Surgical laser system with illumination

Abstract

Systems and methods for surgical laser systems with illumination are disclosed. In some embodiments, a laser system includes a surgical laser and an illumination source, the outputs of which are combined into and guided by a fiber optic cable to a target surface. The illumination visible light can be continuous and / or pulsed. The surgical laser pulses and illumination pulses can be synchronized to obtain a strobe effect. The laser system can also monitor laser electromagnetic radiation returned through the fiber optic cable.

Description

Technical Field

[0001] This disclosure relates to laser systems, such as laser systems used in ophthalmic procedures. Background Technology

[0002] Lasers are used in many different medical procedures, including several different ophthalmic procedures. For example, lasers can be used in cataract surgery, such as to fragment the lens of the cataract. In some procedures, a laser is used to initially fragment the lens, which is then phacoemulsified using an ultrasonic handpiece to completely pulverize and remove the lens. In other procedures, lasers can be used for complete fragmentation or phacoemulsification of the lens without the need for separate application of ultrasonic energy. Lasers can also be used in other steps of cataract surgery, such as to create corneal incisions and / or open the capsule.

[0003] Lasers can also be used in vitreoretinal surgery. In some procedures, lasers can be used in vitrectomy to cut or destroy vitreous fibers for removal. The laser can be incorporated into a vitrectomy probe, and energy from the laser can be applied to the vitreous fibers to cut or destroy them for removal.

[0004] In other vitreoretinal applications, lasers can be used for photocoagulation of retinal tissue. Laser photocoagulation can be used to treat problems such as retinal tears and / or the effects of diabetic retinopathy.

[0005] Other surgical applications of lasers include neurosurgery, otolaryngology, vascular surgery, dental surgery, and plastic surgery.

[0006] U.S. Patent Application Publication No. 2018 / 0360657 discloses examples of ophthalmic laser systems. This application describes the use of lasers, for example, for forming surgical incisions or for photo-destructive treatment of ophthalmic tissues, and for use in cataract surgery (such as laser-assisted cataract surgery (LACS)). U.S. Patent Application Publication No. 2019 / 0201238 discloses other examples of ophthalmic laser systems. This application describes the use of lasers, for example, in vitrectomy probes for cutting or destroying vitreous fibers. U.S. Patent Application Publication Nos. 2018 / 0360657 and 2019 / 0201238 are expressly incorporated herein by reference in their entirety.

[0007] Improvements are needed in laser systems and related methods. Summary of the Invention

[0008] This disclosure relates to an improved laser system and a method for operating a laser system with illumination.

[0009] In some embodiments, a laser system includes a surgical laser configured to emit electromagnetic radiation, an illumination source configured to emit illuminating visible light, and at least one fiber optic cable for transmitting the surgical laser electromagnetic radiation and the illuminating visible light. The at least one fiber optic cable is configured to receive electromagnetic radiation from the surgical laser and illuminating visible light from the illumination source at its proximal end, and to transmit the electromagnetic radiation from the surgical laser and the illuminating visible light from the illumination source to its distal end and outward from the distal end of the at least one fiber optic cable to a target surface.

[0010] The illumination source can be configured to continuously emit illuminating visible light over a desired time period and / or emit illuminating visible light in a pulsed manner. The surgical laser can be configured to emit electromagnetic radiation from the surgical laser in a pulsed manner, and the laser system can be configured to synchronize the pulses from the surgical laser with the pulses from the illumination source to produce a stroboscopic effect.

[0011] The fiber optic cable may have at least one optical fiber configured to receive electromagnetic radiation from a surgical laser and visible illumination light from an illumination source. Additionally or alternatively, the fiber optic cable may have at least one first optical fiber configured to receive electromagnetic radiation from a surgical laser and at least one second optical fiber configured to receive visible illumination light from an illumination source.

[0012] The at least one fiber optic cable may include a delivery fiber optic cable and an output fiber optic cable, each having a proximal end and a distal end. The output fiber optic cable may be positioned distal to the delivery fiber optic cable, and the proximal end of the output fiber optic cable may be configured to receive electromagnetic radiation from the surgical laser and visible illumination light from the illumination source from the distal end of the delivery fiber optic cable.

[0013] The laser system may include a laser housing. The surgical laser may be located inside the laser housing. The illumination source may also be located inside the laser housing. At least one fiber optic cable may be adapted to be removably connected to the laser housing.

[0014] The laser system may further include a monitoring sensor positioned to detect the returned electromagnetic radiation from the laser.

[0015] In some embodiments, a method of operating a laser system includes emitting electromagnetic radiation from a surgical laser, emitting illumination visible light from an illumination source, receiving electromagnetic radiation from the surgical laser and illumination visible light from the illumination source at a proximal end of at least one optical fiber cable, and transmitting the electromagnetic radiation from the surgical laser and the illumination visible light through the at least one optical fiber cable to a distal end of the at least one optical fiber cable and transmitting them from the distal end of the at least one optical fiber cable to a target surface.

[0016] The step of emitting visible light from an illumination source to the at least one fiber optic cable may include continuously emitting visible light from the illumination source over a desired time period. The step of emitting visible light from an illumination source to the at least one fiber optic cable may include emitting visible light from the illumination source in a pulsed manner. The step of emitting electromagnetic radiation from a surgical laser to the at least one fiber optic cable may include emitting electromagnetic radiation from the surgical laser in a pulsed manner, and the step of emitting visible light from an illumination source to the at least one fiber optic cable may include emitting visible light from the illumination source in a pulsed manner, and the laser system may synchronize the pulses from the surgical laser and the pulses from the illumination source to produce a stroboscopic effect. The stroboscopic effect may be, for example, a slow-motion effect.

[0017] Further examples and features of embodiments of the present invention will become apparent from the accompanying drawings and detailed description. Attached Figure Description

[0018] The accompanying drawings illustrate exemplary embodiments of the apparatus and methods disclosed herein, and together with the specification, serve to explain the principles of this disclosure.

[0019] Figure 1 A schematic diagram of an example laser system according to this disclosure is shown, which is configured to deliver electromagnetic radiation from a surgical laser and illumination visible light from an illumination source.

[0020] Figure 2 An example illumination of a surgical laser according to this disclosure is shown.

[0021] Figure 3 A schematic diagram of another example laser system according to this disclosure is shown, which is configured to deliver electromagnetic radiation from a surgical laser and illumination visible light from an illumination source while simultaneously monitoring the returning electromagnetic radiation.

[0022] Figure 4 A flowchart of an example method for operating a laser system according to this disclosure is shown.

[0023] The accompanying drawings can be better understood by referring to the following detailed embodiments. Detailed Implementation

[0024] To facilitate understanding of the principles of this disclosure, reference will now be made to the embodiments illustrated in the accompanying drawings, and specific language will be used to describe these and other embodiments. However, it will be understood that the examples shown in the drawings or described herein are not intended to limit the scope of the claims. Those skilled in the art to which this disclosure pertains will generally be fully capable of conceiving any changes and further modifications to the systems, apparatuses, devices, or methods shown or described, and any further applications of the principles of this disclosure. In particular, features, components, and / or steps described with respect to one embodiment of this disclosure may be combined with features, components, and / or steps described with respect to other embodiments of this disclosure. For simplicity, in some cases, the same reference numerals are used in all drawings to refer to the same or identical components.

[0025] The terms “proximal” and “distal” are used herein to refer to the orientation or end of a component, wherein the proximal direction or proximal end points or is oriented toward the laser source, and the distal direction or distal end points or is oriented toward the working output end (such as the working output end or tip of a fiber optic cable adjacent to the tissue to be treated). The designations “first” and “second” as used herein do not indicate or imply any particular location or other characteristic. Rather, when the designations “first” and “second” are used herein, they are used only to distinguish one component from another. For example, unless otherwise stated, a first fiber optic cable or a second fiber optic cable may be positioned closer to the laser source.

[0026] Figure 1 A schematic diagram of an example laser system 10 according to this disclosure is shown, which is configured to deliver electromagnetic radiation from a surgical laser and illuminating visible light from an illumination source. Laser system 10 may be a laser system suitable for one or more ophthalmic procedures. Laser system 10 may be a stand-alone laser system or a laser module within an ophthalmic system or a console for ophthalmic procedures.

[0027] In some embodiments, the laser system 10 may be adapted for cataract surgery. In some embodiments, the output energy of the laser system is adapted to fragmentation or phacoemulsification of the cataract lens. In some examples, the laser output is used for initial fragmentation of the cataract lens, followed by phacoemulsification of the lens using an ultrasonic handpiece to complete the fragmentation and removal of the lens. In other examples, the laser output is used to fragment or phacoemulsify the lens to a degree sufficient for lens removal without the need for separate application of ultrasonic energy. Additionally or alternatively, the laser output may be adapted to create a corneal incision and / or to open the lens capsule.

[0028] In other embodiments, the laser system may be adapted for vitreoretinal surgery. In some embodiments, the output energy of the laser system is adapted to cut or destroy vitreous fibers for removal. In other vitreoretinal applications, the laser output may be adapted for ophthalmic tissue treatments, such as photocoagulation of retinal tissue, to treat problems such as retinal tears and / or the effects of diabetic retinopathy.

[0029] like Figure 1 As shown, the laser system 10 includes Figure 1 The laser housing 12 is schematically shown as a dashed box. The laser housing 12 houses the surgical laser 14. In addition to the surgical laser 14, other components may also be located within the laser housing 12. For example, the laser housing 12 may house components for operating the surgical laser 14. Furthermore, the laser housing 12 may house components in the optical path of the laser output, such as one or more lenses or other optical components (not shown).

[0030] The surgical laser 14 can be any type of laser suitable for the desired application. The surgical laser 14 can output suitable electromagnetic radiation of any suitable wavelength. For example, the surgical laser 14 can emit electromagnetic radiation of one or more wavelengths selected from visible, infrared, and / or ultraviolet wavelengths. The surgical laser 14 can be operated or operated to emit a continuous beam of electromagnetic radiation. Alternatively, the surgical laser 14 can be operated or operated to emit a pulsed beam.

[0031] In one example, the surgical laser 14 operates in the infrared range. For example, the surgical laser 14 may output electromagnetic radiation in the mid-infrared range (e.g., in the range of about 2.0 micrometers to about 4.0 micrometers). Some example wavelengths include about 2.5 micrometers to 3.5 micrometers, such as about 2.775 micrometers, about 2.8 micrometers, or about 3.0 micrometers. Such a surgical laser may be used for procedures such as lens fragmentation in cataract surgery or for other procedures.

[0032] In another example, the surgical laser 14 emits electromagnetic radiation in the ultraviolet range. In yet another example, the surgical laser 14 emits electromagnetic radiation in the visible range.

[0033] The laser system 10 is designed to direct the electromagnetic radiation from the surgical laser 14 to the output port 16 of the laser housing 12. Figure 1 In this diagram, output port 16 is schematically indicated as the distal end of optical path 54 within laser housing 12, but it will be understood that optical components (such as lenses) may be located at output port 16. Laser system 10 may guide laser electromagnetic radiation from surgical laser 14 to output port 16 via one or more optical components.

[0034] The device 22 can be optically connected to the laser housing 12 to receive laser electromagnetic radiation from the output port 16. The device 22 can be, for example, a handheld device for ophthalmic procedures. The device or handheld device 22 is in... Figure 1 The diagram is schematically shown as a dashed box.

[0035] The device or handheld component 22 can be connected to the laser housing 12 via at least one fiber optic cable (e.g., a delivery fiber optic cable 24). The delivery fiber optic cable 24 can be flexible and relatively long to provide the operator with the flexibility to manipulate the handheld component 22 at a distance from the laser housing 12. The length of the delivery fiber optic cable 24 can be, for example, from 1 meter to 3 meters. In an example embodiment, the length of the delivery fiber optic cable 24 can be approximately 2 meters.

[0036] The fiber optic cable 24 may be a part permanently attached to the handheld device 22. Alternatively, the fiber optic cable 24 may be removably connected to the handheld device 22. The fiber optic cable 24 may be permanently or removably connected to the handheld device 22, either directly or via one or more other components, including via one or more other fiber optic cables.

[0037] At its proximal end 32, the fiber optic cable 24 can be removably connected to the laser housing 12. The fiber optic cable 24 may have a connector (not shown) that mates with a connector at the output port 16 of the laser housing 12. Alternatively, the fiber optic cable 24 may be permanently attached to the laser housing 12. The fiber optic cable 24 may be permanently or removably connected to the laser housing 12, either directly or via one or more other components (including via one or more other fiber optic cables).

[0038] At the distal end 34 of the delivery fiber optic cable 24, the delivery fiber optic cable 24 can be optically coupled to the output fiber optic cable 26. The output fiber optic cable 26 has a proximal end 36 and a distal end 38. The distal output 38 of the output fiber optic cable 26 constitutes the distal output of the laser system 10. At its proximal end 36, the output fiber optic cable 26 can be connected to a connector or ferrule that connects the output fiber optic cable 26 to the handheld component 22, such that the output fiber optic cable 26 constitutes a removable portion of the handheld component 22. In other embodiments, the output fiber optic cable can be permanently attached to the remainder of the handheld component 22. The output fiber optic cable 26 can be permanently or removably connected to the remainder of the handheld component 22, either directly or via one or more other components. The distal end 34 of the delivery fiber optic cable 24 can be optically coupled to the proximal end 36 of the output fiber optic cable 26, either directly or via one or more other components. For example, one or more fiber optic cables can be located between the delivery fiber optic cable 24 and the output fiber optic cable 26. One or more other components (such as connectors, lenses, or other components) may be located between the transmission fiber optic cable 24 and the output fiber optic cable 26.

[0039] The output fiber optic cable 26 can be of any suitable length. For example, the length of the output fiber optic cable 26 can be between 20 mm and 100 mm. In the example embodiment, the length of the output fiber optic cable 26 can be approximately 50 mm.

[0040] In one example embodiment, the output fiber optic cable 26 is secured to a connector or ferrule that can be connected to and removed from the remainder of the handheld component 22. The output fiber optic cable 26 may be a disposable component, such that after use, it can be removed from the remainder of the handheld component 22 and discarded. A new disposable output fiber optic cable 26 can be connected to the remainder of the handheld component 22 for subsequent procedures.

[0041] The fiber optic cables in a laser system can have one or more optical fibers capable of transmitting electromagnetic radiation suitable for the intended application. Any suitable material fiber can be used, including glass fiber or plastic fiber. In one example embodiment, the delivery fiber optic cable 24 may include one or more germanium oxide (GeO2) fibers, and the output fiber optic cable 26 may include one or more sapphire fibers. Many other examples are possible.

[0042] exist Figure 1 In this embodiment, in addition to the surgical laser 14 configured to emit electromagnetic radiation, the laser system 10 also includes an illumination source 70 configured to emit illuminating visible light. The proximal end 32 of the transmission fiber optic cable 24 is configured to receive electromagnetic radiation from the surgical laser 14 and illuminating visible light from the illumination source 70. The transmission fiber optic cable 24 is configured to transmit the electromagnetic radiation from the surgical laser 14 and the illuminating visible light from the illumination source 70 from the proximal end 32 to the distal end 34 of the transmission fiber optic cable 24, and to transmit them outward from the distal end 34 of the transmission fiber optic cable 24. The proximal end 36 of the output fiber optic cable 26 is configured to receive electromagnetic radiation from the surgical laser and illuminating visible light from the illumination source from the distal end 34 of the transmission fiber optic cable 24. The output fiber optic cable 26 is configured to transmit electromagnetic radiation from the surgical laser 14 and illumination visible light from the illumination source 70 from the proximal end 36 of the output fiber optic cable 26 to the distal end 38 of the output fiber optic cable 26, and from the distal end 38 of the output fiber optic cable 26 to a target surface, such as ophthalmic tissue or other tissue.

[0043] The illumination provided via fiber optic cable will light up the area targeted by the surgical laser. This illumination helps the operator see the target location and the surgical procedure.

[0044] exist Figure 1In the example, electromagnetic radiation from the surgical laser 14 and visible illumination from the illumination source 70 are combined within the laser housing 12 to travel along a common optical path 54 to the output terminal 16 of the laser housing 12. This combination can be achieved by one or more suitable optical components. For example, in Figure 1 In one embodiment, the laser system 10 includes a beam combiner 74 configured to combine electromagnetic radiation from the surgical laser 14 and illuminating visible light from the illumination source 70. The beam combiner 74 may be, for example, a beam splitter, a dichroic mirror, a polarizing beam splitter, a dispersive prism, a diffraction grating, or other suitable beam combiner.

[0045] In the example shown, surgical laser 14 emits electromagnetic radiation along optical path 52 in the direction of arrow 53, and beam combiner 74 allows the electromagnetic radiation from surgical laser 14 to pass through beam combiner 74 to travel along optical path 54 to output terminal 16 and fiber optic cable 24. Illumination source 70 emits illuminating visible light along optical path 72 in the direction of arrow 73, and beam combiner 74 reflects the illuminating visible light and guides it along optical path 54 to output terminal 16 and fiber optic cable 24.

[0046] In an alternative example, the surgical laser 14 is located in Figure 1 The position of the light source 70, and the light source 70 is located in Figure 1 The surgical laser 14 is positioned as shown in the image. In this example, the illumination source 70 emits visible light along the optical path 52 in the direction of arrow 53, and the beam combiner 74 allows the visible light from the illumination source 70 to pass through the beam combiner 74 to travel along the optical path 54 to the output end 16 and the fiber optic cable 24. The surgical laser 14 emits electromagnetic radiation along the optical path 72 in the direction of arrow 73, and the beam combiner 74 reflects this electromagnetic radiation from the surgical laser 14 and guides it along the optical path 54 to the output end 16 and the fiber optic cable 24.

[0047] The transmission fiber optic cable 24 and the output fiber optic cable 26 may each have one or more optical fibers capable of transmitting electromagnetic radiation from the surgical laser and / or illumination visible light. In some embodiments, electromagnetic radiation from the surgical laser and illumination visible light from the illumination source are received and transmitted through the same optical fiber within one or more of these fiber optic cables. In other embodiments, electromagnetic radiation from the surgical laser is received and transmitted through one or more first optical fibers within the fiber optic cable, and illumination visible light from the illumination source is received and transmitted through one or more second optical fibers within the fiber optic cable. For example, electromagnetic radiation from the surgical laser may be directed to a first output end of the laser housing, while illumination visible light from the illumination source may be directed to a second output end of the laser housing. The transmission fiber optic cable may have a bi-input branch for connecting to the two output ends, wherein one or more first optical fibers are connected to the first output end to receive electromagnetic radiation from the surgical laser, and one or more second optical fibers are connected to the second output end to receive illumination visible light from the illumination source. These two branches can be converged into a single fiber optic cable, in which both the first and second fibers are contained.

[0048] The illumination source 70 can emit visible light continuously or in a pulsed manner. For example, in some embodiments, the illumination source 70 can emit visible light continuously during its operation. An operator can control the illumination source 70 to be turned on or off so that continuous visible light is emitted for a desired time period. In other embodiments, the illumination source 70 can emit visible light in a pulsed manner during its operation. An operator can control the illumination source 70 to be turned on or off so that pulsed visible light is emitted for a desired time period. In other embodiments, the illumination source 70 may be able to emit visible light continuously or in a pulsed manner, depending on the selected operating mode. An operator can control the illumination source 70 to be turned on or off, select an operating mode, and switch between operating modes so that visible light can be emitted continuously or in a pulsed manner, and can switch between emitting continuous visible light and pulsed visible light.

[0049] In some embodiments, the surgical laser 14 is configured to emit electromagnetic radiation in a pulsed manner, the illumination source 70 is configured to emit illuminating visible light in a pulsed manner, and the laser system is configured to synchronize the pulses from the surgical laser 14 and the pulses from the illumination source 70 to produce a stroboscopic effect. The laser system 10 may include a trigger 76 for coordinating these pulses. The trigger 76 may receive input from the surgical laser 14 along a communication connection 77 and send a signal regarding the pulses of the surgical laser 14 to the illumination source 70 along a communication connection 78. Additionally or alternatively, the trigger 76 may receive input from the illumination source 70 along a communication connection 78 and send a signal regarding the pulses of the illumination source 70 to the surgical laser 14 along a communication connection 78. For example, the timing of the pulses of the surgical laser 14 may be used to trigger the timing of the pulses of the illumination source 70. Similarly, the timing of the pulses of the illumination source 70 may be used to trigger the timing of the pulses of the surgical laser 14.

[0050] The laser system 10 produces a stroboscopic effect by operating the surgical laser 14 and the illumination source 70 in a pulsed manner at a selected frequency, depending on the desired effect. For example, if the surgical laser 14 operates at a pulse frequency of 1 kHz and the illumination source 70 is synchronized with the surgical laser 14 but operates at a pulse frequency of 999 Hz, the result is a stroboscopic effect that shows the process being slowed down by a factor of 1000.

[0051] Other flickering effects can be achieved through other synchronization methods. For example, if the frequency of the illumination source 70 is set to the same frequency as the surgical laser 14, movement at the surgical tip may appear to stop or pause. A slow-motion effect can be achieved by using a frequency of the illumination source 70 that is close to, but slightly lower than, the frequency of the surgical laser 14.

[0052] In certain procedures, the stroboscopic effect can help the operator visualize the surgical process. Where pulsed laser energy produces a response that repeats with each laser pulse, the stroboscopic effect can slow down the appearance of that response. For example, in cataract surgery, laser energy directed at the cataract lens can create bubbles within the lens with each laser pulse. These bubbles form over the time intervals between pulses. The stroboscopic effect can be used to visualize the stages of bubble formation by illuminating the sample time-lapse with a series of laser pulses, where each sample is slightly shifted relative to the laser pulse over time. Therefore, the operator can see the slowed bubble formation in real time.

[0053] The stroboscopic effect can also be useful for visualizing other responses. For example, in cataract surgery, the stroboscopic effect can be useful for visualizing tissue fragmentation and liquefaction, complex flow fields, occlusion of the irrigation and aspiration system, and other effects.

[0054] In addition to emitting visible light continuously or in a pulsed manner, the illumination source 70 can also emit visible light of different intensities and colors. The illumination source 70 can be, for example, a continuous or pulsed LED, or a continuous or pulsed laser diode.

[0055] The wavelength of the visible light used for illumination can be selected based on the application. For example, for ophthalmic surgery, the ANSI standard for maximum permissible exposure and the operator's typical retinal sensitivity should be considered. An example operating range for the wavelength of visible light used for illumination is approximately 570 nm to approximately 620 nm, such as approximately 590 nm. Other wavelengths within the visible spectrum can be used for illumination.

[0056] In addition to illuminating the area targeted by the surgical laser and helping the operator see the target location and the surgical procedure, the illumination can also help the operator estimate the distance from the instrument tip to the boundary of different tissues. Figure 2 A schematic diagram illustrates the illumination of tissue surface T by visible light emitted from the distal end 38 of output fiber optic cable 26. The visible light emitted from the fiber tip typically has a composition... Figure 2 The light cone 58, marked with a light cone angle A, is a circularly symmetrical conical distribution. When at a certain incident angle, for example... Figure 2 When an incident angle B is introduced, such a beam of light forms an elliptical spot S at the boundary of different tissues (such as the lens capsule). At the tissue surface T, spot T has a horizontal axis D1 and a vertical axis D2 as shown in the figure. The ratio of D1 to D2 is approximately equal to the cosine of the incident angle B. The size of D1 is proportional to the distance from the instrument tip 38 to the tissue surface T and the light cone angle A. For a known or stable light cone, the size of spot S and the length of the horizontal axis D1 will become smaller as the instrument tip 38 gets closer to the tissue surface T. By looking at the size of the horizontal axis D1, the operator can estimate the distance from the instrument tip 38 to the tissue surface T. Knowing the distance from the tip to the tissue is important to avoid damage to critical tissues (such as the lens capsule or retina).

[0057] Figure 3 A schematic diagram of another example laser system 11 according to this disclosure is shown, configured to deliver electromagnetic radiation from a surgical laser and illuminating visible light from an illumination source. Laser system 11 is similar to laser system 10, having the components and functions described above. In addition to the components of laser system 10, laser system 11 further includes a return signal monitoring sensor positioned to detect the returned laser electromagnetic radiation. Figure 3As shown, beam splitter 60 is located in the optical path 54 between laser source 14 and output port 16 of laser housing 12. In the illustrated embodiment, when laser electromagnetic radiation is directed toward output port 16 along optical path 54 in the direction of arrow 53, most or all of the laser electromagnetic radiation passes through beam splitter 60 and continues through output port 16 to delivery fiber optic cable 24 and handheld device 22. Similarly, when illumination visible light is directed toward output port 16 along optical path 54 in the direction of arrow 53, most or all of the illumination visible light passes through beam splitter 60 and continues through output port 16 to delivery fiber optic cable 24 and handheld device 22. A small portion (e.g., 1% to 10%) of the electromagnetic radiation from laser 14 is deflected by beam splitter 60 along optical path 64 in the direction of arrow 65 as a reference signal for measuring the output energy of laser 14, identified by reference signal component 68.

[0058] As described in more detail below, depending on the usage of the laser system 11, a portion of the laser electromagnetic radiation transmitted from the fiber optic cable to the tissue surface T returns to the fiber optic cable in the opposite direction. The returned signal can be a combination of back reflection, backscattering, fluorescence, Raman scattering, etc., of the laser electromagnetic radiation. This returned electromagnetic radiation returns through the fiber optic cable and along optical path 54 in the direction of arrow 55 to beam splitter 60. Beam splitter 60 guides 1%–10% of the returned laser electromagnetic radiation along optical path 62 in the direction of arrow 63. The back-reflected laser electromagnetic radiation guided along optical path 62 in the direction of arrow 63 is directed to back reflection monitoring sensor 67 for measuring the back-reflected laser electromagnetic radiation. The laser electromagnetic radiation returning from the tissue can carry information about the distance from the end to the tissue, the fluorescence characteristics of the tissue near the end, or other information. For example, Raman-scattered light can be used to identify the molecular composition of the tissue near the fiber optic end.

[0059] To distinguish between these two main directions of travel, the terms "forward transmission" and "transmitted forward" are used to refer to electromagnetic radiation traveling in the direction from the beam splitter 60 toward the distal end 38 of the output fiber optic cable 26 (i.e., toward the distal end of the laser system 11). The term "return" is used to refer to electromagnetic radiation returning from the distal end 38 of the output fiber optic cable 26 toward the beam splitter 60 (i.e., away from the distal end of the laser system 11).

[0060] Sensor 67 may be, for example, a photodiode capable of converting returned electromagnetic radiation into an electrical signal. As an example, each of components 67 and 68 may be a lead selenide photodetector. Other types of photodetectors and other types of sensors may be used. In some applications, it is advantageous to protect detectors 67 and 68 from illumination light by combining each of them with a filter that absorbs visible light.

[0061] exist Figure 3 In this example, beam splitter 60, sensor 67, and sensor 68 are housed within laser housing 12. In other embodiments, one or more of these components may be located outside laser housing 12.

[0062] exist Figure 1 Example laser system 10 and Figure 3 In the operation of the laser system 11, the surgical laser 14 is operated to emit electromagnetic radiation, which is transmitted from the surgical laser 14 along optical paths 52 and 54 in the direction of arrow 53 to the output port 16. Furthermore, the illumination source 70 is operated to emit illuminating visible light, which is transmitted from the illumination source 70 along optical paths 72 and 54 in the direction of arrows 73 and 53 to the output port 16.

[0063] From output port 16, laser electromagnetic radiation and illumination visible light enter the proximal end 32 of the transmission fiber optic cable 24, travel through the transmission fiber optic cable 24, and exit at the distal end 34. From the distal end 34 of the transmission fiber optic cable 24, laser electromagnetic radiation and illumination visible light enter the proximal end 36 of the output fiber optic cable 26, travel through the output fiber optic cable 26, and exit at the distal end 38, traveling along optical path 56 toward the target site. The target site may be, for example, the lens of a cataract, vitreous fibers, retinal tissue, other ophthalmic tissues, or other general tissues.

[0064] The illumination visible light is directed onto the target surface (such as ophthalmic tissue) and helps the operator see the target location and the surgical procedure. The laser electromagnetic radiation can be continuous and / or pulsed, and as mentioned above, the illumination visible light can be continuous and / or pulsed and can be synchronized with the surgical laser to achieve a stroboscopic effect.

[0065] The system may include a computing system, such as a processor, memory, and software, firmware, and / or hardware, for controlling the surgical laser 14 and / or illumination source 70. The computing system may also receive and monitor signals from monitoring sensors.

[0066] Figure 4 A flowchart illustrating an example method for operating a laser system with illumination is shown. Figure 4 The example method steps shown are merely representative of embodiments, as other variations are possible within the scope of this disclosure.

[0067] In step 80, electromagnetic radiation is emitted from the surgical laser to at least one fiber optic cable. For example, electromagnetic radiation is emitted from surgical laser 14 to fiber optic cables 24 and 26.

[0068] In step 82, visible light is emitted from the illumination source to the at least one fiber optic cable. For example, visible light is emitted from illumination source 70 to fiber optic cables 24 and 26.

[0069] In step 84, electromagnetic radiation from the surgical laser and visible light from the illumination source are received at the proximal end of the at least one fiber optic cable. For example, electromagnetic radiation from the surgical laser 14 and visible light from the illumination source 70 are received at the proximal end 32 of the fiber optic cable 24.

[0070] In step 86, electromagnetic radiation from the surgical laser and visible light from the illumination source are transmitted from the proximal end of the at least one fiber optic cable to the distal end of the at least one fiber optic cable and then transmitted from the distal end of the at least one fiber optic cable to the target surface. For example, electromagnetic radiation from the surgical laser 14 and visible light from the illumination source 70 are transmitted from the proximal end 32 of the at least one fiber optic cable 24, 26 to the distal end 38 of the at least one fiber optic cable 24, 26 and then transmitted from the distal end 38 of the at least one fiber optic cable 24, 26 to the target surface T.

[0071] As will be understood by those skilled in the art, the systems and methods disclosed herein have advantages over existing systems and methods. For example, in some existing systems and methods, visibility near the surgical fiber tip is nonexistent or very poor. Using the systems and methods disclosed herein, high-resolution visualization of the surrounding area near the surgical fiber tip can be achieved. Furthermore, other visualization and monitoring advantages can be achieved through the stroboscopic effect and monitoring of the returned signal. Improved visualization and monitoring can improve surgical procedures and patient outcomes.

[0072] Those skilled in the art will appreciate that the embodiments covered by this disclosure are not limited to the specific exemplary embodiments described above. Although illustrative embodiments have been shown and described, various modifications, variations, and substitutions are contemplated in the foregoing disclosure. It should be understood that such variations can be made to the foregoing without departing from the scope of this disclosure. Accordingly, it should be understood that the appended claims should be interpreted broadly and in accordance with the manner consistent with this disclosure.

Claims

1. A laser system, comprising: A surgical laser configured to emit electromagnetic radiation; At least one optical fiber cable having a proximal end and a distal end, the at least one optical fiber cable being configured to receive the electromagnetic radiation from the surgical laser at the proximal end of the at least one optical fiber cable and to transmit the electromagnetic radiation from the surgical laser from the proximal end of the at least one optical fiber cable to the distal end of the at least one optical fiber cable and to transmit it out from the distal end of the at least one optical fiber cable. as well as It is configured as an illumination source that emits visible light. The at least one optical fiber cable is configured to receive the illumination visible light from the illumination source at its proximal end and transmit the illumination visible light from the illumination source from the proximal end of the at least one optical fiber cable to its distal end and outward from its distal end. The surgical laser is configured to emit electromagnetic radiation from the surgical laser in a pulsed manner, the illumination source is configured to emit illumination visible light in a pulsed manner, and the laser system is configured to synchronize the pulses from the surgical laser with the pulses from the illumination source to produce a stroboscopic effect.

2. The laser system as described in claim 1, wherein, The fiber optic cable includes at least one optical fiber configured to receive electromagnetic radiation from the surgical laser and visible light from the illumination source.

3. The laser system as described in claim 1, wherein, The fiber optic cable includes at least one first fiber configured to receive the electromagnetic radiation from the surgical laser and at least one second fiber configured to receive the illumination visible light from the illumination source.

4. The laser system of claim 1, further comprising a beam combiner configured to combine the electromagnetic radiation from the surgical laser and the illumination visible light from the illumination source along a common optical path.

5. The laser system as described in claim 4, wherein, The beam combiner is adapted to allow the electromagnetic radiation from the surgical laser to pass through the beam combiner to the at least one fiber optic cable, and wherein the beam combiner is adapted to direct the illumination visible light from the illumination source to the at least one fiber optic cable.

6. The laser system as claimed in claim 4, wherein, The combining component is adapted to direct the electromagnetic radiation from the surgical laser to the at least one fiber optic cable, and wherein the combining component is adapted to allow the illumination visible light from the illumination source to pass through the combining component to the at least one fiber optic cable.

7. The laser system as claimed in claim 1, wherein, The at least one optical fiber cable includes a transmission optical fiber cable and an output optical fiber cable, each having a proximal end and a distal end, wherein the output optical fiber cable is located distal to the transmission optical fiber cable, and wherein the proximal end of the output optical fiber cable is configured to receive electromagnetic radiation from the surgical laser and illumination visible light from the illumination source from the distal end of the transmission optical fiber cable.

8. The laser system of claim 1, further comprising a laser housing, wherein, The surgical laser is located inside the laser housing, and wherein the at least one fiber optic cable is adapted to be removably connected to the laser housing.

9. The laser system of claim 1, further comprising a monitoring sensor positioned to detect returning laser electromagnetic radiation.

10. The laser system of claim 1, wherein, The laser system is configured to synchronize pulses from the surgical laser with pulses from the illumination source, such that the stroboscopic effect displays the stages of bubble formation by illuminating the sample time-lapse with a series of laser pulses, wherein each sample is shifted time-lapse relative to the laser pulses, thus allowing the operator to see the slowing bubble formation in real time.

Images