ARTIFICIAL INTELLIGENCE-BASED MODEL FOR PATIENT-INDIVIDUALIZED PLANNING OF REFRACTIVE EYE SURGERY

Abstract

A computer program is provided, comprising an artificial intelligence-based model, wherein the computer program is designed to, when executed by a computer, induce the computer, by means of the model, to determine a treatment plan for refractive eye surgery based on information characterizing a patient and information characterizing a refractive error in one of the patient's eyes that is to be corrected by means of refractive eye surgery.

Description

[0001] The present disclosure relates to a computer program comprising an artificial intelligence-based model, an apparatus for data processing with the model, a method for training the model, and a computer-readable medium with the model.

[0002] The disclosed model can be used for patient-specific planning of refractive eye surgery for a patient's eye using a laser. Refractive eye surgery, or refractive surgery, encompasses eye operations that change the overall refractive power of the eye. One goal may be to eliminate the need for conventional optical corrections such as glasses or contact lenses, or at least to reduce their required power. Ophthalmology knows several surgical methods for correcting ametropia or refractive errors using refractive eye surgery.

[0003] A fundamental distinction is made between laser procedures and implants, particularly intraocular lenses that are inserted into the beam path. The present disclosure relates to the correction of refractive errors using a laser procedure and / or an implant.

[0004] Laser procedures use a laser to alter the refractive power of the eye to correct the visual defect or ametropia. This can be done indirectly, for example, by working on the cornea, and / or directly, for example, by creating an incision for inserting an intraocular lens (IOL).

[0005] One laser procedure is LASIK (laser in situ keratomileusis). In this procedure, a microkeratome (corneal planer) or a femtosecond laser (so-called femto-LASIK) is used to cut a thin lamella (approximately 8 to 9.5 mm in diameter and between 100 and 160 µm thick) into the cornea. This lamella is then opened up, and the actual laser treatment takes place on the underlying tissue.

[0006] Other laser procedures include photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), and epithelial laser in situ keratomileusis (EpiLASIK). In these procedures, the tissue is removed from the surface of the cornea. This is why they are also referred to as surface ablation. In all three methods, the epithelium is first removed from a sufficiently large, central area of ​​the cornea, and then the corneal surface is treated with the laser. The procedures differ in how the epithelium is removed and what happens to it after treatment. In PRK, the epithelium is scraped off using a surgical instrument and is not reused. The LASEK and EpiLASIK procedures use the epithelium as a natural wound dressing after treatment.In LASEK, the epithelium is loosened with alcohol and pushed aside with a suitable instrument. In EpiLASIK, however, it is lifted away with a blunt corneal plane similar to a microkeratome, forming a kind of epithelial flap. In all three procedures, the epithelium must regenerate after treatment.

[0007] Another well-known technique is femtosecond lenticule extraction. As with the excimer laser procedures PRK and LASIK, the correction of refractive errors is achieved by changing the curvature of the cornea. However, unlike the aforementioned procedures, this is not achieved by vaporizing corneal tissue. A femtosecond laser is used to cut a so-called lenticule within the cornea. This lens-shaped piece of tissue is then removed, and the resulting change in the curvature of the cornea corrects the refractive error. Depending on how this lenticule is removed, a distinction is made between two procedures. In the FLEx (Femtosecond Lenticle Extraction) method, not only the lenticule is cut during the laser treatment, but also an overlying lamella (flap).

[0008] This flap is then opened, allowing the lenticule to be removed. In the second method, called SmILE or SMILE (small incision lenticle extraction), the laser does not create a complete flap, but rather only a small, peripheral incision through which the doctor can remove the lenticule. Femtosecond lenticule extraction is generally indicated for the correction of myopia up to -10 diopters and astigmatism up to 3 diopters.

[0009] In the aforementioned refractive eye surgery using a laser, patient-individual (treatment) planning is conventionally carried out.

[0010] When planning refractive eye surgery, the practitioner derives appropriate treatment parameters (e.g., target, laser set, optical zone, laser energy, laser spot parameters, etc.) based on patient data (e.g., gender, age, etc.) and diagnostic data (e.g., manifest refraction, pachymetry, etc.). The patient data and diagnostic data can include numerical values ​​(e.g., measured values), text data, videos, and / or image data (e.g., diagnostic images).

[0011] The planning parameters, i.e. the patient data and diagnostic data, are entered by the practitioner into the planning software of the laser or the associated workstation.

[0012] In this context, reference is made to US 2020 / 155351 A1, which concerns the development of treatment recommendations for topography-based surgical excimer laser procedures.

[0013] In conventional planning for refractive eye surgery, the planning parameters are selected and entered manually. This can result in the overall refractive procedure being slowed down due to the large number of inputs. Furthermore, input errors can occur. Advice on selecting suitable planning parameters or the appropriate treatment type for the individual patient, based on recommendations from other physicians or previously entered data, is also not available.

[0014] It is therefore an object of the present disclosure to enrich the prior art outlined above.

[0015] According to the disclosure, this object is achieved by the subject matter of the independent claims, with optional further developments thereof being specified in the subordinate claims and the subclaims.

[0016] The task is solved by a computer program comprising a model based on artificial intelligence.

[0017] The computer program is designed so that, when the computer program is executed by a computer, the computer, by means of the model, causes the computer to determine information characterizing a treatment plan for the refractive eye surgery based on information characterizing a patient and information characterizing a visual impairment of an eye of the patient that is to be treated by means of the refractive eye surgery.

[0018] In other words, an artificial intelligence-based model is provided in the form of or as part of a computer program. This means that the artificial intelligence-based model is designed to be used by a computer as part of or in the form of a computer program. The model is trained in such a way that it automatically generates output data based on input data, which in turn corresponds to automated, patient-specific planning of refractive eye surgery for a patient's eye. The input data for the model are information characterizing the patient and information characterizing a visual impairment of the patient's eye that is to be treated, or optionally corrected, by means of refractive eye surgery.These input data are processed by the model when the computer program is executed by the computer in such a way that the output data is generated, which includes information characterizing a treatment plan for the refractive eye surgery.

[0019] The model can thus enable patient-specific planning of a refractive eye surgery for a patient's eye, e.g., using a laser and / or an implant.

[0020] A computer program can be understood as a sequence of instructions that complies with the rules of a specific programming language in order to process or solve certain functions, tasks or problems, in this case a patient-specific planning of a refractive eye operation for one eye of a patient, with the help of a computer.

[0021] A computer program is part of a computer's software. It can be present (e.g., on a data storage medium) as a computer-executable program file, often in so-called machine code, which can be loaded into the computer's memory for execution. The computer program is processed as a sequence of machine or processor instructions by the computer's processor(s) and thus executed.

[0022] For the definition of refractive eye surgery, reference is made to the above statements, particularly regarding laser procedures. Consequently, a laser can be used in eye surgery, for example, a femtosecond laser and / or an excimer laser. It is conceivable that the artificial intelligence-based model is specifically tailored to the laser, i.e., that the model is also fed information characterizing the laser during training (see below in detail). This could, for example, be nomograms.

[0023] In this context, an artificial intelligence-based model can be understood as a model created using machine learning. Machine learning can be understood as the "artificial" generation of knowledge from experience. An artificial system or model learns from one or more examples and can generalize them after the learning phase or training is completed. To do this, machine learning algorithms build a statistical model based on training data, which can optionally be tested against test data. This means that the examples are not simply memorized, but patterns and regularities are recognized in the training data. This allows the model to evaluate even unknown data (so-called learning transfer).

[0024] The computer program described above offers a number of advantages. Among other things, the computer program enables automated, yet patient-specific planning of refractive eye surgery using an artificial intelligence-based model (AI model), which can draw on expert knowledge. Patient-specific means that the AI ​​model can plan refractive eye surgery based on patient-specific information that serves as input data for the AI ​​model. The use of the AI ​​model is advantageous in that, as part of the learning transfer described above, it can independently generate information characterizing a treatment plan (e.g., comprising a treatment method and / or a setting for a laser used in the eye surgery) that is suitable for performing the refractive eye surgery.eye surgery. Unlike a comparable deterministic algorithm, the AI ​​model is not limited to a predefined, fixed set of rules when determining the output data, but can rely on (expert) knowledge acquired during the learning or training phase when determining the output data. This enables a better representation of the conventional, manual planning processes using a computer program than conventional, deterministic algorithms. In other words, the AI ​​model, as a knowledge-based system, allows the conventional, complex planning process of an experienced surgical planner to be modeled and thus automated, something that cannot be represented with a deterministic algorithm. Furthermore, there is the possibility that the AI ​​model can also be used in the field, i.e.is (optionally further) trained when used as intended, for example based on user feedback from the surgical planner.

[0025] Optional further training courses for the computer program described above are explained in detail below.

[0026] The information identifying the patient may include information about the biomechanical stability of the eye, a previous disease of the eye, a previous treatment of the eye, an eye shape of the eye to be treated (optionally in the form of information about the origin and / or ethnicity of the patient), an age and / or a gender of the patient.

[0027] The information characterizing the refractive error of the patient's eye to be treated by refractive eye surgery may include information on a manifest refraction and / or pachymetry.

[0028] The information identifying the treatment plan for refractive eye surgery may include a treatment procedure from a list of predetermined treatment procedures.

[0029] The list may include at least two of the following treatment procedures: femtosecond lenticule extraction (SMILE), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epithelial laser in situ keratomileusis (EpiLASIK), laser in situ keratomileusis (LASIK), and / or provision of an implant, optionally an intraocular lens (IOL) and / or an implantable contact lens (ICL), and / or corneal intrastromal implantation surgery (CISIS).

[0030] For the definition and description of these individual procedures, please refer to the above.

[0031] The computer program according to the disclosure can thus, by using the AI ​​model, assist in selecting a treatment procedure suitable for the patient.

[0032] It is conceivable that the information characterizing the treatment plan for refractive eye surgery includes further or additional information. This may be a laser setting for performing the treatment procedure, optionally including information about a laser set, an optical zone, a laser energy, and / or a laser spot parameter. Additionally or alternatively, a target can be specified.

[0033] The computer program according to the disclosure can thus, using the AI ​​model, not only select a treatment method suitable for the patient, but also determine further information corresponding to or suitable for the selected treatment method, such as the setting of the laser.

[0034] A target can be understood as a desired refraction or a desired refraction of the eye after treatment. The change in refractive power can be achieved through the use of an implant (see above) and / or a laser (see above).

[0035] A laser set can be understood as a piece of information, optionally a necessary refractive change. This information can be represented by control data, whereby the control data is used for the laser, i.e., provided to it to reach the target.

[0036] It is conceivable that for this purpose, the user (e.g.) sets the necessary refractive changes, e.g. in the form of sphere, cylinder and / or higher orders in diopters, on the laser in order to achieve the desired refraction / target by means of the refractive procedure. If, for example, SMILE is selected as the treatment method, software can be provided that translates this entered refractive change into a lenticule geometry (i.e. radius of the lenticule incision). Further lenticule parameters (e.g. minimum thickness, OZ, depth of the lenticule in the cornea, size and / or position of the incision for lenticule extraction, a buffer or transition zone, and / or a clearance) can be specified by the user in addition to the refractive change (or the laser set). This results in the final lenticule geometry.If, for example, PRK, Trans-PRK, or LASIK is chosen as the treatment procedure, software can be provided that translates the refractive change into an ablation profile that the (excimer) laser ablates from the corneal surface (e.g., photoablation, vaporization without long-range heating of the tissue). For LASIK, additional flap parameters (e.g., flap thickness, hinge position, etc.) can be entered (e.g., by the user) in addition to the laser setting. Input by the user is only one example of an implementation possibility, and input of the laser set can also be automated, optionally controlled by the computer program according to the disclosure.

[0037] The optical zone can be understood as an optically active area of ​​a lenticule, flap or ablation profile to be cut.

[0038] Laser energy can be understood as the energy per laser pulse emitted by the laser during the treatment of the eye, i.e., one pulse energy. Such energy can vary depending on the treatment method (for example, in the SMILE method, in a range of 115 to 150 nJ). When using an excimer laser, pulse energies between 1.04 and 1.08 mJ can occur for a Gaussian spot with a diameter of 0.7 mm. The aforementioned numerical values ​​serve exclusively to explain the concept of laser energy and do not limit the disclosure to these numerical values.

[0039] The laser spot parameter can be understood as information relating to an ellipsoid spiral scan, which in turn can include information relating to spot spacing (i.e., the spatial distances between the spots on a spiral path) and / or track spacing (i.e., the spatial distance between the spiral arms). Both of the aforementioned can, for example, be in a range from 0.1 to 4 micrometers, optionally 1 to 4 micrometers. The spatial distance between the spots and the spatial distance between the spiral arms can be selected to be the same. The aforementioned numerical values ​​serve solely to explain the term laser spot parameter and do not restrict the disclosure to these numerical values.

[0040] Furthermore, the disclosure relates to a data processing device, wherein the data processing device is designed to determine information characterizing a treatment plan for the refractive eye surgery by means of an artificial intelligence-based model based on information characterizing a patient and information characterizing a refractive error of an eye of the patient that is to be corrected by means of a refractive eye surgery.

[0041] The data processing device may comprise an input interface for receiving the information identifying the patient and / or the information identifying a refractive error of the patient's eye to be treated by means of the refractive eye surgery.

[0042] The data processing device or computer can be a local processing unit that is wirelessly and / or wiredly connected to the laser and / or is embodied as part of the laser. Additionally or alternatively, it is conceivable that parts of the data processing device are arranged remotely and in turn are wirelessly and / or wiredly connected to the local processing unit. This means, for example, that the AI ​​model is provided at least partially in a cloud, e.g., as Software as a Service (SaaS). In such a case, it is conceivable that the input data required for the AI ​​model is output from the local computer to a server, e.g., via the Internet. The AI ​​model can then be executed in the cloud or by the respective cloud component, which, as part of the server, is also part of the data processing devices.In this case, the AI ​​model's output data determined on the server—i.e., the specific laser setting characteristic of the refractive eye surgery—can be output to the local computer, again, for example, via the internet. The server, and thus the computer program comprising the AI ​​model, can be operated, maintained, and further developed by a software manufacturer, possibly based on input data from multiple local computers and thus users.

[0043] The input interface may comprise an input interface, optionally comprising a display device, configured to receive a user input concerning the information characterizing the patient and / or the information characterizing a refractive error of the patient's eye to be treated by means of the refractive eye surgery.

[0044] The input interface may comprise a data receiving interface configured to receive a data signal comprising the information identifying the patient and / or the information identifying a refractive error of the patient's eye to be treated by means of the refractive eye surgery.

[0045] In the case of a distributed system, i.e., the use of a server or cloud as described above, this can be implemented in such a way that the surgical planner or user makes their input on the local computer regarding the information characterizing the patient and / or the information characterizing a visual impairment of the patient's eye that is to be treated by refractive eye surgery (i.e., via the input interface). This information received via the user input can then be forwarded to the server (i.e., to the data interface), which enters the received information into the AI ​​model in the manner described above. It is also conceivable that the user input only comprises part of the information characterizing the patient and / or the information characterizing a visual impairment of the patient's eye that is to be corrected by refractive eye surgery.Further information can be loaded from one or more databases, for example based on the information contained in the user input. It is conceivable, for example, that the information identifying the patient consists of the patient's name and / or ID. Based on the name and / or ID of the patient or test subject, further information identifying the patient (e.g. gender and / or age, see above) and / or information identifying a visual impairment of the patient's eye that is to be corrected by refractive eye surgery can then be loaded from one or more databases. In this way, information from multiple sources can be combined and the amount of data to be transmitted can be kept to a minimum, which can also be advantageous from a security perspective regarding sensitive personal data.

[0046] The data processing device may comprise an output interface for outputting the determined information characterizing the treatment plan for the refractive eye surgery.

[0047] The output interface may comprise an output interface for outputting the specific information identifying the treatment plan to a user of the device. This may, for example, be a display or a display device via which the information identifying the treatment plan is visibly displayed or visualized for the user.

[0048] The output interface may comprise a data output interface configured to output a data signal comprising the specific information identifying the treatment plan. This may, for example, be an interface to a database in which the specific information identifying the treatment plan is stored.

[0049] It is conceivable that the device is designed to determine a control signal for a laser used in the eye surgery based on the specific information characterizing the treatment plan and to output the specific control signal to the laser via the output interface for controlling the laser. It is conceivable that the laser itself can access the output control signal. This allows remote control of the laser, at least in part.

[0050] It is conceivable that the device is designed to access a plurality of different computer-implemented models based on artificial intelligence, by means of which the data processing device is designed in each case to determine the information characterizing the treatment plan for the refractive eye surgery based on the information characterizing the patient and the information characterizing the refractive error of the patient's eye that is to be treated by means of the refractive eye surgery.

[0051] One or more of the models may be selectable via the input interface of the device to determine the information characterizing the treatment plan for the refractive eye surgery.

[0052] It is conceivable that a user could choose between several AI models or assistants when planning or determining the laser setting. For this purpose, the input interface described above could be used, for example. The available assistants can be trained with user data and / or with expert data. The assistant can therefore either be used to execute the planning process more quickly by being trained with its own data, or it can serve as an advisor based on recommendations from other experts. The latter scenario is advantageous for inexperienced users and can be used as a training method within the framework of application support.

[0053] What has been described above with reference to the computer program also applies analogously to the data processing device and vice versa.

[0054] Furthermore, the disclosure relates to a computer-implemented method for training a model based on artificial intelligence, wherein the method comprises training the model such that, after training, the model is configured to determine information characterizing a treatment plan for the refractive eye surgery based on information characterizing a patient and information characterizing a refractive error of an eye of the patient that is to be treated by means of refractive eye surgery.

[0055] A computer-implemented method can be understood as a method in which one, several or all steps of the method are carried out at least partially by a computer or a data processing device.

[0056] It is conceivable that the training process is structured in two stages. This means that in a first stage the model can be pre-trained using predefined training data. In a second stage of the process the model(s) can be fine-tuned or adjusted. It is conceivable that the model(s) can be updated or further trained during ongoing operation (e.g. after each operation and / or after each recorded batch of surgical inputs). It is conceivable that the model(s) are trained in the second stage exclusively for those samples or input data for which the model predictions have a high uncertainty (i.e. one that exceeds a predetermined limit). Additionally or alternatively the model(s) can be trained in the second stage for such samples or input data.Input data is introduced that exhibits a distribution shift compared to previous input data (a new data representation results in a covariance shift or other variations in the range representation).

[0057] What has been described above with reference to the computer program and the data processing device also applies analogously to the computer-implemented method and vice versa.

[0058] Furthermore, the disclosure relates to a computer-readable medium comprising a model based on artificial intelligence, wherein the model is designed to cause a computer, when the model is executed, to use the model to cause the computer to determine information characterizing a treatment plan for the refractive eye surgery based on information characterizing a patient and information characterizing a visual impairment of an eye of the patient that is to be treated by means of a refractive eye surgery.

[0059] This means that a computer-readable medium can be provided that contains a computer program as defined above. The computer-readable medium can be any digital data storage device, such as a USB flash drive, a hard disk, a CD-ROM, an SD card, or an SSD card (or SSD drive / SSD hard disk).

[0060] The computer program does not necessarily have to be stored on such a computer-readable storage medium in order to be made available to the computer, but can also be obtained via the Internet or otherwise externally.

[0061] The computer-readable medium can therefore be a data signal comprising an artificial intelligence-based model for patient-individual planning of a refractive eye surgery for a patient's eye by means of a laser, wherein the model is designed so that, when the model is executed by a computer, the computer, by means of the model, causes the computer to determine a setting of the laser characterizing the refractive eye surgery based on information characterizing the patient and information characterizing a visual impairment of the patient's eye that is to be corrected by means of the refractive eye surgery.

[0062] What has been described above with reference to the computer program, the data processing device and the computer-implemented (training) method also applies analogously to the computer-readable medium and vice versa.

[0063] The above description can be summarized in other words and in a possible more concrete embodiment of the disclosure as described below, whereby the following description is not to be interpreted as limiting the disclosure.

[0064] In summary, the proposal is to provide an AI-based assistance function (short: assistant) for planning refractive eye surgery, optionally including laser treatments. The assistant can learn the relationship between diagnosis / patient data and the resulting treatment data through training with data from refractive surgery experts and / or the respective device user.

[0065] The assistant trained in this way can be made available for planning refractive eye surgeries and can suggest one or more treatment parameters to a user based on the entered patient / diagnosis data.

[0066] If the user changes a value suggested by the assistant during planning, it is conceivable that these changed data will be used for further training of the assistant.

[0067] It is also conceivable that the user can choose between several assistants during the planning process. These available assistants can be trained with user data and / or expert data.

[0068] The assistant can therefore help the user to complete their own planning more quickly by training the assistant with the user's data, and / or the assistant can support the user as a consultant based on recommendations from other physicians / experts. The latter scenario can be particularly helpful for inexperienced physicians and can be used as a training method for application support.

[0069] The disclosure therefore makes it possible to provide a comprehensive assistance function for the planning of refractive eye surgeries.

[0070] It is conceivable that during the model training, the user will subsequently evaluate the treatment parameters determined by the model. This assessment can be used to weight the training data.

[0071] It is conceivable that during model training, the user may be given the opportunity to point out or comment on certain dependencies between parameters. This information could be displayed to the user when using the wizard.

[0072] Connecting the devices and their planning software to a global IT data infrastructure (cloud) can facilitate the training and deployment of assistants between multiple users.

[0073] A training hierarchy can be used to train assistants. Assistants can be trained first with expert data and then fine-tuned with data from the respective user of the pre-trained model.

[0074] It's conceivable that the assistants could learn and apply interdependencies between treatment parameters. If certain dependencies are violated, the user can be notified.

[0075] It is conceivable that results from (possibly standardized) questionnaires completed by the patient are used by the assistant to suggest treatment parameters or a therapy modality.

[0076] It is conceivable that the results obtained via the questionnaire, initially presented as subjective data, are automatically objectified. These results can be converted into parameters, for example, and / or (optionally AI) models can be used to convert text obtained via the questionnaire into embeddings that can be fed as additional inputs into one or more of the models described herein. An (AI) model (e.g., RNNs, TCNs, transformers, etc.) for natural language processing can be used to convert the results obtained via the questionnaire, optionally presented as text, into more abstract information.

[0077] It is conceivable to offer the user the option to select for one or more treatment parameters whether the user would like to receive data from the assistant for this treatment parameter in future planning.

[0078] It is conceivable that the disclosed solution could be used as a training tool in application training courses. Based on the assistant's suggestions, the trainee could be taught how to select parameters or their knowledge could be tested.

[0079] It is conceivable that the disclosed solution could be used in the context of device maintenance. There, the assistant could, for example, support the service technician in selecting parameters for the device configuration.

[0080] It is conceivable that the assistant supports the user in selecting the treatment modality (SMILE, LASIK, PRK, IOL, ICL, etc.). It is also conceivable that the assistant provides the user with a plan recommendation based on a predetermined rule. A rule could be to only provide the assistant user with treatment recommendations generated by a model trained with the user's own treatment plans and / or expert treatment plans and / or treatment plans from colleagues in the user's country.

[0081] It is conceivable that the treatment plans issued by the assistant will be commented on or evaluated by experts and / or automatically based on the achieved refractive patient outcome. The patient outcome can be determined by measuring the subjective and / or objective refraction of the eye after surgery and / or by assessing patient satisfaction after refractive surgery, e.g., using questionnaires.

[0082] Below, an optional embodiment of the disclosure is described with reference to Fig. 1 to 3. Fig. 1 shows a data processing system according to the disclosure, which is designed to execute a computer program according to the disclosure, Fig. 2 shows a flow diagram of a computer-implemented method according to the disclosure, which can be used as the computer program according to the disclosure in the Fig. 1 is implemented in the disclosed data processing system, and Fig. 3 shows a flowchart of another disclosed computer-implemented method for training an artificial intelligence-based model, which is part of the disclosed computer program.

[0083] The Fig. The data processing system 1 shown in Figure 1, which can also be referred to as a data processing device, comprises a local computing unit 2 designed as a personal computer (PC) and a server 3 which is arranged remotely (i.e. spatially separated) from the PC 2 and is connected wirelessly (e.g. via the Internet) to the PC 2 for bidirectional data exchange.

[0084] For this purpose, the PC 2 comprises an input interface, comprising an input interface 6 for receiving user input (e.g., as a touch input and / or by means of a PC mouse and / or PC keyboard) and a data reception interface 7 for (in this case, wirelessly) receiving data or information from the server 3. The PC 2 comprises an output interface, comprising an output interface 4 for (in this case, visually) outputting information to a user of the PC 2 (which is designed as a display in this case) and a data output interface 8 for (in this case, wirelessly) outputting data to or to the server 3.

[0085] The server 3 comprises a data reception interface 9 for (in this case wirelessly) receiving data or information from the PC 2. The server 3 comprises a data output interface 10 for (in this case wirelessly) outputting data to or from the PC 2.

[0086] The server 3 is configured to execute a portion of a computer program or software by means of which a model 5 based on artificial intelligence is implemented. The PC 2 is configured to execute a further portion of the computer program that is complementary to the portion of the computer program executed by the server 3 and that implements user interaction. The following describes a sequence of a computer-implemented method that is implemented by this computer program and executed by the data processing system 1 described above.

[0087] In a first step S1 of the method, a user input concerning information identifying a patient and information identifying a visual impairment of one of the patient's eyes that is to be treated by means of refractive eye surgery is received via the input interface 6 of the PC 2.

[0088] The information characterizing the patient includes information about the biomechanical stability of the eye to be treated, a pre-existing condition of the eye to be treated, a previous treatment of the eye to be treated, the shape of the eye to be treated, and the patient's age and / or gender. The information characterizing the refractive error of the patient's eye to be treated, which is to be treated by refractive eye surgery, includes information about the manifest refraction and / or pachymetry of the eye to be treated.

[0089] In a second step S2 of the method, the information identifying the patient and the information identifying the refractive error of the patient's eye to be treated by refractive eye surgery are wirelessly output as a data signal via the data output interface 8 of the PC 2 to the data reception interface 9 of the server 3.

[0090] In a third step S3 of the method, the server 3 inputs the information characterizing the patient received as a data signal and the received information characterizing the refractive error of the patient's eye to be treated by means of the refractive eye surgery into the artificial intelligence-based model 5.

[0091] The artificial intelligence-based Model 5 is designed for patient-specific planning of refractive eye surgery. For this purpose, the Model 5 is trained to determine information characterizing a treatment plan for the refractive eye surgery based on the information characterizing the patient and the information characterizing the refractive error of the patient's eye that is to be treated by refractive eye surgery.

[0092] Consequently, in a fourth step S4 of the method, the information characterizing the treatment plan for the refractive eye surgery is determined by means of the model 5 based on the information entered into the model 5 in the third step S3. The information characterizing the treatment plan for the refractive eye surgery comprises (at least) one treatment method from a list of predetermined treatment methods. The list from which the treatment procedure is selected by Model 5 may include at least two of the following treatment procedures: femtosecond lenticule extraction (SMILE), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epithelial laser in situ keratomileusis (EpiLASIK), laser in situ keratomileusis (LASIK), and / or provision of an implant, optionally an intraocular lens (IOL) and / or an implantable contact lens (ICL), and / or corneal intrastromal implantation surgery (CISIS).In addition to the treatment procedure, the model 5 can determine a target and / or a laser setting for performing the treatment procedure, optionally including information about a laser set, an optical zone, a laser energy, and / or a laser spot parameter. The specific target and / or the laser setting can also be part of the information characterizing the treatment plan for the refractive eye surgery.

[0093] In a fifth step S5 of the method, the determined information characterizing the treatment plan for the refractive eye surgery is again output in the form of a data signal via the data output interface 10 of the server 3 to the data reception interface 7 of the PC 2.

[0094] In a sixth step S6, the PC 2 controls its output interface 4 based on the received information identifying the treatment plan for the refractive eye surgery so that the output interface 4 displays the information identifying the treatment plan for the refractive eye surgery.

[0095] In a seventh step S7 of the method, the user can again provide feedback via the input interface 6 of the PC 2 regarding the information characterizing the treatment plan for the refractive eye surgery (as a whole and / or regarding one or more of the above-described information contained in the information characterizing the treatment plan for the refractive eye surgery). The user can thus accept the information characterizing the treatment plan for the refractive eye surgery directly or unchanged, or they can first modify it and then accept or approve the modified information characterizing the treatment plan for the refractive eye surgery.

[0096] In an eighth step S8 of the method, the PC 2 generates a control signal based on the accepted information characterizing the treatment plan for the refractive eye surgery and outputs it to the laser (not shown). The control signal is designed to condition the laser to perform the refractive eye surgery in compliance with the information characterizing the treatment plan for the refractive eye surgery, as approved by the user.

[0097] In a ninth step S9 of the method, the user feedback (see step S7) and / or the changed and released information characterizing the treatment plan for the refractive eye surgery is output to the server 3 in the manner described above.

[0098] The following describes a training procedure for the artificial intelligence-based model 5 described above, the flow chart of which is shown in Fig. 3. After performing the training procedure, model 5 is configured to execute the procedure described above.

[0099] In a first step S11 of the training method, a training data set is provided, comprising a plurality of training examples. Each of the training examples, in turn, comprises information identifying a patient, information identifying a refractive error in one of the patient's eyes that is to be treated by refractive surgery, and information identifying a treatment plan for the refractive surgery.

[0100] In a second step S12 of the training method, which is carried out for each of the training examples, the information characterizing the patient and the information characterizing the refractive error of the eye of this patient, which is to be treated by means of refractive eye surgery, of the respective training example are input into the model 5 and, based thereon, information characterizing a treatment plan for the refractive eye surgery is determined by means of the model 5.

[0101] In a third step S13 of the training process, which is again performed for each of the training examples, the determined information characterizing the treatment plan for the refractive eye surgery is compared with the information characterizing the treatment plan for the refractive eye surgery stored in the respective training example. Based on the result of the comparison, parameters of model 5 are adjusted so that the information characterizing the treatment plan for the refractive eye surgery determined in the second step S2 increasingly approximates the information characterizing the treatment plan for the refractive eye surgery in the respective training example over the course of the training process. Thus, supervised (machine) learning is proposed.

[0102] In a fourth step S14 of the training process, the model 5 trained as described above is presented to a user in the manner described above with reference to Fig. 1 and Fig. 2 described manner.

[0103] In a fifth step S15 of the training method, which is carried out, for example, by the server 3, a (further) adjustment of the parameters of the trained model 5 takes place based on the user feedback and / or the changed and released information characterizing the treatment plan for the refractive eye surgery, which was carried out in the ninth step S9 of the training method described above with reference to Fig. 2 is output to the server 3. In this way, the model 5 can be continuously improved.

[0104] Below is a possible further development of the above with reference to Fig. 1 described system for data processing 1 and the system related to Fig. The procedure described in section 2 is explained.

[0105] It is conceivable that several artificial intelligence-based models 5 can be trained or taught using the training method described above. For this purpose, several training data sets can be provided, each containing various training examples. The training data sets can include training examples based on refractive eye surgeries performed in the past by various users. The training method described above, in particular the first three or four steps S1-S4, can be performed for each of the training data sets.

[0106] The result is a server 3 that includes several different computer-implemented models 5 based on artificial intelligence.

[0107] This with reference to Fig.The method described in Figure 2 may then comprise an initial step S0 in which the user selects one or more of the models 5 via the input interface 6 of the PC 2, which are to be used for the subsequent steps S1-S9 to determine the information characterizing the treatment plan for the refractive eye surgery. The models 5 may be part of a single or different computer programs. List of reference symbols 1 Device or system for data processing 2 local processing units, optional PC 3 Remote computing unit, optional server 4 Output interface of the local processing unit 5 model based on artificial intelligence 6 Input interface of the local processing unit 7 Data reception interface of the local processing unit 8 Data output interface of the local processing unit 9 Data reception interface of the remote computing unit 10 Data output interface of the remote computing unit S0 - S9, S11 - S15 process steps 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] US 2020 / 155351 A1

[0012]

Claims

[1] A computer program comprising a model (5) based on artificial intelligence, wherein the computer program is designed to cause a computer (1) to execute the computer program by means of the model (5) based on: - information identifying a patient, and - information identifying a visual impairment of one of the patient's eyes that is to be treated by refractive eye surgery, to determine information identifying a treatment plan for the refractive eye surgery. [2] Computer program according to claim 1, wherein the information characterizing the patient comprises information about a biomechanical stability of the eye, a previous disease of the eye, a previous treatment of the eye, an eye shape of the eye to be treated, an age and / or a sex of the patient. [3] Computer program according to claim 1 or 2, wherein the information characterizing the refractive error of the patient's eye to be treated by means of the refractive eye surgery comprises information about a manifest refraction and / or a pachymetry. [4] Computer program according to one of claims 1 to 3, wherein the information characterizing the treatment plan for the refractive eye surgery comprises: - a treatment procedure from a list of predetermined treatment procedures, the list optionally comprising at least two of the following treatment procedures: femtosecond lenticule extraction (SMILE), photorefractive keratectomy (PRK), laser epithelial keratomileusis (LASEK), epithelial laser in situ keratomileusis (EpiLASIK), laser in situ keratomileusis (LASIK), and / or providing an implant, optionally an intraocular lens (IOL) and / or an implantable contact lens (ICL), and / or corneal intrastromal implantation surgery (CISIS), and - optionally a target and / or a setting of the laser for carrying out the treatment procedure, optionally comprising information about a laser set, an optical zone, a laser energy and / or a laser spot parameter. [5] Device for data processing (1), wherein the device for data processing (1) is designed to use an artificial intelligence-based model (5) based on: - information identifying a patient, and - information identifying a visual impairment of one of the patient's eyes that is to be treated by refractive eye surgery, to determine information identifying a treatment plan for the refractive eye surgery. [6] Data processing device (1) according to claim 5, wherein the data processing device (1) comprises an input interface for receiving the information characterizing the patient and / or the information characterizing a refractive error of the patient's eye to be treated by means of the refractive eye surgery. [7] Data processing device (1) according to claim 6, wherein the input interface comprises an input interface (6), optionally comprising a display device, which is designed to receive a user input concerning the information characterizing the patient and / or the information characterizing a refractive error of the patient's eye to be treated by means of the refractive eye surgery. [8] Data processing device (1) according to claim 6 or 7, wherein the input interface comprises a data receiving interface (7, 10) designed to receive a data signal comprising the information characterizing the patient and / or the information characterizing a refractive error of the patient's eye to be treated by means of the refractive eye surgery. [9] Data processing device (1) according to one of claims 5 to 8, wherein the data processing device (1) comprises an output interface for outputting the determined information characterizing the treatment plan for the refractive eye surgery. [10] The data processing device (1) according to claim 9, wherein the output interface comprises an output interface (4) for outputting the determined information characterizing the treatment plan for the refractive eye surgery to a user of the data processing device (1). [11] Data processing device (1) according to claim 9 or 10, wherein the output interface comprises a data output interface (10) configured to output a data signal comprising the determined information characterizing the treatment plan for the refractive eye surgery. [12] Data processing device (1) according to one of claims 9 to 11, wherein the device (1) is designed to determine a control signal for the laser based on the determined information characterizing the treatment plan for the refractive eye surgery and to output the determined control signal for controlling the laser to the laser via the output interface. [13] Data processing device (1) according to one of claims 5 to 12, wherein the device (1) is designed to access a plurality of different computer-implemented artificial intelligence-based models (5), by means of which the data processing device (1) is each designed to be based on: - the information identifying the patient, and - the information characterising the refractive error of the patient's eye to be treated by refractive eye surgery, the information characterising the treatment plan for the refractive eye surgery. [14] Device for data processing (1) according to claim 13, as far as it refers back to one of claims 6 to 8, wherein one or more of the models (5) is or are selectable via the input interface, optionally the input interface (6), of the device (1). [15] Computer-implemented method for training an artificial intelligence-based model (5), the method comprising training (S11 - S13, S15) the model such that the model (5) is configured after training to be based on: - information identifying a patient, and - information identifying a visual impairment of one of the patient's eyes that is to be treated by refractive eye surgery, to determine information identifying a treatment plan for the refractive eye surgery. [16] A computer-readable medium comprising a model (5) based on artificial intelligence, wherein the model (5) is designed to, when the model (5) is executed by a computer, cause the computer to do so by means of the model (5) based on: - information identifying a patient, and - information identifying a visual impairment of one of the patient's eyes that is to be treated by refractive eye surgery, information identifying a treatment plan for the refractive eye surgery.

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