Device and method for generating at least one cutting surface, device and method for generating control data

Abstract

The invention relates to a device for generating at least one cut surface and to an associated method. The device (100) is used for generating at least one cutting surface in a processing volume (17). The device comprises a laser system (110) having: a laser device (4) for generating a laser beam (6); a beam splitter arrangement (70) having beam splitter optics (70a) for generating a plurality of synchronized laser output beams (90 to 93); a movable focusing optics (18) for focusing the laser output beam as a spot (19) into the processing volume (17); and movement means (8) for moving the focusing optics (18) on at least one path (B) selected from the group consisting of a path in a direction determined by spatial directions x, y and z, a path relative to the central reference axis (a), a path relative to the central axis (A) of the processing volume, and a combination of said paths. The device comprises a control device (11) which is designed to control the beam splitter device (70) and the movement device (8) in such a way that a spot (19) of each laser output beam (90 to 93) in the processing volume (17) is moved on and / or along a respective scanning path (19a), and / or on a respective surface (19c).

Description

TECHNICAL FIELD

[0001] The invention relates to a device for generating at least one cutting surface, in particular for correcting the refractive state of an eye by reshaping the cornea, and a related method, a device for generating control data and a related method, a device for correcting the refractive state of an eye and a related method, and a software product for carrying out the methods. BACKGROUND

[0002] Humans have historically corrected refractive errors by means of additional lenses in the form of eyeglasses. In recent years, various methods have emerged for correcting the refractive errors of the eye by means of reshaping the cornea. This reshaping is intended to change the curvature of the cornea. In order to correct myopia, the anterior surface of the cornea must be flattened, so that more volume is removed centrally, i.e. in the region of the visual axis, than at the edge. Conversely, in order to correct hyperopia, the curvature of the anterior surface of the cornea must be made greater, so that more volume is removed at the edge than centrally. This affects the overall imaging properties of the eye, so that the refractive error is reduced, or in the ideal case even completely corrected.

[0003] For such vision correction surgery, various different surgical methods are known. In the so-called LASIK procedure according to EP 1719483 A1, a corneal flap is first peeled away from one side of the corneal surface and folded to one side. In this way, the interior of the cornea is exposed, and the tissue therein is then vaporized using an ablation laser, a process also known as lysis or photodisruption. Subsequently, the corneal flap is folded back into place, and the natural anterior surface of the cornea remains intact. Since vaporization has taken place in the interior of the cornea, the curvature of the front of the cornea changes, which is determined in such a way that the original refractive error is corrected. In this case, material removal takes place by ablation. Ablation, also known as photodisruption, vaporizes tissue when laser radiation is absorbed on the tissue surface. Pulsed laser radiation is used, and each pulse vaporizes a certain volume of corneal tissue. Multiple irradiations are distributed over the exposed interior of the cornea, so that the required tissue is completely ablated.

[0004] Unlike this ablation technique, according to WO 2005 / 011545 Al, a cutting plane is generated inside the tissue, which, for example, defines a tissue block as an interface and makes it removable. Unlike ablation, for this purpose laser radiation is used which penetrates the surface into the interior of the material, i.e. is not absorbed at the surface. This laser radiation is concentrated in a focal point inside the tissue in the form of short pulses. Thereby, a specific power density is achieved at the focal point in space and time, so that tissue layers inside the tissue are separated. Here, the separation essentially takes place at the focal point or in the surrounding area immediately adjacent to the focal point. Inside / surrounding the focal point, a so-called optical breakdown limited to a few micrometers can occur, for example in the form of a plasma bubble. However, some solutions are also known which work without such a breakdown, for example by overlapping multiple focal point positions. In all cases, the cutting plane is generated directly inside the tissue by means of multiple optical focal point positions. Only in this way can a cutting plane be generated inside the cornea which defines a tissue block as an interface and makes it removable. This is not possible with ablation. Control data for ablation-based techniques (so-called "pulse files") are also not suitable for generating a cutting plane inside the tissue - mainly because they do not contain depth coordinates, since the ablation radiation is absorbed at the surface of the tissue.

[0005] In the prior art, the term "ablation" also refers to the vaporization of tissue inside the cornea by pulsed laser radiation. For example, in US 5984916 A, it is envisaged to dissolve a tissue block to be removed directly within the corneal stroma. For this purpose, the term "intrastromal ablation" is used. However, it turned out that this vaporization leads to unacceptably high gas pressure inside the cornea. Therefore, this approach was not further investigated and was never put into practical use.

[0006] A very successful method, which is known as SMILE, has been developed by Carl Zeiss Meditec AG (see, for example, DE 102007019813 A1). This method uses pulsed laser radiation to isolate a lenticule in the cornea, which can then be removed from the cornea through a side-cutting incision that leads to the corneal surface and serves as a working channel. To this end, a suitable cutting surface is generated in the corneal tissue by a plurality of laser focus points. These focus points are arranged in a specific pattern on the corneal tissue, which ultimately defines the shape and orientation of the cutting surface. The tissue block of the lenticule is structured and dimensioned such that the curvature of the anterior surface of the cornea can be changed as required for correction. This method achieves a subtractive correction by removing volume. Another option is to embed an implant in the cornea. To this end, a small incision is introduced into the cornea, into which the implant is inserted. This implant is designed such that it changes the curvature of the anterior surface of the cornea in the desired manner. This option thus achieves an additive correction by adding volume. In both cases, an incision has to be generated inside the cornea. This is achieved using laser radiation.

[0007] In ophthalmic surgery or eye measurements, it is common to move a plurality of laser beams simultaneously over the eye of a patient. The movement of one or more laser beams over the eye is also referred to as scanning. In order to generate a plurality of laser beams from a single laser beam, there are beam splitter devices, for example US 20130231644 A1, WO 2022194484 A1 and US 2019159933 A1. Some laser systems are also known from the prior art, which focus the laser beam by means of a so-called micro-lens, which is moved over the volume to be cut, for example DE 102015212877 A1 and US 20210386586 A1. Furthermore, there are also systems which can produce two laser beams in order to cut two surfaces at different corneal depths, for example US 11090191 B2. Such systems have various disadvantages in terms of scanning time and cutting of arbitrary lenticule geometries, in particular higher-order lenticules (custom lenticules), since the Multispots spacing is too large to ensure effective interaction. Furthermore, the spot spacing and the number of spots remain essentially constant. SUMMARY

[0008] It is an object of the present application to provide a device and a method for generating at least one cutting surface, which enable a high degree of flexibility in the generation of the cutting surface in a short scanning time.

[0009] The features of the present application are set forth in the claims. The dependent claims relate to preferred improvements.

[0010] Embodiments relate to a device for generating at least one cutting surface in a treatment volume of a transparent material, in particular for correcting the refractive state of an eye by corneal reshaping, comprising

[0011] a laser system having - a laser device for generating a laser beam; - a beam splitter device having beam splitter optics for generating a plurality of simultaneous laser output beams from the laser beam; - a movable focusing optics for focusing the laser output beams as focal spots, in particular as simultaneous focal spots, into a treatment volume, which treatment volume extends in mutually orthogonal spatial directions x, y and z, wherein the z direction is parallel to a central reference axis (Grundstellungs-Achse) of the laser system; and - a movement device for moving the movable focusing optics in at least one path, which path is selected from the group consisting of a path in a direction determined by the directions x, y and z, a path relative to the central reference axis a, a path relative to a central axis of the treatment volume, and combinations of the aforementioned paths; wherein the device further comprises - a control device designed to control at least the beam splitter device and the movement device by control data, such that the focal spots of the individual laser output beams in the treatment volume are moved in and / or along at least one respective scanning path and / or on at least one respective surface. In the process, the at least one cutting surface can be generated.

[0012] The movable focusing optics are preferably designed as movable micro-lenses. The focusing optics comprise for example one or more optical elements for focusing the laser output beams. With this device the scan time required for generating the at least one cutting surface can be dramatically shortened and a high degree of flexibility is achieved in generating the cutting surface. This can be achieved by generating a plurality of sub-laser beams (also referred to as laser output beams) from the laser beam using the beam splitter device. These sub-laser beams can be provided here as synchronized laser output beams, in particular as synchronized pulsed laser output beams. These synchronized laser output beams can be directed by the movable focusing optics as light spots into the treatment volume for generating the cutting surface and moved over individual scan paths (also referred to as scan-paths) and / or surfaces (also referred to as scan-surfaces). Here, essentially synchronized light spots, also referred to as multi-spots, can be generated. The scan paths can be at least partially straight, curved, one-dimensionally and / or two-dimensionally shaped. The scan surfaces can be at least partially planar, curved, two-dimensionally and / or three-dimensionally shaped. This makes it possible for the position and number of the light spots to be varied flexibly. The light spot spacing and / or the number of light spots can be optimally adjusted in accordance with the movement of the focusing optics. In addition, it is also possible to reduce the risk of suction loss occurring on the patient's eye surface. In addition, an optimized cutting quality can also be achieved.

[0013] In all embodiments and variants it is possible to move the entire focusing optics, which can comprise one or more optical elements, using the movement device. In addition, the movement of the focusing optics can be slow or fast. The control device can also be designed for controlling the laser device. The term "path of the focusing optics relative to the central reference axis" can comprise that the path is generated with the central reference axis as a starting point, for example in the case of a spiral path.

[0014] The path and / or the scan path can be selected from the group consisting of a spiral, an ellipse, a circle, a Pol-Scanbahn, a meandering scan path (in particular a contour scan path), and combinations of the aforementioned paths.

[0015] The focusing optics can be movable on at least one path, for example on a helical, elliptical, circular, polar scanning path and a meandering scanning path, in particular a contour scanning path, and combinations of the above-mentioned paths, or along these paths. To this end, the focusing optics can be designed deflectable. This comprises that the focusing optics can be moved on and / or along the at least one path. In order to generate a path in the form of a helical, elliptical, circular and / or meandering scanning path, in particular a contour scanning path, the focusing optics can be deflected in rotation around a reference axis of the laser system, for example by means of a motor, i.e. guided on and / or along the relevant path and / or adjusted radially. In a polar scanning, the focusing optics can be guided with a slow wobbling motion from a latitude line of a hemispherical scanning surface containing the pole, wherein the wobbling motion line is rotated 360° around the pole. Transversely to the wobbling motion line, for example on the latitude line, a plurality of light spots can be arranged by means of a fast wobbling motion.

[0016] The treatment volume can be spatially oriented or orientable such that a central axis of the treatment volume is parallel to the z-direction. The movement device can have at least one scanner selected from one or more x-y scanners, one or more z scanners, an azimuthal-radius scanner, and combinations of the above-mentioned scanners. An azimuthal-radius scanner is a scanner capable of guiding the entire focusing optics, for example on a circular path and / or a helical path around an axis.

[0017] The beam splitter optics can be movable, for example movably suspended. The movement device can be designed for moving the beam splitter optics together with the focusing optics. Here, the beam splitter optics and the focusing optics can be firmly connected to each other. The beam splitter optics can be immovable, i.e. position fixed. The beam splitter device and / or the control device can be designed for generating the laser output beam in synchrony with the movement of the focusing optics. The latter is particularly advantageous in the case of immovable beam splitter optics. The beam splitter optics can have at least one element selected from one or more semi-transparent mirrors, one or more prisms and one or more phase masks.

[0018] At least one dynamic x, y, z scanner, in particular at least one resonant x, y, z scanner, can be provided for dynamically moving at least one of the laser output beams in at least one of the x, y, z directions. Here, the at least one dynamic x, y, z scanner can be connected upstream or downstream of the beam splitter optics or integrated into the beam splitter optics. By quickly and dynamically moving the laser output beams at a scan speed much greater than 100 mm / s, for example between 800 and 2500 mm / s, a quick oscillating movement of the laser output beams can be achieved. This movement is also referred to as wobbling and can be used for shaping the light spots. By connecting a dynamic x, y, z scanner upstream or downstream of the beam splitter optics, the light spots of different laser output beams can be dynamically moved in the same way. By integrating a dynamic x, y, z scanner into the beam splitter device, the light spots of different laser output beams can be dynamically moved in different ways. Furthermore, at least two of the dynamic x, y, z scanners can be combined such that the amplitudes of the two dynamic scanners add up in at least one of the x, y, z directions. This can be referred to as multiple wobbling, for example double wobbling. In the case of a technically limited number of light spots, wobbling can advantageously increase the vaporization and / or lysis efficiency of a transparent material, for example corneal tissue, in terms of volume per unit of time. In the case of a technically limited number of light spots and a limited amplitude of the fast dynamic scan movement, double wobbling can increase the vaporization and / or lysis efficiency of the tissue in terms of volume per unit of time.

[0019] The beam splitter device and / or the control device can be designed to synchronize and / or change the distribution, number and / or spacing of the laser output beams depending on the movement and / or radial position of the focusing optics. This makes it possible to produce a plasma bubble with a uniform density within the treatment volume. Furthermore, the beam splitter device for synchronizing and / or changing the laser output beams can have at least one element selected from one or more acousto-optic modulation devices (AOM), one or more electro-optic modulation devices (EOM) and one or more diaphragms. The beam splitter device can be designed to provide a plurality of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode.

[0020] The laser device can be designed for generating a pulsed laser beam. The beam splitter device can be designed for providing a multi-beam synchronized pulsed laser output beam. The laser device, the beam splitter device and / or the movement device can each be controllable. Furthermore, the scan path can be selected from a spiral, an ellipse, a circle, a polar scan path, a meandering scan path, in particular a contour scan path, and combinations thereof. Thus, the distribution, the number and / or the spacing of the light spots can be varied flexibly. The control device can be designed for controlling the beam splitter device and the movement device by control data such that the light spots of the multi-beam synchronized pulsed laser output beam are arranged as synchronized light spots, in particular as multi-spot, in a constant or varying arrangement.

[0021] The control device can be designed for controlling at least the beam splitter device and the movement device such that: - the light spots are arranged transversely to the direction of the scan path; - the scan path is designed as a spiral and the ratio of the number of light spots in an inner region of the spiral to the number of light spots in an outer region of the spiral increases with increasing radial distance from the center; - the scan path is designed as a polar scan path and the number of light spots closer to the pole is reduced; - switching between a first operating mode providing a multi-beam laser output beam of the laser output beams and a second operating mode providing a single-beam laser output beam of the laser output beams; - the scan mode is selected such that successively generated light spots and / or multi-spots of a cutting surface to be generated in a rear portion of the treatment volume are generated in succession in a direction towards the central axis of the treatment volume, while successively generated light spots and / or multi-spots of a cutting surface to be generated in a front portion of the treatment volume are generated in succession in a direction away from the central axis of the treatment volume; and / or - upon changing the laser output beam in dependence on a limit value of a laser radiation load of the tissue of the treatment volume, the single-beam or multi-beam laser output beam is changed, in particular masked.

[0022] The switching between the first operating mode and the second operating mode can comprise a reverse switching, i.e. switching between the second operating mode and the first operating mode. For example, a corneal flap cut can be performed in a single-spot mode, while a curved cut can be performed in a multi-spot mode. In a spiral scan, for example, a single-spot mode can be started, with additional spirals being added with increasing radial distance from the center of the spiral and / or from the center of the optical zone of the eye to be cut. The scanning of such a scan path can be completed in a very short scan time.

[0023] Another embodiment relates to a device for generating control data for generating at least one cutting surface, in particular for correcting the refractive state of an eye by corneal reshaping, for a device according to one of the preceding claims, the device comprising an interface for receiving data on the refractive correction requirements of an eye, and a computing device connected to the interface. The computing device is configured to: - receive data on the refractive correction requirements; - calculate a cutting surface based on the data on the refractive correction requirements; and - generate control data for controlling at least the beam splitter device and the movement device of a device according to one of the preceding claims, such that the cutting surface is generated by moving the focal spots of the individual laser output beams in the treatment volume on and / or along at least one respective scan path and / or on at least one respective surface, also referred to as scan surface.

[0024] The computing device can be designed to generate control data such that: - the beam splitter optics is moved together with the focusing optics, wherein the beam splitter optics is movable; - the beam splitter device and / or the control device generate the laser output beams in synchrony with the movement of the focusing optics, wherein the beam splitter optics is movable or not movable; - at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions using the at least one dynamic x, y, z scanner (180), in particular at least one resonant x, y, z scanner; - at least two of the dynamic x, y, z scanners are used to add their amplitudes in at least one of the x, y, z directions when dynamically moving the laser output beams; - the distribution, number and / or spacing of the laser output beams is synchronized and / or changed in accordance with the movement and / or radial position of the focusing optics using the beam splitter device and / or the control device; - the laser output beams are synchronized and / or changed using the beam splitter device and / or the control device; - a plurality of the laser output beams is provided in a first operating mode and one of the laser output beams is provided in a second operating mode using the beam splitter device; - a pulsed laser beam is generated using the laser device; - a plurality of synchronized pulsed laser output beams is provided using the beam splitter device; and / or - the path and / or the scanning path is selected from the group consisting of a spiral, an ellipse, a circle, a polar scanning path, a meandering scanning path, in particular a contour scanning path, and combinations thereof.

[0025] The computing device can be designed to generate control data such that: - the light spots are arranged transversely to the direction of the scanning path; - the scanning path is designed as a spiral, and the ratio of the number of light spots in an inner region of the spiral to the number of light spots in an outer region of the spiral increases with increasing radial distance from the center; - the scanning path is designed as a polar scanning path, and the number of light spots closer to the pole is reduced; - switching between a first operating mode in which a plurality of laser output beams in the laser output beam is provided and a second operating mode in which one laser output beam in the laser output beam is provided; - providing a scanning mode with which successively generated light spots and / or multi-spots of a cutting surface to be generated in a rear portion of the treatment volume are generated in succession in a direction towards the central axis of the treatment volume, while successively generated light spots and / or multi-spots of a cutting surface to be generated in a front portion of the treatment volume are generated in succession in a direction away from the central axis of the treatment volume; and / or - changing one or a plurality of laser output beams, in particular masking them, when the laser output beam is changed depending on the limit value of the laser radiation load of the tissue of the treatment volume; and / or the light spots of the plurality of synchronously pulsed laser output beams are arranged as synchronous light spots, in particular as multi-spots, in a constant or varying arrangement.

[0026] Another embodiment relates to a device for correcting the refractive state of an eye by corneal reshaping, comprising a device for generating at least one cutting surface according to one of the preceding embodiments and variants, and a device for generating control data according to one of the preceding embodiments and variants. The device for correcting the refractive state of an eye by corneal reshaping achieves in a surprising manner a short treatment time required for correcting the refractive state, a high flexibility in generating the cutting surfaces required for the correction and a high quality of the cutting surfaces and thus also of the correction of the refractive state.

[0027] Another embodiment relates to a method for generating at least one cutting surface in a treatment volume of a transparent material, in particular for correcting the refractive state of an eye by corneal reshaping, using a device for generating at least one cutting surface according to one of the preceding embodiments and variants. The method comprises: - generating a laser beam with a laser device of a laser system; - generating a plurality of synchronously pulsed laser output beams from the laser beam with a beam splitter device; - focusing the laser output beams as spots, in particular as synchronized spots, into a treatment volume using movable focusing optics, which treatment volume extends in mutually orthogonal spatial directions x, y and z, wherein the z direction is parallel to a central reference axis of the laser system; - moving the focusing optics using a movement device, wherein the focusing optics are moved in at least one path, which path is selected from the group consisting of a path in a direction x, y and z, a path relative to the central reference axis a, a path relative to a central axis of the treatment volume, and combinations of the aforementioned paths; and - using a control device, controlling at least the beam splitter device and the movement device by control data, and moving the spots of the individual laser output beams in the treatment volume in and / or along at least one respective scan path, and / or over at least one respective surface. In the process, the at least one cutting surface can be generated.

[0028] In the method of the preceding embodiment, the path and / or the scan path can be selected from the group consisting of a spiral, an ellipse, a circle, a polar point scan path, a meandering scan path, in particular a contour scan path, and combinations of the aforementioned paths. The treatment volume can be spatially oriented such that a central axis of the treatment volume is parallel to the z direction. In the method of the preceding embodiment, the beam splitter optics can be movable, and / or the movement device can move the beam splitter optics together with the focusing optics. Alternatively, the beam splitter optics can be non-movable, i.e. position fixed. The beam splitter optics can be moved or non-moved, and the beam splitter device and / or the control device can generate the laser output beams synchronously with the movement of the focusing optics. Using the at least one dynamic x, y, z scanner, in particular the at least one resonant x, y, z scanner, at least one of the laser output beams can be moved dynamically in at least one of the x, y, z directions. Using at least two of the dynamic x, y, z scanners, the amplitudes of the two dynamic scanners can be added in at least one of the x, y, z directions when dynamically moving the laser output beams. Using the beam splitter device and / or the control device, the distribution, number and / or spacing of the laser output beams can be synchronized and / or changed depending on the movement and / or radial position of the focusing optics. The laser output beams can be synchronized and / or changed using the beam splitter device and / or the control device. Using the beam splitter device, a plurality of the laser output beams can be provided in a first operating mode, and one of the laser output beams can be provided in a second operating mode.

[0029] In the methods of the preceding embodiments and variants, the pulsed laser beam can be generated by means of a laser device. By means of a beam splitter device, a plurality of synchronously pulsed laser output beams can be provided. Furthermore, the scan path can be selected from a helix, an ellipse, a circle, a polar scan path, a meandering scan path, in particular a contour scan path, and combinations of the aforementioned paths. The spots of the plurality of synchronously pulsed laser output beams can be arranged as synchronous spots, in particular as multi-spots, in a constant or varying arrangement.

[0030] In the methods of the preceding embodiments and variants, - the spots can be arranged transversely to the scan path direction; - the scan path can be designed as a helix, and the ratio of the number of spots in the inner region of the helix to the number of spots in the outer region of the helix can be increased with increasing radial distance from the center; - the scan path can be designed as a polar scan path, and the number of spots closer to the pole can be reduced; - a switching between a first operating mode in which a plurality of laser output beams of the laser output beams is provided and a second operating mode in which one laser output beam of the laser output beams is provided can be performed; - a scan mode can be selected in which, by means of the scan mode, successively generated spots and / or multi-spots of a cutting surface to be generated in the rear portion of the treatment volume are generated in succession in the direction of the central axis of the treatment volume, while successively generated spots and / or multi-spots of a cutting surface to be generated in the front portion of the treatment volume are generated in succession in the direction away from the central axis of the treatment volume; and / or - upon changing the laser output beam in accordance with the laser radiation load limit value of the tissue of the treatment volume, one or a plurality of laser output beams can be changed, in particular masked.

[0031] In another embodiment, a method for generating control data for generating at least one cutting surface, in particular for correcting the refractive state of an eye by corneal reshaping, is provided, which uses a device for generating control data for generating at least one cutting surface according to one of the preceding embodiments and variants. The method comprises: - receiving data on the refractive correction requirements of the eye by means of the interface; and - calculating, by means of the computing device connected to the interface, - receiving data on the refractive correction requirements, - calculating the cutting surface on the basis of the data on the refractive correction requirements, and -- generating control data to control at least a beam splitter device and a movement device of an apparatus for generating at least one cutting surface according to one of the preceding embodiments and variants, such that a cutting surface is generated by moving the spots of the individual laser output beams in the treatment volume on and / or along at least one respective scan path and / or on at least one respective surface.

[0032] In the method of the preceding embodiments, the control data can be generated such that: - the beam splitter optics is moved together with the focusing optics, wherein the beam splitter optics is movable; - the beam splitter device and / or the control device generates the laser output beams in synchronization with the movement of the focusing optics, wherein the beam splitter optics is movable or not movable; - at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions with the at least one dynamic x, y, z scanner, in particular at least one resonant x, y, z scanner, - at least two of the dynamic x, y, z scanners are summed in at least one of the x, y, z directions in their amplitudes when dynamically moving the laser output beams; - the distribution, number and / or spacing of the laser output beams is synchronized and / or changed with the beam splitter device and / or the control device in accordance with the movement and / or radial position of the focusing optics; - the laser output beams are synchronized and / or changed with the beam splitter device and / or the control device; - a plurality of the laser output beams is provided in a first operating mode and one of the laser output beams is provided in a second operating mode with the beam splitter device; - a pulsed laser beam (6) is generated with the laser device (5); - a plurality of synchronized pulsed laser output beams is provided with the beam splitter device; and / or - the paths and / or scan paths are selected from a helix, an ellipse, a circle, a polar point scan path, a meandering scan path, in particular a contour scan path, and combinations of the aforementioned paths.

[0033] In the method for generating control data to generate at least one cutting surface, in particular for correcting the refractive state of an eye by corneal reshaping, the control data can be generated such that: - the spots are arranged transversely to the direction of the scan path; - the scan path is designed as a spiral, and the ratio of the number of spots in the inner region of the spiral to the number of spots in the outer region of the spiral increases with increasing radial distance from the center; - the scan path is designed as a polar scan path, and the number of spots closer to the pole is reduced; - switching between a first operating mode in which a plurality of laser output beams in the laser output beam is provided and a second operating mode in which one laser output beam in the laser output beam is provided; - providing a scan mode with which successively generated spots and / or multi-spots of a cutting surface to be generated in a rear portion of the treatment volume are generated in succession in a direction towards the central axis of the treatment volume, while successively generated spots and / or multi-spots of a cutting surface to be generated in a front portion of the treatment volume are generated in succession in a direction away from the central axis of the treatment volume; and / or - changing one or a plurality of laser output beams, in particular masking, when the laser output beam is changed depending on the laser radiation load limit value of the tissue of the treatment volume; and / or - arranging spots of a plurality of synchronously pulsed laser output beams as synchronous spots, in particular as multi-spots, in a constant or varying arrangement.

[0034] Another embodiment relates to a method for correcting the refractive state of an eye by corneal reshaping, the method comprising at least one of the aforementioned embodiments and variants for generating control data for generating at least one cutting surface, in particular for correcting the refractive state of an eye by corneal reshaping.

[0035] In another embodiment, a computer program product is provided, the computer program product having program code which, when loaded into a computer, executes at least one of the aforementioned embodiments and variants. The computer can comprise a storage device for storing data.

[0036] With the aforementioned embodiments of the device for generating control data for generating at least one cutting surface, the device for correcting the refractive state of an eye, the method for generating at least one cutting surface and the method for generating control data for generating at least one cutting surface, the same advantages and functions as the embodiments of the device for generating at least one cutting surface can be achieved, in particular with the same and / or similar features.

[0037] The described method for generating control data comprises the preparation for generating at least one incision, which is to be made for correcting the refractive state of an eye by corneal reshaping, but the method itself does not yet require the generation of the incision, i.e. in particular not a surgical step. However, it is also possible to add the step of generating the incision. In this step, the incision is then generated using a laser device. Here, the method for generating at least one incision can be carried out without intervention in a living human or animal body, for example for the preparation of an implant to be used (later) which is made of tissue of a deceased donor or of artificial tissue material. Likewise, it is also possible to test, investigate or demonstrate the generation of at least one incision on a deceased material, for example on an enucleated animal eyeball. The generation of the incision can preferably extend to a surgical method for correcting a refractive error of an eye. For the correction of a refractive error, a tissue block is then isolated and removed from the cornea.

[0038] The method for generating at least one incision and / or the method for generating control data can here and in principle be carried out completely by a computer, in particular a computer comprising a processor. The computer for generating control data can be designed as a planning station, which is also known from the prior art.

[0039] The present application comprises a software product for carrying out the method for generating control data, the method for generating at least one incision and / or the method for correcting a refractive error of an eye, since the calculation of the incision, the determination of the control data for the device and the control of the device can all be easily carried out by a corresponding software.

[0040] In the aforementioned embodiments and variants of the device for generating at least one incision, the aforementioned embodiments or variants of the device for generating control data, in particular the calculation device, can be provided. Here, a wireless or wired data transmission connection can be established between the device for generating at least one incision and the device for generating control data. Furthermore, the aforementioned embodiments and variants of the method for generating at least one incision can comprise the aforementioned embodiments or variants of the method for generating control data.

[0041] It should be understood that the features mentioned above and those still to be set forth hereinafter are not exclusively able to be used in the combinations indicated, but are also able to be used individually or in other combinations, without departing from the scope of the present application. BRIEF DESCRIPTION OF DRAWINGS

[0042] The application is further elucidated by way of examples with reference to the accompanying drawings, which by way of illustration disclose the essential features of the application. These examples are not to be construed as limiting. For example, the description of an embodiment with a number of elements or components is meant to be illustrative and is not to be construed as limiting. Other embodiments can include alternative elements and components, fewer elements or components, or additional elements or components. Elements or components of various embodiments can be combined, unless otherwise specified. Modifications and changes to described embodiments are meant to be within the scope of other embodiments. To avoid repetition, identical elements or components throughout the figures are denoted with the same reference numerals and will not be repeatedly explained. In the drawings: Figure 1 A schematic representation of a treatment device 1 for ophthalmic refractive correction is shown, Figure 2 A schematic representation of a treatment device used in Figure 1 is shown, Figure 3a A schematic representation of an example of a device 100 for generating at least one cut surface is shown, Figure 3b A schematic representation of a cross-section of a cornea is shown for illustrating the removal of a corneal tissue block in connection with ophthalmic refractive correction, Figure 3c An example of a substantially parallel helical path of a plurality of synchronized light spots is schematically shown, Figure 3d An example of a helical scan is schematically shown, Figure 3e An example of a polar scan is schematically shown, Figure 3f An example of a device 100 with a dynamic x, y, z scanner 180 for dynamically moving at least one of the light spots is shown, Figures 3g to 3n An example of an example scan pattern generated with a device 100 is schematically shown, Figure 4a A schematic representation of focusing optics and a beam splitter device of an example of a device 100 for generating at least one cut surface is shown, Figure 4b and Figure 4c A schematic representation of an amplitude addition of a dynamic x, y, z scanner integrated in the beam splitter device shown in Figure 4a is shown, Figure 5 A schematic representation of a planning device of a treatment device in Figure 1 is shown, Figure 6a block diagram of an exemplary method for generating at least one cutting surface is shown, Figure 7 a block diagram of an exemplary method for generating control data for generating at least one cutting surface is shown, and Figure 8 a variant of an example of the apparatus 100 for generating at least one cutting surface is shown schematically. DETAILED DESCRIPTION

[0043] In this context, the term "slow" motion can refer to a motion, e.g. a motion and / or a scanning motion, with a speed of motion of less than 100 mm / s, preferably between 0 and 80 mm / s, more preferably between 0.1 and 12 mm / s. The term "fast" motion or "dynamic" motion can refer to a motion, e.g. a scanning motion, with a speed of motion equal to or greater than 100 mm / s, preferably between 800 and 2500 mm / s, more preferably between 900 and 2000 mm / s. Similar applies to the terms "slow scanner" and "fast scanner". For example, the deflectable focusing optics can be deflected in rotation about a reference axis of the laser system by a motor, i.e. guided on a path and / or along a path and / or radially adjusted. Here, the constant rotational speed of the focusing optics can be selected in the range of 100 to 300 Hz, e.g. 200 Hz. The motion of the micro-lenses can be a rotational path, e.g. in case of a circular path or a helical path. The micro-lenses can also be guided over the process volume in a meandering fashion. As a slow scanning motion, the rate of change of the radius per time can be in the range of 0.1 to 1 mm / s, e.g. 0.5 mm / s. As a slow scanning motion or a fast scanning motion, the path speed, i.e. the guiding speed of the focusing optics on the path, can be in the range of 0 to 20 m / s. In case of an azimuthal-radius scanner, the path speed of the micro-lenses on the outermost spiral arm can be e.g. 10 m / s. In case of a polar scanning, the implementation speed of the wobbling motion of the focusing optics with slow scanner can be 8 to 50 mm / s, preferably 15 to 20 mm / s, the slow or fast scanning motion of the multi-spot can be performed with a speed of 0 to 20 m / s, and / or the wobbling motion line can be rotated about the pole with a frequency of e.g. 1 / 5 to 1 / 16 Hz, preferably 1 / 6 to 1 / 15 Hz. For example, a wobble of one 360 degree rotation takes about 5 to 16 seconds. Within the first 180 degrees, a lenticular cut can be generated. Within the last 180 degrees, a cap cut can be generated. The path speed of the wobbling focusing optics rotating about the pole can be e.g. 2 mm / s.

[0044] As mentioned before, the treatment volume can have a central axis. The central axis of the treatment volume can have the same orientation as the reference axis of the laser system, when the treatment volume is correspondingly oriented. The reference position of the laser system can be the position of the laser system and / or the focusing optics, from which the means for generating at least one cutting surface are started. The reference axis of the laser system can be the position of the laser system and / or the focusing optics. The term "path in a direction determined by the directions x, y and z" can refer to a path calculated based on at least one of the directions x, y and z. The term "moving the movable focusing optics on a path in a direction determined by the directions x, y and z" can refer to starting from the reference axis of the laser system and deflecting and / or moving the focusing optics in the relevant direction(s) at an angle. The term "moving the movable focusing optics on a path relative to the central reference axis a" can include deflecting and / or moving the focusing optics radially on a path around the central reference axis a, e.g. at a constant or varying angle, and / or starting from the central reference axis a. The term "moving the movable focusing optics on a path relative to the central axis of the treatment volume" can include deflecting and / or moving the focusing optics radially on a path around the central axis A, e.g. at a constant or varying angle, and / or starting from the central axis. Here, the path can be selected from a spiral, an ellipse, a circle, a polar point scanning path, a serpentine scanning path, in particular a contour scanning path, and combinations thereof. In this context, the term "scanning-path" is also referred to as "scan-path". The same applies to grammatical variations of these terms.

[0045] Figure 1 An exemplary means 100 for generating at least one cutting surface is shown, which is part of a therapeutic device 1 for eye surgery, i.e. in this case part of a device for correcting the refractive state of an eye. The therapeutic device 1 is designed for making a cut inside the eye 2 of a patient 3. To this end, the device 100 has a laser system 110 with a laser device 4, which emits a laser beam 6 from a laser source as a focused light beam into the eye 2 or the cornea 17 as a treatment volume. Preferably, the laser beam 6 is a pulsed laser beam with a wavelength of between 300 nanometers and 10 micrometers. Furthermore, the pulse length of the laser beam 6 is in the range of 1 femtosecond and 100 nanoseconds, wherein the pulse repetition frequency can be 50 to 20,000 kilohertz and the pulse energy can be between 0.01 microjoule and 0.01 millijoule. The device 100 generates a cutting surface in the treatment volume 17, i.e. in this case in the cornea 17 of the eye 2, by means of deflecting the pulsed laser beam 6. To this end, a radiation intensity modulator (not shown) can additionally be provided in the device 100.

[0046] During operation, the patient 3 is for example positioned on a treatment couch 10 of the treatment device 1, which can be adjusted in three spatial directions in order to spatially align the eye 2 with the entry of the laser beam 6. In a preferred design, the treatment couch can be adjusted by means of a motor. Alternatively, the laser system 110 can also be adjusted for this purpose. In this way, the treatment volume 17 of the eye can be oriented or orientable in space, such that the central axis A of the treatment volume 17 is parallel to the central reference axis a of the laser system 110. The control can be effected in particular by means of a control device 11, which in principle controls the operation of the devices 100 and 1, and for this purpose is connected to the device 100 or the treatment device 1 by means of a suitable data connection, for example a connection line. Of course, this communication can also take place by other means, for example by means of an optical fiber or radio. The control device 11 effects the corresponding setting and time control of the treatment device 1, in particular of the laser device 4 and other controllable components of the device 100 and the treatment device 1.

[0047] The treatment device 1 can have a fixation device 15, which fixes the cornea 17 of the eye 2 in a position opposite the laser device 4. The fixation device 15 can be pressed against the eye or the cornea by means of a negative pressure in order to fix the eye. In an embodiment, the fixation device can also impart the desired geometry to the cornea of the eye. The fixation device can for example be designed as a contact lens 45. Such contact lenses are known to the person skilled in the art from the prior art, for example from DE 102 05 040 338 Al. The description of the structural form of the contact lens 45 possible for the treatment device 1 in the disclosure of this document is fully incorporated herein.

[0048] The treatment device 1 further optionally has a not shown camera, which can take an image of the cornea 17 through the contact lens 45. Here, the illumination of the camera can take place in the visible spectral range, but also in the infrared spectral range.

[0049] The control device 11 can have a device for generating control data, in the present case a planning device 16, which will be explained in more detail later and which comprises a computing device and optionally a data store, which, as a preliminary work, calculates the cutting plane(s) and / or control data, in particular control data for the treatment device, in order to be able to generate the cutting plane(s) in the surgical operation. The control data can be specific setting values for the movement device 8, which is used to move the movable focusing optics 18 of the device 100. These control data are output by the control device 11 as control signals for the respective drive devices of the movement device 8. However, the control data can also be coordinates of target points, to which the laser beam should be focused, and an order of these target points, which are preset on a quasi-higher control level. The control data can in particular comprise one or more path curves (also called scan paths) of the laser spot, along which the focal point position should be adjusted.

[0050] Figure 2 The mode of action of the laser radiation incident into the cornea 17 is schematically shown by means of the laser output beam 90, which is generated from the laser beam 6 together with further laser output beams 91 to 93 (not shown in Figure 2 ). The beam splitter device 70 of the device 100 generates the laser output beams 90 to 93 from the laser beam 6. The beam splitter device 70 will be described later. The laser output beam 90 is focused by the focusing optics 18 into the cornea 17 of the eye 2. The focusing optics are designed as a micro-lens in the present case and comprise one or more optical elements (e.g. lenses) for focusing the laser output beams 90 to 93. For the sake of simplicity only, the focusing optics 18 are shown in Figure 2 , Figure 3a and Figure 3fThe focusing optics 18 are schematically and exemplary shown in the form of a lens. The focusing optics 18 induces the formation of a focal point in the cornea 17, which forms a spot 19 of the laser output beam 90 within the processing volume. At the focal point, the laser radiation energy density is so high that, combined with the pulse length of the pulsed laser radiation 6, a nonlinear effect is generated in the cornea 17. For example, each pulse of the pulsed laser radiation 6 can generate optical breakdown in the cornea 17 at the spot 19, thereby initiating a plasma bubble. When the plasma bubble forms, the area involved in tissue layer separation is larger than the spot 19, although the conditions for generating optical breakdown are only met at the spot 19. For each laser pulse to generate optical breakdown, the energy density, i.e., the luminous flux of the laser radiation, must be higher than a certain threshold related to the pulse length. This relationship is known to those skilled in the art, for example, from DE 69500997 T2. Alternatively, tissue separation can also be achieved by pulsed laser radiation in the form of multiple laser radiation pulses emitted over a region, where the focal spots overlap. Then, multiple laser radiation pulses work together to achieve tissue separation. However, the tissue separation method used by the treatment device 1 is not further relevant to the description below; the focus is solely on creating a cutting surface in the cornea 17 of the eye 2.

[0051] The imaging characteristics of the eye are related to several factors, one of which is the curvature of the cornea 17 in eye 2. The frontal surface of cornea 17 refracts light due to its curvature, therefore the radius of curvature of the cornea is particularly relevant to the imaging characteristics of the eye. When visual defects are present, due to refractive errors such as myopia or hyperopia (to be corrected), the focal point of a parallel-incident light beam will not fall on the retina of eye 2, but rather in front of or behind the retina. Other refractive errors (such as astigmatism) can cause image distortion, i.e., the focal point is not point-like. There are also other refractive errors that cause visual defects, depending on the location of the focal point on the retina. These visual defects are collectively described using refractive error data. Refractive errors are corrected by specifically altering the refractive properties of cornea 17 by changing the frontal surface of the cornea. Because the frontal surface of the cornea is remodeled into a new frontal surface, the focal point shifts or changes, thereby correcting the pre-existing refractive error.

[0052] To perform ophthalmic refractive surgery, a tissue block called a microlens is removed from a region within the cornea 17 by means of laser output beams 90, 91, 92, and 93 synchronously generated from the laser beam 6 by a beam splitter device 70. This is achieved by separating a tissue layer inside the cornea that isolates the tissue block, allowing for its removal. The tissue block is defined by three-dimensionally shaped cutting surfaces. For this purpose, the position of the spot 19 of the focused laser output beams 90 to 93 is three-dimensionally adjusted within the cornea 17 when pulsed laser radiation is introduced. This...Figure 3a The laser output beams 90 and 91 are shown in the figures only by way of example. By removing the micro-lenses, the curvature of the front of the cornea 17 can be changed in a targeted manner, thus enabling refractive correction. A tissue block of uniform thickness does not significantly change the curvature of the front of the cornea - hence the term micro-lens.

[0053] Figure 3a A device 100 is shown for generating at least one cutting surface in a treatment volume 17 of a transparent material, in particular for correcting the refractive state of an eye 2 by corneal reshaping. The device 100 comprises a laser device 4 for generating a laser beam 6, a beam splitter device 70 having beam splitter optics 70a for generating a plurality of simultaneous laser output beams 90 to 93 from the laser beam 6, movable focusing optics 18 for focusing the laser output beams as simultaneous light spots 19, in particular offset arranged light spots, into the treatment volume 17, which extends in mutually orthogonal spatial directions x, y and z, wherein the z direction is parallel to a central reference axis a of the laser system 110, a movement device 8 for moving the focusing optics 18 in at least one path, which is selected from the group consisting of a path in a direction x, y and z, a path relative to the central reference axis a, a path relative to a central axis A of the treatment volume 17, and combinations of the aforementioned paths, and a control device 11 designed to control at least the beam splitter device 70 and the movement device 8 by control data, such that the light spots 19 of the respective laser output beams 90 to 93 in the treatment volume 17 are moved in and / or along at least one respective scanning path 19a and / or on at least one respective surface 19c. In Figure 3a In the case shown, the central axis A of the treatment volume 17 has the same orientation as the central reference axis a of the laser system. The movement device 8 can be designed, for example, to move the focusing optics 18 in at least one path, which is selected from the group consisting of a path in a direction x, y and z, a path around the central reference axis a, a path around the central axis A of the treatment volume 17, and combinations of the aforementioned paths, whereby, for example, circular or helical paths can be generated.

[0054] In Figure 3aThe elements of the apparatus 100 for generating at least one cut surface are shown schematically only in a manner necessary for understanding. As previously described, the laser beam 6 is focused in the cornea 19 into a synchronized spot 19 of laser output beams 90, 91 generated by the beam splitter device 70, and the orientation of the spot 19 in the cornea is adjusted so that energy from the laser radiation pulses focused at different locations is introduced into the tissue of the cornea 17 to generate the cut surface. The laser radiation 6 is preferably provided by the laser device 4 in the form of pulsed radiation and split into offset laser output beams 90, 91 by the beam splitter device 70. The laser output beams 90, 91 enter the focusing optics 18. A moving device 8 is provided, which is functionally connected to the focusing optics 18 as an actuator. In this example, the moving device 8 includes an actuator designed as an x, y, z scanner, which... Figure 3aThe structural form of the x, y scanner 8a, which is composed of two parts and comprises the x, y scanner 8a, deflects the entire focusing optics 18 parallel to the x direction and / or the y direction. This enables a two-dimensional deflection of the laser output beams 90, 91 from the beam splitter device 70. Here, the x, y scanner 8a causes the azimuth of the focal spot 19 to be adjusted essentially perpendicularly to the respective direction of incidence of the laser output beams. In addition to the x, y scanner 8a, a z scanner 8b is also provided to adjust the depth position of the focal spot 19, which scanner can be designed, for example, as an adjustable telescope, by means of which the entire focusing optics 18 can be displaced in the z direction; and / or as a unit for adjusting the z position of one or more optical elements of the focusing optics 18. The z scanner 8b ensures that the z position of the focal spot 19, i.e. the position parallel to the direction of incidence of the respective laser output beam, is changed. The scanners 8a and 8b can displace the focal spot 19 of each laser output beam, for example, on and / or along a respective three-dimensional scan path along which the laser pulses are emitted to form the cutting surface(s). As a supplement or alternative to the x-y scanner 8a, the movement device 8 is provided with a drive device 8c as an actuator, which is designed as an x-y scanner or an azimuth-radius scanner and serves to move the entire focusing optics 18 on a path about a central reference axis a of the laser system 110. The path of the focusing optics can be, for example, in the shape of a spiral, an ellipse, a circle, a meandering scan path or a combination of these shapes. The laser pulses can be emitted on and / or along the path(s) to form the cutting surface(s). The scan path of the focal spot of each laser output beam thus produced is then in the shape of a spiral, an ellipse, a circle, a meandering shape or a combination of these shapes. A plurality of offset arranged, parallel extending scan paths of the focal spot of the laser output beams can thereby be generated. The movement of the focusing optics 18, i.e. the scan movement caused by the scanners 8a and 8b and / or the movement caused by the drive device 8c, can be carried out, for example, at a slow scan speed of 10 mm / s.

[0055] In an alternative example of the device 100 for generating at least one cutting surface, no drive device 8c can be provided, but only the x, y, z scanners 8a, 8b. In other examples of the device 100 for generating at least one cutting surface, no x, y scanner 8a can be provided, but only the drive device 8c and the z scanner 8b. In other examples, the device 100 can be provided with a slow x, y scanner, a fast x, y scanner, a slow z scanner and / or the drive device 8c.

[0056] Figure 8A variant of the apparatus 100 for generating at least one cut surface is schematically shown. In this variant, only a z-scanner 8b and a drive unit 8c are provided in the moving device 8 of the apparatus 100. Here, both the z-scanner and the drive unit 8c are implemented as slow scanners. In this example, the beam splitter optics 70a of the beam splitter device 70 are fixed in position, while the focusing optics 18 can move along at least one path B with the scanners 8b and 8c. In this example, a deflector 210 is provided within the beam splitter device 70. Here, the deflector 210, arranged directly in front of the focusing optics 18, can be moved and / or oriented according to the movement of the focusing optics 18, as indicated by arrow U. In this variant of the apparatus 100, the focusing optics 18 can be guided, for example, on and / or along the helical path B above the processing volume 17. Therefore, the synchronous spot 19 focused by the focusing optics 18 into the processing volume can move within the processing volume 17 on and / or along the corresponding helical paths 19a, 19b. In this example, the control device 11 is wirelessly connected to the laser system 110 and its components, including the laser device 4, the beam splitter device 70, the movable focusing optics 18, and the moving device 8, for data transmission.

[0057] For the operating principle of device 100, a two-stage scanning structure known from WO 2017 / 0058115 A1 can be used. Furthermore, Cartesian or non-Cartesian coordinate systems can be used to deflect or control the orientation of spot 19. Examples for this are spherical or cylindrical coordinates. The orientation control of spot 19 is performed by control device 11, which controls the laser device 4 and optional modulator (…). Figure 3a (Not shown in the diagram) and the moving device 8 are set accordingly. The control device 11 ensures the proper operation of the laser device 4, the beam splitter device 70, and the three-dimensional focusing adjustment device exemplarily described herein, thereby ultimately forming a cutting surface that isolates a specific corneal tissue block that should be removed or taken out for refractive correction. Here, the control device operates according to preset control data.

[0058] Control data includes, for example, data pre-set for the beam splitter device 70, data for the movement path of the focusing optics, and data for the scanning path 19a or surface 19c (also referred to as scanning surface 19c) on and / or along which the target point and / or spot of the focusing adjustment device should move. Control data is typically compiled into a control dataset. This control dataset specifies the geometric parameters (e.g., coordinates of the target point) of the cut surface to be formed as a template. In this embodiment, the control dataset also includes specific settings for the focusing orientation adjustment mechanism (e.g., the moving device 8 or an additional dynamic scanner). The control data is based on control data specifying the cut surfaces(s) to be generated, which will be described later.

[0059] Figure 3b The process of generating a cut surface with the device 100 is exemplarily shown. By adjusting the focus 19 of the laser output beam 90 concentrated therein, a corneal tissue block 121 in the cornea 17 is isolated. At least one cut surface is formed, which can also be multi-part, and is therefore also referred to as "cut surface(s)". Here, the cut surface exemplarily has an anterior cut surface 122 and a posterior lenticule cut surface 123. Here, these terms are to be understood only as examples and are chosen in accordance with the conventional Lasik procedure. Depending on the case of the surgical procedure, the cut surfaces 122 and 123 and possibly present edge incisions, which join the cut surfaces 122 and 123 at their edges if necessary, jointly delimit and isolate the corneal tissue block 121. The corneal tissue block 121 can be removed through an opening incision 124, as proposed in the previously described SMILE method.

[0060] Figure 3c An example of a substantially parallel helical scan path of synchronized foci 19 of the multiple beam laser output beams for generating a cut surface in the cornea 17 is shown. The switching between the first operating mode and the second operating mode of the device 100 can comprise a reverse switching, i.e. switching between the second operating mode and the first operating mode. For example, a flap cut can be performed in the single focus mode and a curved cut in the multi-focus mode. In the helical scan, for example, starting from the single focus mode, additional helices can be added with increasing radial distance from the center of the helix and / or from the center of the optical zone of the eye to be cut, as shown. The scanning of such a scan path can be completed in a very short scan time. Figure 3d

[0061] Figure 3e An example of a polar scan path is shown. Here, the number of foci 19 having a small spacing from the pole point P can be reduced. The beam splitter device and / or the control device synchronize the laser output beams with the movement of the focusing optics. In the polar scan, the focusing optics are guided from a latitude line of a hemispherical scan surface 19c to be generated in the cornea 17, which contains the pole point, in a slow wobbling motion through the pole point P, wherein the wobbling motion line rotates 360° around the pole point, as indicated by the arrow Q. In the direction transverse to the wobbling motion line, for example on the latitude line, a plurality of synchronized foci 19 are generated as multi-foci by a fast movement. Additionally, these multi-foci can be dynamically moved (i.e. wobbled) in the x, y and / or z direction in order to shape the foci.

[0062] Figure 4a ​A schematic of the focusing optics 18 and the beam splitter device 70 of an example of the apparatus 100 for generating at least one cutting surface is shown. The beam splitter optics 70a of the beam splitter device 70 can have at least one element selected from one or more half-mirrors, one or more prisms, and one or more phase masks. Such beam splitter devices are known to the person skilled in the art from the prior art, for example from WO 2022194484 A1. The description in the disclosure of this document relating to the structural form of the beam splitter device 70 that can be used in the apparatus 100 is fully incorporated herein.

[0063] Figure 4aThe example of the beam splitter device 70 shown is designed to generate laser output beams 90 to 93 from a laser beam 6, also referred to as a laser input beam or input beam. The beam splitter optics 70a of this example comprises a first beam multiplication element 20 for generating two intermediate beams 75 and 76 from the laser input beam 6. The first beam multiplication element 20 has a first polarizing beam splitter 22, a second polarizing beam splitter 24 and at least one first deflection element 26 for deflecting the intermediate beam 76 by a preset angle. The beam splitter optics 70a is designed such that, when the laser input beam 6 impinges on the first polarizing beam splitter 22 of the first beam multiplication element 20, the input beam 6 is split by the first polarizing beam splitter 22 of the first beam multiplication element 20 into a first intermediate beam 75 and a second intermediate beam 76, wherein the two intermediate beams 75, 76 fan out into the x-y plane, the second intermediate beam 76 is deflected by the first deflection element 26 by a preset angle, in particular by about 90° or about 180°, and the first intermediate beam 75 and the second intermediate beam 76 impinge on the second polarizing beam splitter 24 of the first beam multiplication element 20 such that the first intermediate beam 75 and the second intermediate beam 76 exit the second polarizing beam splitter 24 of the first beam multiplication element 20 offset from each other substantially parallel or with a preset angular difference, in particular less than 3 mrad, preferably less than 1.4 mrad, particularly preferably less than 0.6 mrad. Furthermore, there is also provided a second beam multiplication element 40 having a first polarizing beam splitter 42, a first deflection element 46 and a second polarizing beam splitter 44, wherein the second beam multiplication element 40 is designed such that, when the two intermediate beams 75, 76 impinge on the first polarizing beam splitter 42 of the second beam multiplication element 40, the two intermediate beams 75, 76 are each split by the first polarizing beam splitter 42 of the second beam multiplication element 40 into a first sub-beam 80, 81 and a second sub-beam 85, 86, the second sub-beams 85, 86 are deflected in the second beam multiplication element 40 by a preset angle, in particular by about 90° or about 180°, and the first sub-beams 80, 81 and the second sub-beams 85, 86 impinge on the second polarizing beam splitter 42 of the second beam multiplication element 40 such that the four laser output beams 90 to 93 exit the second polarizing beam splitter 42 of the second beam multiplication element 40 offset from each other substantially parallel or with an angular difference, in particular less than 3 mrad, preferably less than 1.4 mrad, particularly preferably less than 0.6 mrad.

[0064] As previously mentioned, at least one dynamic x, y, z scanner 180, in particular at least one resonant x, y, z scanner, can be provided in the device 100 for dynamically moving the at least one laser output beam 90 to 93 in at least one of the x, y, z directions. The at least one dynamic x, y, z scanner 180 can be designed as an x, y scanner and / or a z scanner, for example, which can only scan in one or two of the x, y, z directions. The at least one dynamic x, y, z scanner 180 can be connected upstream or downstream of the beam splitter device 70, in particular the beam splitter optics 70a, or integrated into the beam splitter optics 70a. At least two of the dynamic x, y, z scanners can be combined such that the amplitudes of the two dynamic scanners add up in at least one of the x, y, z directions. Thereby, a multiple wobble, for example a double wobble, can be generated.

[0065] Figure 3f An example is shown in which one of the dynamic x, y, z scanners 180 is arranged between the laser device 4 and the beam splitter device 70. The dynamic x, y, z scanner 180 can comprise an x, y scanner, which is realized, for example, by two substantially orthogonal deflected galvanometer mirrors, and / or a z scanner, which is designed, for example, as an adjustable telescope. The x, y scanner causes a two-dimensional deflection of the laser beam 6 in the x, y directions. The z scanner ensures a z position of the position of the focal point 19. The dynamic movement can be carried out, for example, with a scan speed of between 800 and 2000 mm / s.

[0066] Figure 4a One of the dynamic x, y, z scanners 180, also referred to as scanner 180, integrated into the beam splitter optics 70a is shown as an example. In this example, the scanner 180 is configured as an x, y scanner for moving the first deflection element 26 in at least one of the x, y directions, as indicated by arrows 181 and 182. By dynamically moving the deflection element 26 with the scanner 180, the intermediate beam 76, and thus the laser output beams 90 and 91, can be dynamically moved. Figure 4b Another example is shown in which the intermediate beam 76 is dynamically moved by two of the scanners 180. Figure 4a Starting from the example of the first beam multiplication element 20, the second polarizing beam splitter 24 is additionally provided with a further dynamic x, y scanner 180, whereby it can be dynamically moved in at least one of the x, y directions. Figure 4b The dynamic movement of the intermediate beam 76 and the intermediate beam 75 in both the x and y directions is shown schematically. Here, the intermediate beam 75 is only subjected to a single wobble since it is dynamically moved by one of the scanners 180. The intermediate beam 76 is dynamically moved by two scanners 180 and is thus subjected to a multiple wobble. Here, the deflection amplitudes of the intermediate beam 76 generated by the two scanners 180 add up.Figure 4c Exemplary parallel helical paths 19a and 19b generated in this way are shown, in which the spot 19 of the helical path 19a is wobbled by the dynamic movement of the intermediate beam 75, and thus also of the laser output beam generating this spot. The spot 19 of the helical path 19b is multi-wobbled by the multiple dynamic movements of the intermediate beam 76, and thus also of the laser output beam generating this spot. The dynamic movement of the intermediate beam 75 and / or 76 can take place, for example, at a scan speed of between 800 and 2000 mm / s, so that a rapid oscillatory movement of the associated laser output beam is achieved at essentially the same scan speed.

[0067] In some examples, the spots are arranged transversely to the direction of the scan path, for example the multi-spot line is arranged transversely and / or laterally to the movement direction of the focusing optics. The multi-spot line is designed as a line of multiple synchronized spots, in which a two- or three-dimensional volume structure can be generated in the transparent material. In the example of the multi-spot scanning of an ellipsoidal helix, the spots are arranged transversely to the movement direction of the micro-lenses. Here, the focusing optics are guided on and / or along the path of the ellipsoidal helix, while the spots are arranged, for example, on and / or along a multi-spot line arranged transversely and / or laterally to the helical path. This is shown as Figures 3g to 31 Figure 3g A helical scan with a single-spot scanning mode is shown schematically as a comparative example. In contrast, Figure 3h An example of a multi-spot scanning mode of the device 100 is shown, in which a constant subsurface 119 is generated with a multi-spot. Figure 31 An example of a scanning mode of the device 100 is shown schematically, in which a single spot is generated in the center of the helical path and a variable subsurface 119 or subregion is generated with a multi-spot in the edge region of the helical path around the center. Figure 3j An example of a multi-spot scanning mode of the device 100 is also shown schematically, in which a variable circular subsurface 119 or spherical subregion is generated with a multi-spot. In this example, the subsurface 119 increases with increasing radius of the helical path. The length of the multi-spot line is adjusted optimally depending on the position of the focusing optics.

[0068] ​In other examples, the volume of synchronously generated focal spots (or foci) constitutes a sub-volume of the entire treatment volume. The shape of this sub-volume can be arbitrary, for example it can be circular or polygonal in a top view or cross-sectional view. The shape of the sub-volume can be varied depending on the position of the microlenses. The maximum radial extension (transverse to the optical axis) of the sub-volume is limited by the field of view of the movable focusing optics. The maximum z-extension (e.g. along the optical axis of the treatment volume) of the sub-volume is defined by the numerical aperture of the moving focusing optics. The density of the focal spots in the sub-volume is high enough so that the resulting photodisruption bubble density is high enough to safely remove the generated treatment volume. Preferably, there is spatial overlap between the focal spots. In this case, the energy of a single focal spot is not sufficient to create a photodisruption, but only the overlap of multiple simultaneous focal spots creates a photodisruption. In comparison to the single focal spot scanning mode, in the multi-focal spot scanning mode the spatial overlap can be reduced, as shown in Figure 3k and Figure 31 In this case, Figure 3k a non-simultaneous single focal spot 9 overlap arrangement is shown, by which a part of the treatment volume is disintegrated. In contrast, Figure 31 a multi-focal spot scanning using the device 100 is shown, in which the simultaneous multi-focal spots 19 do not overlap excessively, so that a photodisruption sub-volume is generated, thus this scanning mode is more efficient in comparison to the single focal spot mode.

[0069] In a multi-focal spot scanning, for example an ellipsoidal spiral, the multi-focal spot sub-volume can be generated so that it is isosceles trapezoidal in a top view. The ratio of the short base to the long base of the isosceles trapezoid can be greater inside the spiral than outside the spiral, for example in order to achieve a dense coverage of the microlens face, which is generally circular in a top view.

[0070] Figure 3m and Figure 3n Exemplary scanning patterns generated by the device 100 using different wobbling techniques are shown. According to Figure 3m the simultaneous multi-focal spots are wobbled by laterally dynamically moving (i.e. oscillating) the focusing optics 18 or the laser input beam 6. According to Figure 3n the simultaneous multi-focal spots are wobbled by laterally dynamically oscillating each sub-beam 90-93.

[0071] As mentioned before, the successively generated focal spots and / or multi-focal spots to be generated for the cutting face at the back of the treatment volume can be generated successively in the direction towards the central axis of the treatment volume, while the successively generated focal spots and / or multi-focal spots to be generated for the cutting face at the front of the treatment volume can be generated successively in the direction away from the central axis of the treatment volume. In a microlens cut, for example for Figure 3bThe scanning mode is referred to as "Out-In-Scan" for the shown rear microlens cut 123. In the hat-shaped cut for generating the front cut 122, the scanning mode is referred to as "In-Out-Scan". Thereby, the time difference between the different subvolumes generated by the multi-spot synchronization can be minimized in the center of the optical zone of the eye, thereby minimizing the risk of opaque bubble layers.

[0072] Figure 5 A part of the apparatus 100 for generating at least one cut is shown schematically by way of example, and the importance of the apparatus 16 for generating control data, in this case a planning apparatus 16, is explained in detail thereby. The laser apparatus 4 described has emitted a laser beam 6. As described previously, the apparatus 100 is operated fully automatically here by means of the control apparatus 11. After receiving the corresponding start signal, the laser apparatus 4 begins to generate the laser beam 6, the beam splitter apparatus 70 generates the laser output beams 90 to 93, and the movement apparatus 8 moves the focusing optics 18. In this way, a cut is generated which is constructed in the manner described. The laser apparatus 4, the beam splitter apparatus 70 and the movement apparatus 8 receive the control signals required for operation from the control apparatus 11, which has been provided with the corresponding control data in advance. This can be carried out, for example, by means of the planning apparatus 16, Figure 5 The planning apparatus is shown here merely by way of example as an integral part of the control apparatus 11. Of course, the planning apparatus 16 can also be designed independently and communicate with the control apparatus 11 by means of a wired or wireless connection. In this case, a corresponding data transmission channel is provided between the planning apparatus 16 and the control apparatus 11.

[0073] The planning apparatus 16 comprises, as a core element, a computing apparatus 16a which calculates the cut(s) to be generated in the cornea 17 and determines the data required for these cuts, as described below. Thereby, a control data set is generated by the planning apparatus 16 or directly by the computing apparatus 16a, which is provided to the control apparatus 11 for carrying out the refractive surgery on the eye.

[0074] For calculating the cut(s), the computing apparatus 16a uses measurement data of the eye cornea, which are formed into refractive correction requirement data. In the embodiments described here, these measurement data originate from a measurement apparatus (not shown), which has previously measured the eye 2 of the patient 2. Of course, the measurement apparatus can be designed in any way and transmit the corresponding measurement data to the interface 29 of the planning apparatus 16.

[0075] The planning device 16 assists the operator of the device 100 in determining the cutting surfaces for isolating the corneal tissue block 121. This can even enable a fully automatic determination of the cutting surfaces 122, 123, 124, which for example can be achieved in that the planning device 16a determines from the measurement data the corneal tissue block 121 to be removed, defines its boundary surface(s) as the cutting surface(s), and generates corresponding control data for the control device 11 in accordance therewith. At the other end of the automation scale, the planning device 16 can provide input options at which the user can input the cutting surfaces in the form of geometric parameters or the like. Intermediate levels provide cutting surface proposals, which are automatically generated by the planning device 16 and can subsequently be modified by the operator.

[0076] Figure 6 A block diagram of a method for generating at least one cutting surface with the device 100 is shown schematically by way of example. The method comprises the following steps: S1 generating a laser beam 6 with the laser device 4; S2 generating a plurality of synchronized laser output beams 90 to 93 from the laser beam with the beam splitter device 70; S3 focusing the laser output beams 90 to 93 into the treatment volume 17 as focal spots, in particular as synchronized focal spots, with the movable focusing optics 18, which treatment volume extends in mutually orthogonal spatial directions x, y and z, wherein the z direction is parallel to the central reference axis a of the laser system 110; S4 moving the focusing optics 18 with the movement device 8, wherein the focusing optics are moved in at least one path, which path is selected from the group consisting of a path in a direction determined by the directions x, y and z, a path relative to the central reference axis a, a path relative to the central axis of the treatment volume, and a combination of the aforementioned paths; and S5 controlling at least the beam splitter device 70 and the movement device 8 by control data with the control device 11 and moving the focal spots 19 of the respective laser output beams 90 to 93 in the treatment volume 17 in and / or along at least one respective scanning path 19a or on at least one respective surface 19c. For example, the focusing optics can be moved in a path about the central reference axis a, in a path about the central axis A of the treatment volume and / or a combination of the two.

[0077] Figure 7 A block diagram of a method for generating control data for generating a cutting surface is shown schematically by way of example, for example for correcting a refractive error. In a step S11, refractive error data of an eye are received, which specify a refractive correction requirement of the eye, which refractive error data can for example be provided in a step prior thereto, which can in particular comprise a measurement of the eye. On the basis of this refractive correction requirement, the volume of a tissue block to be removed from the cornea is determined in a step S12. Since the refractive error correction depends primarily on the thickness profile (cf. Fig. 2), the volume of the tissue block to be removed can be determined in a step S13 on the basis of the refractive error data and the thickness profile of the cornea. The thickness profile of the cornea can be determined in a step S14, for example on the basis of a measurement of the cornea, which can be performed in a step prior thereto. The thickness profile of the cornea can be determined in a step S15 on the basis of the refractive error data and the refractive correction requirement. The refractive error data can be determined in a step S16 on the basis of a measurement of the eye, which can be performed in a step prior thereto. Figure 3bThe definition of the tissue block is not yet specific here, since it is not defined in the specification, so that in step S13 the tissue block, i.e. the lenticule to be isolated in the cornea, is calculated. In the last step S14 the cutting surfaces (e.g. 122, 123, 124 and the edge surface) required to isolate the lenticule in the cornea are calculated. In step S15 the corresponding control data for the cutting surfaces are generated. These data are then used as control data for the device 100, wherein data of the above-mentioned higher control levels can be completely involved, e.g. the definition of a scanning path (on and / or along which the light spot should be adjusted) and / or the coordinates of the target point, which are then converted into the corresponding control data for the device 100 (possibly only during the operation of the device 100).

Claims

1. An apparatus (100) for generating at least one cut surface (122, 123, 124) in a processing volume (17) of a transparent material, particularly for correcting the refractive state of an eye (2) by corneal reshaping, said apparatus comprising Laser system (110), the laser system having: - A laser device (4) for generating a laser beam (6); - A beam splitter device (70) having a beam splitter optics (70a) for generating multiple synchronized laser output beams (90, 91) from the laser beam (6). - A movable focusing optics (18) for focusing the laser output beam as a spot (19) into the processing volume (17), the processing volume extending in mutually orthogonal spatial directions x, y, and z, wherein the z direction is parallel to the central reference axis (a) of the laser system (110); and -Moving devices (8, 8a, 8b, 8c) for moving the movable focusing optics (18) on at least one path (B), the path being selected from a path in the direction determined by the directions x, y and z, a path relative to the central reference axis (a), a path relative to the central axis (A) of the processing volume (17), and a combination of the above paths; The device (100) further includes A control device (11) is designed to control the beam splitter device (70) and the moving device (8, 8a, 8b, 8c) by means of control data, such that the spot (19) of each laser output beam in the processing volume (17) moves on at least one corresponding scanning path (19a; 19b) and / or along the at least one corresponding scanning path and / or on at least one corresponding surface (19c).

2. The apparatus according to claim 1, The path and / or the scan path is selected from spiral, elliptical, circular, pole scan path, meandering scan path, especially contour scan path, and combinations thereof; and / or The processing volume (17) is spatially oriented or orientable such that the central axis (A) of the processing volume (17) is parallel to the z-direction; and / or The beam splitter optics (70a) is movable, and / or the moving devices (8, 8a, 8b, 8c) are designed to move the beam splitter optics together with the focusing optics (18); and / or The mobile device (8, 8a, 8b, 8c) has at least one scanner selected from one or more xy scanners (8a), one or more z scanners (8b), azimuth-radius scanners (8c), and combinations thereof; and / or The beam splitter optics are either immovable or movable, and the beam splitter assembly and / or the control device are designed to generate the laser output beam synchronously with the movement of the focusing optics; and / or The device includes at least one dynamic x, y, z scanner (180), particularly at least one resonant x, y, z scanner, for dynamically moving at least one of the laser output beams in at least one of the x, y, z directions. The at least one dynamic x, y, z scanner is connected upstream or downstream of the beam splitter optics or integrated into the beam splitter optics, and / or at least two of the dynamic x, y, z scanners are combined such that the amplitudes of the two dynamic scanners are added in at least one of the x, y, z directions.

3. The apparatus according to any one of the preceding claims, The beam splitter device and / or the control device are designed to synchronously and / or change the distribution, number, and / or spacing of the laser output beams according to the movement and / or radial position of the focusing optics; and / or The beam splitter device for synchronizing and / or changing the laser output beam has at least one element selected from one or more acousto-optic modulation devices (AOM), one or more electro-optic modulation devices (EOM), and one or more apertures; and / or The beam splitter device is designed to: provide multiple laser output beams in a first operating mode, and provide one laser output beam in a second operating mode.

4. The apparatus according to any one of the preceding claims, The laser device is designed to generate pulsed laser beams (6); and / or The beam splitter device is designed to provide multiple synchronous pulse laser output beams (90, 91, 92, 93); and / or The control device (11) is designed to control the beam splitter device (70) and the moving device (8, 8a, 8b, 8c) by means of control data, such that the laser output beams of the multiple synchronous pulses are arranged as synchronous beams, and especially as multiple beams, in a constant or variable arrangement.

5. The apparatus according to any one of the preceding claims, The control device is designed to control at least the beam splitter device and the moving device, such that: - The light spot is arranged transversely to the direction of the scanning path; and / or - The scanning path is designed as a spiral, and the ratio of the number of light spots in the inner region of the spiral to the number of light spots in the outer region of the spiral increases with increasing radial distance from the center; and / or - The scanning path is designed as a pole scanning path, and the number of light spots closer to the poles is reduced; and / or - Switching between the first operating mode providing multiple laser output beams from the laser output beams and the second operating mode providing one laser output beam from the laser output beams (90, 91, 92, 93); and / or - Select the scanning mode as follows: The successive light spots and / or multiple light spots to be generated on the cutting surface to be generated at the rear of the processing volume are generated sequentially towards the central axis (A) of the processing volume, while the successive light spots and / or multiple light spots to be generated on the cutting surface to be generated at the front of the processing volume are generated sequentially in a direction away from the central axis (A) of the processing volume; and / or - When the laser output beam is changed according to the laser radiation load limit of the tissue being processed, one or more laser output beams are altered, or in particular, blocked.

6. An apparatus (16) for generating control data to generate at least one cut surface, particularly for correcting the refractive state of an eye (2) by corneal reshaping, for use in the apparatus (100) according to any one of the preceding claims, comprising: - An interface (29) for receiving data on the refractive correction requirements of the eyes (2, 17). - Computing device (16a), the computing device being connected to the interface (29) and configured for use --Receive the data regarding the stated refractive correction requirements. --Calculate the cutting planes (122, 123, 124) based on the data regarding the aforementioned refractive correction requirements, and -- Generate the control data to control the beam splitter device (70) and the moving device (8, 8a, 8b, 8c) of the apparatus according to any one of the preceding claims, thereby generating the cutting surface by moving the spot (19) of each laser output beam (90, 91) in the processing volume on at least one corresponding scanning path (19a; 19b) and / or along the at least one corresponding scanning path and / or on at least one corresponding surface (19c).

7. The apparatus of claim 6, wherein the computing device (16a) is configured to generate the control data such that: - The beam splitter optics (70a) move together with the focusing optics (18), wherein the beam splitter optics (70a) is movable; and / or - The beam splitter device and / or the control device synchronously generate the laser output beam as the focusing optics move, wherein the beam splitter optics may be movable or immovable; and / or - Using the at least one dynamic x, y, z scanner (180), especially at least one resonant x, y, z scanner, dynamically move at least one of the laser output beams (90, 91, 92, 93) in at least one of the x, y, z directions; and / or - Utilizing at least two of the dynamic x, y, z scanners, when the laser output beam is dynamically moved, the amplitudes of the two dynamic scanners are added together in at least one of the x, y, z directions; and / or - Using the beam splitter device and / or the control device, the distribution, number, and / or spacing of the laser output beams are synchronously and / or changed according to the movement and / or radial position of the focusing optics; and / or -Use the beam splitter device and / or the control device to synchronize and / or change the laser output beam; and / or - Using the beam splitter device, multiple laser output beams (90, 91, 92, 93) are provided in a first operating mode, and one laser output beam is provided in a second operating mode. and / or - Generate a pulsed laser beam (6) using the laser device (5); and / or - The beam splitter device (70) provides multiple synchronous pulse laser output beams (90, 91, 92, 93); and / or - The path and / or the scan path (19a; 19b) is selected from spiral, elliptical, circular, pole scan path, or meandering scan path, especially contour scan path, and combinations thereof.

8. The apparatus according to any one of claims 6 and 7, wherein the computing device is configured to generate the control data such that: - The light spot is arranged transversely to the direction of the scanning path; and / or - The scanning path is designed as a spiral, and the ratio of the number of light spots in the inner region of the spiral to the number of light spots in the outer region of the spiral increases with increasing radial distance from the center; and / or - The scanning path is designed as a pole scanning path, and the number of light spots closer to the poles is reduced; and / or - Switching between the first operating mode providing multiple laser output beams (90, 91, 92, 93) and the second operating mode providing one of the laser output beams; and / or - A scanning mode is provided in which the successively generated light spots and / or multiple light spots of the cutting surface to be generated at the rear of the processing volume are generated sequentially toward the central axis (A) of the processing volume, while the successively generated light spots and / or multiple light spots of the cutting surface to be generated at the front of the processing volume are generated sequentially in a direction away from the central axis (A) of the processing volume; and / or - When the laser output beam is altered according to the laser radiation load limit of the tissue being treated, one or more laser output beams are changed, in particular, blocked; and / or - The laser output beams of the multiple synchronous pulses are arranged as synchronous beams, especially as multiple beams, in a constant or variable arrangement.

9. An apparatus (1) for correcting the refractive state of an eye (2) by corneal reshaping, comprising an apparatus (100) for generating at least one cut surface according to any one of claims 1 to 5, and an apparatus (16) for generating control data according to any one of claims 6 to 8.

10. A method for generating at least one cut surface in a processing volume (17) of a transparent material, particularly for correcting the refractive state of an eye (2) by corneal reshaping, said method using an apparatus (100; 1) according to any one of claims 1 to 5 or 9, said method comprising: - A laser beam (6) is generated using the laser device (4) of the laser system (110) (S1). - Using the beam splitter device (70), multiple synchronous laser output beams (90, 91) are generated from the laser beam (6) (S2). - Using the movable focusing optics (18), the laser output beam is focused as a spot (19) into the processing volume (17), which extends in mutually orthogonal spatial directions x, y and z, wherein the z direction is parallel to the central reference axis (a) of the laser system (110) (S3). - The movable focusing optics (18) are moved using the moving devices (8, 8a, 8b, 8c), wherein the focusing optics (18) are moved along at least one path (B), the path being selected from a path in the direction determined by the directions x, y, and z, a path relative to the central reference axis (a), a path relative to the central axis (A) of the processing volume (17), and a combination of the above paths (S4); and - Using the control device (11), the beam splitter device (70) and the moving device (8, 8a, 8b, 8c) are controlled by control data, and the spot (19) of each laser output beam (90, 91) in the processing volume (17) is moved on at least one corresponding scanning path (19a; 19b) and / or along the at least one corresponding scanning path and / or on at least one corresponding surface (19c) (S5).

11. The method according to claim 10, The path and / or the scan path are selected from spiral, elliptical, circular, pole scan paths, meandering scan paths, especially contour scan paths, and combinations thereof; and / or The processing volume (17) is spatially oriented such that the central axis (A) of the processing volume (17) is parallel to the z-direction; and / or The beam splitter optics are movable, and / or the moving device causes the beam splitter optics to move together with the focusing optics; and / or The beam splitter optics may be moved or not, and the beam splitter device and / or the control device generate the laser output beam (90, 91, 92, 93) synchronously with the movement of the focusing optics. and / or The laser output beam (90, 91, 92, 93) is dynamically moved in at least one direction in the x, y, z directions using at least one dynamic x, y, z scanner, particularly at least one resonant x, y, z scanner; and / or Wherein, at least two of the dynamic x, y, z scanners are used, and when the laser output beam is dynamically moved, the amplitudes of the two dynamic scanners are added in at least one of the x, y, z directions; and / or The beam splitter device and / or the control device are used to synchronously and / or change the distribution, number, and / or spacing of the laser output beams according to the movement and / or radial position of the focusing optics; and / or The laser output beam is synchronized and / or changed using the beam splitter device and / or the control device; and / or The beam splitter device is used to provide multiple laser output beams in the laser output beam in a first operating mode, and to provide one laser output beam in the laser output beam in a second operating mode.

12. The method according to any one of claims 10 and 11, The laser device is used to generate a pulsed laser beam (6); and / or The beam splitter device is used to provide multiple synchronous pulse laser output beams (90, 91, 92, 93); and / or The laser output beams of the multiple synchronous pulses are arranged as synchronous spots, or more particularly as multiple spots in a constant or variable arrangement.

13. The method according to any one of claims 10 to 12, wherein - The light spot is arranged transversely to the direction of the scanning path; and / or - The scanning path is designed as a spiral, and the ratio of the number of light spots in the inner region of the spiral to the number of light spots in the outer region of the spiral increases with increasing radial distance from the center; and / or - Design the scanning path as an pole scanning path and reduce the number of light spots close to the poles; and / or - Switching between the first operating mode providing multiple laser output beams (90, 91, 92, 93) and the second operating mode providing one of the laser output beams; and / or - Select the following scanning mode, namely: using the scanning mode, the successively generated light spots and / or multiple light spots of the cutting surface to be generated in the rear part of the processing volume are generated sequentially in the direction of the central axis (A) of the processing volume, while the successively generated light spots and / or multiple light spots of the cutting surface to be generated in the front part of the processing volume are generated sequentially in the direction away from the central axis (A) of the processing volume; and / or - When changing the laser output beam according to the laser radiation load limit of the tissue being processed, one or more laser output beams may be altered, in particular, blocked.

14. A method for generating control data to generate at least one cutting surface, particularly for correcting the refractive state of an eye (2) by corneal reshaping, said method using the apparatus (16; 1) according to any one of claims 6 to 9, said method comprising: - Receive data (S11) regarding the refractive correction requirements of the eye (2) via interface (29), and - Utilize a computing device (16a) connected to the interface (29). -- Receive the data regarding the refractive correction requirements (S11). --Calculate the cutting planes (122, 123, 124) (S12 to S14) based on the data regarding the refractive correction requirements, and -- Generate the control data to control the beam splitter device and the moving device of the apparatus according to any one of claims 1 to 5, thereby generating the cutting surface (S15) by moving the spot of each laser output beam (90, 91, 92, 93) in the processing volume on and / or along the at least one corresponding scanning path and / or on at least one corresponding surface (19c).

15. The method of claim 14, wherein the control data is generated such that: - The beam splitter optics move together with the focusing optics (18), wherein the beam splitter optics (70a) are movable; and / or - The beam splitter device and / or the control device synchronously generate the laser output beam as the focusing optics move, wherein the beam splitter optics may be movable or immovable; and / or - Using the at least one dynamic x, y, z scanner, especially at least one resonant x, y, z scanner, dynamically move at least one of the laser output beams in at least one of the x, y, z directions; and / or - Utilizing at least two of the dynamic x, y, z scanners, when the laser output beam is dynamically moved, the amplitudes of the two dynamic scanners are added together in at least one of the x, y, z directions; and / or - Using the beam splitter device and / or the control device, the distribution, number, and / or spacing of the laser output beams are synchronously and / or changed according to the movement and / or radial position of the focusing optics; and / or -Use the beam splitter device and / or the control device to synchronize and / or change the laser output beam; and / or - Using the beam splitter device, multiple laser output beams are provided in the laser output beam in a first operating mode, and one laser output beam is provided in the laser output beam in a second operating mode; and / or - Generate a pulsed laser beam (6) using the laser device (5); and / or - The beam splitter device is used to provide a laser output beam with multiple synchronous pulses; and / or - Select the path and / or the scan path from spiral, elliptical, circular, pole scan path, meandering scan path, especially contour scan path, and combinations of the above paths.

16. The method according to any one of claims 14 and 15, wherein the control data is generated such that: - The light spot (19) is arranged transversely to the direction of the scanning path; and / or - The scanning path is designed as a spiral, and the ratio of the number of light spots in the inner region of the spiral to the number of light spots in the outer region of the spiral increases with increasing radial distance from the center; and / or - The scanning path is designed as a pole scanning path, and the number of light spots closer to the poles is reduced; and / or - Switching between the first operating mode providing multiple laser output beams (90, 91, 92, 93) and the second operating mode providing one of the laser output beams; and / or - A scanning mode is provided in which the successively generated light spots and / or multiple light spots of the cutting surface to be generated at the rear of the processing volume are generated sequentially toward the central axis (A) of the processing volume, while the successively generated light spots and / or multiple light spots of the cutting surface to be generated at the front of the processing volume are generated sequentially in a direction away from the central axis (A) of the processing volume; and / or - When the laser output beam is altered according to the laser radiation load limit of the tissue being treated, one or more laser output beams are changed, in particular, blocked; and / or - The laser output beams of the multiple synchronous pulses are arranged as synchronous beams, especially as multiple beams, in a constant or variable arrangement.

17. A method for correcting the refractive state of an eye (2) by corneal reshaping, comprising at least one method according to any one of claims 10 to 16.

18. A computer program product having program code, which, after being loaded into a computer, executes at least one method according to any one of claims 10 to 17.

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