Ophthalmic surgical microscope with stroboscopic illumination

Abstract

An ophthalmic system for visualizing interaction between an ocular matter and a probe tip of a probe within or in contact with an ocular space of an eye includes a visualization tool having a field of view that encompasses at least a portion of the ocular space of the eye at an interface of the probe tip and the ocular matter, and a stroboscopic illumination source configured to stroboscopically illuminate the at least the portion of the field of view at an illumination frequency. A method for operating a stroboscopic illumination source during an ophthalmic procedure includes identifying an illumination source type of the stroboscopic illumination source, identifying a probe type, identifying a first procedure trigger, and operating the stroboscopic illumination source based on the probe type, the illumination source type, and the first procedure trigger.

Description

TECHNICAL FIELD

[0001] The present disclosure relates generally to methods and systems for visualizing interactions within or associated with an inter-ocular space of an eye. BACKGROUND

[0002] During small incision surgery, particularly during ophthalmic surgery, small probes are inserted into the surgical site to fragment, remove, or otherwise manipulate tissue. During these surgeries, fluid and tissue can be fragmented (e.g., cut or emulsified) and / or removed from the surgical site. It can be difficult to visualize the surgery due to the frequency and / or power utilized in manipulating the tissue.

[0003] Examples of ophthalmic surgeries in which fluid and tissue are fragmented, removed, or otherwise manipulated include vitreoretinal surgery. Vitreoretinal surgery can include various procedures performed to restore, preserve, and enhance vision. Vitreoretinal surgery can be indicated for the treatment of many serious disorders of the back of the eye. Vitreoretinal surgery can treat disorders such as age-related macular degeneration (AMD), diabetic retinopathy and diabetic vitreous hemorrhage, macular hole, retinal detachment, epiretinal membrane, CMV retinitis, and many other ophthalmic disorders. To treat certain disorders of the back of the eye, a physician can first perform a vitrectomy as part of an ongoing vitreoretinal surgery. Vitrectomy refers to the surgical removal of the vitreous, a clear, gel-like substance that fills the center of the eye. The vitreous can occupy about two-thirds of the volume of the eye, giving the eye its shape and form before birth.

[0004] Removal of the vitreous can involve a vitreous cutter (also referred to as a “cutter” or “vitreous cutter”). In some examples, the vitreous cutter can be powered by a pneumatic vitreous cutter machine (e.g., a “surgical console”) that includes one or more pneumatic valves (also referred to as drive valves). In such examples, the vitreous cutter can work like a microkeratome, with an oscillating microcutter for removing the vitreous gel in a controlled manner. In some other examples, the vitreous cutter can use a laser or some other technology such as ultrasound to cut the vitreous. In addition to cutting the vitreous, the cutter can be configured to remove or aspirate the vitreous cuttings from the surgery.

[0005] Examples of other ophthalmic surgeries in which fluid and tissue are cut, removed, or otherwise manipulated include phacoemulsification, which refers to cataract surgery in which a diseased lens is emulsified and aspirated from the lens capsule. In some examples, a phacoemulsification probe can emulsify the lens by ultrasound (or other technology, such as a laser, etc.).

[0006] Thus, probes utilized in ophthalmic surgery interact with and / or manipulate ocular matter through various means, such as oscillating microdissectors, lasers, ultrasound, and vacuum suction. The surgeon can see the interaction with the eye with the aid of a microscope. The microscope can provide an illumination source, such as an LED, to illuminate the surgical area. In addition to or instead of the illumination source of the microscope, an illumination probe can be inserted into the eye to illuminate the ocular space. The surgeon can then react to the visual feedback. For example, if the probe appears to be approaching a sensitive area of the eye, the surgeon can react by changing the direction or orientation of the probe, changing the energy characteristics of the probe, and / or retracting the probe. However, modern probes often operate at high frequencies and / or high powers. Often, the interaction of the probe with the ocular matter occurs too quickly for the surgeon to visually detect and / or react in time to prevent damage to the eye. It would be beneficial for the surgeon to have available tools to visualize the interaction of the ophthalmic surgery with high temporal precision. SUMMARY

[0007] The present disclosure relates generally to methods and systems that visualize interactions within or associated with the ocular space of an eye.

[0008] Certain embodiments provide an ophthalmic system for visualizing interactions between ocular matter and a probe tip of a probe within or in contact with the ocular space of an eye. The system includes a visualization tool having a field of view that includes at least a portion of the ocular space of the eye at an interface of the probe tip and the ocular matter, and a stroboscopic illumination source configured to stroboscopically illuminate the at least the portion of the field of view at an illumination frequency.

[0009] Certain embodiments provide a method for operating a stroboscopic illumination source during an ophthalmic procedure. The method includes identifying an illumination source type of the stroboscopic illumination source, wherein the stroboscopic illumination source is configured to stroboscopically illuminate at least a portion of a field of view of a visualization tool at an illumination frequency, identifying a probe type of a probe for the ophthalmic procedure, the probe having a probe tip configured to contact ocular matter in the portion of the field of view of the visualization tool, identifying a first procedural trigger corresponding to a first operation of the ophthalmic procedure, and operating the stroboscopic illumination source based on the probe type, the illumination source type, and the first procedural trigger.

[0010] The following description and associated drawings set forth certain illustrative features of one or more embodiments. BRIEF DESCRIPTION OF DRAWINGS

[0011] The accompanying drawings are only intended to depict example embodiments of certain embodiments of the present disclosure and therefore should not be thought to limit the scope of the present disclosure.

[0012] Figure 1 FIGURE illustrates an exemplary surgical console, in accordance with certain embodiments.

[0013] Figure 2 FIGURE illustrates an exemplary vitrectomy probe, in accordance with certain embodiments.

[0014] Figure 3 FIGURE illustrates an exemplary phacoemulsification probe, in accordance with certain embodiments.

[0015] Figure 4A FIGURE illustrates a cross-sectional view of an eye during an exemplary ophthalmic procedure using an exemplary vitrectomy probe with internal strobe illumination, in accordance with certain embodiments. Figure 2

[0016] Figure 4B FIGURE illustrates a cross-sectional view of an eye during an exemplary ophthalmic procedure using an exemplary phacoemulsification probe with internal strobe illumination, in accordance with certain embodiments. Figure 3

[0017] Figure 5A FIGURE illustrates a cross-sectional view of an eye during an exemplary ophthalmic procedure using an exemplary vitrectomy probe with external strobe illumination, in accordance with certain embodiments. Figure 2

[0018] Figure 5B FIGURE illustrates a cross-sectional view of an eye during an exemplary ophthalmic procedure using an exemplary phacoemulsification probe with external strobe illumination, in accordance with certain embodiments. Figure 3

[0019] Figure 6A FIGURE illustrates a cross-sectional view of an eye during another exemplary ophthalmic procedure using an exemplary vitrectomy probe with external strobe illumination, in accordance with certain embodiments. Figure 2

[0020] Figure 6B FIGURE illustrates a cross-sectional view of an eye during another exemplary ophthalmic procedure using an exemplary phacoemulsification probe with external strobe illumination, in accordance with certain embodiments. Figure 3

[0021] Figures 7A to 7L FIGURE illustrates exemplary strobe visualization of interactions between energy emitted from a probe tip and surrounding fluid, in accordance with certain embodiments.

[0022] Figure 8 FIGURE illustrates an exemplary process flow for visualizing interactions within or associated with the inter-ocular space of an eye by strobe illumination, in accordance with certain embodiments.

[0023] ​​​​​​Figure 9 FIGURE illustrates an exemplary diagram of a surgical console, in accordance with certain embodiments.

[0024] For ease of understanding, the same reference numbers are used in different drawings to designate the same or similar elements shared by the drawings. It is contemplated that elements and features of one embodiment can be beneficially incorporated into other embodiments without further recitation. DETAILED DESCRIPTION

[0025] While features of the present application can be discussed with respect to certain embodiments and drawings described below, one or more of the advantageous features discussed herein can be employed in all embodiments of the application. In other words, while one or more embodiments can be discussed as having certain advantageous features, one or more of such features can be employed

[0026] Embodiments include devices and methods related to ophthalmic surgical visualization tools with stroboscopic illumination. Generally, the interaction of a surgical probe with ocular matter occurs too quickly for a surgeon to visually detect and / or react in time to prevent damage to the eye. Thus, it can be beneficial to utilize an ophthalmic surgical visualization tool with stroboscopic illumination to illuminate the surgical site such that the details of the interaction of the eye can be visualized.

[0027] As used herein, the phrase "ocular space" generally refers to intraocular space, extraocular space (e.g., an ocular surface, such as a corneal surface), and periocular space (e.g., a space surrounding the eye, such as the interface between the eyelid and the eye). Similarly, the phrase "ocular matter" generally refers to intraocular matter, extraocular matter (e.g., a corneal surface), and periocular matter (e.g., matter associated with the interface between the eyelid and the eye, such as Schlemm's canal, the lacrimal gland, and the nasolacrimal duct).

[0028] Ophthalmic surgical visualization tools with stroboscopic illumination can be used to illuminate details of interactions of the eye, such as: the position of a surgical probe relative to structures of the eye (e.g., the retina, the lens capsule, etc.), the detachment and / or movement of the vitreous during vitrectomy, the detachment and / or movement of lens particles in response to phacoemulsification, cavitation bubbles, gas propagation, ablation plumes, etc. Stroboscopic illumination allows for the visualization of fast (e.g., high speed, high frequency, or high power) processes by converting the view from a continuous high-speed image to a discontinuous, slowed-down appearance. Stroboscopic illumination can improve visualization, whether with the “naked eye,” lens-aided visualization (e.g., with a microscope), or with a video camera. It can be said that stroboscopic illumination “slows down” the visual details of the eye’s interactions. Surgeons can leverage stroboscopic illumination to improve visualization, thereby better identifying when and how to use a probe during ophthalmic surgery. As a result, stroboscopic illumination can reduce risk and improve surgical quality. For example, stroboscopic illumination can increase the safety of surgery near the retina and / or the capsular bag.

[0029] Figure 1 An example of a surgical console 101 is illustrated in accordance with certain embodiments. The surgical console 101 can be configured to drive one or more tools 103, which can include various types of ophthalmic probes, including laser probes (e.g., picosecond infrared laser probes, femtosecond laser probes), vitrectomy probes, phacoemulsification probes, flap cutters, and other ophthalmic surgical tools. In operation, the surgical console 101 can function to assist a physician in performing various ophthalmic surgeries, such as vitrectomy, phacoemulsification, cataract surgery, LASIK, and similar surgeries.

[0030] In embodiments in which the tool 103 is a vitrectomy cutter, the surgical console 101 can include one or more modules or components for powering the vitrectomy cutter to achieve the purpose of pulverizing (e.g., cutting) the vitreous. For example, in certain embodiments, the surgical console 101 can include a pneumatic module that uses compressed gas, such as nitrogen gas, to power the vitrectomy cutter. In certain other embodiments, the surgical console 101 can include a laser source for generating a laser that the vitrectomy cutter uses to pulverize the vitreous (see, e.g., U.S. Patent Publication 2019 / 0201238).

[0031] In some embodiments, the tool 103 can be a phacoemulsification probe. For example, the tool 103 can be a phacoemulsification probe that is capable of emulsifying or pulverizing a lens during a cataract surgery. As another example, the tool 103 can be configured to emit a laser for performing a lens emulsification. In embodiments where the tool 103 is a phacoemulsification probe, the surgical console 101 includes one or more modules or components for powering the phacoemulsification probe to emulsify a lens during a cataract surgery. In some embodiments, the tool 103 can be a pico-second infrared laser (pIRL).

[0032] In some embodiments, the tool 103 can be configured to emit a laser, e.g., a femtosecond laser, for making incisions and / or cutting flaps during an ophthalmic surgery. A suitable example femtosecond laser is the FS200 laser available from Alcon, Inc. of Fort Worth, Texas. In some embodiments, the tool 103 can be a laser, e.g., an excimer laser, for use in photorefractive keratectomy and / or LASIK surgery (e.g., laser ablation of the cornea). A suitable example excimer laser is the EX500 laser available from Alcon of Fort Worth, Texas.

[0033] The surgical console 101 can include a display 109 for displaying information to a user (which display can also incorporate a touch screen for receiving user input). The tool 103 is operatively coupled to the surgical console 101 by a tube 105 that is connected to a port 107. It should be noted that the tube 105 can represent a plurality of tubes that can couple the tool 103 with the surgical console 101. For example, the tube 105 can represent a pneumatic tube, an optical fiber cable, or an ultrasonic power line for powering the tool 103 for cutting purposes, and an aspiration tube or vacuum line for transporting aspirated matter back to the surgical console 101.

[0034] Figure 2 FIG. 1 illustrates a perspective view of an example vitreous cutter 203, in accordance with some embodiments described herein. The vitreous cutter 203 is an example of the tool 103. As Figure 2 depicted, the vitreous cutter 203 includes a probe 210 and a base unit 220. The probe 210 is partially and longitudinally disposed through a distal end 221 of the base unit 220 and can be attached directly or indirectly to the distal end within an internal chamber of the base unit 220. The probe 210 can be inserted into an eye for performing a vitreous cut. It should be noted that, as described herein, a distal end or distal portion of a component refers to the end or portion that is closer to a patient’s body during its use. On the other hand, a proximal end or proximal portion of a component refers to the end or portion that is further away from the patient’s body.

[0035] The base unit 220 further provides a port 223 at its proximal end 225 for one or more supply lines to be laid into the internal chamber of the base unit 220. In some embodiments, port 223 may represent two or more ports. In some embodiments, port 223 may provide tubing or vacuum lines between the base unit 220 and a vacuum generator (e.g., a vacuum generator in the surgical console 101). Figure 1 The connection between the tubing 105 and the probe 210 is used for aspiration. In some embodiments, port 223 may provide a connection to an optical fiber cable that is coupled to one or more laser sources (e.g., in the surgical console 101) to provide laser light for cutting the vitreous body by the vitreous cutter 203. In some embodiments, port 223 may provide a connection to a pneumatic tubing that is coupled to a pneumatic module (e.g., in the surgical console 101) that uses a compressed gas, such as nitrogen, to power the vitreous cutter 203 to cut the vitreous body. It should be noted that other techniques, as known to those skilled in the art, may be used to power the vitreous cutter 203. The vitreous cutter 203 includes a cutting port at the tip 216 (i.e., the distal portion) of the probe 210. In some embodiments, the vitreous cutter 203 is capable of cutting the vitreous body and aspirating the vitreous body through this port.

[0036] It should be noted that Figure 2 Only one example of a glass cutter is illustrated. As mentioned above, a laser or other mechanism can be used instead. For example, glass cutter 203 may include a probe 210 that emits a laser from its tip 216 to replace the cutting port.

[0037] Figure 3 A perspective view of an exemplary ultrasonic emulsification probe 303 according to some embodiments described herein is illustrated. The ultrasonic emulsification probe 303 is another example of tool 103. Figure 3 The depicted phacoemulsification probe 303 includes a handheld body 320 and a probe 310 that can be inserted into the eye to perform phacoemulsification. An emulsification tip 316 extends beyond the distal end of the probe 310. The emulsification tip 316 is a hollow cylindrical tube or shaft that transmits ultrasonic waves provided by an ultrasonic power line 324. The ultrasonic waves are capable of pulverizing (e.g., emulsifying) the lens. The emulsification tip 316 also provides an aspiration port 318 through which the emulsified lens is aspirated due to the vacuum pressure provided by the aspiration line 323. The tool 303 also has a flushing port for flushing the lens through the flushing line 325 during phacoemulsification. It should be noted that... Figure 3 Only one example of an phacoemulsification probe is shown. Furthermore, Figure 3 Only one example of an emulsification mechanism that can be used as part of an ultrasonic emulsification probe is shown.

[0038] As noted above, the use of stroboscopic illumination during various ophthalmic surgical procedures improves the surgeon's visualization of the interaction between the surgical probe and the ocular matter, and thus allows the surgeon to more effectively adjust the position and / or use of the surgical probe within the eye. For example, in operating the surgical probe, the use of stroboscopic illumination can help the surgeon to visually detect or recognize the real-time position of the surgical probe tip within the eye, and in some cases react in time to prevent damage to the eye. Accordingly, embodiments herein describe a wide variety of systems and techniques for using stroboscopic illumination.

[0039] Embodiments described under the subheading "Internal Illuminator Stroboscopic Illumination" Figure 4A and 4B include stroboscopic illumination provided by an internal illumination device. Embodiments described under the subheading "External Stroboscopic Illumination" Figure 5A and Figure 5B include stroboscopic illumination provided by an external illumination device (i.e., an illumination device that is located outside of the eye during the surgical procedure). Embodiments described under the subheading "Microscope Stroboscopic Illuminator" Figure 6A and Figure 6B include stroboscopic illumination provided by a microscope illuminator that is integral to the visualization tool. It should be noted that the various embodiments described with reference to Figures 4A to 4B , Figures 5A to 5B and Figures 6A to 6B may include one or more continuous illumination sources in addition to at least one stroboscopic illumination source.

[0040] It should also be noted that Figure 4A , Figure 5A and Figure 6A are provided to demonstrate that stroboscopic illumination can be advantageously used during vitrectomy procedures involving a vitreous cutter (similar to vitreous cutter 203). Figure 4B , Figure 5B and Figure 6B are provided to demonstrate that stroboscopic illumination can be advantageously used when performing phacoemulsification using a phacoemulsification probe (similar to phacoemulsification probe 303). Finally, it should be noted that while Figures 4A to 4B , Figures 5A to 5B and Figures 6A to 6B demonstrate the use of stroboscopic illumination with respect to vitreous cutter 203 and phacoemulsification probe 303, the embodiments described herein are applicable to any other type of ophthalmic surgical procedure involving different types of surgical probes (examples of which were previously discussed).

[0041] Internal Illuminator Stroboscopic Illumination

[0042] Figure 4A and Figure 4BA cross-sectional view of an eye 430 is illustrated during an exemplary ophthalmic procedure with a surgical probe (e.g., tool 103) utilizing strobed illumination with an internal illuminator. As Figure 4A As illustrated, a vitreous cutter 203 and an internal illumination device 400 are inserted into an inter-ocular space of the eye 430. The internal illumination device 400 illuminates at least the inter-ocular space near the tip 216 of the probe 210 of the vitreous cutter 203 for observation with a visualization tool 420 (e.g., a microscope system). As described further below, a surgical console (such as surgical console 101) can receive information from, deliver instructions to, and / or otherwise communicate with one or more of the vitreous cutter 203, the light source 408, and the visualization tool 420.

[0043] As Figure 4A illustrated, the visualization tool 420 provides visualization of a portion of the interior of the eye 430, as indicated by the dashed line 413 demarcating a field of view 414. Light 412 emitted from the internal illumination device 400 illuminates at least a portion of the field of view 414, allowing for observation of that portion and possibly additional portions of the interior of the eye 430 with the visualization tool 420. The visualization tool 420 can include any microscope suitable for ophthalmic surgery, including a surgical microscope or a digital visualization system (e.g., a digital microscope). In the illustrated example, the visualization tool 420 includes a body 426, an objective 422, and an attachment 424 (e.g., a polarizing filter, a coaxial light source, etc.).

[0044] In some embodiments, the visualization tool 420 includes a microscope illuminator (not shown) (e.g., internally integrated, externally attached, etc.). For example, the microscope illuminator can be located proximally with respect to the objective 422 or any other suitable location, as would be appreciated by one of ordinary skill in the art. It should be noted that in embodiments where the microscope illuminator is located proximally with respect to the objective 422, the optical axis of the objective 422 (also referred to herein as the "visualization axis" of the visualization tool 420) can be parallel to or coaxial with the illumination axis of the microscope illuminator.

[0045] In Figure 4A embodiments, the microscope illuminator can provide continuous illumination (e.g., bright light, background light, broad band light, narrow band light, and / or white light) to illuminate the surgical area. The microscope illuminator can include an incandescent bulb, a halogen bulb, a metal halide bulb, a xenon bulb, a mercury vapor bulb, a light emitting diode (LED), a fluorescent light, other suitable components, and / or combinations thereof that provide continuous light. In some embodiments, the operation of the microscope illuminator can be controlled by the surgical console 101. For example, the surgical console 101 can transmit a control signal to the microscope illuminator to turn the microscope illuminator on or off or to change the voltage, wavelength, etc. thereof.

[0046] AsFigure 4A As illustrated, the internal illumination device 400 includes a handpiece 402 coupled to a proximal end of a shaft or "tube" 404. The handpiece 402 is removably coupled to a distal end of an optical cable 410, a proximal end of which is coupled to a light source 408. The light source 408 can include a light-emitting diode (LED), a broadband laser source, or other light source suitable for use in ophthalmic surgery. In certain embodiments, the light source 408 is an integral part of the surgical console 101, which also controls the vitreous cutter 203. In certain other embodiments, the light source 408 is a standalone unit. In such embodiments, the light source 408 can be communicatively coupled (e.g., wired or wirelessly) to the surgical console 101, as described in further detail below.

[0047] Regardless of whether the light source 408 is an integral part of the surgical console 101, in certain embodiments, the surgical console 101 can control operation of the light source 408. Controlling operation of the light source 408 includes controlling a frequency at which the light source 408 provides stereoscopic illumination to illuminate the field of view 414 through the internal illumination device 400. Controlling the frequency of the light source 408 can include synchronizing the frequency of the light source 408 with a drive frequency at which the vitreous cutter 203 is operated, at least during certain procedures of a vitreous cutting operation. Controlling operation of the light source 408 can also include sending control signals to the light source 408 to cause it to switch from providing stroboscopic illumination to providing continuous illumination, and vice versa.

[0048] The handpiece 402 is configured to provide a graspable portion of the internal illumination device 400 to a user (e.g., an ophthalmic surgeon) to provide the surgeon with a means for manipulating the depth and position of the tube 404 within the eye 430 and for directing the emitted light 412. The tube 404 is a substantially hollow stainless steel shaft or hypodermic tube configured to be inserted into the eye 430 via the insertion cannula 406. It should be noted that while illustrated and referred to as an internal illumination device, the internal illumination device 400 can include any of a variety of illumination probes, including an ophthalmic pendant light probe or other suitable surgical illumination device.

[0049] The internal illumination device 400 is further configured to house one or more optical fibers configured to direct light out of a distal end of the tube 404. For example, the optical fibers can include a single optical fiber, an array of optical fibers (e.g., a plurality of optical fibers arranged in a regular linear arrangement or a two-dimensional pattern arrangement), and / or a multicore optical fiber (e.g., a single-mode (SM) or a multi-mode (MM) optical fiber having a plurality of cores). In particular, the hollow portion of the tube 404 includes an internal compartment configured to house the optical fiber(s). It should be noted that in some embodiments, the light source 408 is not external to the handpiece 402. For example, in certain embodiments, the handpiece 402 contains the light source 408 within a housing or structure of the handpiece 402.

[0050] InFigure 4A In certain embodiments, the internal illuminator 400 illuminates the portion of the field of view 414 with stroboscopic light at least during certain procedures during a surgical operation using the vitreous cutter 203. More specifically, the internal illuminator 400 can illuminate the surgical region with pulses of light (e.g., broad wavelength band light, narrow wavelength band light) having a particular illumination frequency.

[0051] In some embodiments, one or more of the microscope illuminator and the internal illuminator 400 can provide polarized light. It is known that flow fields induce flow birefringence, and thus polarized stroboscopic illumination can be utilized to see the flow field around the tip of a surgical probe (e.g., the tip of the vitreous cutter 203 or the phacoemulsification probe 303, etc.). In some embodiments, the optical fibers of the internal illuminator 400 can include one or more of polarization maintaining optical fibers, polarization optical fibers, and / or any other optical fibers suitable for light transmission. Polarization maintaining optical fibers can maintain an existing polarization direction aligned with the birefringence axis of the optical fiber and are capable of maintaining the polarization direction. Similarly, a stress (e.g., lateral pressure on the wire) can be applied to the optical fiber to induce a birefringence axis, thereby maintaining the polarization of light passing through the optical fiber. In contrast, polarization optical fibers can receive polarized or unpolarized light and propagate the light in one polarization direction while preventing the light from propagating in all other directions. For example, a polarization optical fiber can receive transmitted light and filter the incident component while transmitting the polarized component of the light (i.e., prevent transmission of the incident component of the light by reflection or absorption).

[0052] Thus, polarization optical fibers can polarize, maintain, and / or change the direction of light that is already polarized propagating through the optical fiber. For example, in some embodiments, the light source 408 drives unpolarized light into the entry point of the optical cable 410, which provides the light to the optical fibers of the internal illuminator 400. In such embodiments, the internal illuminator 400 can be configured to polarize the unpolarized light. In some embodiments, the light source 408 linearly, circularly, or elliptically drives polarized light into the optical cable 410. In such embodiments, the optical cable 410 and / or the internal illuminator 400 can include polarization maintaining optical fibers configured to maintain the polarization direction of the light in the optical cable 410. Also, in some embodiments, the internal illuminator 400 can be configured to change the polarization of received polarized light.

[0053] Similarly to Figure 4A , Figure 4B FIGURE 13 illustrates a cross-sectional view of the eye 430 during another example ophthalmic surgical procedure utilizing stroboscopic illumination by the internal illuminator. As Figure 4B illustrated, the phacoemulsification probe 303 is inserted into the lens capsule of the eye 430. Similarly to Figure 4Aat least during certain procedures of a surgical operation performed using the phacoemulsification probe 303, the internal illumination device 400 uses stroboscopic illumination to illuminate the interocular space of the eye 430. Light from the internal illumination device 400 can reflect off the retina to illuminate the lens space posteriorly for observation with the visualization tool 420. It should be noted that the internal illumination device 400, the light source 408, the visualization tool 420, and the surgical console 101 all operate in a similar manner as described with respect to Figure 4A

[0054] As described above, while the internal illumination device 400 is capable of providing stroboscopic illumination, in certain embodiments, the internal illumination device 400 can be switched to provide continuous light to illuminate at least that portion of the field of view 414. In other words, the light source 408 can be configured to switch from providing continuous light to providing stroboscopic light, and vice versa, in response to a control signal received from the surgical console 101 or another device.

[0055] For example, the internal illumination device 400 can be configured to provide continuous illumination (e.g., bright light, background light, broad band light, narrow band light, and / or white light) to illuminate the surgical region during surgical operation procedures in which stroboscopic illumination is not used and / or is not beneficial. In some embodiments, the internal illumination device 400 can selectively (e.g., at different times) provide only continuous light, only stroboscopic illumination, and / or a combination of continuous light and stroboscopic illumination (e.g., continuous light of one wavelength (or band) and stroboscopic illumination of a different (e.g., non-overlapping) wavelength (or band)).

[0056] In embodiments in which the internal illumination device 400 provides stroboscopic illumination, the microscope illuminator of the visualization tool 420 can be turned off or simultaneously provide continuous light having the same intensity (i.e., the same as when stroboscopic illumination is not provided) or a reduced intensity. Figure 4A Figure 4B

[0057]

[0058] Figure 5A Figure 5B FIG. 1 illustrates a cross-sectional view of an eye 130 during an exemplary ophthalmic surgical procedure utilizing a surgical probe (e.g., the tool 103), an external stroboscopic illumination device 100, an internal illumination device 400, and a visualization tool 420. In the embodiment of FIG. 1, the surgical probe is a vitreous cutter 203 used during vitrectomy, while Figure 5A FIG. 2 illustrates a cross-sectional view of the eye 130 during the exemplary ophthalmic surgical procedure of FIG. 1. In the embodiment of FIG. 2, the surgical probe is the vitreous cutter 203 used during vitrectomy, while Figure 5B FIG. 3 illustrates a cross-sectional view of the eye 130 during the exemplary ophthalmic surgical procedure of FIG. 1. In the embodiment of FIG. 3, the surgical probe is an exemplary phacoemulsification probe 303 used during cataract surgery. Figure 5A Figure 5B In embodiments in which the internal illumination device 400 provides stroboscopic illumination, the microscope illuminator of the visualization tool 420 can be turned off or simultaneously provide continuous light having the same intensity (i.e., the same as when stroboscopic illumination is not provided) or a reduced intensity. Figure 4A Figure 4B ​​​​​​​The internal illumination device 400 is configured to provide continuous illumination, while at least during certain procedures of a surgical operation performed in Figure 5A and Figure 5B stroboscopic illumination is provided by the external stroboscopic illumination device 500. In certain embodiments, at least during certain procedures of a surgical operation performed using a vitreous cutter 203 (as illustrated in Figure 5A ) or a phacoemulsification probe 303 (as illustrated in Figure 5B ), the stroboscopic illumination device 500 illuminates the portion of the field of view 514 with stroboscopic light.

[0059] More specifically, the external stroboscopic illumination device 500 can illuminate the surgical area with light pulses (e.g., broad wavelength band light, narrow wavelength band light) having a specific illumination frequency. The external stroboscopic illumination device 500 can include a point illuminator, an optical fiber, a flash LED, a pulsed LED, a laser diode, a pulsed laser, a flash tube (e.g., a xenon flash tube, a krypton flash tube, an argon flash tube, a neon flash tube, etc.), other suitable components, and / or combinations thereof that provide light pulses.

[0060] As illustrated, the external stroboscopic illumination device 500 is external to the eye 530, thus, the emitted stroboscopic light 512 passes through the cornea into the eye and allows for the observation of the interior of the eye 530 with the visualization tool 420. The external stroboscopic illumination device 500 is coupled to a light source 508 that serves as the stroboscopic illumination source of the external stroboscopic illumination device 500. Although not illustrated, in certain embodiments, the external stroboscopic illumination device 500 and / or its light source 508 can be mounted on and / or as an integral part of the visualization tool 420. In certain other embodiments, the external stroboscopic illumination device 500 and / or its light source 508 can be distinct from the visualization tool 420.

[0061] In certain embodiments, the external stroboscopic illumination device 500 can define an external stroboscopic illumination axis that is non-parallel to the visualization axis of the visualization tool 420. In some other embodiments, the external stroboscopic illumination device 500 can be coupled to the visualization tool such that the visualization axis and the external stroboscopic illumination axis are parallel. The external stroboscopic illumination axis can intersect the visualization axis at or near the site of interaction of the eye (e.g., within the field of view of the visualization tool 420). In some embodiments, the angle between the visualization axis and the external stroboscopic illumination axis can be selected to provide a desired visualization result (e.g., reduced glare, selected polarization configuration, etc.). It should be appreciated that a large angle (e.g., greater than 45°) between the visualization axis and the external stroboscopic illumination axis can result in poor stroboscopic illumination. In some embodiments, the angle between the visualization axis and the external stroboscopic illumination axis can be about 15° to about 30°, or about 20° to about 25°. Providing stroboscopic illumination at such an angle to the visualization axis can provide off-axis dark field illumination. Off-axis dark field illumination is a type of dark field illumination that further enhances the visibility of the images provided by the visualization tool 420. For example, off-axis dark field illumination can be used to see liquid flow processes, especially for fluids of different densities.

[0062] In certain embodiments, the light source 508 can be an integral part of the surgical console 101 that controls the surgical probe (e.g., the vitreous cutter 203, the phacoemulsification probe 303, etc.) shown in FIGS. 1-3. In certain other embodiments, the light source 508 is a separate unit rather than an integral part of the surgical console 101. In such embodiments, the light source 508 can be communicatively coupled (e.g., wired or wirelessly) to the surgical console 101, as described in further detail below. Figure 5A and Figure 5B In certain embodiments, the light source 508 can be an integral part of the surgical console 101 that controls the surgical probe (e.g., the vitreous cutter 203, the phacoemulsification probe 303, etc.) shown in FIGS. 1-3. In certain other embodiments, the light source 508 is a separate unit rather than an integral part of the surgical console 101. In such embodiments, the light source 508 can be communicatively coupled (e.g., wired or wirelessly) to the surgical console 101, as described in further detail below.

[0063] Regardless of whether the light source 508 is an integral part of the surgical console 101, in certain embodiments, the surgical console 101 can control the operation of the light source 508. Controlling the operation of the light source 508 includes controlling the frequency at which the light source 508 provides stereoscopic illumination to illuminate the surgical region by the external stroboscopic illumination device 500. Controlling the frequency of the light source 508 can include synchronizing the frequency of the light source 508 with the drive frequency used to operate the surgical probe at least during certain procedures of the corresponding surgical operation. Controlling the operation of the light source 508 can also include sending control signals to the light source 508 to cause it to switch from providing stroboscopic illumination to providing continuous illumination, and vice versa.

[0064] It should be noted that when the external stroboscopic illumination device 500 provides stroboscopic illumination, additional illumination sources (e.g., the microscope illuminator of the visualization tool 420, the optional internal illumination device 400, etc.) can be turned off completely or simultaneously provide continuous light with the same intensity (i.e., the same as when stroboscopic illumination is not provided) or with reduced intensity.

[0065] Microscope stroboscopic illuminator

[0066] Figure 6A and Figure 6B A cross-sectional view of an eye 630 during an exemplary ophthalmic surgical procedure utilizing a surgical probe (e.g., tool 103), an internal illumination device 400, and a visualization tool 420 is illustrated. In Figure 6A the surgical probe is a vitreous cutter 203 used during vitreous cutting, and Figure 6B An exemplary phacoemulsification probe 303 used during a cataract surgery is shown. As previously discussed, the visualization tool 420 can include a microscope illuminator configured to provide continuous illumination. In one example, this previously discussed microscope illuminator can be adapted or reconfigured to be a stroboscopic illumination source. In another example, in addition to this previously discussed microscope illuminator configured to provide continuous illumination, the visualization tool 420 can include a stroboscopic microscope illuminator 600 (e.g., internally integrated). In yet another example, the visualization tool 420 can include a stroboscopic microscope illuminator 600 in place of the previously discussed microscope illuminator.

[0067] In certain embodiments, the stroboscopic microscope illuminator 600 illuminates the portion of the field of view 614 with a stroboscopic light at least during certain procedures during a surgical operation performed using the vitreous cutter 203 (as Figure 6A illustrated) or the phacoemulsification probe 303 (as Figure 6B illustrated). In certain embodiments, the stroboscopic microscope illuminator 600 can be provided by arranging a ring of LEDs around the central axis of the attachment 424. In certain other embodiments, one or more stroboscopic LEDs can be positioned proximally relative to the objective 422. In certain embodiments, the stroboscopic microscope illuminator 600 can define an illumination axis that is non-parallel to the visualization axis of the visualization tool 420. In some other embodiments, the illumination axis can be parallel or coaxial to the visualization axis.

[0068] In Figure 6A and Figure 6B embodiments, when the stroboscopic microscope illuminator 600 provides stroboscopic illumination, additional illumination sources (e.g., the internal illumination device 400, etc.) can be turned off completely or simultaneously provide continuous light with the same intensity (i.e., the same as when stroboscopic illumination is not provided) or with reduced intensity.

[0069] time sequence

[0070] Figures 7A to 7L An exemplary stroboscopic visualization of the interaction between energy emitted from a surgical probe tip and the surrounding fluid is illustrated. Figures 7A to 7L includes a series of images taken from a video obtained through stroboscopic illumination. In the illustrated example, the surgical probe is a laser with a drive frequency of about 1500 Hz. The stroboscopic illumination frequency is 1499 Hz. As illustrated by the figure, stroboscopic illumination allows for visualization of the formation (see Figure 7A ), expansion (see Figure 7B and Figure 7C ), oscillation (see Figure 7D and Figure 7E ), translation (see Figure 7F ), and disintegration (see Figures 7G to 7L ) of a bubble in the ocular fluid. Other interactions that can be visualized through stroboscopic illumination include: angular radiation pattern of ultrasound waves around a phacoemulsification tip, development of cavitation bubbles around a phacoemulsification tip, acoustic streaming around a phacoemulsification tip, hammering effect of a phacoemulsification tip, motion of a phacoemulsification tip, motion of different components of a phacoemulsification handpiece, oscillation and / or bending of a balanced phacoemulsification tip (see, e.g., U.S. Patent No. 10,258,505), lens fragmentation and / or fragment movement in the anterior chamber of the eye, vitreous movement during vitrectomy, etc.

[0071] frequency coordination

[0072] Many ophthalmic surgical procedures involve interactions with the eye that occur too quickly to be observed with the naked eye or a typical video camera. For example, common ophthalmic surgical tools (e.g., tool 103 discussed above) operate at high frequencies that can result in high-speed interactions with the eye. Table 1 lists common ophthalmic surgical probe types and the typical operating / drive frequency range for each probe.

[0073] Table 1

[0074]

[0075] According to embodiments of the present disclosure, the drive frequency of the surgical probe and the illumination frequency of the stroboscopic illumination source can be coordinated. Specifically, the drive frequency of the surgical probe and the illumination frequency of the stroboscopic illumination source can be coordinated to be close, but not equal. In such cases, the surgeon observing the surgery through the surgical microscope will see the illuminated interaction occurring at a frequency equal to the absolute value of the difference between the illumination frequency and the drive frequency. For example, if the drive frequency is 125 Hz, and the illumination frequency is 115 Hz or 135 Hz, then the frequency of the illuminated interaction appears to be 10 Hz (absolute value of 125 Hz - 115 Hz and 125 Hz - 135 Hz). As another example, if the drive frequency is 200 Hz, and the illumination frequency is 199 Hz or 201 Hz, then the frequency of the illuminated interaction appears to be 1 Hz. In other words, the illuminated interaction appears to have slowed down by a factor of 200. As another example, if the drive frequency is 1500 Hz, and the illumination frequency is 1499 Hz or 1501 Hz, then the frequency of the illuminated interaction appears to be 1 Hz. In the case of an illumination frequency of 1499 Hz, the observer will see the process moving forward, while in the case of an illumination frequency of 1501 Hz, the process will appear to move backward. In other words, the illuminated interaction appears to have slowed down by a factor of 1500.

[0076] The sign / polarity of the difference between the drive frequency and the illumination frequency determines whether the illuminated interaction is moving forward (in time) or backward. The surgeon can or can not be able to distinguish between the physiological differences between the reverse and forward motion of the ocular tissue. In some embodiments, the surgeon can prefer to view the tissue motion in either the forward or backward manner. The surgeon can control the magnitude and sign / polarity of the frequency difference to achieve the desired visualization.

[0077] Because the ocular tissue appears to move at a slower speed under stroboscopic illumination, the surgeon can more clearly see the amplitude and shape of the interaction, and thus perform the surgery accordingly. The significantly slower motion also allows the surgeon to confirm that the probe is functioning as intended. For example, without stroboscopic illumination, the pulsed energy of the probe is typically too fast for the surgeon to see. It should be noted that if the illumination frequency is set to be equal to the drive frequency, it can result in the appearance of the ocular tissue being stationary. By changing the phase between the illumination frequency and the drive frequency (e.g., manually), the surgeon can “freeze” the image at any stage of the periodic tip-tissue interaction.

[0078] The stroboscopic illumination frequency can be coordinated to be a sub-harmonic of the drive frequency (i.e., illumination frequency = drive frequency / N, where N = 2, 3, 4, etc.).

[0079] The strobe illumination frequency can be automatically coordinated with the drive frequency of the surgical probe. For example, many phacoemulsification probes can change the drive frequency by several percent during operation in response to changes in lens hardness. The strobe illumination frequency can be automatically adjusted according to the drive frequency of the phacoemulsification probe as it varies during operation.

[0080] The strobe illumination source can be characterized by an illumination frequency and a light pulse duration. The pulse duration can at least partially determine the temporal resolution of the strobe image. For example, the light pulse duration of a laser diode can be as short as a few nanoseconds. Utilizing such a laser diode as a strobe illumination source provides a temporal resolution of the strobe image as short as a few nanoseconds.

[0081] In addition to coordinating the relative frequencies, coordinating the oscillations of the probe and the strobe illumination source can include coordinating the phase of each. The phase difference between the probe and the strobe illumination source can be accurately controlled electronically. By keeping the phase difference between the strobe illumination source and the probe constant, the surgeon will see a "time frozen" image of the surgical procedure at some stage of the procedure.

[0082] Wavelength and illumination configuration

[0083] In some embodiments, as described above, the strobe illumination source can be used in conjunction with a continuous illumination source. In some embodiments, the wavelength (or band of wavelengths) of light utilized in the strobe illumination source can be different than the wavelength (or band of wavelengths) associated with the continuous illumination provided, for example, simultaneously. In some embodiments, the polarization of light utilized in the strobe illumination source can be different than the polarization associated with the continuous illumination provided, for example, simultaneously.

[0084] In some embodiments, the strobe illumination is positioned and / or configured to provide forward illumination of one or more elements in the field of view of the visualization tool. For example, the strobe illumination can be positioned and / or configured to cause light to reflect off of one or more elements in the field of view and into the objective lens of the visualization tool. In some embodiments, the strobe illumination is positioned and / or configured to provide back illumination of one or more elements in the field of view of the visualization tool. For example, the strobe illumination can be positioned and / or configured to cause light to transmit through one or more elements in the field of view (e.g., a transparent fluid) (while being reflected or absorbed by one or more other elements) and then directly (without any reflection) into the objective lens of the visualization tool.

[0085] In some embodiments, the stroboscopic illumination is positioned and / or configured to provide reflected illumination of one or more elements in the visualization tool field of view. For example, the stroboscopic illumination can be positioned and / or configured to transmit light through one or more elements (e.g., a transparent fluid) in the field of view (while being reflected or absorbed by one or more other elements) to a back screen (e.g., a retina), and then reflected back from the back screen and into the objective lens of the visualization tool. In some embodiments, the stroboscopic illumination is positioned and / or configured to provide retroreflected illumination of one or more elements in the visualization tool field of view. For example, the stroboscopic illumination can be positioned and / or configured to transmit light to a back screen (e.g., a retina), and then reflected back from the back screen and through one or more elements (e.g., a transparent fluid) in the field of view (while being reflected or absorbed by one or more other elements), and then directly (without any reflection) into the objective lens of the visualization tool.

[0086] Operation of stroboscopic illumination source

[0087] Figure 8 FIG. 8 illustrates example operations 800 used by a surgical console (e.g., surgical console 101, surgical console 900) to directly or indirectly control operation of a stroboscopic illumination source during a surgical procedure. The process flow can begin with one or more of operations 802, 804, and 806. It should be noted that operations 802, 804, and 806 do not necessarily correspond to distinct steps that must be performed separately and / or in a particular order. In certain embodiments, one or more of operations 802, 804, and 806 can be performed as a single step. In certain embodiments, one or more of operations 802, 804, and 806 are optional and can be omitted. Furthermore, the order of operations 802, 804, and 806 can vary in various implementations. It should be noted that any one of operations 802, 804, and 806 can act as a trigger for the surgical console 900 to control (e.g., set or toggle) the operational state of a stroboscopic illumination source that the surgical console 900 is communicatively coupled to.

[0088] In operation 802, the control module (e.g., control module 902) of the surgical console 900 determines whether the stroboscopic illumination source is in an on state. In some embodiments, the control module 902 determines whether the stroboscopic illumination source is in an on state by receiving a signal from the stroboscopic illumination source indicating that the stroboscopic illumination source is in an on state. In some embodiments, the control module 902 determines whether the stroboscopic illumination source is in an on state by receiving a signal from the stroboscopic illumination source indicating that the stroboscopic illumination source is in an off state and then sending a signal to the stroboscopic illumination source to turn on the stroboscopic illumination source. In some embodiments, the control module 902 determines whether the stroboscopic illumination source is in an on state by receiving a signal from the stroboscopic illumination source indicating that the stroboscopic illumination source is in an on state and then sending a signal to the stroboscopic illumination source to turn off the stroboscopic illumination source. Figure 9The program flow module 926 of the control module 901 can identify a procedure trigger associated with a certain surgical operation. In certain embodiments, the surgical console 900 can be configured with multiple types of surgical probes to allow a surgeon to perform multiple corresponding surgical operations. For example, the surgical console 900 can be configured with one or more of the previously discussed surgical probes (e.g., a vitreous cutter, a phacoemulsification probe, a pIRL, etc.) for performing one or more of the previously discussed surgical operations (e.g., a vitreoretinal surgery, a cataract surgery, a LASIK surgery, etc.). Each of these surgical operations can include various steps or procedures that need to be completed. Accordingly, the surgical console 900 can be configured with information and workflows related to each of these surgical operations. As an example, the surgical console 900 can be configured with a surgical operation profile (e.g., surgical operation profile 924) for each surgical operation that the console is configured to perform. In one example, a surgical operation profile can correspond to a cataract surgery, while another surgical operation profile can correspond to a vitreoretinal surgery, and so on. Each surgical profile can indicate a workflow of multiple procedures.

[0089] Prior to starting a surgical operation, a user (surgeon or technician) can use the user interface of the surgical console 900 to select a surgical operation from a plurality of surgical operations presented on the user interface. In response, the surgical console 900 can execute the corresponding surgical operation profile, which can then cause the surgical console 900 to display a workflow of all procedures that need to be performed to complete the cataract surgery. The user can then use the user interface to select a first procedure in the workflow, i.e., can cause the surgical console 900 to enter a mode that allows the surgeon to perform the first procedure. Once the first procedure is completed, the user can select a second procedure in the workflow, i.e., can cause the surgical console 900 to enter a mode that allows the surgeon to perform the second procedure, and so on, until the surgery is completed.

[0090] For each surgical procedure discussed above, there may be at least one or more procedures during which the use of stroboscopic illumination can be advantageous. For example, during cataract surgery, the surgeon may benefit from the use of stroboscopic illumination when performing a phacoemulsification procedure. In such an example, as further described with respect to operation 808, when the user selects a phacoemulsification procedure (e.g., phacoemulsification, laser phacoemulsification) in the workflow, the surgical console 900 is configured to recognize that a phacoemulsification procedure has been triggered and thus control the operation of the stroboscopic illumination source accordingly. When the surgeon completes the phacoemulsification procedure, the user can select the next procedure, i.e., causing the surgical console 900 to recognize the procedure trigger associated with the next procedure. Recognizing the procedure trigger associated with the next procedure will indicate to the surgical console 900 that the previous procedure (e.g., the phacoemulsification procedure) has been completed, and thus may cause the surgical console 900 to change the operation of the stroboscopic illumination source, as further described with respect to operation 808.

[0091] In another example, during vitreoretinal surgery, the surgeon may benefit from the use of stroboscopic illumination when cutting and removing the vitreous. In such an example, when the user selects a vitrectomy procedure in the workflow, the surgical console 900 is configured to recognize that the vitrectomy procedure has been triggered and thus control the operation of the stroboscopic illumination source accordingly, and so on. It should be noted that in some embodiments, the surgical console 900 may be configured to have only one surgical operation, in which case the control module is able to automatically and by default determine the workflow associated with the surgical operation.

[0092] In operation 804, the control module of the surgical console 900 (e.g., Figure 9 The program flow module 926 can identify the type of surgical probe. In some embodiments, the control module can identify the type of surgical probe based on the surgical procedure and / or the latest program trigger selected by the technician. For example, if the user selects a vitreoretinal surgery procedure and the latest program trigger corresponds to vitrectomy, the control module can identify that the appropriate probe for that surgical procedure is a vitrectomy device. The control module can then retrieve the corresponding probe profile from memory to operate the probe based on user input, etc.

[0093] In another example, if the technician selected a cataract surgery and the latest procedure trigger corresponds to phacoemulsification, the control module can identify that the appropriate probe for this surgical procedure is a phacoemulsification probe. In certain embodiments, the control module can identify the probe type based on user input indicating a selection from a plurality of probe types. In certain embodiments, the surgical console 900 can be configured with only one probe, in which case the control module automatically and by default identifies the corresponding probe type. In certain embodiments, the control module can identify the probe type through some other mechanism not described herein but well known to those of ordinary skill in the art.

[0094] In operation 806, an illumination source type can be identified. In some embodiments, the control module (e.g., the illumination management module 928) can identify the illumination source type based on the surgical operation and / or the latest procedure trigger selected by the technician. For example, if the user selected a vitreoretinal surgery operation and the latest procedure trigger corresponds to vitreous cutting, the control module can identify that stroboscopic illumination should be used during this procedure. Information about what type of illumination should be used during which surgical operation procedure can be indicated by the corresponding surgical operation profile and / or probe type profile. For a certain procedure, the control module can also be configured with information about how to operate any continuous illumination source. For example, when providing stroboscopic illumination during vitreous cutting, the control module can be configured to turn off any continuous illumination source.

[0095] In operation 808, the surgical console sets or switches the operating state of the stroboscopic illumination source based on the indication. The indication can include user input received by the surgical console 900 or can be based on the identified probe type, illumination source type, and / or procedure trigger type. For example, as described below with reference to FIG. 9, the control module can be configured to set or switch the operating state of the stroboscopic illumination source based on the identified probe type, illumination source type, and / or procedure trigger type. Figure 9Further described, the illumination management module 928 of the surgical console 900 can be configured to control certain aspects of a stroboscopic illumination source (e.g., the illumination source 914 or the illumination source 916). For example, a stroboscopic illumination source can have one or more operating states, including “on” and “off.” The illumination management module 928 of the surgical console 900 can be configured to control switching the stroboscopic illumination source from one state to another. As another example, a stroboscopic illumination system can operate at one or more frequency settings. The illumination management module 928 of the surgical console 900 can be configured to adjust the frequency setting of the stroboscopic illumination source. The illumination management module 928 of the surgical console 900 can also be configured to adjust the frequency of the stroboscopic illumination source based on an indication of a real-time drive frequency of a surgical probe. The indication of the real-time drive frequency of the surgical probe can be received by the illumination management module 928 from a drive circuit that drives the surgical probe or through another mechanism as can be known to those of ordinary skill in the art. As another example, a stroboscopic illumination source can operate at one or more light wavelengths (or wavelength bands). The illumination management module 928 of the surgical console 900 can be configured to control adjustment of the wavelength setting of the stroboscopic illumination source.

[0096] The illumination management module 928 of the surgical console 900 can be configured to control certain aspects of a stroboscopic illumination source in response to one or more inputs. For example, a surgeon can directly input (e.g., via the I / O device interface 909) a set of desired aspects (e.g., to turn the stroboscopic illumination source “on” at an illumination frequency of 1499 Hz and a wavelength band of 570 nm - 590 nm). As another example, the illumination management module 928 can receive an input from other components of the surgical console 900 (e.g., the procedure flow module 926). The illumination management module 928 can utilize the input from the other components along with a mapping of specified aspect settings for the stroboscopic illumination source. The mapping can include a mapping between one or more of the following: a surgical probe, a stroboscopic illumination, a surgical operation, a procedure and / or a procedure trigger, a probe frequency, an available stroboscopic illumination frequency, a continuous light wavelength, an available stroboscopic illumination wavelength, a continuous light polarization, an available stroboscopic illumination polarization, etc.

[0097] The stroboscopic illumination sources described can provide beneficial illumination for time-resolved visualization of a surgical region for a variety of ophthalmic procedures and the various procedures included in each. For example, applicable ophthalmic procedures can include: vitreoretinal surgery, pIRL-based cataract surgery, phacoemulsification surgery, femtosecond laser-assisted cataract surgery (FLACS), femtosecond flap creation, LASIK, and photorefractive keratectomy. Further, the procedural uses of such procedures can include: creating an incision, replacing and / or replacing a flap, cutting and / or chopping a vitreous fluid, aspirating a vitreous fluid, chopping and / or emulsifying a cataract, aspirating a cataract, disintegration of a lens, removal of a lens particle, ablation of a cornea, and removal of scar tissue and / or other tissue.

[0098] Switching between procedures can be accompanied by and / or identified by several triggers related to surgical illumination. Also, during any particular procedure, certain operating conditions can indicate a trigger for a desired change in a procedural aspect related to surgical illumination. Examples of potential switching between procedures include: a surgeon can switch from manipulating one tool to another tool. Such a switch can indicate a trigger for switching an illumination type(s) and / or aspect(s). As a further example of a potential transition, a surgeon can change an aspect(s) of a tool being utilized, such as a drive frequency, power, wavelength, probe position, and / or probe angle. As a further example, the surgical console control module 901 can detect an operating condition (e.g., proximity of a probe tip to a retina, hardness of ocular matter near a probe tip) that indicates a desired change in an aspect(s) of a tool being utilized, such as a drive frequency, power, and / or wavelength. As a further example, the surgical console control module 901 can change an aspect(s) of a tool being used in response to a switch between procedures. Any of these examples, alone or in combination, can indicate a trigger for switching an illumination type(s) and / or illumination aspect(s).

[0099] Figure 9 FIGURE illustrates an example diagram of a surgical console 900 in accordance with embodiments disclosed herein, Figure 1 As shown, the surgical console 900 includes, but is not limited to, a control module 901, a user interface display 908 (e.g., a display 109 of a console 100), an interconnect 906, and at least one I / O device interface 909, which can allow various I / O devices (e.g., a keyboard, a display, a mouse device, a pen input, etc.) to be connected to the surgical console 900. The surgical console 900 can also include an illumination source 914 (e.g., a continuous illumination source and / or a stroboscopic illumination source). In some embodiments, the surgical console 900 can be operably coupled to an illumination source 916 (e.g., a continuous illumination source and / or a stroboscopic illumination source). Figure 1 As shown, the surgical console 900 includes, but is not limited to, a control module 901, a user interface display 908 (e.g., a display 109 of a console 100), an interconnect 906, and at least one I / O device interface 909, which can allow various I / O devices (e.g., a keyboard, a display, a mouse device, a pen input, etc.) to be connected to the surgical console 900. The surgical console 900 can also include an illumination source 914 (e.g., a continuous illumination source and / or a stroboscopic illumination source). In some embodiments, the surgical console 900 can be operably coupled to an illumination source 916 (e.g., a continuous illumination source and / or a stroboscopic illumination source).

[0100] The control module 901 includes a controller (e.g., CPU 912), a memory 902, and a storage device 904. The CPU 912 is configured to retrieve and execute programmed instructions stored in the memory 902. Similarly, the CPU 912 can retrieve and store application data present in the memory 902. An interconnect 906 transports programmed instructions and application data between the CPU 912, an I / O device interface 909, a user interface 908, the memory 902 and the storage device 904, the illumination source 914, the illumination source 916, etc. The CPU 912 can include a single CPU, multiple CPUs, a single CPU with multiple processing cores, etc. The memory 902 can be a random access memory, while the storage device 904 can be a disk drive. Further, the memory 902 and / or the storage device 904 can be any type of readily available memory such as random access memory (RAM), read only memory (ROM), a floppy disk, a hard disk, solid state, flash memory, magnetic memory, or any other form of local or remote digital storage. In certain embodiments, the memory 902 and / or the storage device 904 include instructions that, when executed by the CPU 912, cause the driving frequency of the probe and the illumination frequency of the stroboscopic illumination source to be coordinated. In certain embodiments, the CPU 912, the memory 902, and the storage device 904 can be the main processor and memory of the surgical console 101 (see Figure 1 ) which can implement or include the surgical console 101.

[0101] As shown, the storage device 904 includes probe configuration files 920 representative of various probe types as previously described with reference to the tool 103. The storage device 904 also includes illumination source configuration files 922 representative of various stroboscopic illumination source types as previously described. Figure 1

[0102] The memory 902 includes program flow modules 926 for adjusting aspects (e.g., frequency or power) of the probe during ophthalmic surgery as described in embodiments herein. Additionally, the memory 902 includes illumination management modules 928 for interfacing with the illumination source 914 and / or the illumination source 916.

[0103] In embodiments, an ophthalmic system for visualizing an interaction between an ocular matter and a probe tip of a probe within or in contact with an inter-ocular space of an eye includes a visualization tool having a field of view including at least a portion of the inter-ocular space of the eye at an interface of the probe tip and the ocular matter, and a stroboscopic illumination source configured to stroboscopically illuminate the at least a portion of the field of view at an illumination frequency.

[0104] ​In one or more embodiments disclosed herein, the visualization tool comprises one or more of: a microscope; a digital microscope; and a camera.

[0105] In one or more embodiments disclosed herein, the system further comprises a surgical console configured to: drive the probe at a drive frequency to generate energy at the probe tip; and coordinate the illumination frequency with the drive frequency.

[0106] In one or more embodiments disclosed herein, the energy comprises one or more of: optical energy; ultrasonic energy; energy that pulverizes the ocular matter; and energy that induces movement in the ocular matter.

[0107] In one or more embodiments disclosed herein, coordinating the illumination frequency with the drive frequency comprises: maintaining the illumination frequency within a range of about 1 Hz less than the drive frequency to about 5 Hz less than the drive frequency.

[0108] In one or more embodiments disclosed herein, the drive frequency changes in response to one or more procedural triggers.

[0109] In one or more embodiments disclosed herein, the probe comprises: a picosecond infrared laser probe; a femtosecond laser probe; a vitrectomy probe; a phacoemulsification probe; an excimer laser; or a flap cutter.

[0110] In one or more embodiments disclosed herein, the stroboscopic illumination source comprises any one of: a light emitting diode (LED), a laser diode, a flash tube, a polarized light source, a broad band light source, a narrow band light source, and an optical fiber positioned in the ocular matter.

[0111] In one or more embodiments disclosed herein, the stroboscopic illumination source is configured to illuminate the portion of the field of view with one or more of: endoscopic illumination; extraocular illumination; forward illumination; rearward illumination; angled illumination; reflected illumination; and co-illumination with a second illumination source.

[0112] In one or more embodiments disclosed herein, the stroboscopic illumination source defines an illumination axis, the visualization tool defines a visualization axis, and the illumination axis intersects the visualization axis at an angle in the portion of the field of view.

[0113] In one or more embodiments disclosed herein, the angle is about 15° to about 30°.

[0114] In one or more embodiments disclosed herein, the system further includes a controller configured with instructions to: identify a probe type of the probe; identify an illumination source type of the stroboscopic illumination source; identify a procedure trigger; and operate the stroboscopic illumination source based on the probe type, the illumination source type, and the procedure trigger.

[0115] In one or more embodiments disclosed herein, the controller configured with instructions to operate the stroboscopic illumination source includes the controller configured with instructions to change a state of the illumination source.

[0116] In one or more embodiments disclosed herein, the state includes “on” or “off”.

[0117] In one or more embodiments disclosed herein, the state includes a specified setting of an illumination frequency.

[0118] In one or more embodiments disclosed herein, operating the stroboscopic illumination source includes: driving the probe at a drive frequency; and coordinating the illumination frequency with the drive frequency.

[0119] In one or more embodiments disclosed herein, the system further includes a second illumination source configured to illuminate the portion of the field of view, wherein the second illumination source is a continuous light source.

[0120] In one or more embodiments disclosed herein, the stroboscopic illumination source produces light of a first wavelength band, the second illumination source produces light of a second wavelength band, and the first wavelength band is at least partially outside the second wavelength band.

[0121] In an embodiment, a method for operating a stroboscopic illumination source during an ophthalmic procedure includes: identifying an illumination source type of the stroboscopic illumination source, wherein the stroboscopic illumination source is configured to stroboscopically illuminate at least a portion of a field of view of a visualization tool at an illumination frequency; identifying a probe type of a probe for the ophthalmic procedure, the probe having a probe tip configured to contact an ocular matter in the portion of the field of view of the visualization tool; identifying a first procedure trigger corresponding to a first operation of the ophthalmic procedure; and operating the stroboscopic illumination source based on the probe type, the illumination source type, and the first procedure trigger.

[0122] In one or more embodiments disclosed herein, operating the stroboscopic illumination source includes: driving the probe at a drive frequency; and coordinating the illumination frequency with the drive frequency.

[0123] In one or more embodiments disclosed herein, driving the probe produces energy at the probe tip, the energy including one or more of: optical energy; ultrasonic energy; energy to pulverize the ocular matter; and energy to induce movement in the ocular matter.

[0124] In one or more embodiments disclosed herein, the first procedure trigger indicates a start of the first operation, and operating the stroboscopic illumination source includes “turning on” the stroboscopic illumination source in response to identifying the first procedure trigger.

[0125] In one or more embodiments disclosed herein, the method further includes identifying a second procedure trigger, wherein: the second procedure trigger indicates an end of the first operation, and operating the stroboscopic illumination source includes “turning off” the stroboscopic illumination source in response to identifying the second procedure trigger.

[0126] In one or more embodiments disclosed herein, the first operation includes: using the probe to pulverize and remove a lens in an ocular gap; or using the probe to cut and aspirate a vitreous in an intraocular space.

[0127] In one or more embodiments disclosed herein, the first operation includes at least one of: pulverizing a cataract; removing a cataract; removing a vitreous; and removing scar tissue;

[0128] In one or more embodiments disclosed herein, operating the stroboscopic illumination source includes changing a state of the stroboscopic illumination source.

[0129] In one or more embodiments disclosed herein, changing the state of the stroboscopic illumination source includes “turning on” the stroboscopic illumination source based at least in part on the first procedure trigger.

[0130] In one or more embodiments disclosed herein, the method further includes: identifying a second procedure trigger corresponding to a second operation of the ophthalmic surgery, wherein changing the state of the stroboscopic illumination source includes “turning off” the stroboscopic illumination source based at least in part on the second procedure trigger.

[0131] In one or more embodiments disclosed herein, the method further includes: while “turning off” the stroboscopic illumination source: continuing to illuminate the portion of the field of view with the second illumination source; or “turning off” the second illumination source.

[0132] In one or more embodiments disclosed herein, operating the stroboscopic illumination source includes operating the stroboscopic illumination source according to a specified setting of an illumination frequency, wherein the specified setting is determined based on a mapping relationship between the specified setting and at least one of the first procedure trigger and the probe type.

[0133] The preceding description is provided to enable any person skilled in the art to practice the various embodiments described herein. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein can be applied to other embodiments. Thus, the claims are not intended to be limited to the embodiments shown herein, but is to be accorded the full scope consistent with the language of the claims.

Claims

1. An ophthalmic system for visualizing interaction between ocular matter and a probe tip of a probe within or in contact with an ocular space of an eye, comprising: a visualization tool having a field of view, the field of view containing at least a portion of the ocular space of the eye at an interface of the probe tip and the ocular matter, the visualization tool defining a visualization axis; and a stroboscopic illumination source configured to stroboscopically illuminate the at least the portion of the field of view at an illumination frequency, wherein the stroboscopic illumination source defines an illumination axis, wherein the illumination axis intersects the visualization axis at an angle of 15° to 30° in the portion of the field of view.

2. The system of claim 1, wherein, the visualization tool comprises one or more of: a microscope; a digital microscope; and a camera.

3. The system of claim 1, further comprising a surgical console configured for: driving the probe at a drive frequency to generate energy at the probe tip; and coordinating the illumination frequency with the drive frequency.

4. The system of claim 3, wherein, the energy comprises one or more of: optical energy; ultrasound energy; energy to pulverize the ocular matter; and energy to induce movement in the ocular matter.

5. The system of claim 3, wherein, coordinating the illumination frequency with the drive frequency comprises maintaining the illumination frequency within a range of 1 Hz less than the drive frequency to 5 Hz less than the drive frequency.

6. The system of claim 1, wherein, the probe comprises: a picosecond infrared laser probe; a femtosecond laser probe; a vitrectomy probe; a phacoemulsification probe; an excimer laser; or a femtosecond flap cutter.

7. The system of claim 1, wherein, the stroboscopic illumination source is configured to illuminate the portion of the field of view with one or more of: endoscopic illumination; external ocular illumination; forward illumination; backwards illumination; angled illumination; transscleral illumination; reflected illumination; and co-illumination with a second illumination source. ​

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