the illustrated embodiment, in a flattened state, the optical regions of the anterior lenticule incision 301 and the posterior lenticule incision 302 are mirror-symmetrical with respect to an imaginary central plane 304 parallel to the anterior corneal surface 303. However, in an alternative embodiment, the optical regions of the anterior and posterior lenticule incisions may have different curvatures and therefore different corrective refractive powers.
[0058] and Figure 2A The difference lies in Figure 3A In this implementation, the flat transition regions 301B and 302B are inclined toward the anterior corneal surface 303 while extending radially outward. In other words, the transition regions 301B and 302B remain parallel to each other (therefore the volume defined between them remains a flat transition region of a microlens with a substantially uniform thickness), but they are not parallel to the anterior corneal surface. This inclined shape further facilitates the alignment of the anterior and posterior microlens incisions within the optical zone. The inclination of the flat transition regions toward the anterior corneal surface also allows for an increase in the overall size of the posterior microlens incision 302 relative to the anterior microlens incision 301 (see...). Figure 3A (at position 302A1), thus making the areas of the two cuts more equal after the contact lens is removed (see...). Figure 3B In a preferred embodiment, in the flattened state, the angle between the flat transition zone and the anterior corneal surface is approximately 0 to 30 degrees.
[0059] In various implementations, the flat transition zone may have a uniform radial width along the entire circumference (see...). Figure 2CThis transition zone may have a non-uniform radial width. For example, the transition zone may be wider along one lateral axis (the axis perpendicular to the optical axis) than along another lateral axis; this is particularly suitable when the optical area of the microlens itself is not a perfect circle (e.g., when it is elliptical). In different implementations, the flat transition zone may have a uniform angle relative to the anterior corneal surface along the entire circumference (see...). Figure 3A (This can be done by using a non-uniform transition zone, or by using a different angle at different locations along the circumference.) The use of a non-uniform transition zone width and / or angle can improve the treatment of astigmatism.
[0060] exist Figures 2A to 2C and Figures 3A to 3B In the implementation plan, the surgeon can appropriately select the radial width, thickness, radius of curvature of the edge area, and angle of the flat transition area.
[0061] shallow arc-shaped incision
[0062] The corneal arcuate incision is the currently known and used procedure for treating myopia, in which the incision is typically made through more than half the thickness of the stroma to allow the central region of the cornea to flatten. Creating a deep arcuate incision near the limbus releases the tension generated by intraocular pressure within the cornea, thus allowing the anterior corneal surface between the incisions to flatten. When using an arcuate incision to correct myopic astigmatism, a pair of arcuate incisions are typically placed facing each other and spaced apart along the steep axis of the corneal surface.
[0063] In the second set of embodiments of the present invention, such as Figures 4A to 4C As shown, improved mating of the front and rear surfaces is achieved by placing shallow, arc-shaped cuts near the edge of the microlens. These cuts can be used with or without forming a flat transition zone.
[0064] like Figure 4A (Side view section) and Figure 4B As shown in the top view, multiple shallow arcuate incisions 405 are formed substantially vertically from the anterior corneal surface into the remaining corneal tissue above, near, and medially to the anterior lenticule incision. The arcuate incisions 405 are shallow because they only partially extend into the remaining corneal tissue above the anterior lenticule incision, and not beyond it. In a preferred embodiment, the depth of the arcuate incisions 405 is approximately 50 μm to 150 μm, and more preferably approximately 100 μm. In a preferred embodiment, the arcuate incisions 405 are located medial to the outer edge of the lenticule (e.g., where the anterior and posterior incisions intersect), at a distance of approximately 0 mm to 1 mm from the edge in the top view. In embodiments forming a flat transition zone (e.g.... Figure 4A and Figure 4B As shown in the diagram, the arc-shaped cutout 405 is positioned where it overlaps with the flat transition area in the top view.
[0065] like Figure 4A As shown in the right-hand image, the shallow, curved incision creates a wedge-shaped groove in the corneal tissue, allowing for relaxation. This allows the anterior lenticule surface (cap) to more freely cover the posterior surface (bed). When the anterior lenticule surface aligns with the posterior surface, this reduces bulging of the anterior corneal surface and mitigates visual aberrations at the optical zone margins.
[0066] In some embodiments, the arcuate cuts 405 are distributed substantially uniformly in the angular direction along the entire periphery of the microlens (except for the area forming the inlet cut 406) in a top view. The arc length of the arcuate cuts 405 can be, for example, from 5 degrees to 80 degrees, and the angular spacing between them can be, for example, from 5 degrees to 85 degrees. Figure 4B and Figure 4C Two examples of different angle lengths and intervals of the arc-shaped cut 405 are shown.
[0067] It should be noted that the inlet incision 406 (which is an arcuate incision leading to the anterior microlens incision to allow removal of the microlens) also allows free rotation of the anterior microlens surface. For practical reasons, the shallow arcuate incision 405 should have different lengths or locations to allow the surgeon to clearly identify the inlet incision 406. In an alternative embodiment, the shallow arcuate incision is a continuous incision in the angular direction, rather than multiple incisions spaced apart therebetween, and this continuous shallow arcuate incision is separated from the inlet incision by gaps on each side.
[0068] In an alternative implementation, the shallow arcuate incisions do not need to be uniformly distributed along the angular direction. For example, they may be formed only near one transverse axis of the cornea. The spacing and depth of the incisions may also vary in different quadrants of the cornea.
[0069] The depth, arc length, spacing, and radial position of the shallow arc-shaped incision 405 can be appropriately selected by the surgeon.
[0070] In an alternative embodiment, the arcuate incision is formed beneath the anterior corneal surface and entirely within the stroma. In such embodiments, the arcuate incision may have a shape similar to... Figures 4A to 4C The incisions shown are in the same location as the aforementioned 405 / 405A, but they do not reach the corneal surface. Such incisions can prevent inward epithelial growth while still allowing for anterior stromal relaxation.
[0071] Both the flat transition zone and the shallow arc-shaped incision are used to improve the fit between the anterior and posterior surfaces after microlens removal. These techniques can be used individually or in combination.
[0072] A corneal microlentiform profile with a wider posterior incision, transition zone, and annular incision.
[0073] In conventional corneal lenticule removal procedures, lenticule cutting is typically performed after corneal flattening, and in this configuration, the lenticule is cut to ensure equal optical power and therefore equal surface area for the anterior (cap) and posterior (bed) surfaces. However, when flattening is removed from the cornea, the anterior lenticule surface area increases more than the posterior lenticule surface area because the anterior surface is compressed more during flattening. This can lead to poor surface fit after lenticule removal, including wrinkling of the anterior lenticule surface. Additionally, air bubbles may form during lenticule cutting on the posterior surface, becoming trapped at the lenticule's edge and potentially deforming the anterior portion of the corneal stroma as it is cut. This can result in variations in the achieved lenticule cutting depth, increased light scattering, and more unpredictable visual outcomes. Furthermore, air bubble trapping at the lenticule's edge can form tissue bridges at the edge of the optical zone, hindering lenticule removal.
[0074] The third set of embodiments described below provides a microlens cutting profile having features that can reduce the aforementioned problems associated with microlens cutting and removal.
[0075] exist Figure 5 The side cross-sectional view shows a corneal microlens cutting profile for myopia treatment according to a third embodiment of the present invention. During the procedure, the cornea 500 is flattened by a patient interface device (not shown). The microlens cutting profile includes an anterior microlens incision 501, a posterior microlens incision 502, an annular incision 503, and one or more inlet incisions 504. The anterior microlens incision 501 and the posterior microlens incision 502 do not intersect each other; the annular incision 503 intersects both the anterior microlens incision 501 and the posterior microlens incision 502 (both intersecting lines are closed curves) and extends around the entire circumference of the microlens to form an isolated microlens volume defined by these three surfaces.
[0076] The anterior microlens incision 501 includes a central anterior optical region 501A and a peripheral transition region 501B smoothly connected to and surrounding the anterior optical region. The posterior microlens incision 502 is a continuous surface (e.g., a continuous spherical surface) and has a wider diameter than the anterior microlens incision 501 including the anterior transition region 501B. The portion of the posterior microlens incision 502 that overlaps with the anterior optical region 501A in a top view is the posterior optical region 502A, while the region outside the posterior optical region is the posterior transition region 502B. In a preferred embodiment, the optical region 501A of the anterior microlens incision has a spherical shape and is circular in a top plan view (not shown), and the entire posterior microlens incision 502 has a spherical shape and is circular in a top plan view; both are convex from the perspective of the microlens. Preferably, the anterior optical region 501A and the posterior optical region 502A are mirror-symmetrical to each other with respect to an imaginary central plane 506 parallel to the flattened anterior corneal surface 505. In an alternative embodiment, the front optical zone 501A and the rear microlens notch 502 may have other suitable shapes, as determined by the power correction requirements.
[0077] The inner edge of the anterior transition region 501B smoothly connects to the outer edge of the anterior optical region 501A. In some embodiments, the portion of the transition region 501B that connects to the anterior optical region 501A may be described by a cubic spline with first-order continuity to form a smooth transition with the anterior optical region 501A. As it extends radially outward, the anterior transition region 501B initially extends downward (away from the flattened anterior corneal surface 505) and then curves upward (towards the anterior corneal surface). The curvature of the outer portion 501B1 of the anterior transition region 501B matches that of the corresponding portion of the posterior transition region 502B, with a specific thickness offset between them, thereby forming a flat transition region volume between them. This flat transition region provides better surface fit between the anterior and posterior surfaces after microlens removal.
[0078] The annular incision 503 extends around the entire microlens and intersects with both the posterior microlens incision 502 and the anterior microlens incision 501 in the transition region near the outer edge of the anterior transition region 501B. In some embodiments, the annular incision 503 extends at the intersection in a direction perpendicular to the anterior transition region 501B and the posterior transition region 502B. In another embodiment, the orientation of the annular incision 503 may deviate from this perpendicular direction; for example, it may be approximately parallel to the optical axis of the cornea.
[0079] The annular cut 503 is a cut separate from the anterior and posterior microlens cuts. In all embodiments of the invention, each of the anterior and posterior microlens cuts may be formed by multiple banded sweeps along the longitude meridian of the microlens, as described in co-owned U.S. Patent No. 10,369,052, entitled “Systems and methods for lenticular laser incision,” published August 6, 2019, the entire disclosure of which is incorporated herein by reference. More specifically, short scan lines generated by a high-frequency scanner (e.g., a resonant scanner) of an ophthalmic laser are positioned tangent to a latitudinal parallel to the microlens surface and swept along the longitude meridian of the microlens surface to form a single sweep. The latitudinal parallel is a closed curve defined by the intersection of the microlens and a plane perpendicular to the Z-axis (optical axis); the longitude meridian is a curve defined by the intersection of the microlens and a plane passing through the Z-axis (the shapes of the front and rear microlens surfaces shown in the various side-view cross-sectional views of this disclosure are longitude meridians). Multiple sweeps around the Z-axis along different longitude meridians collectively form the microlens surface. The annular cutout 503 is formed separately because it is not formed by the portion of the sweeps that form the front or rear microlens surface.
[0080] and Figure 3A Compared to the embodiment shown (in which the front and rear microlens surfaces curve toward each other near their edges and intersect each other to define the outer edge of the microlens volume), Figure 5 The proposed implementation uses a separate annular incision to define the outer edge of the microlens volume. This annular incision reduces tissue bridging at the microlens edge, facilitating easy removal of the microlens. Specifically, when the anterior and posterior surfaces are formed by multiple banded sweeps along the longitude meridian of the microlens, such meridional cutting results in a larger circumferential spacing between laser pulses at the microlens edge. The annular incision reduces the likelihood of tissue bridging at the microlens edge, allowing for easy and complete removal of the microlens without residual tissue.
[0081] The entrance cutout 504 is shown in the top plan view (not shown, but referenced). Figure 1B The incision 504 has an arcuate shape that spans a predefined angular range and intersects the posterior microlenti incision 502 at a position outside the annular incision 503. The incision 504 may be perpendicular to the flattened anterior corneal surface or may be formed at a non-perpendicular angle relative to the flattened anterior corneal surface.
[0082] To form the microlens incision, the rear microlens incision 502 is cut first, followed by the front microlens incision 501, the annular incision 503, and the entrance incision 504 in sequence.
[0083] In the third implementation scheme, because the posterior lenticule incision 502 is larger than the anterior lenticule incision 501, the posterior and anterior lenticule incisions become approximately equal in size when the patient interface is removed and the cornea is in a non-flattened state (not shown). This improves the fit between the two surfaces after lenticule removal. Furthermore, because air bubbles formed during lenticule cutting migrate to the outer edge of the incision, air bubbles formed during posterior lenticule incision cutting will tend to be positioned further away from the optical zone in the central region of the lenticule, reducing their impact on the cutting of the anterior lenticule surface.
[0084] In some alternative embodiments, no flat transition zone is formed, and the transition zone on the top surface overlaps or intersects with the bottom cut, thereby allowing the microlens to be removed without an annular cut.
[0085] Corneal microlens profile with pocket area, pocket incision and inlet extension
[0086] exist Figures 6 to 14 The side cross-sectional view, with the cornea in a flattened state, shows a corneal microlens cutting profile according to another embodiment of the invention. In these figures, the same components are indicated by the same reference numerals, for example: 601, 701, 801, etc., indicate anterior microlens incisions; 601A, 701A, 801A, etc., indicate anterior optical zones; 601B, 701B, 801B, etc., indicate anterior transition zones; 602, 702, 802, etc., indicate posterior microlens incisions; 603, 703, 803, etc., indicate annular incisions; 604, 704, 804, etc., indicate inlet incisions; 1205, 1305, etc., indicate bag incisions, etc.
[0087] Figure 7 and Figure 9 The microlens cutting profile is shown, in which a pouch is formed on the outer side of the microlens edge to allow bubbles to migrate away from the central region (optical zone) of the cut and into the pouch, while Figure 6 and Figure 8 The corresponding corneal microlens cutting profile without these pouches is shown.
[0088] Figure 6The illustrated microlens cut profile includes an anterior microlens cut 601, a posterior microlens cut 602, an annular cut 603, and one or more inlet cuts 604. The anterior microlens cut 601 includes a central anterior optical region 601A and a peripheral transition region 601B connected to and surrounding the anterior optical region. Similarly, the posterior microlens cut 602 includes a central posterior optical region 602A and a peripheral transition region 602B connected to and surrounding the posterior optical region. In the illustrated embodiment, both the anterior optical region 601A and the posterior optical region 602A are convex from the perspective of the microlens and are mirror-symmetric with respect to an imaginary central plane 606 parallel to the flattened anterior corneal surface (not shown), but they may alternatively have different curvatures. In a preferred embodiment, both the anterior microlens cut 601 and the posterior microlens cut 602 are circular in a top plan view (not shown).
[0089] The width W of the transition regions is preferably about 300 μm to 500 μm, but can be up to 1 mm. As they extend away from the optical region, the transition regions 601B and 602B of the front and rear microlens cutouts are inclined away from the imaginary central plane 606, such that the transition regions (the volume between the surfaces of the two transition regions) are thicker at their outer edges than at their junction with the optical region. Preferably, the thickness of the transition regions is between 15 μm and 40 μm (more preferably 30 μm) at the point where they junction with the optical region (the thinnest point), and between 15 μm and 40 μm (more preferably 40 μm) at the outer edges. This makes the edges of the microlens volume thicker, which facilitates microlens removal without making the entire microlens thicker.
[0090] An annular cut 603 (which is a cut separate from the front and rear microlens cuts) extends around the entire microlens and intersects both the rear microlens cut 602 and the front microlens cut 601 in transition regions 601A and 601B near the outer edge of the transition region. The annular cut 603 can be vertical (i.e., parallel to the optical axis), or preferably forms an angle of about 0 to 45 degrees (more preferably about 30 degrees) relative to the vertical direction in either direction. When using a laser, an angled annular cut is easier to form than a strictly vertical cut. The advantages of the annular cut 603 are similar to those of combining... Figure 5 The advantages discussed in the implementation plan.
[0091] The inlet incision 604 intersects with the anterior microlenticular incision 601 and the posterior microlenticular incision 602 in the transition zone inside the annular incision 603. The distance D from the intersection point of the inlet incision 604 and the posterior microlenticular incision 602 to the outer edge of the posterior microlenticular incision 602 can be adjusted by the surgeon. The angle of the inlet incision 604 relative to the vertical direction is preferably 0 to 50 degrees, and more preferably about 30 degrees.
[0092] To form the microlens incision, the rear microlens incision 602 is cut first, followed by the annular incision 603, the front microlens incision 601, and the inlet incision 604 cut in sequence.
[0093] Figure 7 The implementation shown is similar to Figure 6 The embodiment shown differs in that (1) the posterior microlens incision 702 has an additional horizontal annular pocket region 702C connected to and surrounding the transition region 702B; and (2) the inlet incision 704 is located within the pocket region. The anterior microlens incision 701 does not have such a pocket region. In the illustrated embodiment, the pocket region 702C extends substantially horizontally, but it may alternatively extend downward or upward. The width P of the pocket region may be 0 mm to 1 mm (0 means no pocket region), and preferably 100 μm to 500 μm. The inlet incision 704 is located within the pocket region, and the distance D' from the point where the inlet incision 704 and the posterior microlens incision 702 are added to the outer edge of the posterior microlens incision 702 can be adjusted by the surgeon. In a preferred embodiment, the distance D' is approximately 90 μm. Due to the presence of the pocket region 702C, the widths of the transition regions 701B and 702B can be reduced, which reduces the overall microlens volume. In other words, Figure 7 The transition region width W' in the implementation scheme can be compared to Figure 6 The transition region width W in the implementation scheme is small.
[0094] Because the posterior lenticule incision 702 is formed first, the pocket region 702C of the posterior lenticule incision 702 forms a pocket that can be used to guide bubbles away from the optical zone when forming various incisions. Such bubbles form in the cornea when a laser pulse interacts with the corneal tissue to form an incision. Bubble formation is undesirable because bubbles are typically opaque and can distort subsequent laser light. The pocket region 702C in the posterior lenticule incision 702 allows bubbles to remain within the pocket region and prevents them from migrating toward the optical zone.
[0095] The pocket region also has other advantages. For example, because the posterior microlens notch 702 is formed by multiple strip-shaped sweeps along the longitude meridian of the microlens (see...). Figure 15 (Top view), so at the beginning of the meridional sweep, the first pulse emitted by the laser will be in the pocket region and outside the microlens volume. Moreover, the high pulse density transition (when transitioning from one meridional sweep to another) occurs outside the microlens volume.
[0096] Figure 8 The implementation scheme shown is similar to Figure 6The illustrated implementation differs in that the inlet incision 804 intersects only with the anterior microlenticular incision 801. The distance D” from the intersection of the inlet incision 804 and the anterior microlenticular incision 801 to the outer edge of the anterior microlenticular incision 801 can be adjusted by the surgeon.
[0097] Figure 9 The implementation scheme shown is similar to Figure 7 The illustrated embodiment differs in that (1) the anterior microlenticular incision 901 has an inlet extension region 901C extending outward from the transition region 901B; and (2) the inlet incision 904 intersects only with the anterior microlenticular incision 901 in the extension region 901C. The extension region 901C does not need to extend obliquely along the entire periphery of the microlens, as long as it spans a sufficient angular range to accommodate the inlet incision. In the illustrated embodiment, the extension region 901C extends substantially horizontally, but it may alternatively extend downward or upward. The width E of the extension region and the distance D”' from the intersection of the inlet incision 904 and the anterior microlenticular incision 901 to the outer edge of the extension region 901C can be adjusted by the surgeon. The extension region allows the inlet incision to intersect with the anterior microlenticular incision 901.
[0098] and Figure 6 and Figure 8 Compared to the implementation plan, Figure 7 , Figure 9 The implementation plan has the following advantages. Figure 7 and Figure 9 In this implementation, the inlet incision can be formed further away from the optical zone without increasing the width of the transition zone and therefore without increasing the volume of tissue removed. The inlet incision can also be formed close to the anterior or posterior microlenticular incision, wherein the inlet incision will intersect the pocket area of the posterior microlenticular incision or the inlet extension area of the anterior microlenticular incision. These contours improve the surgeon's ability to grasp the microlens without wrinkling and reduce the risk of the inlet incision impacting the optical zone.
[0099] Figure 10 The microlens profile shown is Figure 6 The modification of the microlens profile shown is due to... Figure 6Compared to the annular cut 603, the annular cut 1003 is positioned closer to the optical axis (but still within the transition zone). Small pouches (denoted as pouches 1001C and 1002C, respectively) are formed in the regions of the front transition zone 1001B and the rear transition zone 1002B located outside the annular cut 1003 (and therefore outside the microlens volume), into which air bubbles can migrate. The width of the pouches can be up to 1 mm, and preferably 100 μm to 500 μm. The inlet cut 1004 is initially positioned near the outer edges of the front microlens cut 1001 and the rear microlens cut 1002, but is now located outside the annular cut 1003.
[0100] Figure 11 The microlens profile shown is similar to Figure 10 The microlens profile shown differs in that (1) the front microlens cut 1101 has a different transition zone; and (2) the annular cut 1103 is inclined in different directions. Figure 10 In one embodiment, the annular cut 1003 has a larger diameter at the top than at the bottom (i.e., it slopes outward as the annular cut extends in the deep-to-shallow direction), while... Figure 11 In one embodiment, the annular cut 1103 has a smaller diameter at the top than at the bottom (i.e., it slopes inward as the annular cut extends in a deep-to-shallow direction). The front microlens cut 1101 is a continuous surface (e.g., a continuous spherical surface) having an optical region 1101A corresponding to the optical region 1102A of the rear microlens cut 1102 (as indicated by two vertical dashed lines), and a relatively narrow transition region 1101B surrounding the optical region 1101A but not extending into the rear microlens cut 1102. In other words, the pocket region is formed only in the rear microlens cut 1102. Due to the inward angle of the annular cut 1103, the intersection point of the annular cut 1103 and the front microlens cut 1101 can be positioned relatively close to the outer edge of the optical region 1101A, thereby allowing the front transition region 1101B to be relatively narrow. The position of the inlet cut 1104 can be... Figure 11 The same as shown, but it now intersects only with the rear microlens cutout 1102.
[0101] Figure 12 The microlens profile shown is similar to Figure 11The microlens profile is shown, but a separate bag cut 1205 is added. Bag cut 1205 is a short annular cut and is located outside the annular cut 1203 and the inlet cut 1204, intersecting the bag region 1202C of the rear microlens cut 1202 near the outer edge of the bag region. Bag cut 1205 can be vertical, or preferably forms an angle of about 0 to 45 degrees (more preferably about 30 degrees) relative to the vertical direction in either direction. Bag cut 1205 can be formed first before forming any other cuts, or after the rear microlens cut 1202 but before other cuts. Bag cut 1205 allows bubbles to migrate away from the optical area of the cut and into the bag it forms.
[0102] In an alternative implementation, a separate bag cutout can be added. Figures 5 to 11 Any of the implementation schemes.
[0103] Figure 13 The microlens profile shown is similar to Figure 10 The microlens profile shown differs in that (1) the front microlens cut 1301 has a transition region 1301B that is narrower than the transition region 1302B (including the pocket region 1302C) of the rear microlens cut 1302, i.e., the front microlens cut 1301 does not have a pocket region; (2) the front microlens cut 1301 has an entrance extension region 1301D that is located outside the transition region 1301B and spans a defined angular range less than the entire circumference; (3) the entrance cut 1304 intersects only with the front microlens cut in the extension region 1301D; and (4) a separate pocket cut 1305 is added, similar to Figure 12 The bag shown has a cut of 1205. The cutting sequence is the same as... Figure 12 The cutting order of the implementation schemes is the same.
[0104] Figures 6 to 13 The implementation shown is configured for myopia treatment, while Figure 14 The microlens profile for hyperopia treatment is shown. Figure 14The microlens profile includes an anterior microlens incision 1401, a posterior microlens incision 1402, an annular incision 1403, an inlet incision 1404, and a pouch incision 1405. From the perspective of the microlens, the anterior microlens incision 1401 and the posterior microlens incision 1402 have a concave shape. The anterior microlens incision 1401 includes a central anterior optical region 1401A and a peripheral transition region 1401B connected to and surrounding the anterior optical region. Similarly, the posterior microlens incision 1402 includes a central posterior optical region 1402A and a peripheral transition region 1402B connected to and surrounding the posterior optical region. In the illustrated embodiment, optical regions 1401A and 1402A are mirror-symmetrical with respect to an imaginary central plane 1406 parallel to the flattened anterior corneal surface (not shown), but they may alternatively have different curvatures. The annular incision 1403 is inclined inwards, resulting in a smaller diameter at its apex. The rear transition zone 1402B is wider than the front transition zone 1401B, and the outer portion 1402C of the rear transition zone, located outside the annular cut 1403, serves as a bag area to allow bubbles to migrate away from the optical area of the cut and enter the bag. The annular bag cut 1405 is similar to... Figure 12 and Figure 13 The implementation scheme includes an annular bag cut. The inlet cut 1404 intersects only with the rear microlens cut 1402 at a position between the annular cut 1403 and the bag cut 1405. The cutting sequence is the same as... Figure 12 and Figure 13 The cutting order of the implementation schemes is the same.
[0105] Although Figure 14 An exemplary microlens profile for hyperopia treatment is shown, but other microlens profiles for hyperopia treatment may be derived from [the provided text]. Figures 5 to 13 Various other elements used in the implementation scheme are formed, such as the pouch area in the anterior microlens incision, different angles of the annular incision, and the inlet extension area in the anterior microlens incision.
[0106] In summary, in embodiments of the present invention, the various elements of the microlens cutout profile include: a flat transition region ( Figures 2A to 3B ), wider posterior microlens incision ( Figure 5 , Figure 7 , Figure 9 and Figures 11 to 14 ), a separate annular cut ( Figures 5 to 14 ), an inwardly inclined annular cut ( Figure 5 , Figure 11 , Figure 12 and Figure 14 ), the pocket area in the posterior microlens incision or in both the posterior and anterior microlens incisions ( Figure 5 , Figure 7 and Figures 9 to 14), the extension area in the anterior microlens incision used for the inlet cutting opening ( Figure 9 and Figure 13 ), separate ring-shaped bag cutout ( Figures 12 to 14 ) and shallow arc-shaped incisions on the corneal surface ( Figures 4A to 4C These components can be used individually or in combination. Each of these components, individually or in combination with other components, provides one or more benefits, which relate to better surface fit, reduced bulge near the boundary after microlens removal, better bubble management, and easier and / or more complete removal of the microlens, as described in more detail previously. These advantages ultimately lead to more accurate vision correction and better healing.
[0107] Although many specific implementations have been described, other implementations are also possible using other combinations of the various elements described above.
[0108] The microlens cutting profile of the embodiments of the present invention can be used to form microlenses to treat myopia (when the microlens is thicker at the center than at the edge), hyperopia (when the microlens is thinner at the center than at the edge), and mixed astigmatism.
[0109] It will be apparent to those skilled in the art that various modifications and variations can be made to the corneal microlenticule incision method and related apparatus of the present invention without departing from the spirit or scope of the invention. Therefore, the present invention is intended to cover various modifications and variations falling within the scope of the appended claims and their equivalents.
Claims
1. An ophthalmic surgical laser system for forming microlenses in the cornea of a patient's eye, comprising: Laser source; processor; as well as A memory storing instructions that, when executed by the processor, cause the processor to perform the following operations: Operate the laser source to generate a focused laser beam; as well as The laser beam is scanned in the cornea to form an anterior and posterior lenticule incisions in the cornea. The anterior microlens incision includes a curved anterior optical region, an anterior transition region connected to and surrounding the anterior optical region, and an anterior edge region connected to and surrounding the anterior transition region. The posterior microlens incision includes a curved posterior optical region, a posterior transition region connected to and surrounding the posterior optical region, and a posterior edge region connected to and surrounding the posterior transition region. In a top view, the anterior and posterior optical regions overlap each other along a direction parallel to the optical axis of the eye; the anterior and posterior transition regions overlap each other in the top view; and the anterior and posterior edge regions overlap each other in the top view. The anterior and posterior lenticule incisions form a corneal microlens between them, wherein the anterior and posterior marginal regions intersect each other to form the outer edge of the microlens. The front transition region and the rear transition region are parallel to each other and form a flat transition region of the microlens between them.
2. The ophthalmic surgical laser system according to claim 1, wherein, Both the front optical region and the rear optical region are convex.
3. The ophthalmic surgical laser system according to claim 1, wherein, The radial widths of the front transition region and the rear transition region are 100 µm to 1000 µm, and the distance between the front transition region and the rear transition region is 10 µm to 50 µm.
4. The ophthalmic surgical laser system according to claim 1, wherein, Both the anterior transition zone and the posterior transition zone are parallel to the anterior surface of the cornea.
5. The ophthalmic surgical laser system according to claim 1, wherein, Both the anterior and posterior transition regions are inclined toward the anterior surface of the cornea at an angle of 0 to 30 degrees as they extend radially outward.
6. The ophthalmic surgical laser system according to claim 5, wherein, The front edge region and the rear edge region form a smooth edge profile in the side view section.
7. The ophthalmic surgical laser system according to claim 1, wherein, The operation also includes: The laser beam is scanned in the cornea to form a plurality of arcuate incisions in the cornea from the anterior surface of the cornea, wherein the arcuate incisions have an arcuate shape and are located inside the outer edge of the microlens in the top view, and wherein the arcuate incisions are substantially perpendicular to the anterior surface of the cornea and extend toward the anterior microlens incision without intersecting the anterior microlens incision.
8. An ophthalmic surgical laser system for forming microlenses in the cornea of a patient's eye, comprising: Laser source; processor; as well as A memory storing instructions that, when executed by the processor, cause the processor to perform the following operations: Operate the laser source to generate a focused laser beam; as well as The laser beam is scanned in the cornea to form an anterior lenticule and a posterior lenticule incision in the cornea, wherein the anterior lenticule and the posterior lenticule incision overlap each other in a direction parallel to the optical axis of the eye in a top view, wherein the anterior lenticule and the posterior lenticule incision form a microlens of the corneal tissue between them, and wherein the anterior lenticule and the posterior lenticule incision intersect each other to form the outer edge of the microlens; and The laser beam is scanned in the cornea to form a plurality of arcuate incisions in the cornea from the anterior surface of the cornea, wherein the arcuate incisions have an arcuate shape and are located inside the outer edge of the microlens in the top view, and wherein the arcuate incisions are substantially perpendicular to the anterior surface of the cornea and extend toward the anterior microlens incision without intersecting the anterior microlens incision.
9. The ophthalmic surgical laser system according to claim 8, wherein, The depth of the plurality of arc-shaped incisions is 50 µm to 150 µm from the anterior surface of the cornea.
10. An ophthalmic surgical laser system for forming microlenses in the cornea of a patient's eye, comprising: Laser source; processor; as well as A memory storing instructions that, when executed by the processor, cause the processor to perform the following operations: Operate the laser source to generate a focused laser beam; as well as The laser beam is scanned in the cornea to form an anterior and posterior lenticule incisions in the cornea. The anterior microlens cut includes a curved anterior optical region and an anterior transition region connected to and surrounding the anterior optical region. The posterior microlens cut includes a curved posterior optical region, a posterior transition region connected to and surrounding the posterior optical region, and a posterior pocket region connected to and surrounding the posterior transition region. The anterior and posterior optical regions overlap each other in a direction parallel to the optical axis of the eye in a top view, and the anterior and posterior transition regions overlap each other without intersecting each other in the top view. The posterior microlens cut is larger than the anterior microlens cut in the top view. The laser beam is scanned in the cornea to form an annular incision, wherein the annular incision extends along the entire circumference of the microlens and intersects both the anterior and posterior transition regions to form the microlens of corneal tissue defined by the anterior and posterior microlens incisions and the annular incision; and The laser beam is scanned in the cornea to form an inlet incision, wherein the inlet incision extends in a direction inclined relative to the optical axis and extends from the anterior corneal surface to intersect the posterior lenticule incision, or the anterior lenticule incision, or both the posterior lenticule incision and the anterior lenticule incision, and wherein the inlet incision extends within a predefined angular range in the top view.
11. The ophthalmic surgical laser system according to claim 10, wherein, First, the rear microlens incision is formed, followed by the annular incision, then the front microlens incision, and then the inlet incision.
12. The ophthalmic surgical laser system according to claim 10, wherein, The radial width of the rear pocket area is 30 µm to 300 µm.
13. The ophthalmic surgical laser system according to claim 10, wherein, The rear microlens cut, including the rear optical region, the rear transition region, and the rear pocket region, has a spherical surface.
14. The ophthalmic surgical laser system according to claim 13, wherein, The annular portion of the front transition zone and the corresponding annular portion of the rear transition zone have matching curvatures and are separated from each other by a predefined distance.
15. The ophthalmic surgical laser system according to claim 13, wherein, The annular cut is perpendicular to both the front transition zone and the rear transition zone at the corresponding intersection position.
16. The ophthalmic surgical laser system according to claim 10, wherein, The front transition region and the rear transition region are not parallel to each other, wherein the distance between the front transition region and the rear transition region increases as the front transition region and the rear transition region extend away from the front optical region and the rear optical region, respectively.
17. The ophthalmic surgical laser system according to claim 10, wherein, The inlet cut intersects only with the rear microlens cut in the rear pocket area.
18. The ophthalmic surgical laser system according to claim 10, wherein, The anterior microlens cut also includes an inlet extension area extending outward from the anterior transition region, wherein the inlet extension area extends within a predefined angular range in the top view. Wherein, the inlet cut intersects only with the anterior microlens cut in the inlet extension region, and wherein the predefined angle range of the inlet cut is smaller than the angle range of the inlet extension region and is positioned together with the angle range of the inlet extension region.
19. The ophthalmic surgical laser system according to claim 10, wherein, The operation also includes: The laser beam is scanned in the cornea to form a pouch incision, wherein the pouch incision extends along the entire circumference of the posterior lenticule incision and intersects only with the posterior lenticule incision in the posterior pouch region.
20. The ophthalmic surgical laser system according to claim 19, wherein, First, the bag incision is formed, followed by the rear microlens incision, then the annular incision, then the front microlens incision, and finally the inlet incision; or in, First, the rear microlens incision is formed, followed by the bag incision, then the annular incision, then the front microlens incision, and finally the inlet incision.