Laser pulse control with subcarrier modulation

Abstract

Systems and methods for flexibly controlling laser pulses output from a laser system are disclosed herein. An example surgical system includes a laser, a laser energy control system configured to adjust an amount of electromagnetic energy for each laser pulse exiting the laser system, and a laser pulse controller. The control signal transmitted by the laser pulse controller may include a subcarrier signal that modulates an amount of electromagnetic energy of the laser pulses exiting the laser system. The control signal may further include a threshold signal and / or a maximum power signal. The subcarrier signal may oscillate between a threshold power and a maximum power.

Description

Technical Field

[0001] The present disclosure relates to systems and methods for controlling the output of laser pulses from a laser system. Background Art

[0002] Lasers are used in many different medical procedures, including many different ophthalmic procedures. For example, lasers can be used in cataract surgery, such as to fragment a cataractous lens. In some procedures, a laser is used to achieve initial fragmentation of the lens, followed by phacoemulsification of the lens by an ultrasonic handpiece to complete the breakdown of the lens for removal. In other procedures, a laser can be used for complete fragmentation and / or phacoemulsification of the lens for removal without the need for separate application of ultrasonic energy. Lasers can also be used for other steps in cataract surgery, such as for making one or more corneal incisions and / or opening the capsule.

[0003] Lasers may also be used in glaucoma surgery. For example, a laser may be used to form all or part of a channel through the trabecular meshwork or scleral tissue for draining aqueous humor from the eye.

[0004] Lasers can also be used in vitreoretinal surgery. In some procedures, a laser can be used for vitrectomy to cut or break the 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 break the vitreous fibers for removal.

[0005] 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.

[0006] U.S. Patent Application Publication No. 2018 / 0360657 discloses examples of ophthalmic laser systems. The application describes uses of lasers, such as for forming surgical incisions or for photorupturing ophthalmic tissue and for cataract surgery, such as laser-assisted cataract surgery (LACS). U.S. Patent Application Publication No. 2019 / 0201238 discloses other examples of ophthalmic laser systems. The application describes uses of lasers, such as for cutting or breaking vitreous fibers in a vitrectomy probe. U.S. Patent Application Publication No. 2018 / 0360657 and U.S. Patent Application Publication No. 2019 / 0201238 are expressly incorporated herein by reference in their entirety.

[0007] Some laser systems emit pulses, where the pulses have a desired duration and repetition rate. Operating a laser in a pulsed manner can achieve desirable power and energy characteristics for a particular application. In addition, while the energy of a beam emitted by a laser can be controlled by controlling the laser itself, in some systems it is desirable to control the amount of energy of the laser beam downstream of the laser. Existing systems for laser pulse selection typically have one or more disadvantages, such as power loss, complexity, cost, etc. Therefore, there is a need for improved systems and methods for laser pulse control. Summary of the invention

[0008] The present disclosure relates to improved systems and methods for controlling the output of laser pulses from a laser system.

[0009] In some embodiments, a surgical system includes: a laser configured to emit electromagnetic radiation in laser pulses; a laser energy control system configured to adjust the amount of electromagnetic energy of each laser pulse exiting the laser system; and a laser pulse controller configured to transmit a control signal to the laser energy control system. The control signal transmitted by the laser pulse controller to the laser energy control system may include a subcarrier signal that modulates the amount of electromagnetic energy of the laser pulses exiting the laser system.

[0010] The subcarrier signal may be in a periodic pattern. The subcarrier signal may be in a square wave pattern. The subcarrier signal may be in a sinusoidal pattern.

[0011] The control signal transmitted by the laser pulse controller to the laser energy control system may further include a threshold signal indicating a threshold power and / or a maximum power signal indicating a maximum power. The threshold power and / or the maximum power may be adjustable. The subcarrier signal may oscillate between the threshold power and the maximum power.

[0012] In some examples, the surgical system may further include an adjustable input device configured to actuate within an operating range. The operating range of the adjustable input device may be configured to allow an operator to dynamically control the amount of energy of a laser pulse output from the laser system emitted from the laser. The operating range of the adjustable input device may be configured to allow an operator to dynamically control the amount of energy of a laser pulse output from the laser system emitted from the laser, up to an amount of maximum power or between a threshold power and a maximum power. The adjustable input device may include a foot pedal configured to actuate within the operating range.

[0013] In some examples, the surgical system may further include an optical switching device configured to switch between a first condition that allows laser pulses emitted from the laser to be output from the laser system and a second condition that prevents laser pulses emitted from the laser from being output from the laser system. The optical switching device may include a shutter and a shutter motor.

[0014] In some examples, a laser energy control system can include: a wave plate, a wave plate motor, and a polarizer plate, wherein the wave plate motor is configured to move the wave plate into different positions corresponding to different percentages of laser electromagnetic energy allowed to pass through the laser energy control system.

[0015] In some examples, a method of controlling a surgical system includes: (i) providing input to a surgical system, wherein the surgical system includes: a laser configured to emit electromagnetic radiation in laser pulses; a laser energy control system configured to regulate the amount of electromagnetic energy of each laser pulse exiting the laser system; and a laser pulse controller configured to transmit a control signal to the laser energy control system, wherein the control signal transmitted by the laser pulse controller to the laser energy control system includes a subcarrier signal that modulates the amount of electromagnetic energy of the laser pulse exiting the laser system; (ii) emitting electromagnetic radiation in laser pulses from the laser; and (iii) outputting laser pulses from the laser system in accordance with the control signal transmitted by the laser pulse controller. The subcarrier signal may be in a periodic pattern. The control signal may further include a threshold signal and / or a maximum power signal.

[0016] Other examples and features of embodiments of the present invention will be apparent from the accompanying drawings and detailed description. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] The drawings illustrate example implementations of the systems and methods disclosed herein and, together with the description, serve to explain the principles of the present disclosure.

[0018] Figure 1 An example ophthalmic surgical console is shown having a foot pedal connected thereto.

[0019] Figure 2 An example of an architecture for a surgical system including a laser system is shown.

[0020] Figure 3 An example of an architecture for a laser pulse controller is shown.

[0021] Figure 4 Example operating ranges for an adjustable input device, such as a foot pedal, are shown.

[0022] Figure 5An example data packet for instructions sent to a laser pulse controller is shown.

[0023] Fig. 6A An example of laser pulses emitted from a laser is shown.

[0024] Figure 6B An example of a static pulse control signal is shown.

[0025] Figure 6C Shown according to Figure 6B The static pulse control signal is the output of the laser pulse.

[0026] Fig. 7A Shown with Fig. 6A Similar examples of laser pulses emitted from a laser.

[0027] Figure 7B An example of a pulse control signal in linear mode is shown.

[0028] Figure 7C Shown according to Figure 7B The linear mode pulse control signal is the output of the laser pulse.

[0029] Fig. 8A Shown with Fig. 6A and Fig. 7A Similar examples of laser pulses emitted from a laser.

[0030] Figure 8B Examples of subcarrier signals and threshold signals are shown.

[0031] Figure 8C Shown according to Figure 8B The subcarrier signal and threshold signal are the output of the laser pulse.

[0032] Fig.9A Shown with Fig. 6A , Fig. 7A and Fig. 8A Similar examples of laser pulses emitted from a laser.

[0033] Fig. 9B Another example of a subcarrier signal and a threshold signal is shown.

[0034] Fig. 9C Shown according to Fig. 9B The subcarrier signal and threshold signal are the output of the laser pulse.

[0035] The drawings can be better understood with reference to the following detailed description. DETAILED DESCRIPTION

[0036] For the purpose of promoting understanding of the principles of the present disclosure, reference will now be made to the implementations illustrated in the accompanying drawings, and specific language will be used to describe those implementations and other implementations. Nevertheless, 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 in the technical field to which the present disclosure relates are generally fully able to envision any changes and further modifications to the illustrated or described systems, devices, instruments or methods, as well as any further applications of the principles of the present disclosure. In particular, the features, components and / or steps described with respect to one embodiment of the present disclosure may be combined with the features, components and / or steps described with respect to other embodiments of the present disclosure. For simplicity, in some cases, the same reference numerals are used throughout the drawings to refer to the same or similar parts.

[0037] The names "first" and "second" as used herein are not meant to indicate or imply any particular positioning or other characteristics. Rather, when the names "first" and "second" are used herein, they are only used to distinguish one component from another. Unless direct or indirect attachment, connection, coupling, etc. is specified, the terms "attachment", "connection", "coupling", etc. indicate that one part is attached, connected, coupled, etc. to another part directly or indirectly through one or more other parts.

[0038] Figure 1 An example ophthalmic surgical console 100 is shown having a foot pedal 106 connected thereto. The example ophthalmic surgical console 100 may be used in systems and methods according to the present disclosure. The ophthalmic surgical console 100 may be similar to an ophthalmic surgical console as shown and described in U.S. Patent No. 9,931,447, the entire disclosure of which is hereby expressly incorporated herein by reference. The ophthalmic surgical console 100 may be similar to an ophthalmic surgical console that is known and has been used, for example, in a surgical console available from Alcon Laboratories, Inc. (Fort Worth, Texas, USA). Vision system or CONSTELLA available from Alcon Laboratories, Inc. (Fort Worth, Texas, USA) vision system, or any other ophthalmic surgical console suitable for use with the principles described herein.

[0039] like Figure 1 As shown, an example ophthalmic surgical console 100 includes a housing 102 in which a computer system is disposed and an associated display screen 104 that displays data related to system operation and performance during an ophthalmic surgical procedure.

[0040] The foot pedal 106 is an adjustable input device that the operator can actuate within an operating range to control one or more functions. The foot pedal 106 can be depressed to a plurality of different positions within the operating range to control functions, as further described below. Although the foot pedal 106 is shown, other adjustable input devices, such as manual buttons or knobs, may also be used. The foot pedal 106 or other adjustable input device may be connected to the surgical console 100 via a wired or wireless connection.

[0041] The surgical console 100 includes one or more systems that can be used to perform an ophthalmic surgical procedure. For example, the surgical console 100 can include a fluid system including an irrigation system for delivering fluid to the eye and an aspiration system for aspirating fluid from the eye.

[0042] Example surgical systems according to the present disclosure may include a laser system suitable for one or more ophthalmic procedures. Figure 2 An example of an architecture for a surgical system is shown that includes a surgical console 100, an adjustable input device (e.g., a foot pedal 106), and an example laser system 200. The laser system 200 may include a laser 212, an optical switch 214, and a laser pulse controller 216. In the illustrated embodiment, the laser pulse controller 216 is or includes a subcarrier pulse controller. In some embodiments, the laser system 200 may be housed within the surgical console 100. In other embodiments, the laser system 200 may be housed in a separate console that communicates with the surgical console 100. In other embodiments, one or more portions of the laser system 200 (such as the laser 212 and the optical switch 214) may be housed in a separate console that communicates with the surgical console 100, while one or more other portions of the laser system 200 (such as the laser pulse controller 216) may be housed in the surgical console 100. In other embodiments, the laser system 200 may be located in a separate housing that may receive input from a foot pedal or other adjustable input device 106 without requiring a separate surgical console 100.

[0043] In addition to the laser 212, the optical switching device 214, and the laser pulse controller 216, the laser system 200 may also have other components. For example, the laser system 200 may include components for operating the laser, such as a power supply, a laser pump, a laser energy control, and a monitor. In addition, the laser system 200 may include other components in the optical path of the laser output, such as one or more lenses, mirrors, and optical fibers (not shown).

[0044] In some embodiments, the laser system 200 can be suitable for cataract surgery. In some embodiments, the output energy of the laser system is suitable for fragmentation and / or emulsification of cataractous lenses. In some examples, the laser output is used to fragment and / or phacoemulsify the lens to a sufficient degree to remove the lens.

[0045] In some embodiments, the laser system 200 can be suitable for glaucoma surgery. In some embodiments, the output energy of the laser system is suitable for causing or promoting the formation of drainage channels in ocular tissue.

[0046] Laser 212 can be any type of laser suitable for the desired application. Laser 212 can output suitable electromagnetic radiation of any suitable wavelength. For example, laser 212 can emit electromagnetic radiation of one or more wavelengths of visible wavelengths, infrared wavelengths, and / or ultraviolet wavelengths. Laser 212 can operate or be operated to emit a continuous beam of electromagnetic radiation. Alternatively, laser 212 can operate or be operated to emit a pulsed beam.

[0047] In one example, laser 212 operates in the infrared range. For example, laser 212 can output electromagnetic radiation in the mid-infrared range (e.g., in the range of about 2.0 microns to about 4.0 microns). Some example wavelengths include about 2.5 microns to 3.5 microns, such as about 2.775 microns, about 2.8 microns, or about 3.0 microns. Such a laser can be suitable, for example, for lens fragmentation in cataract surgery, or for other procedures.

[0048] The laser system 200 is designed to direct the laser electromagnetic radiation from the laser 212 to the output port. The laser system 200 may direct the laser electromagnetic radiation from the laser 212 to the output port through one or more optical components, such as lenses and mirrors.

[0049] The instrument can be optically connected to the laser system 200 to receive laser electromagnetic radiation from the output port. The instrument can be, for example, a handpiece used in an ophthalmic procedure. The instrument or handpiece can be connected to the laser system via a delivery fiber. The delivery fiber can be flexible and relatively long to give the operator the flexibility to manipulate the handpiece at a distance away from the laser system 200. The laser electromagnetic radiation can be transmitted from the laser system 200, through the optical fiber and the handpiece, and from the output end of the handpiece to a desired target, such as a lens or lens fragment in the patient's eye.

[0050] Optical switching device 214 is a device that operates to allow laser electromagnetic radiation (e.g., laser pulses) emitted from laser 212 to be output from the laser system or to prevent laser electromagnetic radiation (e.g., laser pulses) emitted from laser 212 from being output from the laser system. Under the control of laser pulse controller 216, optical switching device 214 can switch back and forth between these two conditions.

[0051] In some examples, the optical switching device 214 may include a shutter and a shutter motor. Examples of suitable optical switching devices are described and illustrated in U.S. Provisional Patent Application No. 63 / 186,387 (hereby incorporated by reference in its entirety) and U.S. Provisional Patent Application No. 63 / 222,521 (hereby incorporated by reference in its entirety).

[0052] For example, the optical switching device 214 may include a shutter that is moved into or out of the path of the laser electromagnetic radiation by a shutter motor to selectively allow or prevent the laser electromagnetic radiation from being output from the laser system. The shutter motor may be configured to move the shutter in an alternating manner between a first position corresponding to a first condition of the optical switching device, wherein laser electromagnetic energy (e.g., laser pulses) emitted from the laser is allowed to be output from the laser system, and a second position corresponding to a second condition of the optical switching device, wherein laser electromagnetic energy (e.g., laser pulses) emitted from the laser is prevented from being output from the laser system. In an example, the shutter includes a reflector and the shutter motor includes a galvanometer motor.

[0053] In another example, the optical switching device 214 may include: (i) a shutter having a rotation axis and at least one open area and at least one solid area arranged around the rotation axis of the shutter, and (ii) a shutter motor configured to rotate the shutter around the rotation axis of the shutter. In this example, a first condition of the optical switching device (wherein laser electromagnetic energy (e.g., laser pulses) emitted from the laser is allowed to be output from the laser system) corresponds to a position of the shutter where the solid area of ​​the shutter is not located in the path of the laser pulses emitted from the laser, and a second condition of the optical switching device (wherein laser electromagnetic energy (e.g., laser pulses) emitted from the laser is prevented from being output from the laser system) corresponds to a position of the shutter where the solid area of ​​the shutter is located in the path of the laser pulses emitted from the laser.

[0054] The optical switching device 214 may further include a laser energy control system configured to adjust the amount of electromagnetic energy of each laser pulse that leaves the laser system. For example, the laser energy control system may include a wave plate, a wave plate motor, and a polarizer plate, wherein the wave plate motor is configured to move the wave plate to different positions corresponding to different percentages of the laser electromagnetic energy that is allowed to pass through the laser energy control system. Examples of such laser energy control systems are described and illustrated in U.S. Provisional Patent Application No. 63 / 186,387 (hereby incorporated herein by reference in its entirety) and U.S. Provisional Patent Application No. 63 / 222,521 (incorporated herein by reference as described above).

[0055] In another alternative embodiment, the optical switching device 214 may include a Pockels cell. Under the control of the laser pulse controller 216, the Pockels cell optical switching device may switch back and forth between a first condition that allows the laser pulse emitted from the laser to be output from the laser system and a second condition that prevents the laser pulse emitted from the laser from being output from the laser system. In addition, the Pockels cell optical switching device may also be operated incrementally to allow different percentages of the electromagnetic energy emitted by the laser to be output by the laser system.

[0056] The laser pulse controller 216 is configured to transmit optical switching control signals to the optical switching device 214. The optical switching control signals are based on inputs to the surgical system, including inputs from an adjustable input device (eg, foot pedal 106), if an adjustable input device is provided.

[0057] The optical switching device 214 may include a power control device and a pulse picking device. The pulse picking device may include any suitable pulse picking device, including but not limited to a pulse picking device based on a shutter as described above. The power control device may include any suitable power control device, including but not limited to a power control device based on a wave plate as described above. In an alternative embodiment, the Pockels cell arrangement may act as a pulse picking device and / or a power control device. The laser system 200 may further include a beam polarizer. The laser pulse controller 216 sends a laser power control signal and a pulse picking control signal to the optical switching device 214. As described above, the handpiece may be connected to an output port of the laser system 200, for example, via a cable having an optical fiber. The output laser pulse train from the laser system 200 travels to a target (e.g., a cataractous lens, trabecular meshwork, scleral tissue, other tissues, etc.) through the optical fiber and the handpiece.

[0058] Figure 3An example of an architecture for the laser pulse controller 216 is shown. As will be appreciated by one of ordinary skill in the art, use of the controller in a processing environment may be implemented in software, firmware, hardware, or some suitable combination of software, firmware, and / or hardware, such as software that is loaded into a processor and executed. The laser pulse controller 216 may be implemented in software, firmware, hardware, or some suitable combination of software, firmware, and / or hardware, such as software that is loaded into a processor and executed.

[0059] The example laser pulse controller 216 includes a serial transmitter / receiver (Tx / Rx) module 231 that communicates with a serial communication (Tx / Rx) controller or similar device (e.g., a device similar to a UART, CAN bus, or Ethernet) of the surgical console 100. In use, the surgical console 100 sends packets of data to the laser pulse controller 216, which are received by the serial Tx / Rx module 231. As described in more detail below, the packets may include data based at least in part on input from the adjustable input device 106. The packet parsing module 232 of the laser pulse controller 216 is configured to parse the packet data. In the illustrated example, the packet parsing module 232 sends repetition rate data to a repetition rate control module 233, mode data to a mode detection module 234, power data to a mode power control module 235, subcarrier threshold data to a threshold control module 236, subcarrier frequency data to a subcarrier frequency control module 237, subcarrier duty cycle data to a duty cycle control module 238, pulse modulation data to a modulation mode control module 239, and subrange data to a subrange control module 240. The repetition rate control module 233 also receives a laser trigger input signal that indicates the timing of the start of each laser pulse. The repetition rate control module 233 sends a signal indicating the repetition rate of the laser to an output pulse control module 241, which may also receive the laser trigger input signal. The output pulse control module 241 also receives input signals from the mode detection module 234, the mode power control module 235, the threshold control module 236, the subcarrier frequency control module 237, the duty cycle control module 238, the modulation mode control module 239 and the sub-range control module 240 based on their respective input data.

[0060] The output pulse control module 241 of the laser pulse controller 216 sends a control signal to the optical switching device 214, wherein the control signal may be based in part on the input from the adjustable input device 106. The control signal transmitted by the laser pulse controller 216 to the optical switching device 214 may include a mode power signal (e.g., Mode_Power_Data) that controls the maximum laser pulse power output. The control signal transmitted by the laser pulse controller 216 to the optical switching device 214 may also include a power threshold signal (e.g., Power_Threshold) that sets a threshold amount as described below. The control signal transmitted by the laser pulse controller 216 to the optical switching device 214 may also include a sub-carrier pulse control signal (e.g., Sub-Carrier Pulse Control) that controls the sub-carrier signal as described below. A repetition rate signal may be sent to control the repetition rate of the laser pulses emitted by the laser.

[0061] As described in more detail below, the subcarrier pulse control signal can be used to provide control of the laser pulse output. In some examples, the subcarrier pulse control signal can be used to establish a subcarrier frequency or period. The subcarrier pulse control signal can include a duty cycle, or a separate subcarrier duty cycle signal can be provided, which subcarrier pulse control signal or the subcarrier duty cycle signal establishes a ratio of the amount of the subcarrier signal waveform above the central axis to the amount of the waveform below the central axis, as discussed further below.

[0062] The output pulse control module 241 of the laser pulse controller 216 may send a message confirmation signal to the data packet framing module 242. The data packet framing module 242 assembles the data from the message confirmation signal and sends it as a data packet of data to the serial Tx / Rx module 231. The Tx / Rx module 231 then sends the data packet of data to the serial Tx / Rx controller of the surgical console 100 based on the message confirmation signal to confirm the signal from the laser pulse controller 216.

[0063] Figure 4 An example operating range for an adjustable input device, such as a foot pedal 106, is shown. An operator can actuate the foot pedal 106 or other adjustable input device within the operating range to control the laser output. In the example of a foot pedal, the operator depresses the foot pedal by a desired amount to move the foot pedal to a desired area of ​​the operating range. In other examples, such as a manual button or knob, the operator moves or tunes the input device to a desired area of ​​the operating range. In some embodiments, the foot pedal or other adjustable input device can be adjustable in real time during a surgical procedure, thereby giving the operator the ability to dynamically control the laser pulses output from the laser system during the procedure.

[0064] Many different functional examples are possible within the operating range. In the example shown, the operating range includes three sub-ranges, but more or fewer sub-ranges may also be used.

[0065] The following is a description of one of many examples. When the adjustable input device is moved or tuned to sub-range 1, the surgical console can be activated for a specific function, such as irrigation, without any laser output. When the adjustable input device is moved or tuned to sub-range 2, the surgical console can be activated for a different function, such as aspiration, without any laser output. The irrigation function can continue to operate in sub-range 2. When the adjustable input device is moved or tuned to sub-range 3, the laser system can be activated to output laser electromagnetic energy. The irrigation and / or aspiration functions can continue to operate in sub-range 3. By moving or tuning the adjustable input device within sub-range 3, the operator can dynamically adjust the laser output, as described below.

[0066] Many variations are possible. For example, sub-range 2 and sub-range 3 in the above example can be reversed so that laser control occurs in sub-range 2 and pumping occurs in sub-range 3.

[0067] In one example, the adjustment of the adjustable input device controls the percentage of electromagnetic energy of the laser pulse output. That is, the laser emits laser pulses at a specific energy, and the input from the adjustable input device is used to adjust the laser energy control system of the optical switching device 214 to control the energy percentage of the laser pulse output from the laser system. Based on the input from the adjustable input device, the power level signal sent by the laser pulse controller 216 to the optical switching device 214 can be adjusted to control the amount of energy of the laser pulse output from the laser system. For example, the top of the sub-range 3 can correspond to 0% laser energy output, the bottom of the sub-range 3 can correspond to 100% laser energy output, and the position between the two can correspond to an increment within the range of 0% to 100%. In other examples, the operating range of the adjustable input device is configured to allow the operator to dynamically control the percentage of laser pulses emitted from the laser system output from the laser. In other examples, adjusting the adjustable input device to the sub-range 3 or to a specific point in the sub-range 3 can act as an on-off switch that triggers the operation of the laser system at the set output.

[0068] One or more inputs to the system, such as from a touch screen (with a graphical user interface), a button, a dial, a knob, a foot pedal, an adjustable input device, or other input device, can be used to control the laser system to output only certain laser pulses of the laser pulses emitted by the laser. That is, the laser emits laser pulses at a specific repetition rate, and the input is used to control the optical switching device 214 to switch back and forth between a first condition that allows the laser pulses emitted from the laser to be output from the laser system and a second condition that prevents the laser pulses emitted from the laser from being output from the laser system. One or more of the inputs to the system may include or be part of the console 100, the adjustable input device 106, and / or an external control system (e.g., having its own touch screen (with a graphical user interface), a button, a dial, a knob, or other input device).

[0069] In some embodiments, user input controls the subcarrier frequency and duty cycle, which controls the length of the subcarrier period. Based on the input, the laser pulse controller sends a signal (e.g., a Sub-Carrier Pulse Control signal) to the optical switching device and controls the subcarrier frequency and duty cycle. For example, if the repetition rate of the laser is 1000 Hz, a subcarrier frequency of 100 Hz produces 10 pulses per cycle. By selecting the input that controls the duty cycle, different pulse ranges per cycle (e.g., ranges of 1 to 9, 1 to 10, 0 to 9, 0 to 10, etc.) can be output, thereby controlling the percentage of laser pulses output. As another example, if the repetition rate of the laser is 1000 Hz, a subcarrier frequency of 10 Hz produces 100 pulses per cycle. By selecting the input that controls the duty cycle, different pulse ranges per cycle (e.g., ranges of 1 to 99, 1 to 100, 0 to 99, 0 to 100, etc.) can be output, thereby controlling the percentage of laser pulses output.

[0070] In some examples, the repetition rate of the laser and the energy output of the laser (including different energy outputs of the laser if desired) can also be selected through an adjustable input device or another input device (such as a touch screen, button, dial, knob, or other input).

[0071] Figure 5An example data packet for instructions sent to a laser pulse controller is shown. The data packet includes the following data: packet header, mode, engraving power (or mode power), repetition rate, subcarrier threshold, subcarrier frequency, subcarrier duty cycle, pulse modulation, subrange 1, subrange 2, subrange 3, and packet trailer. The packet header identifies the beginning of the data packet. The mode identifies which operating mode has been selected. The engraving power (or mode power) identifies the selected power output of the laser; this can be a maximum power signal representing the maximum power output. The repetition rate identifies the rate of pulses emitted from the laser. The subcarrier threshold identifies the threshold level or threshold power, as discussed further below. The subcarrier frequency identifies the frequency of the subcarrier signal. The subcarrier duty cycle identifies the duty cycle of the subcarrier signal. Pulse modulation identifies the type of pulse modulation performed with or without a subcarrier signal, such as static or linear. Subrange 1, subrange 2, and subrange 3 identify the position to which the adjustable input device has been moved or tuned, including incremental positions within a range (e.g., 0 to 100).

[0072] Fig. 6A An example of laser pulses emitted from a laser is shown, with each upward arrow representing a laser pulse. This shows the repetition rate of the laser pulses emitted by the laser, which in this example is 1 KHz.

[0073] Figure 6B An example of a static pulse control signal is shown. The power level signal is set to 100%. In static mode, as shown, the power level is constant. In linear or variable mode, the power level is adjustable, for example, by an adjustable input device (e.g., a foot pedal).

[0074] Figure 6C Shown according to Figure 6B The static pulse control signal outputs the laser pulses. As can be seen, all laser pulses are output at 100% power.

[0075] Fig. 7A Shown with Fig. 6A Similar examples of laser pulses emitted from a laser. Fig. 6A Again, this shows the repetition rate of the laser pulses emitted by the laser, which in this example is 1KHz.

[0076] Figure 7B An example of a linear pulse control signal is shown. The power level signal is adjusted over time. In linear (or variable) mode, as shown, the power level is adjustable, for example, by an adjustable input device (eg, a foot pedal).

[0077] Figure 7C Shown according to Figure 7BAs can be seen, all laser pulses are output at different power levels according to the power control signal.

[0078] FIG. 6A to FIG. 6C and FIG. 7A to FIG. 7C The mode of operation in is similar in output to the mode of operation described and illustrated in U.S. Provisional Patent Application No. 63 / 256,071 (the entire contents of which are hereby incorporated by reference herein). For example, Figure 6C and Figure 7C An output of a carving mode similar to that described and illustrated in that application is shown. FIG. 8A to FIG. 8C and 9A to 9C It illustrates how embodiments herein allow for additional control of the laser pulse output through the use of a subcarrier signal (subcarrier frequency and duty cycle) and a threshold signal.

[0079] Fig. 8A Shown with Fig. 6A and Fig. 7A Similar examples of laser pulses emitted from a laser. Fig. 6A and Fig. 7A Again, this shows the repetition rate of the laser pulses emitted by the laser, which in this example is 1KHz.

[0080] Figure 8B An example of a subcarrier signal is shown, which is shown as a waveform in dashed line. In this example, the subcarrier frequency is 100 Hz, which produces 10 laser pulses per subcarrier period at a repetition rate of 1 KHz.

[0081] In the example shown, the subcarrier duty cycle is set to 50% (or 50:50). The duty cycle establishes a ratio of the amount of the subcarrier signal waveform above the center axis to the amount of the waveform below the center axis. That is, the waveform of the subcarrier signal has a center axis. In the example shown, the center axis corresponds to a level of 75% power. As can be seen, the subcarrier oscillates above and below the center axis in the waveform. In the example shown, at a 50% duty cycle, 50% of the subcarrier signal waveform is above the center axis, and 50% of the subcarrier signal waveform is below the center axis.

[0082] Other duty cycles are possible. For example, at a duty cycle of 30% (or 30:70), 30% of the subcarrier signal waveform is above the center axis, while 70% of the subcarrier signal waveform is below the center axis. At a duty cycle of 60% (or 60:40), 60% of the subcarrier signal waveform is above the center axis, while 40% of the subcarrier signal waveform is below the center axis. At a duty cycle of 95% (or 95:5), 95% of the subcarrier signal waveform is above the center axis, while 5% of the subcarrier signal waveform is below the center axis. Duty cycles anywhere in the range of 0% to 100% (including both) are possible.

[0083] Figure 8B Also shown is a subcarrier threshold, shown as a horizontal dashed line. In this example, the threshold signal is at 50% as shown. It is possible for the threshold signal to be anywhere in the range of 0% to 100% (inclusive).

[0084] The threshold signal identifies or indicates a threshold level or threshold power. In the example shown, the threshold signal sets the bottom or minimum value of the subcarrier signal. In the example shown, the maximum power is set to 100%. As further described below, the maximum power can be fixed or adjustable. The subcarrier signal oscillates between the threshold power (50% in the example shown) and the maximum power (100% in the example shown).

[0085] As further described below, the subcarrier signal modulates the amount of electromagnetic energy of the laser pulses leaving the laser system. Figure 8B As shown, the subcarrier signal has a repeating periodic pattern. For example, the subcarrier signal may oscillate between a threshold power and a maximum power, such as Figure 8B In some examples, Figure 8B As shown, the subcarrier signal may be in a square wave pattern. In other examples, the subcarrier signal may be in a sinusoidal pattern. Other patterns of subcarrier signals may be used.

[0086] Figure 8C Shown according to Figure 8B The subcarrier signal modulates the amount of electromagnetic energy of the laser pulses leaving the laser system. That is, the amount of energy of each laser pulse output from the laser system is regulated by the subcarrier signal. In the example shown, the laser pulses are modulated in a periodic pattern between 50% power and 100% power.

[0087] In some examples, all laser pulses may be output from the laser system according to the power indicated by the subcarrier signal. In other examples, the system may operate such that when the subcarrier signal indicates a power level below a threshold, the optical switching device is in a condition that prevents laser pulses emitted from the laser from being output from the laser system. That is, the optical switching device is configured to switch between a first condition that allows laser pulses emitted from the laser to be output from the laser system (e.g., when the subcarrier signal indicates a power level above a threshold) and a second condition that prevents laser pulses emitted from the laser from being output from the laser system (e.g., when the subcarrier signal indicates a power level below a threshold).

[0088] In some examples, for example, in static mode, an input (actuator, button, knob, touch screen, foot pedal, etc.) can act as an on-off switch that triggers operation of the laser system at a set output. For example, moving the input to the on position initiates operation of the laser system at a set output. Figure 8C The input may be an adjustable input device, such as a foot pedal. For example, adjusting the adjustable input device into sub-range 3 or to a specific point in sub-range 3 may act as an on-off switch that triggers operation of the laser system at the set output.

[0089] In some examples, such as in linear or variable modes, adjustments to the adjustable input device can be used to control the percentage of electromagnetic energy of the output laser pulses. That is, the laser emits laser pulses at a specific energy, and the input from the adjustable input device is used to adjust the laser energy control system of the optical switching device 214 to control the energy percentage of the laser pulses output from the laser system. For example, the top of sub-range 3 can correspond to 0% laser energy output, the bottom of sub-range 3 can correspond to 100% laser energy output, and the positions in between can correspond to increments within the range of 0% to 100%. When compared with, for example Figure 8B and Figure 8C When used in conjunction with the subcarrier signal shown, the maximum output is adjusted by the subcarrier signal. That is, adjusting the adjustable input device to 100% produces a value that depends on the Figure 8C The subcarrier signal is shown as a laser pulse, with lower percentages producing corresponding lower amounts of power.

[0090] Thus, in such examples, an adjustable input device (e.g., a foot pedal) is configured to be actuated within an operating range. The operating range of the adjustable input device is configured to allow an operator to dynamically control the amount of energy of a laser pulse output from the laser system emitted from the laser. In some examples, the operating range of the adjustable input device is configured to allow an operator to dynamically control the amount of energy of a laser pulse output from the laser system emitted from the laser, up to an amount of maximum power. In some examples, the operating range of the adjustable input device is configured to allow an operator to dynamically control the amount of energy of a laser pulse output from the laser system emitted from the laser between a threshold power and a maximum power.

[0091] Reference again Figure 8C , the output produces higher power periods alternating with lower power periods. When the power is at lower power or transitioning to lower power, the output energy of the laser pulses is minimized. Certain procedures (e.g., flushing and / or aspiration of tissue) can be timed to coincide with these periods. When the power is at higher power or transitioning to higher power, the output energy of the laser pulses is maximized. Certain procedures (e.g., breaking of hard tissue) can be timed to coincide with these periods.

[0092] Fig.9A Shown with Fig. 6A , Fig. 7A and Fig. 8A Similar examples of laser pulses emitted from a laser. Fig. 6A , Fig. 7A and Fig. 8A Again, this shows the repetition rate of the laser pulses emitted by the laser, which in this example is 1KHz.

[0093] Fig. 9B Another example of a subcarrier signal is shown, which is shown as a waveform in dashed lines. In this example, the subcarrier frequency is 100 Hz, which produces 10 laser pulses per subcarrier period at a repetition rate of 1 KHz.

[0094] In the example shown, the subcarrier duty cycle is set to 50% (or 50:50). As discussed above, the duty cycle establishes the ratio of the amount of the subcarrier signal waveform above the center axis to the amount of the waveform below the center axis. As discussed above, other duty cycles are possible anywhere in the range of 0% to 100% (inclusive).

[0095] Fig. 9BAlso shown is a subcarrier threshold, which is shown as a horizontal dashed line. In this example, the threshold signal is at 50% as shown. As discussed above, it is possible for the threshold signal to be anywhere in the range of 0% to 100% (inclusive). The subcarrier signal oscillates between the threshold power (50% in the example shown) and the maximum power (100% in the example shown). Fig. 9B In the example of FIG. 4 , the subcarrier signal may be in a sinusoidal pattern. Many other forms of the subcarrier signal are possible (eg, sawtooth, staircase, etc.).

[0096] Fig. 9C Shown according to Fig. 9B The subcarrier signal modulates the amount of electromagnetic energy of the laser pulses leaving the laser system. That is, the amount of energy of each laser pulse output from the laser system is regulated by the subcarrier signal. In the example shown, the laser pulses are modulated in a periodic pattern between 50% power and 100% power.

[0097] As discussed above, in some examples, all laser pulses can be output from the laser system according to the power indicated by the subcarrier signal. In other examples, the system can be operated so that when the subcarrier signal indicates a power level below a threshold, the optical switching device is in a condition that prevents laser pulses emitted from the laser from being output from the laser system.

[0098] In some examples, as discussed above, such as Fig. 9C The arrangement shown can be operated in a static mode, where the input can act as an on-off switch to trigger operation of the laser system at a set output. In some examples, as discussed above, such as Fig. 9C The arrangement shown can be operated in either a linear or variable mode, wherein adjustments to the adjustable input device can be used to control the percentage of electromagnetic energy of the output laser pulse.

[0099] An example method of controlling a surgical system as described herein is as follows. An operator selects inputs for an operating mode (e.g., static or linear, with or without a subcarrier), a maximum power, a repetition rate of the laser, a subcarrier frequency, and / or a duty cycle. In some embodiments, certain options may be provided for selection, wherein, depending on the operator's selection, the surgical system sets the operating mode, maximum power, a repetition rate of the laser, a subcarrier frequency, and / or a duty cycle. Alternatively, any of these parameters may be preset. The operator operates the system, wherein the laser output of the handpiece is directed to a desired location (e.g., a cataractous lens, trabecular meshwork, scleral tissue, other tissue, etc.). Based on the inputs and optionally other parameters, control signals are sent (e.g., via a laser such as Figure 5The laser pulse controller may include a laser pulse controller that receives a data packet in a laser pulse controller (data packet in a laser pulse controller). Based on the input, the laser pulse controller sends a control signal to an optical switching device to control the laser output. The laser emits electromagnetic radiation from the laser in the form of laser pulses. Based on the input, the optical switching device selectively controls the energy output of the laser pulses and / or selectively allows certain laser pulses to be output and prevents certain laser pulses from being output. In some embodiments, an operator may actuate an adjustable input device (e.g., a foot pedal) within an operating range to dynamically control the power of the laser pulses output from the laser system.

[0100] The operator can dynamically adjust the adjustable input device in real time to adjust the power output, i.e., the power level signal can be based on the dynamic input from the adjustable input device. The operator can dynamically adjust the adjustable input device in real time to adjust the power level signal, and thus adjust the amount of energy of the laser pulse output from the laser system.

[0101] The operator can switch inputs. The selected input can be based on procedure type, procedure phase, conditions, or other factors.

[0102] The ability to selectively output laser pulses and / or control the laser output energy is useful for procedures where laser control is advantageous. For example, in cataract surgery, it may be desirable to operate the laser system at a high power in order to initially break up the lens. It may be desirable to operate the laser system at a lower power in order to break up smaller fragments, so lower energy levels may be preferred. Pulse energy level control of the laser pulses allows the correct level of force to be applied to smaller particles that would otherwise be likely to be pushed away before they can be aspirated out of the eye by the handpiece's perfusion system. As another example, for glaucoma treatment, it may be desirable to operate the laser system with a single laser pulse or only a few laser pulses to form a channel through the eye tissue. It may also be desirable to use soft or low energy for certain glaucoma procedures.

[0103] As will be appreciated by those of ordinary skill in the art, the systems and methods disclosed herein have advantages over existing systems and methods. For example, the systems and methods described herein allow for simple, flexible and / or dynamic control of laser pulses and / or energy, thereby improving the simplicity, time, efficiency, accuracy, effectiveness and / or cost of the procedure.

[0104] It will be appreciated by those skilled in the art that the embodiments encompassed by the present disclosure are not limited to the specific example embodiments described above. Although illustrative embodiments have been shown and described, a wide range of modifications, changes, and substitutions are contemplated in the foregoing disclosure. It will be appreciated that such changes may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, it will be appreciated that the appended claims should be interpreted broadly and in a manner consistent with the present disclosure.

Claims

1. A surgical system, comprising: a laser configured to emit electromagnetic radiation in the form of laser pulses; a laser energy control system configured to regulate the amount of electromagnetic energy of each laser pulse exiting the laser system; as well as a laser pulse controller configured to transmit control signals to the laser energy control system; wherein the control signal transmitted by the laser pulse controller to the laser energy control system comprises a subcarrier signal that modulates the amount of electromagnetic energy of the laser pulse leaving the laser system.

2. The surgical system of claim 1, wherein: The subcarrier signal has a periodic pattern.

3. The surgical system of claim 2, wherein: The subcarrier signal is in a square wave pattern.

4. The surgical system of claim 2, wherein: The subcarrier signal is in a sinusoidal pattern.

5. The surgical system of claim 1, wherein: The control signal transmitted by the laser pulse controller to the laser energy control system further includes a threshold signal representing a threshold power.

6. The surgical system of claim 5, wherein: The control signal transmitted by the laser pulse controller to the laser energy control system further includes a maximum power signal indicating a maximum power.

7. The surgical system of claim 6, wherein: The maximum power is adjustable.

8. The surgical system of claim 6, wherein: The subcarrier signal oscillates between the threshold power and a maximum power.

9. The surgical system of claim 1, further comprising an adjustable input device configured to be actuated within an operating range.

10. The surgical system of claim 9, wherein: The operating range of the adjustable input device is configured to allow an operator to dynamically control the amount of energy output from the laser system of a laser pulse emitted from the laser.

11. The surgical system of claim 9, wherein: The control signals transmitted by the laser pulse controller to the laser energy control system further include a maximum power signal indicative of a maximum power, and wherein the operating range of the adjustable input device is configured to allow an operator to dynamically control an amount of energy of a laser pulse emitted from the laser output from the laser system, up to the amount of maximum power.

12. The surgical system of claim 9, wherein: The control signals transmitted by the laser pulse controller to the laser energy control system further include a threshold signal representing a threshold power and a maximum power signal representing a maximum power, and wherein the operating range of the adjustable input device is configured to allow an operator to dynamically control the amount of energy of the laser pulse emitted from the laser output from the laser system between the threshold power and the maximum power.

13. The surgical system of claim 9, wherein: The adjustable input device includes a foot pedal configured to be actuated within the operating range.

14. The surgical system of claim 1 , further comprising an optical switching device configured to switch between a first condition that allows the laser pulse emitted from the laser to be output from the laser system and a second condition that prevents the laser pulse emitted from the laser from being output from the laser system.

15. The surgical system of claim 13, wherein: The optical switching device includes a shutter and a shutter motor.

16. The surgical system of claim 1, wherein: The laser energy control system comprises: Wave plates; wave plate motor; and Polarizer plates; Wherein the wave plate motor is configured to move the wave plate into different positions, the different positions corresponding to different percentages of laser electromagnetic energy allowed to pass through the laser energy control system.

17. A method of controlling a surgical system, comprising: (i) providing input to the surgical system, wherein the surgical system comprises: a laser configured to emit electromagnetic radiation in the form of laser pulses; a laser energy control system configured to regulate the amount of electromagnetic energy of each laser pulse exiting the laser system; and a laser pulse controller configured to transmit control signals to the laser energy control system; wherein the control signal transmitted by the laser pulse controller to the laser energy control system comprises a subcarrier signal that modulates the amount of electromagnetic energy of the laser pulse leaving the laser system; (ii) emitting electromagnetic radiation in the form of laser pulses from a laser; and (iii) outputting laser pulses from the laser system in accordance with the control signal transmitted by the laser pulse controller.

18. The method for controlling a surgical system according to claim 17, wherein: The subcarrier signal has a periodic pattern.

19. The method for controlling a surgical system according to claim 17, wherein: The control signal transmitted by the laser pulse controller to the laser energy control system further includes a threshold signal representing a threshold power.

20. The method for controlling a surgical system according to claim 17, wherein: The control signal transmitted by the laser pulse controller to the laser energy control system further includes a maximum power signal indicating a maximum power, and the subcarrier signal oscillates between the threshold power and the maximum power.

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