Method for providing control data for an ophthalmic laser of a treatment device

Abstract

The invention relates to a treatment device (10) and a method for providing control data for an ophthalmic laser (12) of a treatment device (10). The method comprises acquiring (S10) at least one image of an eye (16) by a camera device (28); determining (S12) phenomenological structures (24) of the eye (16) from the image by a computing device (18), wherein the computing device (18) determines the phenomenological structures (24) by means of an image analysis algorithm; determining (S14) treatment positions (26) in the eye for treatment with the ophthalmic laser (12) as a function of the phenomenological structures (24) by the computing device (18); and providing (S16) control data for the treatment device (10) by the computing device (18), which includes the treatment positions (26) in the eye (16) for treatment.

Description

[0001] The invention relates to a method for providing control data for an ophthalmic laser of a treatment device. Furthermore, the invention relates to a treatment device with at least one ophthalmic laser, which is designed to carry out the method.

[0002] Treatment devices and methods for controlling ophthalmic lasers to correct optical refractive errors and / or pathologically or abnormally altered areas of the cornea are known in the prior art. For example, pulsed lasers and a beam focusing device can be configured such that laser pulses in a focus located within the organic tissue cause photodisruption and / or ablation, in particular plasma-assisted ablation, to remove tissue, in particular a tissue lenticle, from the cornea.

[0003] A treatment area for treating the cornea is typically defined by the user of the treatment device, and treatment positions within the treatment area are determined for laser irradiation. However, if problems arise during irradiation of the treatment area, for example, if the treatment has to be interrupted or aborted, it is often difficult to reset to the originally planned treatment area and continue irradiation.

[0004] The object of the invention is to improve the planning of treatment positions, in particular with regard to an inadequately performed pretreatment, for a treatment with an ophthalmological laser.

[0005] This object is achieved by the independent patent claims. Advantageous developments of the invention are disclosed in the dependent patent claims, in the following description, and in the figures.

[0006] The invention is based on the idea that laser pulses are positioned in the eye based on phenomenological structures that can be detected in the eye by a camera device of the treatment device. Preferably, a previously performed treatment, which was, for example, performed inadequately, can be detected by the camera device, in particular already irradiated positions in the eye. New treatment positions, for example, for a follow-up treatment, can then be aligned based on the detected already irradiated positions.

[0007] One aspect of the invention relates to a method for providing control data for an ophthalmic laser of a treatment device. The method comprises capturing at least one eye image of an eye by a camera device, determining phenomenological structures of the eye from the eye image by a computing device, wherein the computing device determines the phenomenological structures using an image analysis algorithm, determining treatment positions in the eye for treatment with the ophthalmic laser as a function of the phenomenological structures by the computing device, and providing control data for the treatment device by the computing device, which control data comprise the treatment positions in the eye for treatment.

[0008] In other words, an optical image of an eye to be treated can be taken by a camera device, which in particular has one or more cameras. The image can then be analyzed using an image analysis algorithm operated by a computing device to determine phenomenological structures in the eye. Phenomenological structures can be, for example, structures in an iris, a shape and / or position of the pupil, possibly also relative to a visual axis, a shape, e.g., a curvature and / or steepness and / or size of the cornea, and / or unnaturally altered areas of the cornea, such as an existing, incipient, or progressive deformation of the cornea.Particularly preferably, the phenomenological structures can also include previously treated locations in the cornea, for example, defective or incompletely treated areas of the cornea that have already been irradiated with a laser. The image analysis algorithm can use edge detection and / or intensity detection to identify the structures. Alternatively or additionally, the image recognition algorithm can be trained on predefined structures and thus detect structures or deviations from structures using artificial intelligence.

[0009] After determining the phenomenological structures, the computer can plan treatment positions in the eye to be irradiated using the ophthalmic laser. The treatment positions can be determined based on the determined phenomenological structures. For example, an alignment and / or positioning of a predetermined treatment profile can be performed, such as centering in the center of the pupil and / or the center of the cornea. Furthermore, unnaturally or pathologically altered areas in the cornea can be recognized as phenomenological structures, and a treatment to remove these structures can be positioned, and / or treatment positions can be determined to complete a deficient or incomplete pretreatment in order to conclude the pretreatment.

[0010] Finally, the computing device can provide control data for the treatment device, which includes the determined treatment positions for treatment. Preferably, the treatment device, in particular the ophthalmic laser and / or a beam deflection device, can be controlled by the computing device or a control device using the control data. The control data can include a respective data set for positioning and / or focusing individual laser pulses in the cornea. The control data can additionally or alternatively include a respective data set for adjusting at least one beam device for beam guidance and / or beam shaping and / or beam deflection and / or beam focusing of a laser beam of the respective laser.

[0011] The camera device and / or the computing device can be part of the treatment device or provided separately. The computing device can be a device or a device component, in particular a computer or processor, that can control the method steps.

[0012] The invention provides the advantage that treatment positions can be planned more precisely, thereby improving treatment with the treatment device.

[0013] The invention also includes embodiments which provide additional advantages.

[0014] A preferred embodiment provides that the acquisition of at least one eye image takes place from an eye that has been treated with an ophthalmological laser device, the determination of phenomenological structures of the eye is a determination of previously treated positions of the eye from the eye image, wherein the computing device determines the previously treated positions by means of an image analysis algorithm, the determination of treatment positions in the eye is a determination of treatment positions in the eye for follow-up treatment with the ophthalmological laser depending on the previously treated positions of the eye, and the provision of control data for the follow-up treatment of the eye is provided.This means that the phenomenological structures are previously treated positions, which were created, for example, in an aborted pre-treatment, and new treatment positions are determined based on the previously treated positions determined, in particular for a follow-up treatment of the eye. The previously treated positions, which may in particular be inadequate or incomplete, can be recognized from the eye image, for example due to clouding or a change in reflection properties, using the image recognition algorithm, which can recognize the previously treated positions, for example, using edge detection and / or an intensity distribution (threshold method) and / or based on a comparison with the untreated eye. The laser device with which the eye was previously treated can be the treatment device or a different one.In particular, the previously treated positions, which may be incomplete, may have been irradiated with an excimer laser and / or a femtosecond laser and, for example, include a marginal incision that does not reach the surface, or positions in the cornea where treatment was interrupted during treatment before the treatment and / or the incision was completed, which may occur, for example, due to a vacuum break in a fixation device and / or a surgeon stopping treatment. In addition to ophthalmic surgery, the new treatment positions can also be used for a laser-induced refractive index change to correct a previous treatment and / or a concomitant correction of a progressive ocular change, particularly presbyopia.This design has the advantage that inadequate or incomplete pretreatments can be detected by means of the camera device and a follow-up treatment can be planned to complete or correct the pretreatment, which leads to an improvement in the treatment.

[0015] A further embodiment provides for determining the treatment positions for the follow-up eye treatment, including untreated areas of the eye. This means that a previous treatment may have been interrupted, meaning that not the entire treatment area was irradiated with the laser. The camera device can then determine the previously irradiated areas, and the remaining areas can be supplemented with the newly determined treatment positions.

[0016] Preferably, the untreated positions of the eye are determined from a difference between a predetermined total treatment area and the previously treated positions. The total treatment area can be specified from predetermined examination data and / or previously planned control data of the laser device. Thus, a complementary area to the previously treated positions or a difference between the total treatment area and the previously treated positions can be used to determine the untreated positions.

[0017] In a further embodiment, it is provided that both the previously treated positions and the still untreated positions in the eye are defined as treatment positions, wherein first irradiation parameters are defined in the control data for the treatment positions of the already treated positions and second irradiation parameters are defined for the not yet treated positions, wherein the first and second irradiation parameters differ from one another. In other words, the entire treatment area can be treated again, wherein different irradiation parameters can be set for already treated positions than for the untreated positions. For example, an energy and / or a spatial pulse spacing can be adjusted as irradiation parameters. Preferably, it can be provided that already irradiated positions are irradiated with a lower energy deposition than still unirradiated treatment positions.Alternatively, it can also be provided that the entire treatment area, which includes the treatment positions that have already been irradiated and those that are still to be irradiated, is irradiated again with the same irradiation parameters.

[0018] A further embodiment provides that the ophthalmological laser device has the camera device by means of which the at least one eye image would be taken during the pre-treatment of the eye. In other words, the laser device, which is different from the treatment device, can have the camera device by means of which the eye image was captured. Thus, the eye image originates from the pre-treatment, and this can be transferred to the new treatment with the treatment device. Using the eye image from the pre-treatment offers the advantage that treated areas are still clearly visible, in particular clouding, which decreases over time. Preferably, the eye image from the pre-treatment can be scaled to a coordinate system of the treatment device by adjustments, for example shifts, rotations and / or scaling.In particular, the treatment positions can also be determined based on phenomenological structures of the eye detected by image processing technology, which are stored in image and / or video data.

[0019] A further advantageous embodiment provides that the treatment device comprises the camera device and the computing device, which determine the treatment positions before the follow-up treatment. Alternatively, an additional diagnostic device can also be provided, which determines the treatment positions and transmits the control data to the treatment device. The advantage of the treatment device comprising both the camera device and the computing device is that no further adjustments to the treatment device, in particular scaling of the eye image, are necessary, and the follow-up treatment can begin immediately.

[0020] Preferably, the treatment positions are determined for an incision in the cornea and / or an ablation of corneal tissue and / or a laser-induced refractive index change.

[0021] A further embodiment provides that the eye image is captured by the camera device in a visual and / or infrared spectral range. This means that the camera device can comprise a light source that can emit light in a visual and / or infrared spectral range. Accordingly, the camera device can have a camera that is configured to detect the correspondingly reflected light signal from the light source.

[0022] A further advantageous embodiment provides that the camera device comprises a slit lamp, by means of which several eye images are acquired, each with a different slit setting, wherein the phenomenological structures of the eye are determined from the several eye images. By means of a slit lamp, a sharply defined slit-shaped light beam can be directed onto the eye in order to capture sections of the eye, in particular also in a depth direction. The eye can thus be scanned through the slit lamp in order to capture the phenomenological structures, in particular previously treated positions of the eye. The slit setting can comprise a slit width and / or a slit position, which can be adjusted to scan the eye. This results in the advantage that the phenomenological structures of the eye can be detected more effectively.

[0023] A further aspect of the invention relates to a treatment device with at least one ophthalmic laser for the treatment of a human or animal eye by means of optical breakdown, in particular by means of photodisruption and / or photoablation, and / or by means of a laser-induced optical refractive index change, wherein the treatment device comprises at least one camera device and a computing device, wherein the treatment device is designed to carry out a method mentioned above. This results in the same advantages and possible variations as in the method. In particular, the treatment device can also comprise a control device designed to control the laser using the provided control data, wherein the control device can be the computing device.

[0024] The method may include at least one additional step that is executed precisely when a use case or application situation occurs that has not been explicitly described here. This step may, for example, include outputting an error message and / or a request for user feedback. Additionally or alternatively, it may be provided that a default setting and / or a predetermined initial state is set.

[0025] A further aspect relates to a control device which is designed to carry out the steps of at least one embodiment of the method described above. For this purpose, the control device can have a computing unit for electronic data processing, such as a processor. The computing unit can comprise at least one microcontroller and / or at least one microprocessor. The computing unit can be embodied as an integrated circuit and / or microchip. Furthermore, the control device can comprise an (electronic) data memory or a memory unit. Program code which encodes the steps of the respective embodiment of the respective method can be stored on the data memory. The program code can comprise the control data for the respective laser. The program code can be executed by means of the computing unit, thereby causing the control device to carry out the respective embodiment.The control device can be designed as a control chip or control unit. The control device can, for example, be comprised of a computer or computer network.

[0026] Another aspect relates to a computer program. The computer program comprises instructions that, for example, form a program code. The program code can include at least one control data set with the respective control data for the respective laser. When the program code is executed by a computer or a computer network, it is caused to execute the previously described method or at least one embodiment thereof.

[0027] A further aspect relates to a computer-readable medium (storage medium) on which the aforementioned computer program or its instructions are stored. To execute the computer program, a computer or a computer network can access the computer-readable medium and read its contents. The storage medium is designed, for example, as a data memory, in particular at least partially as a volatile or non-volatile data memory. A non-volatile data memory can be a flash memory and / or an SSD (solid state drive) and / or a hard disk. A volatile data memory can be a RAM (random access memory). The instructions can be present, for example, as source code of a programming language and / or as assembler and / or as binary code.

[0028] Further features and advantages of one of the described aspects of the invention may arise from the further development of another aspect of the invention. The features of the embodiments of the invention may thus be present in any combination with one another, unless explicitly described as mutually exclusive.

[0029] Additional features and advantages of the invention are described below with reference to the figure(s) in the form of advantageous exemplary embodiments. The features or combinations of features of the exemplary embodiments described below can be present in any combination with one another and / or with the features of the embodiments. This means that the features of the exemplary embodiments can supplement and / or replace the features of the embodiments, and vice versa. Thus, the invention also encompasses and discloses configurations that are not explicitly shown or explained in the figures, but which emerge and can be produced from the exemplary embodiments and / or embodiments through separate combinations of features.Thus, embodiments are also considered to be disclosed that do not have all the features of an originally formulated claim or that go beyond or deviate from the combinations of features set forth in the claims' references. The embodiments are shown in: . Fig. 1 a schematic representation of a treatment device according to an exemplary embodiment; Fig. 2 a schematic process diagram for providing control data according to an exemplary embodiment.

[0030] The Fig. 1 shows a schematic representation of a treatment device 10 with an ophthalmic laser 12 for treating an eye 16, in particular a cornea of ​​the eye 16, by means of photodisruption and / or photoablation and / or a laser-induced refractive index change. In this example, a cut surface 14, for example an anterior and / or posterior cut surface for creating a lenticule in the cornea of ​​the eye 16, can be cut out of the cornea with the ophthalmic laser 12 for the treatment to correct a visual impairment. Treatment positions and / or a geometry of the cut surface 14 can be provided by a computing device 18, which can be designed as a control device of the treatment device 10, in particular in the form of control data, so that the laser 12 emits pulsed laser pulses into the eye 16 in a pattern predefined by the control data to create the cut surface 14.Alternatively, the computing device 18 may be a computing device 18 external to the treatment device 10.

[0031] Furthermore, the Fig. 1, the laser beam 20 generated by the laser can be deflected toward the eye 16 into the cornea by means of a beam deflection device 22, such as a rotary scanner, to create the cutting surface 14. The beam deflection device 22 can also be controlled by the computing device 18.

[0032] The laser 12 shown can preferably be a photodisruptive and / or photoablative laser which is designed to emit laser pulses in a wavelength range between 150 nm and 1400 nm, preferably between 700 nm and 1200 nm or between 150 nm and 250 nm, with a respective pulse duration between one femtosecond and 15 nanoseconds, preferably between 10 femtoseconds and 10 picoseconds or between 5 nanoseconds and 15 nanoseconds, and a repetition frequency between 500 Hz and 10 kHz, preferably between 100 kHz and 100 MHz or between 500 Hz and 1050 Hz. The computing device 18 optionally also has a storage device (not shown) for at least temporarily storing at least one control data set, wherein the control data set(s) comprise control data for positioning and / or focusing individual laser pulses in the cornea of ​​the eye 16.

[0033] Furthermore, the treatment device 10 can have a camera device 28, which can be designed to take eye images in a visual and / or infrared spectral range, preferably in order to capture phenomenological structures in the eye 16.

[0034] During a treatment with the treatment device 10 and / or a pretreatment with another ophthalmic laser device (not shown), it may happen that the treatment has to be aborted or is inadequate. For example, the incision 14 may contain an area 24 that encompasses previously treated positions and an area 26 that contains untreated treatment positions. For example, it may have been planned that the incision surface 14 be created using a spiral pattern leading from the outside to the inside, so that if the treatment is aborted, the inner area 26 is not irradiated.

[0035] In order to complete such an incomplete treatment or to plan a treatment plan based on other phenomenological structures of the eye 16, for example, an orientation of the treatment based on structures of the iris, the Fig. 2 procedures shown can be carried out.

[0036] In Fig. Figure 2 shows a schematic process diagram for providing control data for the ophthalmic laser 12 of the treatment device 10. This process generally allows treatment positions in the eye 16 to be planned based on detected phenomenological structures in the eye. The provision of control data is described below using the unfinished incision 14 in the cornea as an example, where the phenomenological structures may be previously treated positions 24 in the eye 16.

[0037] In a step S10, at least one eye image of the eye 16 can be captured by the camera device 28, wherein the eye image includes the previously treated positions 24. Alternatively, the camera device 28 can also belong to a laser device by means of which the pretreatment was performed, so that the eye images can be subsequently transmitted to the treatment device 10, in particular to the computing device 18. The camera device 28 can preferably record the eye image in a visual and / or infrared spectral range.

[0038] In a step S12, the computing device 18 can determine the previously treated positions 24 from the eye image using an image analysis algorithm, for example, by means of edge detection and / or based on the detection of an intensity distribution. Particularly preferably, the camera device 28 can also comprise a slit lamp (not shown), by means of which individual regions can be scanned, so that the recognition of the phenomenological structures (previously treated positions 24) by the image analysis algorithm can be simplified.

[0039] In a step S14, the treatment positions 26 for follow-up treatment with the laser 12 can be determined based on the previously treated positions 24. For example, the difference between the entire incision surface 14 and the previously treated positions 24 can be determined to determine the remaining treatment positions 26.

[0040] It can also be provided that the entire cutting surface 14 is redefined as a treatment area, wherein the already irradiated positions 24 are planned for re-irradiation with different irradiation parameters than the still unirradiated irradiation positions 26. In particular, the still unirradiated irradiation positions 26 can be planned with a higher power density than the already irradiated positions 24.

[0041] Finally, in a step S16, the computing device 18 can provide control data for the treatment device 10, in particular for the follow-up treatment of the eye 16, wherein the control data include the treatment positions 26. The laser 12 and / or the beam deflection device 22 can then be controlled by the computing device 18 for irradiation.

[0042] Overall, the examples show how treatment positioning can be provided with the support of an image analysis algorithm.

Claims

[1] Method for providing control data for an ophthalmic laser (12) of a treatment device (10), the method comprising the following steps: - capturing (S10) at least one eye image of one eye (16) by a camera device (28); - determining (S12) phenomenological structures (24) of the eye (16) from the eye image by a computing device (18), wherein the computing device (18) determines the phenomenological structures (24) by means of an image analysis algorithm; - determining (S14) treatment positions (26) in the eye for treatment with the ophthalmological laser (12) as a function of the phenomenological structures (24) by the computing device (18); - Providing (S16) control data for the treatment device (10) by the computing device (18), which control data comprise the treatment positions (26) in the eye (16) for treatment. [2] The method according to claim 1, wherein - the acquisition (S10) of the at least one eye image is carried out from an eye (16) which is treated with an ophthalmological laser device; - the determination (S12) of phenomenological structures of the eye (16) is a determination of previously treated positions (24) of the eye (16) from the eye image, wherein the computing device (18) determines the previously treated positions (24) by means of an image analysis algorithm; - the determination (S14) of treatment positions in the eye is a determination of treatment positions (26) in the eye (16) for follow-up treatment with the ophthalmic laser (12) depending on the previously treated positions (24) of the eye (16); and - the provision (S16) of control data for the follow-up treatment of the eye (16) is provided. [3] Method according to claim 2, wherein, when determining the treatment positions for the follow-up treatment of the eye, still untreated positions (26) of the eye (16) are determined. [4] Method according to claim 3, wherein the still untreated positions (26) of the eye (16) are determined from a difference between a predetermined total treatment area (14) and the determined previously treated positions (24). [5] Method according to one of claims 2 to 4, wherein both the previously treated positions (24) and the still untreated positions (26) in the eye (16) are defined as treatment positions, wherein first irradiation parameters are defined in the control data for the treatment positions of the already treated positions (24) and second irradiation parameters are defined for the still untreated positions (26), wherein the first and second irradiation parameters differ from one another. [6] Method according to one of claims 2 to 5, wherein the ophthalmological laser device comprises the camera device (28) by which the at least one eye image was taken during the pretreatment of the eye (16). [7] Method according to one of claims 2 to 5, wherein the treatment device (10) comprises the camera device (28) and the computing device (18) by which the determination of the treatment positions is carried out before the post-treatment. [8] Method according to one of claims 2 to 7, wherein the treatment positions are determined for an incision (14) in the cornea and / or an ablation of corneal tissue and / or a laser-induced refractive index change. [9] Method according to one of the preceding claims, wherein the eye image is captured in a visual and / or infrared spectral range by the camera device (28). [10] Method according to one of the preceding claims, wherein the camera device (28) comprises a slit lamp, by means of which a plurality of eye images are acquired, each with a different slit setting, wherein the phenomenological structures of the eye are determined from the plurality of eye images. [11] Treatment device (10) with at least one ophthalmological laser (12) for the treatment of a human or animal eye (16) by means of optical breakdown, in particular by means of photodisruption and / or photoablation, and / or by means of a laser-induced optical refractive index change, wherein the treatment device (10) comprises at least one camera device (28) and a computing device (18), wherein the treatment device (10) is designed to carry out a method according to one of the preceding claims.

Images