Method for providing control data for ophthalmic laser of treatment device

Abstract

A method for providing control data for an ophthalmic laser (12) of a treatment device (10) for treating a cornea (16) of a human and / or animal eye. As a step, the method carried out by the control device (18) comprises: determining (S10) eye parameters as a function of predetermined examination data; determining (S12) an initial correction parameter for treating the cornea (16) from the eye parameter; determining (S14) treatment outcome data by a database (24) comprising predetermined treatment outcomes of previous corneal treatments, where the treatment outcome data is retrieved from treatments having comparable eye parameters and initial corrective parameters; determining (S16), from the retrieved treatment result data, whether a treatment of the corneal treatments has aberrated; adjusting (S18) an initial correction parameter for treating the cornea (16) as a function of the aberration determined from the treatment result data; and providing (S20) control data, the control data comprising the adjusted correction parameter.

Description

Technical Field

[0001] The invention relates to a method for providing control data for an ophthalmic laser of a treatment device for treating the cornea of ​​a human or animal eye. Furthermore, the invention relates to a control device configured to perform the method, a treatment device having such a control device, a computer program comprising commands for causing the treatment device to perform the method, and a computer-readable medium having the computer program stored thereon. Background Art

[0002] Therapeutic devices and methods for controlling ophthalmic lasers to correct optical visual disorders or pathological and / or unnaturally altered areas of the cornea are known in the prior art, wherein the pulsed laser and the beam focusing device can, for example, be formed such that the laser pulses achieve photodisruption and / or ablation in a focus located within the organic tissue to remove tissue, in particular tissue lenticules, from the cornea.

[0003] When the eye is treated with ophthalmic lasers, new aberrations may occur after corneal correction, especially spherical aberrations, which were not present before. Such new aberrations can cause disturbing side effects, which are difficult to estimate before treatment. SUMMARY OF THE INVENTION

[0005] The object of the present invention is to provide improved corneal correction, in particular while avoiding newly created aberrations.

[0006] This object is solved by the independent claims. Advantageous embodiments of the invention are disclosed in the dependent claims, the following description and the drawings.

[0007] The invention is based on the idea that newly introduced aberrations can be pre-compensated by determining from pre-treatment statistical data with identical treatment parameters and physiological conditions which aberrations typically occur and which can then be taken into account and pre-compensated for the benefit of the individual treatment.

[0008] One aspect of the invention relates to a method for providing control data for an ophthalmic laser of a treatment device for treating the cornea of ​​a human and / or animal eye, wherein the method comprises the following steps performed by a control device, wherein the control device refers to an apparatus and / or an apparatus component, in particular a computer and / or a processor, which can perform the following steps in an automatic and / or semi-automatic manner (i.e. inputting data and / or commands).

[0009] In the method, the following are achieved: determining eye parameters based on predetermined examination data; determining initial correction parameters for treating the cornea based on the eye parameters; determining treatment result data through a database, the database including predetermined treatment results of previous corneal treatments, wherein the treatment result data is retrieved from treatments with comparable eye parameters and initial correction parameters; determining whether aberrations are produced by the treatments in these corneal treatments through the retrieved treatment result data; adjusting the initial correction parameters for treating the cornea based on the aberrations determined from the treatment result data; and providing control data including the adjusted correction parameters.

[0010] In other words, eye parameters which the eye and / or cornea have before the treatment can first be determined by means of the control device from predetermined examination data. As examination data, for example, topographic measurement results, wavefront measurement results and / or subjective visual impairment data can be predetermined, in particular examination data determined with a phoropter. Eye parameters can then be determined based on these examination data, for example, curvatures, initial aberrations and / or subjective refractive values ​​in the form of sphere values, cylinder values ​​and / or axial values. In other words, the eye parameters can include values ​​which are the basis for the ophthalmic laser treatment.

[0011] Corrective parameters for treating the cornea can then be determined therefrom, for example, to correct a visual disturbance determined from the eye parameters. In particular, an aspheric correction of the cornea can be planned. In particular, the corrective parameters can include refractive values, in particular spherical, cylindrical and axial correction values, optical zones, treatment centering and / or curvature values ​​to be achieved (K readings).

[0012] Subsequently, it can be checked via a database whether patients with identical or similar eye parameters have been treated with identical or similar correction parameters, wherein the treatment results have been predetermined for these patients and stored in the database. If it is determined that one or more of these patients developed aberrations during the treatment, in particular spherical aberration, coma or trefoil aberration, these aberrations can be pre-compensated by adjusting the correction parameters so that no new aberrations are introduced by the treatment. Furthermore, statistical data can be created based on the treatment result data present in the database, which aberrations have occurred in the respective cases, wherein the statistically most frequently introduced aberrations can be pre-compensated. If it is determined that no aberrations were introduced during the treatment, no further adjustment of the initial correction parameters is required.

[0013] The initial correction parameters are the corrections initially planned for the treatment of the visual disturbance, which can be determined from the eye parameters. Therefore, the adjusted correction parameters also include the correction of the visual disturbance as well as the compensation of the aberrations expected for the treatment.

[0014] Treatment outcome data, which may be predetermined in a database, may be collected based in particular on medical follow-up examinations after treatment and provide statements about treatment success and / or newly introduced aberrations.

[0015] The invention provides the advantage that expected aberrations can be pre-compensated in a simple manner, thereby improving treatment with an ophthalmic laser of a treatment device.

[0016] The invention also includes embodiments that produce additional advantages.

[0017] In one embodiment, the correction parameter values ​​of the aspheric refractive correction include in particular sphere values, cylinder values, axis values ​​and / or addition values, and / or parameters of the planned optical zone, in particular the diameter and / or centering of the optical zone, and / or planned curvature values. In other words, the correction parameters provide values ​​for correcting visual disorders and planned treatments.

[0018] In further embodiments, the eye parameters include corneal thickness and / or preoperative keratometric value and / or epithelial thickness and / or visual impairment value.Herein, subjectively determined visual impairment value refers to a visual impairment value, which can be determined, for example, by a phoropter.

[0019] In a further embodiment, higher order aberrations, in particular spherical aberration, coma and / or trefoil aberration, are determined from the treatment outcome data and compensated by adjusting the correction parameters. This means that the treatment outcome data provided in the database may include newly introduced aberrations, in particular higher order aberrations, for example determined by a subsequent examination.

[0020] In a further embodiment, a statistical value of the aberration of all treatment results with comparable eye parameters and initial correction parameters is determined with the aid of the retrieved treatment result data, wherein the adjustment of the initial correction parameters is performed based on the statistical value. In other words, a statistical evaluation of the treatment result data of all previous corneal treatments can be performed, wherein the same or similar eye parameters and initial correction parameters exist or have been used. The statistical value can, for example, include a mean value or a median value. For example, it can be known from the treatment result data that spherical aberration has occurred under the current eye parameters and the initial correction parameters, wherein the statistical value can indicate the severity of the spherical aberration from all previous treatments. Therefore, compensation for this aberration can be planned in an improved manner.

[0021] A method for controlling a therapeutic device may also be provided. The method may include the method steps of at least one embodiment of the method as described above. In addition, the method for controlling a therapeutic device may further include the step of transmitting the provided control data to at least one ophthalmic laser of the therapeutic device and controlling the therapeutic device and / or the laser using the control data.

[0022] The corresponding method may include at least one additional step, which is performed if and only if an application case or application situation occurs, which application case or application situation is not explicitly described here. For example, this step may include outputting an error message and / or outputting a request for input user feedback. Additionally or alternatively, it may be provided that a default setting and / or a predetermined initial state are adjusted.

[0023] Another aspect of the present invention relates to a control device, which is formed to perform the steps of at least one embodiment of one or both of the aforementioned methods. In addition, the control device may include a computing unit, such as a processor, for electronic data processing. The computing unit may include at least one microcontroller and / or at least one microprocessor. The computing unit may be configured as an integrated circuit and / or a microchip. In addition, the control device may include an (electronic) data memory or a storage unit. A program code may be stored on a data memory, by which the steps of the corresponding embodiments of the corresponding method are encoded. The program code may include control data for the corresponding laser. The program code may be executed by a computing unit, thereby causing the control device to perform the corresponding embodiment. The control device may be formed as a control chip or a control unit. The control device may, for example, be included in a computer or a computer cluster.

[0024] Another aspect of the invention relates to a treatment device having at least one eye surgery or ophthalmic laser and a control device, which is formed to perform the steps of at least one embodiment of one or both of the above-mentioned methods. The corresponding laser can be formed to at least partially separate a predetermined corneal volume from a predetermined interface of the human or animal eye by optical breakdown, in particular by photodisruption and / or by ablating corneal layers by means of (photo)ablation and / or achieving a laser-induced refractive index change in the cornea and / or the eye lens and / or increasing cross-linking of the cornea.

[0025] In another embodiment of the treatment device according to the invention, the laser can be suitable for emitting laser pulses with a wavelength range between 300nm and 1400nm, for example between 900nm and 1200nm, and a repetition frequency greater than 10 kilohertz (kHz), for example between 100kHz and 100 megahertz (MHz), with a corresponding pulse duration between 1fs and 1ns, for example between 10fs and 10ps. The use of such a laser in the method according to the invention also has the advantage that the irradiation of the cornea does not have to be carried out in a wavelength range below 300nm. This range is included in the term "deep ultraviolet" in laser technology. As a result, accidental damage to the cornea caused by these extremely short wavelength and high-energy beams is advantageously avoided. Photodisruptive and / or ablative lasers of the type used here usually input pulsed laser radiation with a pulse duration between 1fs and 1ns into the corneal tissue. As a result, the power density of the corresponding laser pulses required for optical breakdown can be narrowly limited spatially, so that high cutting accuracy can be achieved in the generation of the interface. In particular, the range between 700 nm and 780 nm may also be selected as the wavelength range.

[0026] In another embodiment of the therapeutic device according to the invention, the control device may include at least one storage device for at least temporarily storing at least one control data set, wherein one or more control data sets include control data for positioning and / or for focusing individual laser pulses in the cornea; and may include at least one beam device for beam guiding and / or beam shaping and / or beam deflection and / or beam focusing of the laser beam of the laser.

[0027] Another aspect of the invention relates to a computer program. The computer program includes, for example, commands forming a program code. The program code may include at least one control data set having corresponding control data for a corresponding laser. When the program code is executed by a computer or a computer cluster, the previously described method or at least one embodiment thereof is performed.

[0028] Another aspect of the present invention relates to a computer-readable medium (storage medium) on which the above-mentioned computer program and its commands are stored respectively. In order to execute the computer program, a computer or a computer cluster can access the computer-readable medium and read out its content. For example, the storage medium is formed as a data memory, in particular at least partially formed as a volatile or non-volatile data memory. The non-volatile data memory can be a flash memory and / or an SSD (solid state drive) and / or a hard disk. The volatile data memory can be a RAM (random access memory). For example, the command can exist as a source code of a programming language and / or as an assembler and / or as a binary code.

[0029] Further features and advantages of one of the aspects described herein may result from the embodiments of another aspect of the invention. Therefore, if the features of the embodiments of the invention are not explicitly described as mutually exclusive, they may exist in any combination with each other. BRIEF DESCRIPTION OF THE DRAWINGS

[0030] Below, additional features and advantages of the present invention are described in the form of advantageous implementation examples based on the accompanying drawings. The features or feature combinations of the implementation examples described below may exist in any combination in combination with each other and / or with the feature combinations of the implementation examples. This means that the features of the implementation examples may supplement and / or replace the features of the implementation examples, and vice versa. Therefore, configurations are also considered to be covered and disclosed by the present invention, which are not explicitly shown or explained in the drawings, but are produced and can be generated by separate feature combinations from the implementation examples and / or implementation examples. Therefore, configurations are also considered to be disclosed, which do not include all the features of the originally proposed claims or extend beyond or deviate from the feature combinations set forth in the relationship of the claims. For the implementation examples, it is shown:

[0031] Figure 1 is a schematic diagram of a therapeutic device according to an exemplary embodiment;

[0032] Figure 2 is a schematic diagram of a method for providing control data according to an exemplary embodiment.

[0033] In the figures, identical or functionally identical elements are provided with the same reference symbols. DETAILED DESCRIPTION OF THE INVENTION

[0035] Figure 1 A schematic diagram of a treatment device 10 is shown with an ophthalmic laser 12 for removing tissue or a volume 14 from a human or animal cornea 16 by photodestruction and / or ablation. The volume 14 may, for example, represent a lenticule, which may be separated from the cornea 16 by the ophthalmic surgical laser 12 in order to correct a visual disorder. The control device 18 may provide the corrective parameters or the geometry of the volume 14 to be removed, in particular in the form of control data, so that the laser 12 emits pulsed laser pulses into the cornea 16 of the eye in a pattern predefined by the control data in order to remove the volume 14. Alternatively, the control device 18 may be a control device 18 external to the treatment device 10.

[0036] also, Figure 1 It is shown that a laser beam 20 generated by a laser 12 can be deflected toward the cornea 16 by a beam deflection device 22 (eg, a rotary scanner) to remove the volume 14. The beam deflection device 22 can also be controlled by a control device 18 to remove the volume 14.

[0037] In particular, the illustrated laser 12 may be a photodisruptive and / or photoablative laser formed to emit laser pulses having a wavelength in the range of 300 nm to 1400 nm, for example, 700 nm to 1200 nm, with a corresponding pulse duration between 1 femtosecond and 1 nanosecond, for example, between 10 femtoseconds and 10 picoseconds, and a repetition frequency of the laser pulses greater than 10 kHz, for example, between 100 kHz and 100 MHz. In addition, the control device 18 optionally includes a storage device (not shown) for at least temporarily storing at least one control data set, wherein one or more control data sets include control data for positioning and / or for focusing individual laser pulses in the cornea.

[0038] Furthermore, a database 24 is shown, which may belong to the treatment device 10 or may be provided externally. In particular, the control device 18 may comprise a data link to the database, so that data are retrieved from the database. In the database, treatment result data may be stored, which have the treatment results of previous corneal treatments. This means that treatment success or complications, in particular the development of new aberrations resulting only from the treatment, may be stored in the form of treatment result data.

[0039] In laser treatment, it may happen that after the volume 14 is removed from the cornea 16, the treatment with the treatment device 10 may cause aberrations, which may impair the treatment result, for example due to decentration of the volume 14 or other effects. In order to reduce or avoid the generation of new aberrations in such treatment, a control device 18 may be provided to perform Figure 2 The method shown in .

[0040] Figure 2 A schematic diagram of a method for providing control data to an ophthalmic laser 12 of a treatment device 10 for treating a cornea 16 is shown.

[0041] In step S10, eye parameters can be determined from predetermined examination data. In this case, examination data can be recorded within the scope of diagnostic measurements before the treatment, wherein the eye parameters include, for example, corneal thickness and / or preoperative curvature values ​​of the cornea and / or epithelial layer thickness and / or visual impairment values, in particular subjectively determined visual impairment values. For example, already existing aberrations can also be determined as eye parameters from the examination data. The examination data can come from an external device, for example from a database 24.

[0042] In step S12, initial correction parameters for treating the cornea may be determined based on the determined eye parameters. The initial correction parameters may indicate values ​​that are required to compensate for the visual impairment of the eye determined based on the eye parameters. For example, the aspheric refractive correction that the cornea should have after treatment, the diameter of the planned optical zone, or the centering and / or curvature values ​​of the optical zone may belong to the values.

[0043] In step S14 , the control device 18 may in particular retrieve treatment result data from the database 24 , in which treatment results of previous corneal treatments may be stored, for example treatment results of corneal treatments in which comparable eye parameters and initial correction parameters existed before the treatment.

[0044] The treatment result data can then be checked in step S16 to determine whether the treatment has produced aberrations in these comparable treatments. In particular, the statistical data of the treatment result data can be used to check which aberrations have occurred in the corresponding treatments and to what extent, which means the degree of the aberrations.

[0045] In step S18 , the initial correction parameters may be adjusted such that expected aberrations (in particular aberrations expected according to their statistical data) are compensated by adjusting the correction parameters and therefore do not even occur during treatment with the treatment device 10 .

[0046] Finally, control data for controlling the ophthalmic laser 12, which control data is generated based on the adjusted correction parameters, can be provided in step S20. The treatment device 10, in particular the ophthalmic laser 12 and / or the beam deflection device 22, can then be controlled by the control data to remove the volume 14 by the adjusted correction parameters.

[0047] Overall, these examples demonstrate how the present invention can provide aspheric compensation.

Claims

1. A method for providing control data for an ophthalmic laser (12) of a treatment device (10) for treating a cornea (16) of a human and / or animal eye, wherein the method comprises the following steps performed by a control device (18): - determining (S10) eye parameters based on predetermined examination data; - determining (S12) initial correction parameters for treating the cornea (16) based on the eye parameters; - determining (S14) treatment outcome data by means of a database (24) comprising predetermined treatment outcomes of previous corneal treatments, wherein said treatment outcome data are retrieved from treatments having comparable eye parameters and initial correction parameters; - determining (S16) whether the treatment in these corneal treatments has produced aberrations through the retrieved treatment result data; - adjusting (S18) initial correction parameters for treating the cornea (16) according to the aberrations determined from the treatment result data; - providing (S20) said control data, the control data comprising the adjusted correction parameters.

2. The method according to claim 1, wherein: The correction parameters comprise values ​​of the aspheric refractive correction, in particular spherical values, cylinder values, axis values ​​and / or add values, and / or parameters of the planned optical zone, in particular the diameter and / or centering of the optical zone, and / or planned curvature values.

3. A method according to any one of the preceding claims, wherein: The eye parameters include corneal thickness and / or a preoperative curvature value of the cornea (16) and / or an epithelial layer thickness and / or a visual impairment value.

4. A method according to any one of the preceding claims, wherein: Higher-order aberrations, in particular spherical aberration, coma and / or trefoil, are determined from the treatment outcome data and compensated by adjustment of the correction parameters.

5. A method according to any one of the preceding claims, wherein: By means of the retrieved treatment result data, statistical values ​​of the aberrations of all treatment results with comparable eye parameters and initial correction parameters are determined, wherein an adjustment of the initial correction parameters is performed based on the statistical values.

6. A control device (18) configured to carry out the method according to any of the preceding claims.

7. Treatment device (10) comprising: at least one eye surgery laser (12) for separating a corneal volume (14) of a human or animal eye by optical breakdown, in particular photodestruction and / or photoablation, and at least one control device (18) according to claim 6.

8. Computer program comprising instructions causing a therapeutic device (10) according to claim 7 to perform a method according to any one of claims 1 to 5.

9. Computer readable medium having stored thereon a computer program according to claim 8.

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