Method for optimizing laser parameters of ophthalmic laser of treatment device
Through the control device adjusting the laser parameters according to the treatment quality standards, the problem of poor adaptability of laser parameters of ophthalmic lasers is solved, and the stability and consistency of treatment quality are achieved.
Patent Information
- Application Number
- CN202410998888.6
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Priority Date
- 2023-08-03
- Filing Date
- 2024-07-24
- Publication Date
- 2025-02-14
AI Technical Summary
In the prior art, the laser parameters of ophthalmic lasers are difficult to adapt to different environmental conditions and the location of treatment equipment, resulting in unstable treatment quality.
The laser parameters are automatically or semi-automatically adjusted by the control device, and the laser pulse energy, spatial laser pulse distance and spatial laser pulse path distance are adjusted according to the quality standards of previous treatments to ensure the quality of subsequent treatments.
Continuous optimization of laser parameters is achieved, independent of the location and environmental conditions of the treatment equipment, and the stability and consistency of treatment quality are improved.
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Figure CN119424089A_ABST
Abstract
Description
Technical Field
[0001] The invention relates to a method for optimizing laser parameters of an ophthalmic laser of a therapeutic device. Furthermore, the invention relates to a control device configured to perform the method, a therapeutic device having such a control device, a computer program comprising commands for causing the therapeutic 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] In a treatment device, the laser pulse energy, the spatial laser pulse distance in the cornea and the spatial laser pulse path distance between adjacent laser pulse paths in the cornea are usually freely adjustable. The quality of the corneal tissue incision and / or ablation performed depends on the appropriate selection of these laser parameters. However, the appropriate selection of these laser parameters and thus the quality of the incision may also depend on the location of the treatment device, in particular the environmental conditions and / or other parameters. Therefore, it is usually not clear which laser parameters are most suitable for the respective treatment device and / or whether the laser parameters have to be adjusted over time. SUMMARY OF THE INVENTION
[0005] The object of the present invention is to optimize the laser parameters of an ophthalmic laser of a therapeutic device.
[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 of performing at least one treatment, preferably a plurality of treatments, using a treatment device, wherein the treatment quality or treatment result is automatically or manually restored by adapting the laser parameters accordingly. This means that the adjustment of the laser parameters can be provided based on at least one previously performed treatment.
[0008] One aspect of the invention relates to a method for optimizing laser parameters of an ophthalmic laser of a therapeutic device, wherein the method comprises the following steps performed by a control device, wherein the control device is understood to be an apparatus or an apparatus component, in particular a computer or a processor, which can automatically or semi-automatically perform the following steps.
[0009] A determination is made as to whether the quality of a treatment performed with a treatment device using first laser parameters corresponds to a preset treatment quality criterion, wherein the laser parameters include at least laser pulse energy, spatial laser pulse distance and spatial laser pulse path distance. If the quality of the treatment does not meet the treatment quality criterion, second laser parameters are provided, wherein at least one laser parameter is adjusted by a preset value, in particular depending on the treatment quality criterion, wherein the second laser parameters are used for a subsequent treatment performed with the treatment device.
[0010] In other words, a treatment using the treatment device may first be performed, which includes first laser parameters. Here, the laser parameters may include at least laser pulse energy, a distance between adjacent laser pulses, and a distance between adjacent laser pulse paths. For example, the treatment may be performed within the refractive correction range of the patient's cornea.
[0011] After performing the treatment, it can be checked whether the treatment quality complies with preset treatment quality criteria. The treatment quality can, for example, be determined automatically by a capture device (e.g. a camera), or the treatment quality can be determined by a user (in particular a doctor), who can provide the evaluation result to the control device. The treatment quality can, for example, include the incision quality, which means the success of tissue separation, the formation of an opaque bubble layer (in particular, occurs when the energy deposition in the tissue is too high), or the formation of black spots (occurs when the energy deposition in the tissue is too low). Therefore, various aspects of the treatment quality can be evaluated by treatment quality criteria, so that it can be decided whether the laser parameters are to be adjusted. Treatment quality criteria can be conditions or rules for checking the treatment quality.
[0012] If it is determined that the treatment quality does not meet the treatment quality standard, the first laser parameters can be adjusted so that second laser parameters are provided. For the second laser parameters, at least one of the first laser parameters can be changed by a preset value, in particular depending on the treatment quality and / or the treatment quality standard. This means that the laser pulse energy, the spatial pulse distance or the spatial laser pulse path distance or a plurality of the aforementioned laser parameters can be changed. In this case, it is particularly preferably provided that they are changed by a preset value, which is preset so that the corresponding laser parameter is changed in small steps so that the treatment quality standard is met.
[0013] In particular, the second laser parameters can be used for a subsequent treatment with the treatment device. This means that the treatment device can be controlled by the control device using the second laser parameters. Preferably, the method can be performed iteratively, which means that after providing the second laser parameters, it can be checked again whether the treatment quality corresponds to the treatment quality criterion, wherein the second laser pulse parameters can then be adjusted again. This means that when the method is repeated, the second laser parameters become the first laser parameters and it can be checked again whether the treatment quality criterion is met.
[0014] The invention has the advantage that laser parameters can be optimized continuously, in particular independently of the position of the treatment device and / or environmental conditions.
[0015] The invention also includes embodiments that produce additional advantages.
[0016] In one embodiment, the treatment quality criteria include at least one of the following aspects: the formation of an opaque bubble layer in the treatment area, the formation of black spots in the treatment area, the separation result (determined in particular by the required dissection time for irradiating the tissue) and / or the recovery result (determined in particular by the inflammatory reaction and the visual acuity achieved) can be checked. In other words, the treatment criteria can be used to check whether an opaque bubble layer is formed in the treatment area. If too high an energy deposition occurs in the tissue of the treatment area, an opaque bubble layer may appear because too much energy enters the tissue and changes and blurs its structure. For example, this can be determined by a capture device (in particular a camera). Alternatively or additionally, it can be checked whether a black spot is formed in the treatment area. For example, if the energy deposition in the tissue of the treatment area is not sufficient to separate the tissue, a black spot may be formed, so that the tissue changes and becomes black. The development of the black spot can also be determined by the capture device. Alternatively or additionally, the separation result can be checked by the treatment quality criteria, thereby checking the quality of the incision made by the laser in the treatment area. Here, the speed at which the irradiated tissue is separated or can be separated from the surrounding cornea can be determined in particular, where it can be provided as a dissection time. Alternatively or additionally, the recovery result can be checked by the treatment quality criteria. This means that the degree to which the patient tolerates the treatment with the treatment device having the first laser parameters can be checked. In this context, in particular an inflammatory reaction in the eye or cornea can be determined, for example by a physician, who can enter the result into the control device. For example, the visual acuity achieved, i.e. the visual limit after the treatment, can also be used to determine the recovery result. In other words, the speed with which the eye recovers after the treatment can be determined by the recovery result.
[0017] In another embodiment, the treatment quality criterion includes the formation of an opaque bubble layer in the treatment area, wherein when the opaque bubble layer is formed, in order to provide a second laser parameter for subsequent treatment, the laser pulse energy is reduced and / or wherein the spatial pulse distance and / or the spatial laser pulse path distance is increased. In other words, if an opaque bubble layer is formed in the treatment area when using the first laser parameters, the laser pulse parameters can be adjusted so that the result of the formula "laser pulse energy / (laser pulse distance*laser pulse path distance)" is reduced. Thus, the advantage is that the opaque bubble layer in the subsequent treatment can be avoided or reduced.
[0018] In another embodiment, the treatment quality criterion includes the formation of an opaque bubble layer in the treatment area, wherein, when the opaque bubble layer does not appear, in order to provide the second laser parameters for the subsequent treatment, the laser pulse energy is increased, and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is reduced. In other words, if the first laser parameters do not produce an opaque bubble layer, the energy deposition in the treatment area can be increased, for example to achieve an improved separation result. In particular, the result of the formula "laser pulse energy / (laser pulse distance*laser pulse path distance)" can be increased. Thereby, the advantage is that an optimized limit value between the development of an opaque bubble layer and an improved separation result can be iteratively approximated.
[0019] In another embodiment, the treatment quality criterion comprises the formation of a black spot in the treatment area, wherein, when a black spot is formed, the laser pulse energy is increased and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is reduced in order to provide the second laser parameters for the subsequent treatment. In other words, the formation of a black spot can be checked by the treatment quality criterion, wherein, if a black spot occurs, the energy deposition in the treatment area is increased. In particular, the result of the formula "laser pulse energy / (laser pulse distance*laser pulse path distance)" can be increased. Thereby, the advantage is that the formation of a black spot can be avoided or reduced.
[0020] In particular, provision is made for determining the formation of an opaque bubble layer and / or black spots in the treatment area by means of an imaging device. This means that the treatment device can, for example, use an imaging device (which comprises one or more cameras for monitoring the treatment area) to capture changes in the tissue, in particular the formation of an opaque bubble layer and / or black spots. The camera can, for example, record data in the visible or infrared spectral range. Thus, an advantage is that the treatment device can be used during the treatment to monitor treatment quality criteria.
[0021] In another embodiment, the treatment quality criterion includes a separation result, wherein, if the separation result is assessed as insufficient, the laser pulse energy is increased and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is reduced in order to provide a second laser parameter for subsequent treatment. In other words, the separation result can be checked by the treatment quality criterion. Here, for example, the separation result can be evaluated according to a preset scale, which at least provides a distinction between insufficient treatment and sufficient or good treatment. Preferably, a further evaluation stage can be provided, for example in the form of a school grade system. If the separation result is assessed as insufficient, the energy deposition in the tissue of the treatment area can be increased for subsequent treatment. In particular, the result of the formula "laser pulse energy / (laser pulse distance*laser pulse path distance)" can be increased. Preferably, the separation result can be input by a user (e.g., a doctor) via an input device, and the user can check and evaluate the separation result. The resulting advantage is that the separation of tissues can be continuously adjusted and improved.
[0022] In another embodiment, the treatment quality criterion comprises a recovery result, wherein, if the recovery result is assessed as insufficient, the laser pulse energy is reduced and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is increased in order to provide the second laser parameters for the subsequent treatment. This means that the recovery result or the patient's recovery can be checked by the treatment quality criterion, wherein - if insufficient - the energy deposition in the tissue of the treatment area can be reduced. In particular, the result of the formula "laser pulse energy / (laser pulse distance*laser pulse path distance)" can be reduced. Preferably, the recovery result can be input by a user (e.g. a doctor) via an input device, and the user can check and evaluate the recovery result. This has the advantage that the treatment can be continuously adjusted and improved.
[0023] In another embodiment, a degree is determined for the corresponding aspect of the treatment quality criterion, wherein the corresponding aspect is classified into severe, medium and mild degrees, wherein all three laser parameters are adjusted in the case of severe degree, wherein two laser parameters are adjusted in the case of medium degree, and wherein one of the laser parameters is adjusted in the case of mild degree. In other words, the corresponding aspect of the treatment quality criterion can be classified to understand how severely the aspect is affected. Here, the aspect of the treatment quality criterion refers to one of the previously mentioned characteristics, so that an aspect of the treatment quality criterion can include, for example, the formation of an opaque bubble layer, the formation of black spots, the separation result and / or the recovery result. They can be classified into at least one of three preset degrees, in particular severe, medium and mild degrees. For example, it can be checked how many opaque areas are formed in the cornea in the case of an opaque bubble layer, and then the degree can be classified accordingly. Therefore, according to the degree of opaque bubble layer, black spots, separation result and / or patient recovery, one to three laser parameters, in particular laser pulse energy, spatial laser pulse distance and / or spatial laser pulse path distance, can be adjusted accordingly. Therefore, in the case of an opaque bubble layer of a determined severity, the laser pulse energy can be reduced by, for example, 5 nJ, the laser pulse distance can be increased by 0.1 μm, and the laser pulse path distance can be increased by 0.2 μm. In the case of a moderate degree, the laser pulse energy can be reduced by 5 nJ, and the laser pulse path distance can be increased by, for example, 0.2 μm. In the case of a mild degree, the laser pulse energy can be reduced by only 5 nJ. This has the advantage that the optimized laser parameters can be achieved more quickly according to the degree of damage.
[0024] In another embodiment, the laser pulse energy is adjusted to a preset value of 5 nJ and / or the spatial laser pulse distance is adjusted to a preset value of 0.1 μm and / or the spatial laser pulse path distance is adjusted to a preset value of 0.2 μm. Here, "adjustment" means that the corresponding laser parameter can be increased or decreased by this value according to the non-existent treatment quality standard. These preset values represent a suitable adjustment possibility, in particular for iterative adjustment of laser parameters, because this provides a variation, but the variation is not too high to produce other damaging effects.
[0025] In another embodiment, limits are preset for the various laser parameters, and these limits will not be exceeded by adjusting the laser parameters, in particular, the lower limit of the laser pulse energy is 60nJ and the upper limit is 300nJ; the lower limit of the spatial laser pulse distance is 1.5μm and the upper limit is 18μm; the lower limit of the spatial laser pulse path distance is 0.5μm and the upper limit is 10μm. In other words, the range in which the laser parameters can be changed can be limited by the preset limits. Here, the preset limits can be preset so that the laser parameters do not exceed the safety regulations or the limitations of the treatment device.
[0026] In another embodiment, the laser parameters are adjusted according to the treatment position where it has been determined that the treatment quality is impaired. In other words, the laser parameters can be adjusted differently for different treatment positions or treatment sites in the cornea. Thus, for example, the laser parameters can only be adjusted in the peripheral area or in the center of the treatment. Thus, the laser parameters optimized for the treatment as a whole can, for example, only be adjusted when damage occurs. This can occur in particular when an opaque bubble layer is formed, wherein the formation can occur in particular at the beginning of the treatment in the peripheral area, wherein after the first cavitation bubble path is generated, sufficient space is provided to dissipate the excess energy, so that other laser parameters can be used in a more central treatment position. Thus, the advantage is that the treatment result can be improved.
[0027] In another embodiment, the treatment quality of a preset number of treatments performed using the first laser parameters is checked before providing the second laser parameters. In other words, the adjustment of the laser parameters is not performed after each treatment, but after a preset number of treatments. In particular, it can be provided that the adjustment of the laser parameters is performed after at least two, preferably a plurality of treatments (e.g. five or ten treatments). In this case, it is particularly preferred that statistical data from all previously performed treatments can also be formed in order to check the treatment quality by means of treatment quality criteria. This has the advantage that further improvement and optimization of the laser parameters can be provided.
[0028] Another aspect of the present invention relates to a method for controlling a therapeutic device. The method comprises the method steps of at least one embodiment of the method as described above. In addition, the method for controlling a therapeutic device further comprises the following steps: transmitting the provided second laser parameters to at least one ophthalmic laser of the therapeutic device, and controlling the therapeutic device and / or the laser using the second laser parameters and / or control data. The control data may include a corresponding data set for positioning and / or focusing individual laser pulses in the cornea. In addition or alternatively, the control data may include a corresponding data set for adjusting at least one beam device to perform beam guidance and / or beam shaping and / or beam deflection and / or beam focusing of the laser beam of the corresponding laser.
[0029] 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.
[0030] 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.
[0031] 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 of a human or animal eye with a predetermined interface by optical decomposition, 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.
[0032] 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, preferably between 900nm and 1200nm, and a repetition frequency greater than 10 kilohertz (kHz), preferably between 100kHz and 100 megahertz (MHz), with a corresponding pulse duration between 1fs and 1ns, preferably 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 a 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.
[0033] 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.
[0034] 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.
[0035] 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.
[0036] 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
[0037] 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:
[0038] Figure 1 is a schematic diagram of a therapeutic device according to an exemplary embodiment;
[0039] Figure 2 is a schematic process diagram according to an exemplary embodiment.
[0040] In the figures, identical or functionally identical elements are provided with the same reference symbols. DETAILED DESCRIPTION OF THE INVENTION
[0042] Figure 1 A schematic diagram of a treatment device 10 is shown, which is provided with an ophthalmic laser 12 for removing tissue 14 from a human or animal cornea 16 by photodestruction and / or ablation. For example, the tissue 14 may represent a microlens or a volume, which may be separated from the cornea 16 by the ophthalmic surgical laser 12 to correct a visual disorder. The control device 18 may provide a corrective contour or geometry of the tissue 14 to be removed, in particular in the form of control data, so that the laser 12 emits pulsed laser pulses to the cornea 16 of the eye in a pattern predefined by the control data to remove the tissue 14. In addition, the control device 18 may also provide laser parameters, which define at least the laser pulse energy, the spatial laser pulse distance and the spatial laser pulse path distance. Alternatively, the control device 18 may be a control device 18 that is external to the treatment device 10.
[0043] also, Figure 1It is shown that a laser beam 20 generated by a laser 12 can be deflected toward a cornea 16 by a beam deflection device 22 (eg, a rotary scanner) to remove tissue 14. The beam deflection device 22 can also be controlled by a control device 18 to remove tissue 14.
[0044] Preferably, the illustrated laser 12 may be a photodisruptive and / or photoablative laser formed to emit laser pulses having a wavelength in the range of between 300 nanometers and 1400 nanometers, preferably between 700 nanometers and 1200 nanometers, with a respective pulse duration between 1 femtosecond and 1 nanosecond, preferably between 10 femtoseconds and 10 picoseconds, and a repetition frequency of the laser pulses greater than 10 kilohertz, preferably between 100 kilohertz and 100 megahertz. In addition, the control device 18 optionally comprises a storage device (not shown) for at least temporarily storing at least one control data set, wherein one or more control data sets comprise control data for positioning in the cornea and / or for focusing individual laser pulses.
[0045] also, Figure 1 A camera device 24 is shown which can be formed to monitor the treatment area of the cornea 16. The camera device 24 can, for example, be part of the treatment device 10 or be provided separately therefrom. The data that can be recorded by the camera device 24 can be provided to the control device 18, in particular for checking the quality of the treatment.
[0046] For example, the inspection of the treatment quality can be used to appropriately adjust or optimize the laser parameters of the treatment device 10 to improve the treatment results. Figure 2 The method shown in .
[0047] Figure 2 A method diagram is shown for optimizing laser parameters of an ophthalmic laser 12 of a treatment device 10. In step S10, a treatment may be performed using the treatment device 10, wherein the laser 12 and / or the beam deflection device 22 may be controlled using first laser parameters, the first laser parameters comprising at least laser pulse energy, spatial laser pulse distance, and spatial laser pulse path distance.
[0048] In step S12, the treatment quality of the treatment performed using the first laser parameters can then be checked. To this end, the incisions made in the cornea 16 for separating the tissue 14 can be captured, for example, by the camera device 24, wherein they can then be checked by the control device 18 whether they meet one or more treatment quality criteria. Alternatively or additionally, the treatment quality criteria can also be checked by a user (e.g. a doctor), wherein the results of this check (e.g. an assessment of the recovery period of the incision and / or the patient or the cornea 16) can be provided to the control device 18 via a user interface (not shown).
[0049] The treatment quality criteria that can be checked for checking the treatment quality may include at least one, preferably more, of the following aspects: the formation of an opaque bubble layer in the cornea 16 may be checked, the formation of black spots in the cornea 16 may be checked, the separation result of the incision surface of the volume body 14 may be checked, and / or the recovery result, i.e., for example, the inflammatory reaction after treatment, may be checked.
[0050] In step S14, if the treatment quality does not meet the treatment quality standard, the first laser parameter can be adjusted to a second laser parameter, wherein at least the laser pulse energy and / or the spatial laser pulse distance and / or the spatial laser pulse path distance can be adjusted to a preset value compared to the first laser parameter.
[0051] For example, it may be determined that an opaque bubble layer is formed in the cornea, wherein in this case the laser pulse energy may be reduced. Alternatively or additionally, the spatial laser pulse distance and / or the spatial laser pulse path distance may be increased. Conversely, if an opaque bubble layer is not formed and the treatment quality still does not meet the treatment quality criteria, the laser pulse energy may be increased and / or the distance may be reduced to improve tissue separation.
[0052] Alternatively or additionally, it can be checked whether dark spots occur when irradiating the treatment area of the cornea 16 with the first laser parameters, wherein in this case the laser pulse energy can be increased and / or the laser pulse distance can be reduced.
[0053] Alternatively or additionally, the separation result can be checked, for example whether the volume 14 can be removed from the cornea 16 without difficulty, wherein, if the separation result is assessed to be insufficient, the laser pulse energy can be increased and / or the spatial laser pulse distance and the spatial laser pulse path distance, respectively, can be reduced for subsequent treatment.
[0054] Specifically, in order to increase or decrease the laser parameters for providing the second laser parameters, it may be provided that the laser pulse energy is increased or decreased by a preset value of 5 nJ and / or the spatial laser pulse distance is increased or decreased by a preset value of 0.1 μm and / or the spatial laser pulse path distance is increased or decreased by a preset value of 0.2 μm. Here, it may be preferably provided that the value of the laser pulse energy is adjusted to be not less than 60 nJ and not more than 300 nJ, the laser pulse distance is adjusted to be not less than 1.5 μm and not more than 18 μm, and the laser pulse path distance is adjusted to be not less than 0.5 μm and not more than 10 μm.
[0055] Furthermore, how large or to what extent one of the above effects is in the cornea 16 can be evaluated by the treatment quality criteria. Preferably, they can be divided at least according to severity, moderate degree and mild degree. If it is determined that there is a severity, the laser pulse energy, the spatial laser pulse distance and the spatial laser pulse path distance can be adjusted simultaneously. In the case of moderate degree, both laser parameters can be adjusted, while in the case of mild degree, only one of the laser parameters can be adjusted.
[0056] In step S16, the second laser parameters can be finally adjusted for a subsequent treatment with the treatment device 10 and the laser can be controlled with the second laser parameters. Preferably, provision can be made that the method can then be repeated iteratively, which is indicated by the dashed line between step S16 and step S10. Thus, the laser parameters can be optimized continuously. Preferably, provision can be made that the laser parameters are not adjusted after each treatment, but, if an adjustment is necessary, can only be checked after a preset number of treatments, wherein statistical data can be created in particular from the performed treatments to check the presence of treatment quality criteria.
[0057] Overall, these embodiments demonstrate how to achieve automatic optimization of laser parameters.
Claims
1. A method for optimizing laser parameters of an ophthalmic laser (12) of a therapeutic device (10), wherein the method comprises the following steps performed by a control device (18): - determining (S12) whether the quality of the treatment (S10) performed using the treatment device with the first laser parameters meets a preset treatment quality standard, wherein the laser parameters include at least laser pulse energy, spatial laser pulse distance and spatial laser pulse path distance; - if the treatment quality does not meet the treatment quality standard, providing a second laser parameter (S14), wherein at least one laser parameter is adjusted to a preset value; - wherein the second laser parameters are used for subsequent treatment using the treatment device (S16).
2. The method according to claim 1, wherein: The treatment quality standard includes at least one of the following aspects: - Formation of an opaque layer of bubbles in the treatment area; - the formation of dark spots in the treated area; - the separation result, which is determined in particular by the dissection time required for the irradiated tissue; - Recovery outcome, which is determined in particular by the inflammatory response and / or the visual acuity achieved.
3. The method according to claim 1, wherein: The treatment quality standard includes forming an opaque bubble layer in the treatment area, wherein when forming the opaque bubble layer, in order to provide the second laser parameters for the subsequent treatment, the laser pulse energy is reduced and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is increased.
4. A method according to any one of the preceding claims, wherein: The treatment quality criterion includes forming an opaque bubble layer in the treatment area, wherein when the opaque bubble layer does not appear, in order to provide the second laser parameters for the subsequent treatment, the laser pulse energy increases and / or decreases the spatial laser pulse distance and / or the spatial laser pulse path distance.
5. A method according to any one of the preceding claims, wherein: The treatment quality criterion comprises the formation of a black spot in the treatment area, wherein when the black spot is formed, the laser pulse energy is increased and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is reduced in order to provide the second laser parameters for the subsequent treatment.
6. The method according to any one of claims 2 to 5, wherein: The formation of the opaque bubble layer and / or the black spots in the treatment area is determined by a camera device (24).
7. A method according to any one of the preceding claims, wherein: The treatment quality criterion comprises a separation result, wherein, if the separation result is assessed as insufficient, the laser pulse energy is increased and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is decreased in order to provide the second laser parameters for the subsequent treatment.
8. A method according to any one of the preceding claims, wherein: The treatment quality criterion comprises a recovery result, wherein if the recovery result is assessed as insufficient, the laser pulse energy is reduced and / or the spatial laser pulse distance and / or the spatial laser pulse path distance is increased in order to provide the second laser parameters for the subsequent treatment.
9. The method according to any one of claims 2 to 8, wherein: The extent of the respective aspect of the treatment quality criterion is determined, wherein the respective aspect is classified into a severe extent, a moderate extent and a mild extent, wherein in the case of the severe extent all three laser parameters are adjusted, wherein in the case of the moderate extent two laser parameters are adjusted, and wherein in the case of the mild extent one of the laser parameters is adjusted.
10. The method according to any one of the preceding claims, wherein: The laser pulse energy is adjusted to a preset value of 5 nJ and / or the spatial laser pulse distance is adjusted to a preset value of 0.1 μm and / or the spatial laser pulse path distance is adjusted to a preset value of 0.2 μm.
11. A method according to any one of the preceding claims, wherein: Preset limits are preset for each laser parameter, and the adjustment of the laser parameters does not exceed the preset limits. In particular, the lower limit of the laser pulse energy is 60nJ, and the upper limit is 300nJ; the lower limit of the spatial laser pulse distance is 1.5μm, and the upper limit is 18μm; the lower limit of the spatial laser pulse path distance is 0.5μm, and the upper limit is 10μm.
12. A method according to any one of the preceding claims, wherein: The laser parameters are adjusted based on the treatment location where it has been determined that the quality of the treatment is impaired.
13. A method according to any one of the preceding claims, wherein: Prior to providing the second laser parameters, a predetermined number of treatments performed using the first laser parameters are checked for treatment quality.
14. Control device (18) configured to carry out a respective method according to any of the preceding claims.
15. Therapeutic device (10) comprising: at least one eye laser (12) for separating a corneal volume (14) with a predefined interface of a human or animal eye by optical breakdown, in particular by photodestruction and / or photoablation, and at least one control device (18) according to claim 14.
16. Computer program comprising instructions causing a therapeutic device (10) according to claim 15 to perform a method according to any one of claims 1 to 13.
17. Computer readable medium having stored thereon a computer program according to claim 16.