Device and method for generating at least one cross-sectional surface, device and method for generating control data
Patent Information
- Application Number
- DE102023122201
- Authority / Receiving Office
- DE · DE
- Patent Type
- Applications
- Current Assignee / Owner
- Filing Date
- 2023-08-18
- Publication Date
- 2025-02-20
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Abstract
Description
[0001] The invention relates to a device for generating at least one cutting surface, in particular for correcting the refraction of an eye by means of corneal modification, an associated method, a device for generating control data, an associated method, a device for correcting the refraction of an eye, an associated method and a software product for carrying out the methods.
[0002] Human vision problems have long been corrected using lenses in the form of glasses. Recently, there have been various approaches to correcting visual impairment by modifying the cornea. The modification is intended to change the curvature of the cornea. To correct myopia, the front surface of the cornea must be flattened, which is why the volume to be removed is thicker in the center, i.e. in the area of the visual axis, than at the edges. To correct hyperopia, on the other hand, the front surface of the cornea must be curved more sharply, which is why the volume to be removed is thicker at the edges than in the center. The overall imaging properties of the eye are thereby influenced in such a way that visual impairment is reduced or, ideally, even completely corrected.
[0003] Various surgical methods are known for this type of vision correction. In the so-called LASIK procedure according to EP 1719483 A1, a corneal flap is first detached from the corneal surface on one side and folded to the side. This exposes the interior of the cornea, from which material is then vaporized using an ablative laser, also known as disruption or photodisruption. If the corneal flap is then folded back in, the natural front surface of the cornea remains intact. Because material has been vaporized inside the cornea, the front surface of the cornea has a different curvature, which is dimensioned such that a previously existing vision defect is corrected. The material is removed by ablation. Ablation, also known as photoablation, vaporizes tissue when laser radiation is absorbed upon impact with the tissue surface.Pulsed laser radiation is used, and each pulse vaporizes a specific volume of corneal tissue. A large number of shots are distributed across the exposed interior of the cornea so that the desired material is ablated.
[0004] This ablation must be distinguished from the creation of a cut surface inside the tissue according to WO 2005 / 011545 A1, which, for example, acts as an interface to delimit a piece of tissue and make it removable. In contrast to ablation, laser radiation is used for this purpose which penetrates through the surface into the interior of the material and is therefore not absorbed at the surface. This laser radiation is bundled into a focus inside the tissue in the form of short pulses. This achieves a specific power density spatially and temporally at the focus, so that tissue layers inside the tissue are separated. The separation essentially takes place in the focus or in the close spatial area around this focus. An optical breakdown limited to a few micrometers (e.g. in the form of a plasma bubble) can occur in / around the focus. However, approaches are also known which work without such a breakdown, e.g. by overlapping several focus positions.In all cases, a multitude of optical focus positions creates a cut surface directly inside the tissue. Only in this way can a cut surface be created inside the cornea, which acts as a boundary layer to delimit a piece of tissue and make it removable. Ablation cannot achieve this. Control data (so-called "shot files") from ablation-based procedures are also unsuitable for creating a cut surface inside the tissue—if only because they do not contain depth coordinates, since the ablating radiation is absorbed at the tissue surface.
[0005] The term "ablation" is also used in the prior art to describe the proposal to vaporize tissue within the cornea using pulsed laser radiation. The idea, for example, in US Pat. No. 5984916 A, was to dissolve the piece of tissue to be removed directly within the corneal stroma. The term "intrastromal ablation" was used for this. However, it was found that this vaporization caused unacceptably high gas pressures within the cornea. This approach was therefore not pursued further and never put into practice.
[0006] A very successful procedure was developed by Carl Zeiss Meditec AG under the name SMILE (see, for example, DE 102007019813 A1). It uses pulsed laser radiation to isolate a lenticule in the cornea. This lenticule can then be removed from the cornea through a lateral opening incision that leads to the surface of the cornea and serves as a working channel. For this purpose, suitable incision surfaces are created in the corneal tissue using a large number of laser pulse foci. This multitude is arranged in a specific pattern in the cornea, which ultimately defines the shape and position of the incision surfaces. The piece of tissue comprising the lenticule is structured and sized so that the front surface of the cornea changes its curvature as necessary for the correction. The procedure achieves a subtractive correction because volume is removed. Another approach inserts implants into the cornea.To do this, a slit is made in the cornea into which the implant is inserted. It is designed to change the curvature of the anterior surface of the cornea in the desired way. This approach thus provides an additive correction by adding volume. In both cases, an incision must be made inside the cornea. This is done using laser radiation.
[0007] In eye surgery or eye measurement, several laser beams are often moved across the patient's eye simultaneously. The movement of one or more laser beams across an eye is also called scanning. Beam splitter devices are available to generate multiple laser beams from a single laser beam, e.g., US20130231644 A1, WO2022194484 A1, US2019159933 A1. Laser systems are also known from the prior art that focus a laser beam through a so-called micro-lens that is moved across the volume to be cut, e.g., DE102015212877 A1 and US 20210386586 A1. Furthermore, there are systems that generate two laser beams to cut two surfaces at different corneal depths, e.g., US 11090191 B2.Such systems have several disadvantages regarding scan time and the cutting of arbitrary lenticule geometries, especially higher-order ones (customized lenticules), because the spacing of the multispots is too large to ensure effective interaction. Furthermore, the spot spacing and the number of spots remain essentially constant.
[0008] The invention is based on the object of specifying a device and a method for generating at least one cutting surface, which enable a high degree of flexibility in the generation of cutting surfaces with a short scanning time.
[0009] The invention is characterized in the independent claims. The dependent claims relate to preferred developments.
[0010] One embodiment relates to a device for producing at least one cutting surface in a processing volume of a transparent material, in particular for correcting the refraction of an eye by corneal modification, comprising a laser system with - a laser device for generating a laser beam; - a beam splitter device with beam splitter optics for generating a plurality of simultaneous laser output beams from the laser beam; - a movable focusing optic for focusing the laser output beams as spots, in particular simultaneous spots, into the processing volume, which extends in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis of the laser system; and - a movement device for moving the movable focusing optics on at least one path selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis a, a path relative to a central axis of the processing volume and a combination thereof; wherein the device further comprises - a control device configured to control at least the beam splitter device and the movement device using control data such that the spot of each laser output beam is moved in the processing volume on and / or along at least one respective scan path and / or on at least one respective surface. The at least one cutting surface can be generated in this process.
[0011] The movable focusing optics are preferably designed as a movable micro-lens. The focusing optics contain, for example, one or more optical elements for focusing the laser output beams. With the device, the scanning time required to generate the at least one cutting surface can be surprisingly reduced and a high degree of flexibility in generating the cutting surface can be achieved. This is made possible by the fact that several partial laser beams, also called laser output beams, are generated from the laser beam using the beam splitter device. These can be provided as simultaneous laser output beams, in particular as simultaneous pulsed laser output beams. The simultaneous laser output beams can be directed into the processing volume as spots using the movable focusing optics to generate the cutting surface and can be moved along individual scanning paths, also called scanning paths, and / or surfaces, also called scanning surfaces.Essentially simultaneous spots, also called multispots, can be generated. The scan paths can be at least partially straight, curved, one-dimensional, and / or two-dimensional. The scan surfaces can be at least partially flat, curved, two-dimensional, and / or three-dimensional. This allows the position and number of spots to be flexibly varied. The spot spacing and / or the number of spots can be optimally adapted to the movement of the focusing optics. Furthermore, the risk of suction loss at the patient's eye can be reduced. Furthermore, optimized section quality can be achieved.
[0012] In all embodiments and modifications, the entire focusing optics, which may contain one or more optical elements, can be moved with the movement device. Furthermore, the movement of the focusing optics can be slow or fast. The control device can also be configured to control the laser device. The term "path of the focusing optics relative to the central home position axis" can imply that the path is generated starting from the central home position axis, e.g., in the case of a spiral path.
[0013] The path and / or 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 line scan path, and a combination thereof.
[0014] The focusing optics can be moved on at least one path, e.g. on and / or along a spiral, an ellipse, a circle, a polar scan path and a meandering scan path, in particular a contour line scan path, and a combination thereof. For this purpose, the focusing optics can be designed so as to be deflectable. This means that the focusing optics can be moved on and / or along the at least one path. To generate a path in the form of a spiral, an ellipse, a circle, and / or a meandering scan path, in particular a contour line scan path, the focusing optics can be rotated and deflected, e.g. with a motor, around the home position axis of the laser system, i.e. guided on and / or along the relevant path and / or adjusted radially.In a polar scan, the focusing optics can be moved across the pole with slow pendulum movements, starting from a latitude of the hemispherical scan surface containing the pole, with the pendulum movement line being rotated 360° around the pole. Multispots can be arranged with a fast pendulum movement laterally to the pendulum movement line, e.g., on the latitudes.
[0015] The processing volume can be spatially aligned or alignable such that the central axis of the processing volume runs parallel to the z-direction. The movement device can comprise at least one scanner selected from one or more xy scanners, one or more z-scanners, an azimuth-radius scanner, and a combination thereof. The azimuth-radius scanner is a scanner with which the entire focusing optics can be guided, for example, on a circular and / or spiral path around an axis.
[0016] The beam splitter optics can be movable, e.g., suspended so as to be movable. The movement device can be designed to move the beam splitter optics together with the focusing optics. The beam splitter optics and the focusing optics can be firmly connected to one another. The beam splitter optics can be immobile, i.e., stationary. The beam splitter device and / or the control device can be designed to generate the laser output beams synchronized with the movement of the focusing optics. The latter is particularly advantageous in the case of a non-movable 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.
[0017] At least one dynamic x, y, z scanner, in particular at least one harmonic 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. 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, dynamically moving the laser output beams at a scanning speed of significantly more than 100 mm / s, e.g. between 800 and 2500 mm / s, a fast oscillatory movement of the laser output beams can be achieved. This movement is also called wobbling and can be used to shape the spot. With a dynamic x, y, z scanner connected upstream or downstream of the beam splitter optics, the spots of different laser output beams can be moved equally dynamically.With a dynamic x, y, z scanner integrated into the beam splitter device, the spots of different laser output beams can be moved with different dynamics. 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, e.g., double wobbling. Wobbling can advantageously lead to more efficient vaporization and / or disruption of the transparent material, e.g., corneal tissue, as a volume per time, with a technical limitation of the number of multi-spots. Double wobbling can result in more efficient vaporization and / or disruption of tissue as a volume per time, with a technical limitation of the number of multi-spots and a limited amplitude of the fast dynamic scanning movement.
[0018] The beam splitter device and / or the control device can be configured to synchronize and / or vary the distribution, number, and / or spacing of the laser output beams depending on the movement and / or radial position of the focusing optics. This allows a homogeneous density of the plasma bubbles generated in the processing volume to be achieved. Furthermore, the beam splitter device can comprise at least one element selected from one or more acoustic-optical modulation (AOM) devices, one or more electrical-optical modulation (EOM) devices, and one or more apertures for synchronizing and / or varying the laser output beams. The beam splitter device can be configured to provide several of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode.
[0019] The laser device can be configured to generate a pulsed laser beam. The beam splitter device can be configured to provide a plurality of simultaneously pulsed laser output beams. The laser device, the beam splitter device, and / or the movement device can be configured to be controllable. Furthermore, the scanning path can be selected from a spiral, an ellipse, a circle, a polar scanning path, and a meandering scanning path, in particular a contour scanning path, and a combination thereof. Thus, the distribution, number, and / or spacing of the spots can be flexibly varied. The control device can be configured to control the beam splitter device and the movement device using control data such that the spots of the plurality of simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement.
[0020] The control device can be designed to control at least the beam splitter device and the movement device in such a way that - the spots are arranged laterally to the direction of the scan path; - the scanning path is formed 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 is increased with increasing radial distances from the center; - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; - switching between the first operating mode for providing a plurality of the laser output beams and the second operating mode for providing one of the laser output beams; - a scanning regime is selected such that successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and / or - when the laser output beams are varied depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out.
[0021] Switching between the first and second operating modes can also involve switching in reverse, i.e., between the second operating mode and the first operating mode. For example, a flap cut can be cut in single-spot mode, and curved cuts can be cut in multi-spot mode. A spiral scan, for example, can begin in single-spot mode and add additional spirals as the radial distance from the center of the spiral and / or the optical zone of the eye to be cut increases. The scans for such scan paths can be performed with a short scan time.
[0022] A further embodiment relates to a device for generating control data for generating at least one cut surface, in particular for correcting the refraction of an eye by corneal modification, for a device according to one of the preceding claims, comprising an interface for receiving data about a refraction correction requirement of the eye, and a calculation device connected to the interface. The calculation device is configured -- to receive data on the need for refraction correction, -- to calculate a sectional area based on the data on the refractive correction requirement, and -- for generating the control data for controlling at least the beam splitter device and the movement device of the device according to one of the preceding claims such that the cutting surface is generated by moving the spot of each laser output beam in the processing volume on and / or along at least one respective scan path and / or on at least one respective surface, also called scan surface.
[0023] The calculation device can be designed to generate the control data in such a way that - the beam splitter optics are moved together with the focusing optics, whereby the beam splitter optics are movable; - the beam splitter device and / or the control device generates the laser output beams synchronized with the movement of the focusing optics, wherein the beam splitter optics is movable or immovable; - with the at least one dynamic x, y, z scanner (180), in particular at least one harmonic x, y, z scanner, at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions; - with at least two of the dynamic x, y, z scanners, the amplitudes of the two dynamic scanners are added in at least one of the x, y, z directions when dynamically moving the laser output beams; - the beam splitter device and / or the control device are used to synchronise and / or vary the distribution, number and / or spacing of the laser output beams as a function of the movement and / or radial position of the focusing optics; - the laser output beams are synchronised and / or varied using the beam splitter device and / or the control device; - the beam splitter device provides a plurality of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode; - a pulsed laser beam is generated with the laser device; - the beam splitter device provides several simultaneously pulsed laser output beams; and / or - the path and / or the scan path is selected from a spiral, an ellipse, a circle, a polar scan path and a meandering scan path, in particular a contour line scan path, and a combination thereof.
[0024] The calculation device can be designed to generate the control data in such a way that - the spots are arranged laterally to the direction of the scan path; - the scanning path is formed 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 is increased with increasing radial distances from the center; - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; - switching between the first operating mode for providing a plurality of the laser output beams and the second operating mode for providing one of the laser output beams; - a scanning regime is provided with which successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and / or - when varying the laser output beams depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out; and / or the spots of the several simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement.
[0025] A further embodiment relates to a device for correcting the refraction of an eye by corneal modification, comprising a device for generating at least one cut surface according to one of the preceding embodiments and modifications, and a device for generating control data according to one of the preceding embodiments and modifications. The device for correcting the refraction of an eye by corneal modification surprisingly enables a short treatment time required for the refraction correction, high flexibility in generating the cut surfaces required for the correction, and high quality of the cut surfaces and thus the refraction correction.
[0026] Another embodiment relates to a method for producing at least one cutting surface in a processing volume of a transparent material, in particular for correcting the refraction of an eye by corneal modification, with a device for producing at least one cutting surface according to one of the preceding embodiments and modifications. The method comprises - generating a laser beam with the laser device of the laser system; - Generating multiple simultaneous laser output beams from the laser beam with the beam splitter device; - focusing the laser output beams as spots, in particular simultaneous spots, into the processing volume extending in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis of the laser system, with the movable focusing optics; - Moving the focusing optics with the movement device, wherein the focusing optics are moved on at least one path selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis a, a path relative to a central axis of the processing volume and a combination thereof; and - Controlling at least the beam splitter device and the movement device with the control device using control data and moving the spot of each laser output beam in the processing volume on and / or along at least one respective scan path and / or on at least one respective surface. In this process, the at least one cutting surface can be generated.
[0027] In the method of the above embodiment, the path and / or 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 a combination thereof. The processing volume can be spatially aligned such that the central axis of the processing volume runs parallel to the z-direction. In the method of the above 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 immobile, i.e., stationary. The beam splitter optics can be moved or not, and the beam splitter device and / or the control device can generate the laser output beams synchronized with the movement of the focusing optics.With the at least one dynamic x, y, z scanner, in particular at least one harmonic x, y, z scanner, at least one of the laser output beams can be dynamically moved in at least one of the x, y, z directions. With 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 during the dynamic movement of the laser output beams. With 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 varied depending on the movement and / or the radial position of the focusing optics. With the beam splitter device and / or the control device, the laser output beams can be synchronized and / or varied.The beam splitter device can provide several of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode.
[0028] In the method of the above embodiment and modifications thereof, a pulsed laser beam can be generated with the laser device. The beam splitter device can provide multiple simultaneously pulsed laser output beams. Furthermore, the scanning path can be selected from a spiral, an ellipse, a circle, a polar scanning path, a meandering scanning path, in particular a contour scanning path, and a combination thereof. The spots of the multiple simultaneously pulsed laser output beams can be arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement.
[0029] In the method of the above embodiment and modifications thereof - the spots can be arranged lateral to the direction of the scan path; - the scanning path can be 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 can be increased with increasing radial distances from the center; - the scan path can be designed as a pole scan path and the number of spots with a smaller distance to the pole can be reduced; - can be switched between the first operating mode for providing a plurality of the laser output beams and the second operating mode for providing one of the laser output beams; - a scanning regime can be selected with which successively generated spots and / or multispots of a cutting surface to be created posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and / or multispots of a cutting surface to be created anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and / or - when varying the laser output beams depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams can be varied, in particular masked out. In another embodiment, a method for generating control data for generating at least one cutting surface, in particular for correcting the refraction of an eye by corneal modification, with a device for generating control data for generating at least one cutting surface, according to one of the preceding embodiments and modifications, is specified. The method comprises - Receiving data about a refractive correction requirement of the eye with the interface; and - with the calculation device connected to the interface, -- Receiving data on the need for refraction correction, -- Calculating a cut surface based on the data on the refractive correction requirement, and -- Generating the control data for controlling at least the beam splitter device and the movement device of the device for generating at least one cutting surface according to one of the preceding embodiments and modifications such that the cutting surface is generated by moving the spot of each laser output beam in the processing volume on and / or along at least one respective scan path and / or on at least one respective surface.
[0030] In the method of the above embodiment, the control data may be generated such that - the beam splitter optics are moved together with the focusing optics, whereby the beam splitter optics are movable; - the beam splitter device and / or the control device generates the laser output beams synchronized with the movement of the focusing optics, wherein the beam splitter optics is movable or immovable; - with the at least one dynamic x, y, z scanner, in particular at least one harmonic x, y, z scanner, at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions, - with at least two of the dynamic x, y, z scanners, the amplitudes of the two dynamic scanners are added in at least one of the x, y, z directions when dynamically moving the laser output beams; - the beam splitter device and / or the control device are used to synchronise and / or vary the distribution, number and / or spacing of the laser output beams as a function of the movement and / or radial position of the focusing optics; - the laser output beams are synchronised and / or varied using the beam splitter device and / or the control device; - the beam splitter device provides a plurality of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode; - a pulsed laser beam (6) is generated with the laser device (5); - the beam splitter device provides several simultaneously pulsed laser output beams; and / or - the path and / or the scan path is selected from a spiral, an ellipse, a circle, a polar scan path and a meandering scan path, in particular a contour line scan path, and a combination thereof.
[0031] In the method for generating control data for generating at least one cutting surface, in particular for correcting the refraction of an eye by corneal modification, the control data can be generated in such a way that - the spots are arranged laterally to the direction of the scan path; - the scanning path is formed 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 is increased with increasing radial distances from the center; - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; - switching between the first operating mode for providing a plurality of the laser output beams and the second operating mode for providing one of the laser output beams; - a scanning regime is provided with which successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and / or - when varying the laser output beams depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out; and / or - the spots of the plurality of simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement.
[0032] A further embodiment relates to a method for correcting the refraction of an eye by corneal modification, comprising at least one method for generating control data for generating at least one cutting surface, in particular for correcting the refraction of an eye by corneal modification, according to one of the preceding embodiments and modifications.
[0033] In another embodiment, a computer program product is provided with program code which, when loaded into a computer, executes at least one method of one of the above embodiments and modifications. The computer may include a memory device for storing data.
[0034] With the above embodiments of the device for generating control data for generating at least one cutting surface, the device for correcting the refraction 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 can be realized as with the embodiments of the device for generating at least one cutting surface, in particular with identical and / or analogous features.
[0035] The described method for generating control data comprises the preparation for generating at least one cutting surface for the purpose of correcting the refraction of an eye by corneal modification and does not yet require the cutting surface generation itself, i.e. in particular does not require a surgical step. However, it can be supplemented by a cutting surface generation step. In this step, a laser device is then used to generate the cutting surface. The method for generating at least one cutting surface can be carried out without intervention on the living human or animal body, e.g., for producing an implant to be inserted (later) from dead donor tissue or artificial tissue material. Equally, testing, investigation, or demonstration of the generation of at least one cutting surface on dead material, e.g., enucleated animal eyes, is possible.The creation of the incision surface can preferably be further developed into a surgical procedure for correcting refractive errors. A piece of tissue is then isolated and removed from the cornea for the refractive error correction.
[0036] The method for generating at least one cutting surface and / or the method for generating control data can, in principle, be carried out using a computer, in particular comprising a processor. The computer for the method for generating control data can be configured as a planning station, as is otherwise known in the prior art.
[0037] The invention relates to a software product for carrying out the method for generating control data, the method for generating at least one cutting surface and / or the method for correcting ametropia of the eye, since the calculation of the cutting surface and the determination of control data for the device as well as the control of the device can be carried out without problems by corresponding software.
[0038] In the above embodiment and modifications of the device for generating at least one intersection, the above embodiment or modifications of the device for generating control data, in particular the calculation device, can be provided. A data-conducting connection, wireless or wired, can be present between the device for generating at least one intersection and the device for generating control data. Furthermore, the above embodiment and modifications of the method for generating at least one intersection can include the above embodiment or modifications of the method for generating control data.
[0039] It is understood that the features mentioned above and those to be explained below can be used not only in the combinations indicated, but also in other combinations or on their own, without departing from the scope of the present invention.
[0040] The invention is explained in more detail below using exemplary embodiments with reference to the accompanying drawings, which also disclose features essential to the invention. These exemplary embodiments are for illustrative purposes only and are not to be interpreted as restrictive. For example, a description of an embodiment with a large number of elements or components should not be interpreted to mean that all of these elements or components are necessary for implementation. Rather, other embodiments may also contain alternative elements and components, fewer elements or components, or additional elements or components. Elements or components of different exemplary embodiments may be combined with one another unless otherwise stated. Modifications and variations described for one of the exemplary embodiments may also be applicable to other exemplary embodiments.To avoid repetition, identical or corresponding elements in different figures are designated by the same reference numerals and are not explained more than once. The figures show: Fig. 1 a schematic representation of a treatment device 1 for ophthalmic refractive correction, Fig. 2 a schematic representation of the effect of the laser radiation used in the treatment device of Fig. 1 is used, Fig. 3a is a schematic representation of an example of a device 100 for generating at least one cutting surface, Fig. 3b a schematic cross-sectional view through the cornea to illustrate the removal of a piece of corneal tissue in connection with ophthalmic refractive correction, Fig. 3c schematically shows an example of essentially parallel spiral paths of several simultaneous spots, Fig. 3d schematic example of a spiral scan, Fig. 3e shows a schematic example of a pole scan, Fig. 3f shows an example of the device 100 with a dynamic x-, y-, z-scanner 180 for dynamically moving at least one of the spots, Fig. 3g to 3n schematically show examples of exemplary scan modes generated with the device 100, Fig. 4a is a schematic representation of a focusing optics and a beam splitter device of an example of the device 100 for generating at least one cutting surface, Fig. 4b and Fig. 4c Schematic representations of an addition of amplitudes of dynamic x-, y-, z-scanners, which are shown in Fig. 4a shown beam splitter device are integrated, Fig. 5 a schematic representation of the planning device of the treatment device of Fig. 1, Fig. 6 a block diagram of an exemplary method for generating at least one cutting surface, Fig. 7 is a block diagram of an exemplary method for generating control data for generating at least one cutting surface, and Fig. 8 schematically shows a variant of the example of the device 100 for producing at least one cutting surface.
[0041] In the present case, the term “slow” movement can refer to a movement, e.g. a scanning movement and / or a movement with a movement speed of less than 100 mm / s, preferably between 0 and 80 mm / s, more preferably between 0.1 and 12 mm / s. The terms “fast” movement or “dynamic” movement can refer to a movement, e.g. a scanning movement, with a movement speed equal to or greater than 100 mm / s, preferably between 800 and 2500 mm / s, more preferably 900 to 2000 mm / s. The same applies to the terms “slow scanner” and “fast scanner”. For example, the deflectable focusing optics can be rotated and deflected by a motor around the home position axis of the laser system, i.e. guided on and / or along the path, and / or adjusted radially. A constant rotation speed of the focusing optics can be selected in the range of 100 to 300 Hz, e.g., 200 Hz. The movement of the micro-lens can be a rotational path, e.g.,in the case of a circular or spiral path. The micro-lens can also be guided in a meandering manner over the processing volume. The speed of the change in radius per unit time can be a slow scanning movement in the range of 0.1 to 1 mm / s, e.g. 0.5 mm / s. The path speed, i.e. the speed at which the focusing optics are guided along the path, can be a slow or fast scanning movement in the range of 0 to 20 m / s. With an azimuth radius scanner, the path speed of the micro-lens at an outermost spiral arm can be e.g. 10 m / s. With a pole scan, the pendulum movement of the focusing optics can be carried out with a slow scanner at a speed of 8 to 50 mm / s, preferably 15 to 20 mm / s. A slow or fast scanning movement of the multispots can take place at a speed of 0 to 20 m / s and / or the pendulum movement line(s) can be carried out at a speed of e.g.1 / 5 to 1 / 16 Hz, preferably 1 / 6 to 1 / 15 Hz, around the pole. For example, the pendulum is rotated 360 degrees once in approximately 5 to 16 seconds. A lenticule cut can be created in the first 180 degrees. A cap cut can be created in the second 180 degrees. The orbital speed of the rotation of the oscillating focusing optics around the pole can be, for example, 2 mm / s.
[0042] As mentioned, the processing volume can have a central axis. The central axis of the processing volume can be identical in position to a home position axis of the laser system if the processing volume is appropriately aligned. The home position of the laser system can be the position of the laser system and / or the focusing optics from which the operation of the device for generating at least one cutting surface is started. The home position 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, z" can mean that the focusing optics are deflected and / or moved at an angle in the relevant direction(s) starting from the home position axis of the laser system. The term "moving the movable focusing optics on a path relative to the central home position axis a" can include that the focusing optics are deflected and / or moved radially on a path around the home position axis a, e.g., by a constant or varying angle, and / or moved starting from the central home position axis a. The term "moving the movable focusing optics on a path relative to a central axis of the processing volume" can include that the focusing optics are moved on a path around the central axis A, e.g.,radially deflected and / or moved by a constant or varying angle, and / or moved starting from the central axis. The 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 a combination thereof. The term "scan path" is also referred to herein as "scan path." The same applies to grammatical variations of these terms.
[0043] An exemplary device 100 for producing at least one cutting surface is shown as part of a treatment device 1 for eye surgery, ie in the present example as part of a device for correcting the refraction of an eye, in Fig. 1. The treatment device 1 is designed for making incisions inside an eye 2 of a patient 3. For this purpose, the device 100 has a laser system 110 with a laser device 4 that emits a laser beam 6 from a laser source, which is directed as a focused beam into the eye 2 or the cornea 17 as the treatment volume. Preferably, the laser beam 6 is a pulsed laser beam with a wavelength between 300 nanometers and 10 micrometers. Furthermore, the pulse length of the laser beam 6 is in the range between 1 femtosecond and 100 nanoseconds, with pulse repetition rates of 50 to 20,000 kilohertz and pulse energies between 0.01 microjoules and 0.01 millijoules being possible. The device 100 creates a cutting surface in the processing volume 17, ie in the present case in the cornea 17 of the eye 2, by deflecting the pulsed laser beam 6.For this purpose, a radiation intensity modulator (not shown) can additionally be provided in the device 100.
[0044] During operation, the patient 3 is located, for example, on a couch 10 of the treatment device 1, which is adjustable in three spatial directions in order to spatially align the eye 2 to match the incidence of the laser beam 6. In a preferred design, the couch is motor-adjustable. An adjustment of the laser system 110 is alternatively possible for this purpose. In this way, the treatment volume 17 of the eye can be spatially aligned or alignable such that the central axis A of the treatment volume 17 runs parallel to the central home position axis a of the laser system 110. Control can be effected in particular by a control device 11, which fundamentally controls the operation of the devices 100 and 1 and is connected to the device 100 or the treatment device 1 via suitable data connections, for example connecting lines.Of course, this communication can also take place via other means, for example, via fiber optics or radio. The control device 11 performs the corresponding settings and timing on the treatment device 1, in particular the laser device 4 and other controllable components of the device 100 and the treatment device 1.
[0045] The treatment device 1 can have a fixation device 15 that fixes the cornea 17 of the eye 2 in position relative to the laser device 4. This fixation device 15 can be applied to the eye's cornea using negative pressure to fix it. In embodiments, it can additionally impart a desired geometric shape to the cornea. It is designed, for example, 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 102005040338 A1. The disclosure content of this document is incorporated herein in its entirety, as far as the description of a design of the contact lens 45 possible for the treatment device 1 is concerned.
[0046] The treatment device 1 optionally further comprises a camera (not shown) that can capture an image of the cornea 17 through the contact lens 45. The illumination for the camera can be in both the visible and infrared spectral ranges.
[0047] The control device 11 can have a device for generating control data, in this case a planning device 16, which will be explained in more detail later and which comprises a calculation device and optionally a data memory, which calculates the cutting surface(s) and / or control data, in particular control data for the treatment device, in preparation so that the cutting surface(s) can be generated in the surgical procedure. Control data can be concrete control values for a movement device 8 for moving a movable focusing optics 18 of the device 100. They are output by the control device 11 as control signals for the corresponding drives of the movement device 8. However, control data can also be predetermined coordinates of target points, as well as the sequence of these target points, on which the laser radiation is to be focused, at a quasi-higher control level.The control data may in particular comprise one or more trajectories for the laser spots, also called scan paths, on and / or along which the focus position is to be adjusted.
[0048] Fig. Figure 2 shows schematically a laser output beam 90 which, together with further laser output beams 91 to 93 (in Fig. 2) is generated from the laser beam 6 by a beam splitter device 70 of the device 100, the mode of action of the laser radiation incident on the cornea 17. The beam splitter device 70 is described further below. The laser output beam 90 is focused by the focusing optics 18 into the cornea 17 of the eye 2. The focusing optics is designed as a micro-objective and contains one or more optical elements, e.g., lenses, for focusing the laser output beams 90 to 93. In the Fig. 2, Fig. 3a and Fig. 3f, the focusing optics 18 are shown schematically in the form of a lens merely for the sake of simplicity. The focusing optics 18 create a focus in the cornea 17, which is formed in the processing volume as the spot 19 of the laser output beam 90. In the focus, the laser radiation energy density is so high that, in combination with the pulse length of the pulsed laser radiation 6, a non-linear effect occurs in the cornea 17. For example, each pulse of the pulsed laser radiation 6 in the spot 19 can create an optical breakthrough in the cornea 17, which initiates a plasma bubble. When the plasma bubble is created, the tissue layer separation covers a larger area than the spot 19, although the conditions for creating the optical breakthrough are only achieved in the spot 19. In order for each laser pulse to create an optical breakthrough, the energy density, i.e.the fluence of the laser radiation must be above a certain, pulse-length-dependent threshold value. This relationship is known to those skilled in the art, for example, from DE 69500997 T2. Alternatively, a tissue-separating effect can also be achieved through pulsed laser radiation by emitting multiple laser radiation pulses in one area, with the focus spots overlapping. Multiple laser radiation pulses then interact to achieve a tissue-separating effect. The type of tissue separation employed by the treatment device 1 is, however, not further relevant for the following description; the only essential factor is that a cut surface is created in the cornea 17 of the eye 2.
[0049] Several elements are relevant for the imaging properties of the eye, one of which is the curved cornea 17 of eye 2. The front surface of the cornea 17 refracts the light rays due to its curvature, which is why the radius of curvature of the cornea is particularly relevant for the imaging properties of the eye. In the case of a visual defect, the focus of a parallel incident bundle of light rays is not on the retina of eye 2 due to a (correctable) visual defect in the form of myopia or hyperopia, but in front of or behind it. Other visual defects, such as astigmatism, lead to distortion, i.e. a non-point-shaped focus. Still other visual defects cause a visual defect that depends on where the focus is on the retina. Such visual defects are described collectively by visual defect data.The refractive error is corrected by modifying the front of the cornea in such a way that this specifically leads to a change in the refractive properties of the cornea 17. Due to the modification of the front of the cornea to the new front, the focus is shifted or changed in such a way that the preoperatively existing refractive error is corrected.
[0050] To perform an ophthalmic refractive correction, a piece of tissue referred to as a lenticule is removed from an area within the cornea 17 by means of the laser output beams 90, 91, 92, 93, which are simultaneously generated from the laser beam 6 by the beam splitter device 70. Tissue layers within the cornea are separated, isolating the tissue piece within the cornea and then enabling its removal. The tissue piece is delimited by a three-dimensionally shaped cutting surface. For this purpose, in the case of pulsed laser radiation, the position of the spots 19 of the focused laser output beams 90 to 93 is adjusted three-dimensionally within the cornea 17. This is illustrated schematically in Fig. 3a, in which only the laser output beams 90 and 91 are shown as examples. The curvature of the front surface of the cornea 17 is specifically altered by removing the lenticule to achieve refractive correction. A uniformly thick piece of tissue would not significantly change the curvature of the front surface of the cornea—hence the term lenticule.
[0051] Fig. 3a shows the device 100 for generating at least one cutting surface in the processing volume 17 of a transparent material, in particular for correcting the refraction of the eye 2 by corneal modification. The device 100 comprises the laser device 4 for generating the laser beam 6; the beam splitter device 70 with a beam splitter optics 70a for generating the plurality of simultaneous laser output beams 90 to 93 from the laser beam 6; the movable focusing optics 18 for focusing the laser output beams as simultaneous spots 19, in particular as offset spots, into the processing volume 17, which extends in mutually orthogonal spatial directions x, y, and z, wherein the z-direction runs parallel to a central home position axis a of the laser system 110;the movement device 8 for moving the focusing optics 18 on at least one path selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis a, a path relative to a central axis A of the processing volume 17 and a combination thereof; and a control device 11 which is designed to control at least the beam splitter device 70 and the movement device 8 by means of control data such that the spot 19 of each laser output beam 90 to 93 in the processing volume 17 is moved on and / or along at least one respective scan path 19a and / or on at least one respective surface 19c. In the situation shown in; Fig. As shown in Figure 3a, the central axis A of the processing volume 17 and the central home position axis a of the laser system are in identical positions. For example, the movement device 8 can be configured to move the focusing optics 18 along at least one path selected from a path in a direction determined by the x, y, and z directions, a path around the central home position axis a, a path around a central axis A of the processing volume 17, and a combination thereof, whereby, for example, circular paths or spiral paths can be generated.
[0052] In Fig. 3a, the elements of the device 100 for generating at least one cutting surface are shown schematically only to the extent necessary for understanding. As already mentioned, the laser beam 6 is focused into simultaneous spots 19 of the laser output beams 90, 91 generated by the beam splitter device 70 in the cornea 19, and the position of the spots 19 in the cornea is adjusted so that, to generate the cutting surface, focused energy from laser radiation pulses is introduced into the tissue of the cornea 17 at different locations. The laser radiation 6 is preferably provided by the laser device 4 as pulsed radiation and split by the beam splitter device 70 into the offset laser output beams 90, 91. The laser output beams 90, 91 reach the focusing optics 18. A movement device 8 functionally connected to the focusing optics 18 as an actuator is provided.In the present example, the movement device 8 contains an actuator designed as an x-,y-,z scanner, which is constructed in the manner of the . Fig. 3a is constructed in two parts and contains an x-, y-scanner 8a, which deflects the entire focusing optics 18 parallel to the x-direction and / or y-direction. In this way, the laser output beams 90, 91 coming from the beam splitter device 70 can be deflected two-dimensionally. The x-, y-scanner 8a thus effects an adjustment of the position of the spots 19 essentially perpendicular to the respective direction of incidence of the laser output beams. To adjust the depth of the spots 19, in addition to the x-, y-scanner 8a, a z-scanner 8b is also provided, which is designed, for example, as an adjustable telescope with 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 position of the spots 19, ie their position parallel to the direction of incidence of the respective laser output beams, is changed.The scanners 8a and 8b can move the spots 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). In addition to or alternatively to the xy scanner 8a, the movement device 8 is provided with a drive 8c as an actuator, which is designed as an xy scanner or as an azimuth-radius scanner and serves to move the entire focusing optics 18 on a path around the central home position axis a of the laser system 110. The path of the focusing optics can, for example, have the shape of a spiral, an ellipse, a circle, a meandering scan path, or a combination thereof. The laser pulses can be emitted on and / or along the path(s) to form the cutting surface(s).The resulting scan path of the spots of each laser output beam then takes the form of a spiral, an ellipse, a circle, a meandering scan path, or a combination thereof. This allows multiple offset, parallel scan paths of the spots of the laser output beams to be generated. The movement of the focusing optics 18, i.e., the scanning movement caused by the scanners 8a and 8b and / or the movement caused by the drive 8c, can occur, for example, at a slow scanning speed of 10 mm / s.
[0053] In alternative examples of the device 100 for generating at least one cutting surface, the drive 8c may not be provided, and only the x, y, z scanner 8a, 8b is provided. In other examples of the device 100 for generating at least one cutting surface, the x, y scanner 8a may not be provided, and only the drive 8c and the z scanner 8b are provided. In further examples, a slow x, y scanner, a fast x, y scanner, a slow z scanner, and / or the drive 8c are provided in the device 100.
[0054] A variant of the device 100 for producing at least one cutting surface is shown in Fig. 8 is shown schematically. In this variant, only the z-scanner 8b and the drive 8c are provided in the movement device 8 of the device 100. The z-scanner and the drive 8c are each designed as slow scanners. In this example, the beam splitter optics 70a of the beam splitter device 70 is stationary and the focusing optics 18 can be moved with the scanners 8b and 8c on at least one path B. In this example, deflecting mirrors 210 are provided in the beam splitter device 70. The deflecting mirror 210 arranged directly in front of the focusing optics 18 can be moved and / or aligned according to the movement of the focusing optics 18, which is illustrated by the arrow U. In this variant of the device 100, the focusing optics 18 can be guided, for example, on and / or along a spiral path B over the processing volume 17.The simultaneous spots 19 focused into the processing volume by the focusing optics 18 can thus be moved on and / or along a respective spiral path 19a, 19b in the processing volume 17. In this example, the control device 11 is wirelessly connected to the laser system 110 and its components: laser device 4, beam splitter device 70, movable focusing optics 18, and movement device 8.
[0055] For the functional principle of the device 100, two-stage scanner structures, as known from WO 2017 / 0058115 A1, can be used. Furthermore, Cartesian or non-Cartesian coordinate systems can be used for deflecting or controlling the position of the spots 19. Examples of these are spherical coordinates or cylindrical coordinates. The position of the spots 19 is controlled by the control device 11, which makes corresponding settings on the laser device 4, the (in Fig. 3a) and the movement device 8. The control device 11 ensures appropriate operation of the laser device 4, the beam splitter device 70, and the three-dimensional focus adjustment described here as an example, so that ultimately a cutting surface is formed that isolates a specific piece of corneal tissue that is to be removed or harvested for refraction correction. It operates according to predetermined control data.
[0056] The control data are specified, for example, as data for the beam splitter device 70, as data for the movement path of the focusing optics, as target points for the focus adjustment, and / or as data for a scan path 19a or for a surface 19c, also called scan surface 19c, onto and / or along which the spots are to be moved. The control data are generally summarized in a control data set. This specifies geometric specifications for the cutting surface to be formed, for example, the coordinates of the target points as a pattern. In this embodiment, the control data set then also contains concrete control values for the focus position adjustment mechanism, e.g., for the movement device 8 or an additional dynamic scanner. The control data are based on control data that specify the cutting surface(s) to be created, as will be explained below.
[0057] The generation of the cutting surface with the device 100 is exemplified in Fig. 3b. A piece of corneal tissue 121 in the cornea 17 is isolated by adjusting the spot 19 into which the laser output beam 90 is focused. At least one cut surface is formed, which can also be multi-part, which is why it is also referred to as "cut surface(s)." In this example, it has an anterior cut surface 122 and a posterior lenticule cut surface 123. These terms are to be understood merely as examples and are based on the conventional LASIK procedure. Depending on the surgical procedure, the incision surfaces 122 and 123, as well as any marginal incisions not further designated, which join the incision surfaces 122 and 123 together at their edges as necessary, delimit and isolate the piece of corneal tissue 121. The piece of corneal tissue 121 can be removed through an opening incision 124, as provided for by the aforementioned SMILE procedure.
[0058] An example of essentially parallel spiral scanning paths of simultaneous spots 19 of several laser output beams for creating a cut surface in the cornea 17 is shown in Fig. 3c. Switching between a first and a second operating mode of the device 100 can also involve switching in reverse, ie, between the second operating mode and the first operating mode. For example, a flap cut can be cut in a single-spot mode, and curved cuts can be cut in a multi-spot mode. In a spiral scan, for example, it can begin in single-spot mode, and further spirals can be added with increasing radial distance from the center of the spiral and / or the optical zone of the eye to be cut, as shown in Fig. 3d. The scans for such scan paths can be performed with a short scanning time.
[0059] An example of a pole scan trajectory is shown in Fig. 3e. The number of spots 19 with a smaller distance from pole 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. During the pole scan, the focusing optics are guided over pole P with slow pendulum movements starting from a latitude of the hemispherical scan surface 19c of the cornea 17 to be generated, which has the pole, with the pendulum movement line(s) being rotated 360° around the pole, which is illustrated by the arrow Q. Lateral to the pendulum movement line(s), e.g. on the latitudes, simultaneous spots 19 are generated as multispots with a rapid movement. In addition, the multispots can be dynamically moved, i.e. wobbled, in the x-, y-, and / or z-direction in order to shape the spots.
[0060] Fig. 4a shows a schematic representation of the focusing optics 18 and the beam splitter device 70 of an example of the device 100 for generating at least one cut surface. The beam splitter optics 70a of the beam splitter device 70 can comprise at least one element selected from one or more semi-transparent 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 WO2022194484 A1. The disclosure content of this document is incorporated herein in its entirety, as far as the description of a design of the beam splitter device 70 possible for the device 100 is concerned.
[0061] The Fig. The example of the beam splitter device 70 shown in Figure 4a is designed to generate the laser output beams 90 to 93 from the laser beam 6, also called the laser input beam or input beam. The beam splitter optics 70a of this example includes a first beam multiplier element 20 for generating two intermediate beams 75, 76 from the laser input beam 6. The first beam multiplier 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 an intermediate beam 76 by a predetermined angle.The beam splitter optics 70a is designed such that, when the laser input beam 6 is radiated onto the first polarizing beam splitter 22 of the first beam multiplier element 20, the input beam 6 is split into the first intermediate beam 75 and the second intermediate beam 76 by means of the first polarizing beam splitter 22 of the first beam multiplier element 20, wherein the two intermediate beams 75, 76 span the xy plane, the second intermediate beam 76 is deflected by the first deflection element 26 by a predetermined angle, in particular approximately 90° or approximately180°, and the first intermediate beam 75 and the second intermediate beam 76 are radiated onto the second polarizing beam splitter 24 of the first beam multiplier element 20 such that the first intermediate beam 75 and the second intermediate beam 76 radiate away from the second polarizing beam splitter 24 of the first beam multiplier element 20 substantially parallel to one another or with a predetermined angular difference, in particular of less than 3 mrad, preferably less than 1.4 mrad, particularly preferably less than 0.6 mrad.Furthermore, there is provided: a second beam multiplier element 40 with a first polarizing beam splitter 42, a first deflection element 46 and a second polarizing beam splitter 44, the second beam multiplier element 40 being designed such that when the two intermediate beams 75, 76 are radiated onto the first polarizing beam splitter 42 of the second beam multiplier element 40, the two intermediate beams 75, 76 are each split into a first partial beam 80, 81 and a second partial beam 85, 86 by means of the first polarizing beam splitter 42 of the second beam multiplier element 40, the second partial beams 85, 86 are deflected in the second beam multiplier element 40 by a predetermined angle, in particular approximately 90° or approximately180°, are deflected; and the first partial beams 80, 81 and the second partial beams 85, 86 are radiated onto the second polarizing beam splitter 42 of the second beam multiplier element 40 such that the four laser output beams 90 to 93 emerge from the second polarizing beam splitter 42 of the second beam multiplier element 40 substantially parallel to one another or with an angular difference, in particular of less than 3 mrad, preferably less than 1.4 mrad, particularly preferably less than 0.6 mrad.
[0062] As already mentioned, at least one dynamic x, y, z scanner 180, in particular at least one harmonic x, y, z scanner, can be provided in the device 100 for dynamically moving at least one of the laser output beams 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, and / or z scanner, e.g., it can scan only 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 can be integrated into the beam splitter optics 70a. At least two of the dynamic x, y, and z scanners can be combined in such a way that the amplitudes of the two dynamic scanners add up in at least one of the x, y, and z directions. This can generate multiple sweeps, e.g., a double sweep.
[0063] Fig. 3f shows an example 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 include an x, y scanner, which is implemented, for example, by two essentially orthogonally deflecting galvanometer mirrors, and / or a z scanner, which is designed, for example, as an adjustable telescope. The x, y scanner deflects the laser beam 6 two-dimensionally in the x, y direction. The z scanner ensures that the z position of the focus 19 is changed. The dynamic movement can, for example, take place at a scanning speed between 800 and 2000 mm / s.
[0064] Fig. 4a shows, as an example, one of the dynamic x, y, z scanners 180, also called scanner 180, integrated into the beam splitter optics 70a. In this example, the scanner 180 is configured as an x, y scanner to move the first deflection element 26 in at least one of the x, y directions, which is illustrated 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. Fig. Figure 4b illustrates another example in which, starting from the example of Fig. 4a, the second polarizing beam splitter 24 of the first beam multiplier element 20 is additionally provided with a further dynamic x-,y-scanner 180 and can thus be moved dynamically in at least one of the x-,y-directions. Fig. Figure 4b schematically shows the case in which both the intermediate beam 76 and the intermediate beam 75 are dynamically moved in both x and y directions. The intermediate beam 75 is swept once, as it is dynamically moved by one of the scanners 180. The intermediate beam 76, on the other hand, is swept multiple times, as it is dynamically moved by the two scanners 180. The deflection amplitudes of the intermediate beam 76 generated by the two scanners 180 are added together. Fig. 4c illustrates exemplary parallel spiral paths 19a and 19b generated in this way, wherein the spot 19 of the spiral path 19a is swept by the dynamic movement of the intermediate beam 75 and thus also of the laser output beam generating the spot. The spot 19 of the spiral path 19b is swept multiple times by the repeated dynamic movement of the intermediate beam 76 and thus also of the laser output beam generating the spot. The dynamic movement of the intermediate beams 75 and / or 76 can, for example, be carried out at a scanning speed between 800 and 2000 mm / s, whereby the rapid oscillatory movement of the associated laser output beams is achieved with essentially the same scanning speed.
[0065] In some examples, spots are arranged laterally to the direction of the scan path, for example, multispot lines are arranged transversely and / or laterally to the direction of movement of the focusing optics. A multispot line is formed as a line of several simultaneous spots, whereby a two- or three-dimensional volume structure can be generated in the transparent material. In an example of a multispot scan of an ellipsoidal spiral, the spots are arranged transversely to the direction of movement of the micro-objective. The focusing optics are guided on and / or along the path of an ellipsoidal spiral, and the spots are arranged, for example, on and / or along a multispot line transversely and / or lateral to the spiral path. This is described in the Fig. 3g to 3i illustrated. Fig. As a comparison example, Figure 3g schematically shows a spiral scan performed with a single-spot scan mode. In comparison, Fig. 3h shows an example of a multispot scan mode of the device 100, in which constant partial areas 119 were generated with the multispots. Fig. 3i schematically illustrates an example of a scanning mode of the device 100, in which single spots were generated in the center of a spiral path and variable partial areas 119 or partial regions were generated with the multispots in the edge regions of the spiral path surrounding the center. Fig. Figure 3j also schematically illustrates an example of a multispot scan mode of device 100, in which variable circular partial areas 119 or spherical partial regions were generated using the multispots. In this example, the partial areas 119 grow with the increasing radius of the spiral path. The length of the multispot lines is optimally adjusted depending on the position of the focusing optics.
[0066] In other examples, the volume of simultaneously generated spots (or foci) forms a sub-volume of the entire processing volume. The shape of this sub-volume can be arbitrary, e.g., a circle or a polygon in plan view or in cross-section. The shape of the sub-volume can be changed depending on the position of the micro-lens. The maximum radial extent (perpendicular to the optical axis) of the sub-volume is limited by the field of view of the moving focusing optics. The maximum z-extension of the sub-volume, e.g., along the optical axis of the processing volume, is defined by the numerical aperture of the moving focusing optics. The spot density in the sub-volume is sufficiently high that the resulting photodisruption bubble density is sufficiently high to enable safe removal of the generated processing volume. Preferably, there is a spatial overlap of the spots.Then, the energy regime is used where the energy of a single spot is insufficient to generate photodisruption. Photodisruption is only generated through the overlap of several simultaneous spots. Compared to the single-spot scan regime, the spatial overlap can be reduced in the multi-spot scan regime because the spots are generated essentially simultaneously, as shown in . Fig. 3k and Fig. 3l is shown. Fig. Figure 3k shows an overlapping spot arrangement of non-simultaneous single spots 9, with which an area of the processing volume was disrupted. Fig. Figure 3l, on the other hand, illustrates a multispot scan generated with the device 100, in which the simultaneous multispots 19 do not overlap so much to create a sub-volume for photodisruption, so that this scan mode is more efficient compared to a single-spot mode.
[0067] In a multispot scan of an ellipsoidal spiral, for example, the multispot subvolume can be generated such that it has the shape of an isosceles trapezoid in plan view. The ratio of the short to the long base side of the isosceles trapezoid can be larger inside the spiral than outside the spiral, e.g., to achieve dense coverage of a lenticule surface that is usually circular in plan view.
[0068] The Fig. 3m and Fig. 3n illustrate exemplary scan modes generated with the device 100 using different sweep methods. According to Fig. Overlapping simultaneous multispots were swept over a distance of 3 m by dynamically moving the focusing optics 18 or the laser input beam 6 laterally, ie, oscillating them. Fig. 3n non-overlapping simultaneous multispots were swept by dynamically oscillating each sub-beam 90 to 93 laterally.
[0069] As already mentioned, consecutively generated spots and / or multispots of a section surface to be created posteriorly in the processing volume can be generated in a sequence in the direction of the central axis of the processing volume, and consecutively generated spots and / or multispots of a section surface to be created anteriorly in the processing volume can be generated in a sequence in the direction away from the central axis of the processing volume. This is used for a lenticule cut, e.g., in the Fig. 3b, this is called an out-in scan. When a cap cut is used to create the anterior cut surface 122, this is called an in-out scan. This minimizes the time difference between different sub-volumes simultaneously created with the multispots in the center of the eye's optical zone, thus minimizing the risk of opaque bubble layers.
[0070] Fig. Figure 5 schematically shows, as an example, part of the device 100 for generating at least one cutting surface, and based on this, the significance of the device 16 for generating control data, in this case the planning device 16, will be explained in more detail. The previously described laser device 4 emits the laser beam 6. As already described, the device 100 is operated fully automatically by the control device 11. Upon appropriate start signals, the laser device 4 starts generating the laser beam 6, the beam splitter device 70 generates the laser output beams 90 to 93, and the movement device 8 moves the focusing optics 18. In this way, cutting surfaces constructed in the manner described are generated.The laser device 4, the beam splitter device 70, and the movement device 8 receive the control signals required for operation from the control device 11, to which corresponding control data has been previously provided. This is done, for example, by means of the planning device 16, which is shown in FIG. Fig. 5 is shown merely as an example as a component of the control device 11. Of course, the planning device 16 can also be designed independently and communicate with the control device 11 via wired or wireless communication. In this case, a corresponding data transmission channel is provided between the planning device 16 and the control device 11.
[0071] The planning device 16 comprises, as its core element, a calculation device 16a, which, as explained below, calculates the cutting surface(s) to be created in the cornea 17 and determines the data required for these cutting surfaces. The planning device 16, or directly the calculation device 16a, generates the control data set therefrom, which is made available to the control device 11 for carrying out the ophthalmic refractive correction.
[0072] To calculate the cut surface(s), the calculation device 16a uses measurement data about the cornea of the eye, which is configured as data about the refractive correction requirement. In the embodiment described here, this measurement data originates from a measuring device (not shown) that previously measured the eye 2 of the patient 2. Of course, the measuring device can be configured in any desired manner and transmit the corresponding measurement data to the interface 29 of the planning device 16.
[0073] The planning device 16 supports the operator of the device 100 in determining the cutting surface for isolating the corneal tissue piece 121. This can extend to a fully automatic determination of the cutting surfaces 122, 123, 124, which can be achieved, for example, by the calculation device 16a determining the corneal tissue piece 121 to be removed from the measurement data, defining its boundary surface(s) as the cutting surface(s), and generating corresponding control data for the control device 11 therefrom. At the other end of the automation level, the planning device 16 can provide input options where a user enters the cutting surfaces in the form of geometric parameters, etc. Intermediate stages provide suggestions for the cutting surfaces, which the planning device 16 automatically generates and which can then be modified by an operator.
[0074] Fig. 6 shows, as an example, a schematic block diagram of the method for generating at least one cutting surface with the device 100. The method comprises the steps S1 generating the laser beam 6 with the laser device 4; S2 generating a plurality of simultaneous 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 as spots, in particular simultaneous spots, into the processing volume 17, which extends in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis a of the laser system 110, with the movable focusing optics 18;S4 Moving the focusing optics 18 with the movement device 8, wherein the focusing optics are moved along at least one path selected from a path in a direction determined by the directions x, y, and z, a path relative to the central home position axis a, a path relative to a central axis of the processing volume, and a combination thereof; and S5 Controlling at least the beam splitter device 70 and the movement device 8 with the control device 11 using control data and moving the spot 19 of each laser output beam 90 to 93 in the processing volume 17 on and / or along at least one respective scan path 19a or on at least one respective surface 19c. For example, the focusing optics can be moved along a path around the central home position axis a, a path around the central axis A of the processing volume, and / or a combination thereof.
[0075] Fig. Figure 7 shows, as an example, a schematic block diagram of the method for generating the control data for generating a cutting surface, e.g., for a refractive error correction. In a step S11, refractive error data of the eye, which indicate the refractive error correction requirement of the eye, are received, which can be provided, for example, in a preceding step, which can in particular comprise a measurement of the eye. Based on this refractive error correction requirement, the volume of the piece of tissue to be removed from the cornea is determined in a step S12. Since the thickness profile is very important for the refractive error correction (cf. explanations of Fig.3b), there is still no concrete definition of the piece of tissue. In a step S13, the piece of tissue, i.e. the lenticule to be isolated in the cornea, is calculated. In a concluding step S14, the cutting surface (e.g., 122, 123, 124 and an edge surface) required to isolate the lenticule in the cornea is calculated. Appropriate control data is generated for this cutting surface in a step S15. This data then serves as control data for the device 100, whereby it may well be the aforementioned data at a higher control level, e.g., a definition of scan paths on and / or along which the spots are to be adjusted, and / or coordinates of target points, which are then converted—possibly only during operation of the device 100—into appropriate control data for the device 100. QUOTES CONTAINED IN THE DESCRIPTION
[0000] This list of documents submitted by the applicant was generated automatically and is included solely for the convenience of the reader. This list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions. Cited patent literature
[0000] EP 1719483 A1
[0003] WO 2005 / 011545 A1
[0004] US 5984916 A
[0005] DE 102007019813 A1
[0006] US 20130231644 A1
[0007] WO 2022194484 A1 [0007, 0060] US 2019159933 A1
[0007] DE 102015212877 A1
[0007] US 20210386586 A1
[0007] US 11090191 B2
[0007] DE 102005040338 A1
[0045] DE 69500997 T2
[0048] WO 2017 / 0058115 A1
[0055]
Claims
[1] Device (100) for producing at least one cutting surface (122, 123, 124) in a processing volume (17) of a transparent material, in particular for correcting the refraction of an eye (2) by corneal modification, comprising a laser system (110) with - a laser device (4) for generating a laser beam (6); - a beam splitter device (70) with beam splitter optics (70a) for generating a plurality of simultaneous laser output beams (90, 91) from the laser beam (6); - a movable focusing optics (18) for focusing the laser output beams as spots (19) into the processing volume (17) extending in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis (a) of the laser system (110); and - a movement device (8, 8a, 8b, 8c) for moving the movable focusing optics (18) on at least one path (B) selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis (a), a path relative to a central axis (A) of the processing volume (17) and a combination thereof; wherein the device (100) further comprises a control device (11) which is designed to control the beam splitter device (70) and the movement device (8, 8a, 8b, 8c) by means of control data such that the spot (19) of each laser output beam is moved in the processing volume (17) on and / or along at least one respective scan path (19a; 19b) and / or on at least one respective surface (19c). [2] Device according to claim 1, wherein the path and / or the scanning path is selected from a spiral, an ellipse, a circle, a polar scanning path, a meandering scanning path, in particular a contour scanning path, and a combination thereof; and / or wherein the processing volume (17) is spatially aligned or alignable such that the central axis (A) of the processing volume (17) runs parallel to the z-direction; and / or wherein the beam splitter optics (70a) is movable and / or the movement device (8, 8a, 8b, 8c) is designed to move the beam splitter optics together with the focusing optics (18); and / or wherein the movement device (8, 8a, 8b, 8c) comprises at least one scanner selected from one or more xy scanners (8a), one or more z scanners (8b), an azimuth-radius scanner (8c), and a combination thereof; and / or wherein the beam splitter optics are immobile or movable, and the beam splitter device and / or the control device are configured to generate the laser output beams synchronized with the movement of the focusing optics; and / or wherein at least one dynamic x, y, z scanner (180), in particular at least one harmonic x, y, z scanner, is provided for dynamically moving at least one of the laser output beams in at least one of the x, y, z directions, wherein the at least one dynamic x, y, z scanner is connected upstream or downstream of the beam splitter optics or is 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 add up in at least one of the x, y, z directions. [3] Device according to one of the preceding claims, wherein the beam splitter device and / or the control device is designed to synchronize and / or vary the distribution, the number and / or the spacing of the laser output beams depending on the movement and / or the radial position of the focusing optics; and / or wherein the beam splitter device comprises at least one element selected from one or more acoustic-optical modulation devices (AOM), one or more electrical-optical modulation devices (EOM), and one or more apertures for synchronizing and / or varying the laser output beams; and / or wherein the beam splitter device is configured 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. [4] Device according to one of the preceding claims, wherein the laser device is designed to generate a pulsed laser beam (6); and / or wherein the beam splitter device is designed to provide a plurality of simultaneously pulsed laser output beams (90, 91, 92, 93); and / or wherein the control device (11) is designed to control the beam splitter device (70) and the movement device (8, 8a, 8b, 8c) by means of control data such that the spots of the plurality of simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement. [5] Device according to one of the preceding claims, wherein the control device is designed to control at least the beam splitter device and / or the movement device in such a way that - the spots are arranged laterally to the direction of the scan path; and / or - the scanning path is formed 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 is increased with increasing radial distances from the center; and / or - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; and / or - switching between the first operating mode for providing a plurality of the laser output beams and the second operating mode for providing one of the laser output beams (90, 91, 92, 93); and / or - a scanning regime is selected such that successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis (A) of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis (A) of the processing volume; and / or - when the laser output beams are varied depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out. [6] Device (16) for generating control data for generating at least one cut surface, in particular for correcting the refraction of an eye (2) by corneal modification, for a device (100) according to one of the preceding claims, comprising - an interface (29) for receiving data on a refractive correction requirement of the eye (2, 17), - a calculation device (16a) connected to and configured with the interface (29) -- to receive data on the need for refraction correction, -- for calculating a cutting area (122, 123, 124) based on the data on the refractive correction requirement, and -- for generating the control data for controlling the beam splitter device (70) and the movement device (8, 8a, 8b, 8c) of the device according to one of the preceding claims such that the cutting surface is generated by moving the spot (19) of each laser output beam (90, 91) in the processing volume on and / or along at least one respective scan path (19a; 19b) and / or on at least one respective surface (19c). [7] Device according to claim 6, wherein the calculation device (16a) is designed to generate the control data such that - the beam splitter optics (70a) are moved 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 generates the laser output beams synchronized with the movement of the focusing optics, wherein the beam splitter optics is movable or immovable; and / or - with the at least one dynamic x, y, z scanner (180), in particular at least one harmonic x, y, z scanner, at least one of the laser output beams (90, 91, 92, 93) is dynamically moved in at least one of the x, y, z directions; and / or - with at least two of the dynamic x-, y-, z-scanners, the amplitudes of the two dynamic scanners are added in at least one of the x-, y-, z-directions during the dynamic movement of the laser output beams; and / or - the beam splitter device and / or the control device are used to synchronise and / or vary the distribution, number and / or spacing of the laser output beams as a function of the movement and / or radial position of the focusing optics; and / or - the laser output beams are synchronised and / or varied using the beam splitter device and / or the control device; and / or - the beam splitter device provides several of the laser output beams (90, 91, 92, 93) in a first operating mode and one of the laser output beams in a second operating mode; and / or - a pulsed laser beam (6) is generated with the laser device (5); and / or - a plurality of simultaneously pulsed laser output beams (90, 91, 92, 93) are provided by the beam splitter device (70); and / or - the path and / or the scan path (19a; 19b) is selected from a spiral, an ellipse, a circle, a pole scan path or a meandering scan path, in particular a contour line scan path and a combination thereof. [8] Device according to one of claims 6 and 7, wherein the calculation device is designed to generate the control data such that - the spots are arranged laterally to the direction of the scan path; and / or - the scanning path is formed 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 is increased with increasing radial distances from the center; and / or - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; and / or - switching between the first operating mode for providing a plurality of the laser output beams (90, 91, 92, 93) and the second operating mode for providing one of the laser output beams; and / or - a scanning regime is provided with which successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis (A) of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis (A) of the processing volume; and / or - when varying the laser output beams depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out; and / or - the spots of the plurality of simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement. [9] Device (1) for correcting the refraction of an eye (2) by corneal modification, comprising a device (100) for generating at least one cutting surface according to one of claims 1 to 5 and a device (16) for generating control data according to one of claims 6 to 8. [10] Method for producing at least one cutting surface in a processing volume (17) of a transparent material, in particular for correcting the refraction of an eye (2) by corneal modification, with a device (100; 1) according to one of claims 1 to 5 or 9, comprising - generating a laser beam (6) with the laser device (4) of the laser system (110) (S1); - generating a plurality of simultaneous laser output beams (90, 91) from the laser beam (6) with the beam splitter device (70) (S2); - focusing the laser output beams as spots (19) into the processing volume (17) extending in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis (a) of the laser system (110), with the movable focusing optics (18) (S3); - moving the movable focusing optics (18) with the movement device (8, 8a, 8b, 8c), wherein the focusing optics (18) is moved on at least one path (B) selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis (a), a path relative to a central axis (A) of the processing volume (17) and a combination thereof (S4); and - Controlling the beam splitter device (70) and the movement device (8, 8a, 8b, 8c) with the control device (11) by means of control data and moving the spot (19) of each laser output beam (90, 91) in the processing volume (17) on and / or along at least one respective scan path (19a; 19b) and / or on at least one respective surface (19c) (S5). [11] Method according to claim 10, wherein the path and / or the scanning path is selected from a spiral, an ellipse, a circle, a polar scanning path, a meandering scanning path, in particular a contour scanning path, and a combination thereof; and / or wherein the processing volume (17) is spatially aligned such that the central axis (A) of the processing volume (17) runs parallel to the z-direction; and / or wherein the beam splitter optics is movable and / or the movement device moves the beam splitter optics together with the focusing optics; and / or wherein the beam splitter optics is moved or not moved and the beam splitter device and / or the control device generates the laser output beams (90, 91, 92, 93) synchronized with the movement of the focusing optics; and / or wherein at least one of the laser output beams (90, 91, 92, 93) 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 harmonic x, y, z scanner; and / or wherein, with at least two of the dynamic x, y, z scanners, the amplitudes of the two dynamic scanners are added in at least one of the x, y, z directions during the dynamic movement of the laser output beams; and / or wherein the beam splitter device and / or the control device are used to synchronise and / or vary the distribution, number and / or spacing of the laser output beams depending on the movement and / or radial position of the focusing optics; and / or wherein the laser output beams are synchronized and / or varied by the beam splitter device and / or the control device; and / or wherein the beam splitter device provides a plurality of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode. [12] Method according to one of claims 10 and 11, wherein a pulsed laser beam (6) is generated by the laser device; and / or wherein a plurality of simultaneously pulsed laser output beams (90, 91, 92, 93) are provided by the beam splitter device; and / or wherein the spots of the plurality of simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement. [13] Method according to one of claims 10 to 12, wherein - the spots are arranged laterally to the direction of the scan path; and / or - the scanning path is formed 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 is increased with increasing radial distances from the center; and / or - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; and / or - switching between the first operating mode for providing a plurality of the laser output beams (90, 91, 92, 93) and the second operating mode for providing one of the laser output beams; and / or - a scanning regime is selected with which successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis (A) of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis (A) of the processing volume; and / or - when varying the laser output beams depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out. [14] Method for generating control data for generating at least one cutting surface, in particular for correcting the refraction of an eye (2) by corneal modification, with a device (16; 1) according to one of claims 6 to 9, comprising - receiving data about a refraction correction requirement of the eye (2) with the interface (29) (S11); and - with the calculation device (16a) connected to the interface (29), -- Receiving data on the need for refraction correction (S11), -- Calculating a cutting surface (122, 123, 124) based on the data on the refractive correction requirement (S12 to S14), and -- Generating the control data for controlling the beam splitter device and the movement device of the device according to one of claims 1 to 5 such that the cutting surface is generated by moving the spot of each laser output beam (90, 91, 92, 93) in the processing volume on and / or along at least one respective scan path (19a; 19b) and / or on at least one respective surface (19c) (S15). [15] A method according to claim 14, wherein the control data is generated such that - the beam splitter optics are moved 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 generates the laser output beams synchronized with the movement of the focusing optics, wherein the beam splitter optics is movable or immovable; and / or - with the at least one dynamic x, y, z scanner, in particular at least one harmonic x, y, z scanner, at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions; and / or - with at least two of the dynamic x-, y-, z-scanners, the amplitudes of the two dynamic scanners are added in at least one of the x-, y-, z-directions during the dynamic movement of the laser output beams; and / or - the beam splitter device and / or the control device are used to synchronise and / or vary the distribution, number and / or spacing of the laser output beams as a function of the movement and / or radial position of the focusing optics; and / or - the laser output beams are synchronised and / or varied using the beam splitter device and / or the control device; and / or - the beam splitter device provides several of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode; and / or - a pulsed laser beam (6) is generated with the laser device (5); and / or - the beam splitter device provides several simultaneously pulsed laser output beams; and / or - the path and / or the scan path is selected from a spiral, an ellipse, a circle, a polar scan path, a meandering scan path, in particular a contour line scan path, and a combination thereof. [16] Method according to one of claims 14 and 15, wherein the control data are generated such that - the spots (19) are arranged laterally to the direction of the scanning path; and / or - the scanning path is formed 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 is increased with increasing radial distances from the center; and / or - the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; and / or - switching between the first operating mode for providing a plurality of the laser output beams (90, 91, 92, 93) and the second operating mode for providing one of the laser output beams; and / or - a scanning regime is provided with which successively generated spots and / or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis (A) of the processing volume and successively generated spots and / or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis (A) of the processing volume; and / or - when varying the laser output beams depending on a limit value of the laser beam exposure of a tissue in the processing volume, one or more laser output beams are varied, in particular masked out; and / or - the spots of the plurality of simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement. [17] Method for correcting the refraction of an eye (2) by corneal modification, comprising at least one method according to one of claims 10 to 16. [18] A computer program product comprising program code which, when loaded into a computer, executes at least one method according to any one of claims 10 to 17.
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