ARRANGEMENT FOR LASER TREATMENT OF OPACIES

Description

[0001] The present invention relates to an arrangement for laser treatment of ocular opacities.

[0002] The vitreous consists of a mostly clear, gel-like substance inside the eye between the lens and the retina. When you are young, the vitreous is completely transparent and is in contact with the retina. As we get older, the vitreous liquefies and increasingly detaches from the retina, a process known as posterior vitreous detachment. This is a normal aging process that usually occurs after the age of 50. The detached parts of the vitreous collapse inside the eye, and the structural substances and condensations of the vitreous become visible to the patient. Because they can move across the field of vision, they are also known as floaters. Floaters are often caused by membrane-like structures on the posterior side of the vitreous after the detachment of the vitreous, and sometimes even by traces of blood if the vitreous detachment caused retinal injuries.In rarer cases, floaters can also occur as crystal-like precipitates in the vitreous body due to metabolic problems.

[0003] Even though floaters usually do not have a pathological cause, they are not as harmless as is generally assumed because they can sometimes significantly impair the quality of life and work productivity of those affected.

[0004] These opacities are particularly noticeable against a bright background, such as when working on a computer, reading, or looking at a blue sky or snow, and can impair vision. Floaters, which are thrown in and out of the central field of vision as a result of reading movements, can be particularly distracting.

[0005] Because they often resemble a "flying mosquito," they are described by the French term "floaters." However, these opacities can also have other shapes, such as branch-shaped, ring-shaped, or star-shaped, or even appear as dots. In the following, the term "floater" is used for the vitreous opacities to be treated, regardless of their type or shape.

[0006] Floaters generally do not disappear without treatment because the immune system does not recognize them as abnormal and therefore does not break them down. They are difficult for those affected to ignore or overlook. Certain types of floaters, such as those caused by blood residue after retinal hemorrhages, are partially reabsorbed by the body, although this often takes weeks or months.

[0007] In a vitrectomy, the eye is opened with cutting instruments, partially (core vitrectomy) or completely crushed, suctioned, and removed. This procedure is routinely performed for retinal detachments or exfoliation of epiretinal membranes, but is usually considered disproportionate to the treatment of localized vitreous opacities. Furthermore, vitrectomy is invasive, requires a hospital stay, and carries the risks associated with surgical intervention, particularly the frequent induction of cataracts, less frequently retinal detachment, and very rarely, but possibly, endophthalmitis.

[0008] Laser vitreolysis now offers a low-risk treatment alternative. Laser vitreolysis is a gentle, low-risk, and painless laser treatment that vaporizes or atomizes vitreous opacities without opening the eye.

[0009] During laser vitreolysis, short laser light pulses are directed at the vitreous opacities to achieve optical breakthrough or photodisruption due to the high laser intensity in the focal area. The floaters and the surrounding vitreous absorb the laser energy, forming a cutting or expanding laser plasma, which vaporizes and / or crushes the floaters, allowing them to dissolve. The treatment is relatively painless and carries no risk of infection. Laser vitreolysis is a safe procedure for the gentle treatment of bothersome vitreous opacities, provided it can be ensured that important and sensitive eye structures, such as the capsular bag, the crystalline lens, or areas of the retina, especially the macula, are not damaged by the laser.

[0010] However, the success of the treatment depends on the type of floaters. Treatment is particularly successful for so-called white rings. Tissue strands can be severed, and the dense tissue responsible for the disturbing shadows can be removed.

[0011] Floaters have been treated with YAG lasers (particularly Nd:YAG at 1064 nm) for over three decades (Brasse, K., Schmitz-Valckenberg, S., Jünemann, A. et al. Ophthalmologe (2019) 116: 73. https: / / doi.org / 10.1007 / s00347-018-0782-1). However, even with current high-end devices, only the anterior region of the vitreous can be treated with precision and accuracy. In the deeper vitreous region, these lasers are not precise enough. But this is precisely where most vitreous opacities are located, as they are often the result of posterior vitreous detachments. YAG lasers are frequently used in ophthalmology for iridotomy in glaucoma and for the treatment of after-cataracts, i.e., for the removal of opacities or even a after-cataract membrane on artificial lens implants due to cell overgrowth.Frequency-doubled YAG lasers with green laser radiation (532 nm) are also used for retinal coagulation, for example, in cases of hemorrhage or retinal detachment. Less commonly, YAG lasers are also used for phacoemulsification during cataract surgery, i.e., the liquefaction of the clouded and hardened natural lens. In this case, however, they are more likely to be used as Er:YAG lasers with a 2940 nm wavelength and higher water and tissue absorption, which then often requires a complex endoscopic laser insertion with mirror guidance into the eye.

[0012] According to the known state of the art, there are already numerous solutions for laser surgery of tissue of the eye, especially in the vitreous body.

[0013] For example, DE 10 2011 103 181 A1 describes a device and method for femtosecond laser surgery of tissue, particularly in the vitreous body of the eye. The device consists of an ultrashort pulse laser with pulse lengths in the range of approximately 10 fs-1 ps, in particular approximately 300 fs, pulse energies in the range of approximately 5 µJ-5 µJ, in particular approximately 1-2 µJ, and pulse repetition rates of approximately 10 kHz-10 MHz, in particular 500 kHz. The laser system is coupled to a scanner system that enables spatial variation of the focus in three dimensions. In addition to this therapeutic laser scanner optics system, the device also consists of a coupled navigation system.

[0014] US 2006 / 195076 A1 describes a system and method for making incisions in ocular tissue at various depths. The system and method focus light, possibly in a pattern, onto different focal points located at different depths within the ocular tissue. Using a segmented lens, multiple focal points can be created simultaneously. Optimal incisions can be achieved by focusing the light sequentially or simultaneously at different depths, creating an extended plasma column, and a beam with an extended waist. The techniques described here can also be used, among other things, to perform new ophthalmic procedures or improve existing procedures, including dissection of tissue in the posterior pole, such as floaters, membranes, and the retina.

[0015] US 2014 / 257257 A1 also describes a system and method for treating target tissue in the vitreous body of an eye, comprising a laser unit for generating a laser beam and a detector for generating an image of the target tissue. The system also includes a computer that defines a focal spot path for emulsifying the target tissue. A comparator connected to the computer then controls the laser unit to move the focal spot of the laser beam. This focal spot movement is performed to treat the target tissue while minimizing deviations of the focal spot from the defined focal spot path.

[0016] US 2015 / 342782 A1 also relates to a system and method for using a computer-controlled laser system to perform a partial vitrectomy of the vitreous body in an eye. Surgically, an optical canal is first defined through the vitreous body. Vitreous and suspended deposits (floaters) in the optical canal are then ablated and, in some cases, removed from the optical canal (e.g., aspirated). In some cases, a clear fluid may be introduced into the optical canal to replace the ablated material, thereby establishing unobstructed transparency in the optical canal. Generally, the present invention relates to systems for ophthalmic laser surgery. More specifically, the present invention relates to systems for using pulsed laser beams to remove so-called floaters.US 2018 / 028354 A1 also describes a method and system for an ophthalmic procedure on an eye. Undesirable features are identified using an image of at least part of the eye. Undesirable features in the vitreous cavity are vitreous opacities that impair vision, such as floaters. After the floaters are identified and localized by an image processing system, they are automatically "bombarded" with laser pulses following confirmation by a physician. The laser energy vaporizes at least part of a vitreous opacity. This process is repeated until the vitreous opacities are eliminated. The entire process is repeated for each vitreous opacities until the vitreous fluid is deemed sufficiently clear.

[0017] US 2019 / 105519 A1 discloses an ultrasound-based solution for cavitation eye treatment. The ultrasound beam, with a cross-sectional size within a range of approximately 50 µm to approximately 200 µm, can be focused and pulsed at any of several locations to provide a variety of cavitation zones at each of the target regions. The high-intensity focused ultrasound (HIFU) pulses can be configured to generate temporary cavitation, which can be helpful for tissue softening. For surgical tissue removal procedures, the intensity of the ultrasound beam can be set sufficiently high to allow visible cavitation of tissue.

[0018] Another laser-based solution for performing ophthalmological procedures on an eye to remove unwanted features is described in US 2018 / 028354 A1. Based on an image of at least part of the eye, a data processing unit determines the exclusion zone and identifies unwanted features. The data processing unit selects one of the unwanted features outside the exclusion zone to be removed. After confirmation of removal, a control unit controls a laser to remove at least part of the unwanted feature. The exemplary embodiments relate in particular to mechanisms for removing unwanted features in the vitreous cavity, such as floaters. With the solution disclosed here, a physician will be better and more easily able to remove vitreous opacities without surgery.

[0019] A procedure described by ELLEX (product brochure of Ellex Medical Pty Ltd.; "Tango Reflex - Laser Floater Treatment"; PB0025B; 2018; (http: / / www.ellex.com )) involves the use of a pulsed nanosecond laser (YAG) to break down vitreous opacities or completely eliminate them by converting them into a gas. A pilot laser beam is aimed at the target area (the floater) and then "bombarded" with one or more therapeutic laser pulses. Both the pilot laser beam and the therapeutic laser pulses are triggered manually by the user. This type of manual laser treatment typically consists of two individual treatments, each lasting 20-60 minutes.

[0020] The as yet unpublished applications DE 10 2019 007 147.6 and DE 10 2019 007 148.4 describe systems for laser vitreolysis of floaters, which enable the safe and precise atomization of vitreous opacities (floaters) based on a combination of a processing laser with an OCT or an OCDR system. An OCDR system (Optical Coherence Domain Reflectometry) is understood to be a system for the interferometric acquisition of one-dimensional scattering profiles, while OCT (Optical Coherence Tomography) refers to 2- or 3-dimensional imaging. In both cases, variants with recording sequences (i.e., film) are also intended to be included. Minimum distances to sensitive eye structures are ensured, and laser activation is preferably only permitted when the focus of the processing laser and the floater to be treated are positioned with sufficient accuracy relative to one another.

[0021] The disadvantage of both approaches is that the physician must constantly combine the familiar 2-dimensional frontal view of the eye with the 3-dimensional images of the OCT or OCDR system using his spatial imagination, which is extremely difficult in time-critical or rapid interactions with the patient.

[0022] The use of laser energy in laser vitreolysis is non-invasive and avoids the disadvantages of surgical procedures, but is also associated with disadvantages and risks.

[0023] This can make aiming the laser difficult. Because the physician is viewing the vitreous along the beam path, it can be difficult to determine the depth of the retinal position, the depth of the vitreous opacities, or other relevant features. As a result, there is a risk of missing the vitreous opacities and / or injuring the eye.

[0024] In particular, the treatment of floaters that are variable in position and difficult to detect and largely transparent, but which, as phase objects, can nevertheless create disturbing shadows on the retina, proves to be difficult.

[0025] The application of laser energy can also cause additional movement of the vitreous opacities, making treatment even more difficult. This may require the physician to realign the laser after each application of laser energy. This can be time-consuming. Therefore, laser treatment is laborious and stressful for both the patient and the physician.

[0026] Another potential problem is incomplete vitreous detachment, which can lead to local vitreotraction and even retinal detachment. Laser treatment in the vitreous can cause changes in the force balance within the vitreous due to the resulting shock waves, thereby causing tension in the retina, for example.

[0027] Ultimately, treating floaters located close to sensitive structures of the eye proves particularly difficult. Laser radiation can cause damage to the retina, lens, or macula.

[0028] The present invention is based on the task of developing a solution for laser treatment of ocular opacities that eliminates the disadvantages of known technical solutions and offers the possibility of easily combining 2-dimensional views of the eye with the 3-dimensional images of the measuring system, thus facilitating their handling for the operator. Furthermore, the solution should be easy to implement and cost-effective, enabling simpler, faster, and, above all, safer treatment of troublesome vitreous opacities using laser vitreolysis.

[0029] This object is achieved with the arrangement for laser processing of ocular opacities consisting of a measuring system for obtaining depth information of ocular structures, a laser system for comminuting ocular opacities with optical elements for coupling the measuring and laser systems, an eye tracker unit for detecting axial eye movements, a display unit and a control and operating unit, in that the measuring system is designed to provide depth information of ocular structures in the form of depth profiles, that the display unit is designed to display at least one 2D image of the eye as a live image, that the control and operating unit is designed to determine the depth position of ocular structures relative to the depth position of the laser focus from the depth profiles and to determine a no-go zone for laser processing, in particular for the retina and the capsular bag, and that the control and operating unit is further designed,to generate at least one marker each for the restricted zones of the retina and capsular bag and the laser focus, the characteristics of which correspond to the respective depth in the eye, in order to display these markers on the display unit and to overlay them with the live image.

[0030] The deflection unit can be implemented using known electromechanical deflection mirrors (e.g. galvo or MEMS scanners) or by simple manually operated deflection and / or shifting of the laser beam, for example using a hand-held contact glass and a movable and pivotable laser slit lamp.

[0031] According to the invention, the control and operating unit is designed to locate floaters and structures of the eye and, in particular, to determine a no-go zone for laser processing for the retina and capsular bag. Furthermore, the control and operating unit is designed to generate a marker, at least for the no-go zones of the retina and capsular bag and the laser spot, whose size corresponds to the respective depth information in the eye, in order to display these markers on the display unit and overlay them with the live image and / or the scan.

[0032] According to the invention, the object is achieved by the features of the independent claims. Preferred developments and refinements are the subject of the dependent claims.

[0033] A first advantageous embodiment concerns the measuring system for obtaining depth information of the eye, which is an OCDR or OCT system.

[0034] A second group of advantageous embodiments relates to the eye tracker unit, which uses as reference anterior eye areas, preferably iris, capsular bag, lens or front or back surface of the cornea, a contact lens or a reference marking set in the vitreous body by laser processing.

[0035] A third group of advantageous embodiments concerns the display unit, which is designed to display additional images, in particular the scan with the depth information of the eye and / or an overview of current settings and / or operating elements. Particularly advantageously, the display unit is a touchscreen.

[0036] Further advantageous embodiments relate to the control and operating unit, which is further designed to locate retinal landmarks, in particular the fovea, macula, optic nerve head or blood vessels, and to generate a marking in order to additionally display these on the display unit for the laser treatment.

[0037] The markings generated by the control and operating unit vary in color and / or structure. Particularly preferred is the marking generated for the laser spot changing its color and / or structure when the laser spot approaches or enters one of the restricted zones or retinal landmarks.

[0038] The control and operating unit is further configured to shut down the laser system when the laser focus approaches or enters one of the exclusion zones or retinal landmarks. Different tolerances for shutting down the laser system upon approach or entry can be assigned for the two exclusion zones and the retinal landmarks.

[0039] According to a particularly advantageous embodiment, the system for laser vitreolysis of vitreous opacities can be integrated into a slit lamp. The present invention relates to a system for laser treatment of ocular opacities. A partially automated therapy device (system) is proposed in which 2-dimensional views of the eye are combined with depth information (depth profiles) to facilitate its use by an operator in locating the floaters during treatment.

[0040] The invention is described in more detail below using exemplary embodiments. Figure 1: the representation of a fundus image with superimposed markings, Figure 2: the representation of a fundus image with superimposed markings at different focus positions of the laser spot and Figure 3: the representation of a scan with markings for the restricted areas and the laser spot.

[0041] The proposed arrangement for laser treatment of eye opacities Arrangement for laser vitreolysis of vitreous opacities consists of a measuring system for obtaining depth information of the eye, a laser system with deflection unit, optical elements for coupling the measuring and laser systems, an eye tracker unit, a display unit and a control and operating unit.

[0042] In particular, the measurement system is designed to provide depth information of the eye in the form of scans. Axial eye movements are detected and compensated by the eye tracker unit. The display unit is designed to display at least a 2D image of the eye as a live image. For the live image, refresh rates of 5 Hz, preferably 10 Hz, and particularly preferably 20 Hz, and latency times of <200 ms, preferably <100 ms, and particularly preferably <35 ms are used.

[0043] According to the invention, the control and operating unit is designed to determine the depth of eye opacities relative to the depth of the laser focus and to generate markers for the relative position of the eye opacities with respect to the laser focus and to display these markers on the display unit.

[0044] Furthermore, the control and operating unit is designed to localize structures of the eye in the scans provided by the measuring system and to determine a restricted zone for laser processing, particularly for the retina and capsular bag.

[0045] In particular, the control and operating unit is further designed to generate a marking at least for the restricted zones of the retina and capsular bag and the laser spot, the size of which corresponds to the respective depth information in the eye, in order to display these markings on the display unit and to overlay them with the live image.

[0046] By determining the position of the laser focus in relation to the eye structures to be protected, the doctor has the opportunity to manually treat floaters. The generated exclusion zones prevent the laser focus from entering these structures and potentially damaging them.

[0047] According to an advantageous embodiment, the control and operating unit is further designed to determine the depth of eye opacities relative to the depth of the laser focus and to generate markers for the relative position of the eye opacities with respect to the laser focus and to display these markers on the display unit.

[0048] By additionally determining the location of eye opacities (floaters) in relation to the eye structures to be protected or to the exclusion zones generated for these eye structures, it is possible to treat floaters automatically.

[0049] Manual treatment, which is also still possible, is simplified by the fact that the doctor can at least approximately estimate the position of the laser focus in relation to the floaters.

[0050] In the arrangement proposed here, an OCDR or OCT system is used as the measuring system for obtaining depth information of the eye, which is preferably combined with a YAG laser system with a deflection unit.

[0051] When using an OCDR system, an A-scan is taken, along with additional images of the fundus using an additional image acquisition unit. The position of the OCDR measurement beam relative to the fundus is known through calibration. Images of the fundus are preferably taken under IR or NIR illumination, between 780 nm and 1060 nm.

[0052] In contrast, an OCT system acquires a 3D volume scan, with the eye-tracking unit detecting and compensating for eye movements during the acquisition of the 3D volume scan. Compensation for eye movements is necessary because acquiring a 3D volume scan can take up to 2 seconds, and eye movements would cause the scans to be distorted.

[0053] While eye structures can be detected relatively easily in the OCDR or OCT signals, the situation is different with floaters.

[0054] Detection is preferably performed by first determining the scattered signal level of the vitreous body. Floaters are identified as structures that: have signal values ​​that are 2 dB, preferably 5 dB higher than the mean vitreous signal, have a minimum axial size, for example > 15 µm in tissue or an equivalent optical path with an assumed refractive index of 1.36 and in which signals still occur posteriorly at the level of the vitreous or whose signal characteristics correspond to known floaters stored in a database, whereby size or position relationships are used.

[0055] The eye tracker unit is designed to detect and compensate for axial eye movements.

[0056] The reference is particularly the anterior areas of the eye, preferably the capsular bag, lens or the front or back surface of the cornea.

[0057] Because the retina can be more shadowed by floaters, this is not typically used as a reference. Therefore, more anterior eye regions are preferred for tracking axial eye movement relative to floaters.

[0058] However, it is also possible to use the contact lens or a reference mark laser-cut into the glass body as a reference for the eye tracker unit. If the contact lens is to be used as a reference, referencing in the form of a functional coating is conceivable to enable stable tracking.

[0059] According to the invention, the display unit is designed to display, in addition to a 2D image of the eye as a live image, further images, in particular the scan with the depth information of the eye and / or an overview of current settings and / or control elements. It is particularly advantageous if the display unit is a touchscreen.

[0060] According to the invention, binoculars, 3D monitors, HMDs, or similar devices are also provided as display units. Furthermore, the design of the control and operating unit is essential to the invention. In particular, it generates markings for the restricted areas of the retina and capsular bag, as well as for the laser spot, in order to display these on the display unit and overlay them with the live image and / or scan. In particular, the floater itself can also be provided with a marking.

[0061] The control and operating unit is further designed to locate retinal landmarks, in particular the fovea, macula, optic nerve head or blood vessels, and to generate a marker for each of them in order to display them on the display unit if necessary and to overlay them with the live image and / or scan.

[0062] To avoid injury, the laser treatment can be interrupted if the laser beam is directed at one of the retinal landmarks.

[0063] Furthermore, the invention provides for monitoring local changes in the height of the retina, for which purpose critical local areas can also be marked as described in order to avoid tensions that could cause retinal detachments during further laser treatment.

[0064] According to the invention, the markings generated by the control and operating unit differ in terms of color and / or structure.

[0065] The Figure 1 The representation of a fundus image with superimposed markings, where both the fundus image and the markings are actually colored. From outside to inside, the markings indicate: capsular bag 1, anterior exclusion zone boundary 2, Laser focus 3, Floaters 4, posterior exclusion zone boundary 5, retina 6 and laser direction 7.

[0066] Furthermore, the marking generated by the control and operating unit for the laser spot changes its color and / or structure when the laser spot approaches one of the exclusion zones or retinal landmarks.

[0067] It is also possible to warn the operator acoustically and / or visually when the laser focus approaches or enters one of the exclusion zones or retinal landmarks, or to switch off the laser system.

[0068] The Figure 2 The representation of a fundus image with superimposed markings at different focal positions of the laser spot, whereby both the fundus image and the markings are actually colored. For better clarity, only the markings for the retina are shown in the fundus images shown here. 6, the laser focus 3 and the capsular bag 1 While in the two upper images a laser treatment is possible because the laser focus3 in the "safe" area between retina 6 and capsular bag 1 In contrast, in the two lower images, laser treatment is not possible because the laser focus 3 too close to the retina 6 or the capsular bag 1 and is located in their respective restricted zones (not shown).

[0069] The Figure 3 shows a scan with markings for the restricted areas and the laser spot. From this representation of the depth scan 9 The user can quickly and reliably determine the depth at which the laser focus is 3 in relation to the retina 6 and the lens 8 (or the capsular bag 1) In addition, the posterior exclusion zone 5 and the anterior restricted zone 2 shown.

[0070] Furthermore, the control and operating unit is designed to assign different tolerances for the approach for both exclusion zones as well as the retinal landmarks.

[0071] In a particularly advantageous embodiment, the system for laser vitreolysis of vitreous opacities is integrated into a slit lamp. However, the laser vitreolysis concept proposed here can also be applied to surgical microscopes in a similar way.

[0072] The proposed arrangement is also suitable for displaying a kind of treatment history, for example, by marking and storing shot depths and positions. It is also possible to display the gradual change in the position of floaters (as a trajectory) and retinal sections during step-by-step laser firing (marking local elevations).

[0073] The inventive solution provides a system for laser treatment of ocular opacities that eliminates the disadvantages of known technical solutions and offers the possibility of easily combining 2-dimensional views of the eye with the 3-dimensional images of the measuring system, thus facilitating their handling for the operator. Furthermore, the solution is easy to implement and cost-effective, enabling simpler, faster, and, above all, safer treatment of troublesome vitreous opacities through laser vitreolysis.

[0074] According to the invention, the depth information obtained from OCDR or OCT systems regarding the position of sensitive eye structures, the laser focus and the possibly moving floater to be treated are processed in such a way that they can be combined with the 2D view familiar to the physician in an intuitively processable manner.

Claims

1. Arrangement for laser treatment of eye opacification, consisting of a measuring system for obtaining depth information relating to eye structures, a laser system for comminuting eye opacification and having optical elements for coupling the measuring and laser system, an eye tracker unit for detecting axial eye movements, a display unit, and a control and operating unit, characterized in that the measuring system is designed to make available depth information relating to eye structures in the form of depth profiles, in that the display unit is designed to display at least one 2-D image representation of the eye as a live image, in that the control and operating unit is designed to determine the depth of eye structures relative to the depth of the laser focus from the depth profiles and to determine an exclusion zone for laser treatment, for the retina and the capsular bag, and in that the control and operating unit is further designed to generate at least one marking for at least each of the exclusion zones of the retina and capsular bag and the laser focus, the characteristics of which markings correspond to the respective depth in the eye, in order to display these markings on the display unit and overlay these on the live image.

2. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to determine the depth of eye opacification relative to the depth of the laser focus and to generate markers for the relative position of eye opacification in relation to the laser focus and to display these markings on the display unit.

3. Arrangement according to Claim 2, characterized in that the control and operating unit is designed to vary the characteristics of the marking to be generated with regard to colour, shape, numerical value of the depth, but preferably with regard to its size.

4. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to generate the markings with depth-dependent size for retina, capsular bag, lens, laser focus, eye opacification in such a way that the markings are arranged, preferably centred, around the lateral laser focus position.

5. Arrangement according to Claim 1, characterized in that the eye tracker unit is designed to compensate for axial eye movements.

6. Arrangement according to Claim 1, characterized in that the one 2-D image representation is an en face image representation of the posterior segment of the eye which is displayed as a live image with a refresh rate of 5 Hz, preferably 10 Hz, and particularly preferably 20 Hz, and a latency <200 ms, preferably <100 ms and particularly preferably <35 ms.

7. Arrangement according to Claim 1, characterized in that the measuring system for obtaining depth information of the eye is an OCDR system.

8. Arrangement according to Claim 1, characterized in that anterior regions of the eye, preferably the capsular bag, lens or front or back surface of the cornea, serve as a reference for the eye tracker unit.

9. Arrangement according to Claim 1, characterized in that a contact glass or a reference marking placed in the vitreous humour by laser treatment serves as a reference for the eye tracker unit.

10. Arrangement according to Claims 1 and 6, characterized in that the OCDR system is designed to record an A-scan and in that there is also an image recording unit for making recordings of the fundus, with the position of the OCDR measuring beam in relation to the fundus being known through calibration.

11. Arrangement according to Claims 1 and 6, characterized in that the OCT system is designed to record a 3-D volume scan and the eye tracker unit is designed to compensate for eye movements detected during the recording of the 3-D volume scan.

12. Arrangement according to Claim 1, characterized in that the display unit is designed to display further image representations, in particular the scan with the depth information of the eye and / or an overview of current settings and / or operating elements.

13. Arrangement according to Claims 1 and 11, characterized in that the display unit is a touch screen.

14. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to display on the display unit the markings generated for the exclusion zones of the retina and capsular bag and for the laser focus and to overlay these on the scan.

15. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to localize retinal landmarks, in particular the fovea, macula, optic nerve head or blood vessels, and to generate a marking for the retinal landmarks.

16. Arrangement according to Claim 2, characterized in that the markings generated by the control and operating unit differ in terms of colour and / or structure.

17. Arrangement according to Claim 1, characterized in that the marking generated by the control and operating unit for the laser spot changes its colour and / or structure when the laser spot approaches one of the exclusion zones or retinal landmarks.

18. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to warn the operator acoustically and / or optically when the laser system approaches one of the exclusion zones or retinal landmarks.

19. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to switch off the laser system should the latter approach or enter one of the exclusion zones or retinal landmarks.

20. Arrangement according to Claim 1, characterized in that the control and operating unit is designed to be able to assign different tolerances for switching off the laser system when approaching the two exclusion zones and the retinal landmarks.

21. Arrangement according to claim 1, characterized in that the arrangement for laser vitreolysis of vitreous humour opacification is able to be integrated into a slit lamp.