Ophthalmic laser system and method for visualizing a patient's eye

Abstract

The invention relates to a method (400) for visualizing a patient's eye (12) using a contact element (16) of an ophthalmic laser system (10). The method (400) has the steps of illuminating (402) the patient's eye (12) with visible light and infrared light and imaging (404) the illuminated eye (12) onto a detector by means of the contact element (16), said detector being designed to detect the visible light and the infrared light. The method (400) is characterized in that the method (400) additionally has the steps of ascertaining (406) the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12) in the detected image of the patient's eye (12) using the detected infrared light and displaying (408) the image of the patient's eye (12) illuminated by the visible light, wherein the structure, ascertained using the detected infrared light, in and / or on the patient's eye (12) and / or the position of the structure in or on the patient's eye (12) is identified in the display.

Description

[0001] OPHTHALMIC LASER SYSTEM AND METHOD FOR VISUALIZING A PATIENT'S EYE

[0002] Provided are a method for visualizing a patient's eye using a contact element of an ophthalmic laser system, a control device for an ophthalmic laser system, and an ophthalmic laser system for refractive surgical treatment of a patient's eye. The embodiments thus lie particularly in the field of ophthalmic laser systems for refractive surgery.

[0003] Refractive surgical treatments are often performed using a procedure known as SMILE (Small Incision Lenticle Extraction). This involves using laser radiation, optionally femtosecond laser pulses, to extract a lenticule from the surrounding cornea. The lenticule can then be manually removed by a physician. To create the incisions using the laser radiation, a device-patient interface, also known as a contact lens, is usually brought into contact with the eye to fix the eye relative to the laser system. The fixation of the contact lens to the eye typically must be in the correct position and with the correct orientation relative to the patient's cornea in order to perform a correct treatment. For this purpose, the contact lens is moved from an initial position to a working position, i.e. into contact with the patient's cornea.This typically requires the physician to align the center of the contact lens with the planned treatment center of the cornea so that they align. The physician is typically assisted by camera images that capture the eye through the contact lens, as well as a software algorithm that attempts to identify the patient's pupil based on image analysis of the camera images. If the pupil is successfully identified, it provides the physician with position information to assist in centering. Thus, the challenge for both the physician and the software algorithm is to identify the patient's pupil early and, above all, correctly.

[0004] Traditionally, the user, i.e., the physician, is provided with two separate lighting options, in the form of two lighting modes. The first mode, "white light" (VIS), features the typical white light LED spectrum, which results in true-color image reproduction. "Infrared" (IR), the second lighting mode, includes a color spectrum in the infrared spectral range.

[0005] The IR mode allows the pupil to be imaged with high contrast, as even a dark iris appears bright under IR illumination. The VIS mode, on the other hand, allows for color fidelity as well as higher resolution and scattering due to the shorter wavelengths in the spectrum.

[0006] Since conventional observation optics are typically not chromatically compensated across the entire spectral range, dispersion between the VIS and IR illumination is generally not negligible. This can result in the image plane of the sharpest image shifting from VIS to IR to greater depths.

[0007] The VIS mode is conventionally selected when contamination on the contact lens, liquid-air boundaries at the contact between the eye and contact lens (meniscus) and / or the cutting pattern (bubble formation) resulting from the laser treatment are to be observed using the co-observation option through a laser lens of the laser system.

[0008] However, this form of illumination is of limited use for pupil detection, as the contrast between the pupil and iris is very low, especially in eyes with very dark brown irises, which can make detection difficult. Infrared illumination can offer advantages for pupil detection, as infrared illumination can display the pupil-iris contrast for each individual iris color with greater contrast than is possible with VIS illumination. For this reason, the physician frequently switches between VIS mode and IR mode when attempting to center the contact lens on the eye.

[0009] For example, DE 10 2010 012 616 A1 describes a laser system which, in addition to illumination with visible light, also offers a separate mode for illumination with infrared light.

[0010] US Patent No. 10,888,458 B2 describes a surgical microscope with a visible-light camera and an infrared-light camera. The infrared-light camera can be used to detect a scanning OCT measurement beam during surgery.

[0011] US 2005 / 0119642 A1 describes a system for detecting and tracking an eye's position. Different parts of the eye are illuminated with light of different wavelengths, and the detected light is used to determine the eye's position.

[0012] The object is to provide an ophthalmic laser system and a method for visualizing a patient's eye through a contact element, which is suitable for enriching the state of the art.

[0013] The object is achieved by a method, a control device, and an ophthalmic laser system having the features of the respective independent claims. Optional embodiments are specified in the subclaims and in the description.

[0014] A method is provided for visualizing a patient's eye through a contact element of an ophthalmic laser system. The method comprises illuminating the patient's eye with visible light and infrared light, and imaging the illuminated patient's eye through the contact element onto a detector configured to detect the visible light and the infrared light.The method further comprises determining a structure in and / or on the patient's eye and / or a position of the structure in and / or on the patient's eye, which may optionally comprise or be designed as a pupil and / or iris of the patient's eye, in the detected image of the patient's eye using the detected infrared light, and displaying the image of the patient's eye illuminated with the visible light, wherein the structure in and / or on the patient's eye determined using the detected infrared light and / or a position of the structure in and / or on the patient's eye are identified in the display.

[0015] Furthermore, a control device for an ophthalmic laser system with a contact element and at least one light source for illuminating a patient's eye is provided. The control device is configured to control the at least one light source such that the at least one light source illuminates the patient's eye with visible light and infrared light, and to control a detector of the ophthalmic laser system such that the detector detects the visible light and the infrared light of an image of the illuminated patient's eye.In addition, the control device is further configured to determine a structure in and / or on the patient's eye and / or a position of the structure in and / or on the patient's eye in the image of the patient's eye detected by the detector based on the detected infrared light, and to output a signal for a display unit for displaying the image of the patient's eye illuminated with the visible light such that the structure in and / or on the patient's eye determined based on the detected infrared light and / or the position of the structure in and / or on the patient's eye determined based on the detected infrared light are identified in the display.Furthermore, an ophthalmic laser system for the refractive surgical treatment of a patient's eye is provided, wherein the ophthalmic laser system comprises at least one light source for illuminating the patient's eye with visible light and with infrared light, as well as an optical system and a detector, wherein the optical system is configured to image the illuminated patient's eye onto the detector through a contact element, and wherein the detector is configured to detect the visible light and the infrared light.The control device is configured to determine a structure in and / or on the patient's eye and / or a position of the structure in and / or on the patient's eye in a detected image of the patient's eye based on the detected infrared light, and to output a signal for a display unit for displaying an image of the patient's eye illuminated with the visible light such that the structure in and / or on the patient's eye determined based on the detected infrared light and / or the position of the structure in and / or on the patient's eye determined based on the detected infrared light are identified in the display.

[0016] The features and embodiments mentioned above and explained below are not only to be regarded as disclosed in the respective explicitly mentioned combinations, but are also encompassed by the disclosure content in other technically meaningful combinations and embodiments.

[0017] A visualization of the patient's eye can comprise a representation of an image of the patient's eye for a doctor and / or other user of the ophthalmic laser system. In addition to the representation of the image, the visualization can comprise a representation of further content, wherein the representation of the further content can occur together with the representation of the image. Optionally, the displayed image can be enriched with further information which does not necessarily directly form a part of the image and / or is not directly derived from the image. The representation of the image can optionally comprise a representation of a mixed image, wherein the mixed image can be formed partly from the image of the patient's eye illuminated with visible light and partly from the image of the patient's eye illuminated with infrared light.Optionally, a mixed image can be composed of a larger energetic portion from the image of the patient's eye illuminated with visible light and a smaller portion from the image of the patient's eye illuminated with infrared light. Optionally, the energetic portion of the image of the patient's eye illuminated with visible light can be around 85% and the portion of the image of the patient's eye illuminated with infrared light can be around 15%. Optionally, the representation of the image can have a different spectral composition than the captured image of the patient's eye illuminated with visible light. Optionally, the mixed image can have a larger portion of red spectral components than the image of the patient's eye illuminated with visible light. This can give the viewer the impression of a reddish discoloration of the image of the patient's eye.Nevertheless, the display can be designed in such a way that a user can reliably identify all structures essential for surgical treatment, such as dust particles, contaminants, the meniscus, and / or a reflection of the contact lens on the cornea. The light used to illuminate the patient's eye with visible light can optionally have a spectral maximum in the blue and / or green spectral range. The additional spectral components from the infrared illumination, however, can shift the spectral maximum of a composite image toward longer wavelengths, for example, into the red spectral range.

[0018] Refractive surgery can involve treating a patient's eye with a laser beam to specifically alter the patient's optical properties. In particular, refractive surgery can involve SMILE (small incision lenticle extraction) treatment, in which a laser beam is used to extract a lenticule from the cornea with one or more incisions according to patterned cuts. The lenticule can then be surgically removed from the cornea.

[0019] An ophthalmic laser system can be a laser system for performing surgical treatments on a human or animal eye. The ophthalmic laser system can be referred to as a refractive surgical laser system. The ophthalmic laser system can be designed to perform a surgical treatment on a patient's eye docked to the laser system using a laser beam. The ophthalmic laser system can be designed so that the laser beam passes through a contact element in order to surgically treat an eye docked to the contact element using the laser beam. The ophthalmic laser system can have a laser source designed to emit a cw laser beam, i.e., a continuous wave laser beam, and / or to emit a laser beam in the form of a pulse train of femtosecond laser pulses.

[0020] A contact element can represent a patient interface by means of which the patient's eye to be treated can be docked to the ophthalmic laser system. The contact element can be designed to fix the patient's eye relative to the laser system in order to reduce or eliminate any possible relative movement of the patient's eye relative to the laser system and vice versa during treatment. The contact element can optionally be referred to using the terms "contact lens" and / or "patient interface" commonly used in the art.

[0021] Illuminating the patient's eye with visible and infrared light can mean that visible and infrared light is shone onto the patient's eye in order to capture a reflection of the shone light on and / or in the patient's eye as part of an image. Imaging the illuminated patient's eye through the contact element onto a detector can mean that an optical image of an object plane, which at least partially captures the patient's eye, is created onto an image plane in which the detector is arranged. This can include, among other things, capturing the light with which the patient's eye is illuminated and which is reflected in and / or on the patient's eye. The fact that the image is taken through the contact element means that the beam path of the light passes through the contact element during the image.Optionally, the contact element can have a refractive and / or diffractive effect, which contributes to the imaging or is taken into account in the imaging. Optionally, dispersive optical properties of the contact element can be used to achieve different focal lengths for the visible light and the infrared light. Optionally, a chromatic aberration of the contact element can be used to sharply image the visible light in a different object plane, i.e., in a different plane in the patient's eye, than the visible light. Optionally, exclusively dispersive optical properties of the contact element and / or one or more other optical elements in the beam path of the imaging can be used to achieve the imaging of the visible light and the infrared light with different focal lengths.In other words, the different focal lengths for visible light and infrared light can optionally be provided partially or exclusively by the optical properties of the contact element.

[0022] The fact that the detector is designed to detect visible and infrared light can mean that the detector can provide a detector signal based on the visible and infrared light incident on the detector, which can optionally be further processed electronically. The detector can optionally have an array of pixels to capture the light imaged onto the detector. The pixels can be sensitive to both visible and infrared light. Alternatively or additionally, the detector can have several separate arrangements of pixels, some of which are sensitive to visible light and others to infrared light. The different pixels can be arranged in one array or in separate arrays.

[0023] The determination of the structure in and / or on the patient's eye, which may optionally include or be configured as a pupil and / or iris of the patient's eye, in the detected image of the patient's eye can be carried out by means of image analysis. A computer program can be used to determine one or more parts in the detected image that can be assigned to the structure in and / or on the patient's eye with at least a predetermined probability. The determination of the structure in and / or on the patient's eye can optionally include determining a position and / or orientation and / or extent of the structure in and / or on the patient's eye.

[0024] The structure in and / or on the patient’s eye can represent a structural feature of a tissue in and / or on the patient’s eye and / or an element of the patient’s eye that can be captured by means of the image of the patient’s eye. When illuminated with infrared light, the structure in and / or on the patient’s eye can have a particularly pronounced contrast to the surroundings of the structure in and / or on the patient’s eye, so that the structure in and / or on the patient’s eye can be particularly clearly visible when illuminated with infrared light. Optionally, the structure in and / or on the patient’s eye can be the iris and / or the pupil of the patient’s eye or parts thereof. Optionally, the structure in and / or on the patient’s eye can comprise the iris and / or pupil of the patient’s eye. When illuminated with infrared light, the iris can appear particularly high-contrast and / or be particularly clearly visible.

[0025] The fact that the structure in and / or on the patient's eye, optionally the pupil and / or iris, and / or a position of the structure in and / or on the patient's eye, optionally a position of the pupil and / or iris, determined using the detected infrared light are identified in the representation of the image of the patient's eye illuminated with visible light means that the representation of the image can be enriched and / or overlaid with information determined using the detected infrared light. Thus, the representation can contain both information determined using the detected visible light and information determined using the detected infrared light.

[0026] The control device can be part of a laser system or be included in the laser system. The control device can be, for example, an electronic control unit (ECU) and / or a computer. The control device can optionally include a processor and a data memory, as well as one or more modules for communicating with other components of the laser system and / or external to the laser system.

[0027] The disclosure offers the advantage that the representation of the image of the patient's eye illuminated with visible light and the identification of the structure in and / or on the patient's eye, optionally the iris and / or pupil, can be carried out simultaneously and continuously updated in the representation. This offers the advantage that the information obtained by illumination with visible light and by illumination with infrared light can be displayed to the physician simultaneously. In this way, the physician continuously receives a comprehensive picture of the current positioning of the contact lens relative to the patient's eye and an improved representation of the structure in and / or on the patient's eye, optionally the pupil and / or iris, without having to regularly switch between different illumination modes.This can facilitate handling of the ophthalmic laser system and in particular centering and / or docking of the laser system on the patient's eye. Optionally, this can reduce the time required for the centering process and / or a docking process and thus increase patient tolerance and / or efficiency of the ophthalmic laser system. The structure in and / or on the patient's eye can optionally include the pupil and / or iris of the patient's eye and / or be present in the pupil and / or iris. This can offer the advantage that the structure in and / or on the patient's eye appears particularly high-contrast when illuminated with infrared light and, accordingly, the position of the iris and / or pupil can be determined particularly reliably.In addition, this can offer the advantage that determining the exact position of the iris and / or pupil can be of great importance in refractive surgical treatments in order to achieve and / or verify correct alignment of the ophthalmic laser system or contact lens relative to the patient's eye.

[0028] Alternatively or additionally, the structure in and / or on the patient's eye may comprise an intracorneal foreign body. Optionally, the intracorneal foreign body may comprise a graft, an implant, such as an intraocular lens, and / or a contrast agent for visualizing incisions. Alternatively or additionally, the structure in and / or on the patient's eye may comprise an irregularity of the patient's eye, such as a scar and / or swelling of tissue of the patient's eye. This offers the advantage that such structures in and / or on the eye can exhibit a pronounced contrast with the surrounding tissue of the eye when illuminated with infrared light.

[0029] The patient's eye can be illuminated with visible and infrared light at least partially simultaneously and optionally completely simultaneously. "Completely simultaneously" can mean that the patient's eye is illuminated with infrared light throughout the entire time the patient's eye is illuminated with visible light and / or vice versa. Optionally, the illumination of the patient's eye with infrared light can completely overlap in time with the illumination of the patient's eye with visible light. This offers the advantage that the light required for imaging the patient's eye illuminated with visible light and for determining the structure in and / or on the patient's eye can be provided simultaneously. This can eliminate the need to switch between any different light sources for visible light and infrared light.Optionally, with simultaneous illumination with visible and infrared light, the spectral ranges can be mixed in such a way that they are optimized for a planned examination of the objects to be examined in the eye. The mixed illumination spectrum can be adjusted depending on the object being observed. Optionally, the spectral composition, particularly the proportion of visible light or infrared light, can be adjusted in such a way that the contrast of the image is automatically improved or optimized. Optionally, the ophthalmic laser system can be designed to perform real-time contrast control using a variable spectral composition of the illumination light.

[0030] Optionally, the spectral composition of the illumination light can also be influenced in such a way that radiation exposure to the patient's eye and, optionally, heat input into the patient's eye by the illumination light can be kept to a minimum.

[0031] Optionally, the visible light and / or the infrared light can be spectrally adapted to the detector used.

[0032] Illuminating the patient's eye and / or imaging the illuminated patient's eye onto the detector can comprise spectral filtering, such that the visible light is blocked for at least one acquired image and the infrared light is blocked for at least one further image. This can offer the advantage that only one of the two spectral channels can be acquired with one and the same detector, i.e. either the visible light or the infrared light. In this way, the measurement signals acquired by the detector can be assigned to the respective spectral range. The detector can have at least one separate color channel for detecting the visible light and at least one separate color channel for detecting the infrared light. This can enable correct assignment of the detected intensities orThe light quantities for the respective spectral ranges can be achieved even when the light from both spectral ranges hits the detector simultaneously. This allows both pieces of information to be captured simultaneously. Optionally, the analysis of the acquired image data in the respective color channels can be influenced by the object to be detected. Optionally, individual color channels or combinations thereof can be used for the analysis of the acquired image data. Optionally, the representation of the patient's eye can be based on individual color channels or a combination thereof.

[0033] The visible light can comprise white light and optionally cover a spectral range from 400 nm to 500 nm, optionally from 400 nm to 600 nm, and optionally from 380 nm to 700 nm. This can offer the advantage of enabling a true-color representation of the eye. The white light can optionally have a continuous spectrum. Alternatively, the white light can be provided by individual discrete spectral components, such as red, green, and blue light, which together result in a white illumination spectrum. A visible light spectrum of approximately 380 nm to 700 nm can offer the advantage of particularly good detection of dust particles on the contact element or at the contact surface between the contact element and the eye and / or the laser cuts generated by the femtosecond laser in the form of a carpet of air bubbles being particularly clearly visible.

[0034] The infrared light can have at least one spectral component in a spectral range from 700 nm to 1000 nm and optionally in a spectral range from 700 nm to 800 nm. This can offer the advantage that infrared light in this spectral range can be used to achieve a high-contrast image of the structure in and / or on the patient's eye, optionally the iris. Furthermore, this can offer the advantage that the infrared light in this spectral range can optionally be detected using the same detector that is used to detect visible light. Optionally, this can be achieved using a silicon-based detector, such as a CCD detector and / or a CMOS detector. This can thus offer the advantage of eliminating the need to provide multiple different detectors for different spectral ranges.

[0035] The patient's eye can be illuminated, at least in part, by alternating illumination with visible light and infrared light. The time interval between the start of illumination with visible light and infrared light can be 10 s or less, and optionally 1 s or less. This can offer the advantage that illumination with visible and infrared light can occur at very short intervals. This makes it possible to regularly capture images with both visible light and infrared light at short intervals, and accordingly, to continuously capture both pieces of information and update the display. Accordingly, a constantly updated display of the patient's eye can be created based on both pieces of information, without necessarily requiring spectral filtering and / or multiple different detectors.

[0036] Image capture by the detector can be synchronized with the illumination of the patient's eye in such a way that at least one image of the patient's eye is captured by the detector when illuminated exclusively with visible light, and one image of the patient's eye is captured by the detector when illuminated exclusively with infrared light. In other words, image capture and illumination can be coordinated in such a way that the captured images can be precisely assigned to the spectral ranges of the patient's eye's illumination. The imaging of the illuminated patient's eye onto a detector can be performed in such a way that the visible light and the infrared light have different focal planes on the object side. This can offer the advantage that the different spectral ranges can be focused or sharply brought into focus on different objects in and / or on the patient's eye.Optionally, a dispersion of the contact element can be used, which can have a higher refractive index for shorter wavelengths, i.e. in this case the visible spectral range, than for longer wavelengths, i.e. in this case the infrared spectral range. This can help to achieve a longer focal length for infrared light than for visible light. The focal plane of the visible light can optionally at least partially capture the cornea of ​​the patient's eye. Optionally, the focal plane of the infrared light can at least partially capture the structure in and / or on the patient's eye, optionally the iris. This thus offers the advantage that different regions of the patient's eye are sharply imaged for those spectral ranges in which information is to be collected by the illuminating light primarily using the respective spectral range.

[0037] Optionally, the different focal planes can be created at least partially and optionally completely on the basis of a chromatic aberration of the contact element. This offers the advantage that the optical properties of the contact element can be used to create the different focal planes. This can offer the advantage that, optionally, no further optical elements and / or adjustments are absolutely necessary to provide the different focal planes. The chromatic aberration of the contact element can be adjusted in such a way that the focal plane of the visible light at least partially covers the cornea of ​​the patient's eye and / or the focal plane of the infrared light at least partially covers the structure in and / or on the patient's eye. Optionally, dispersive optical properties of the contact element can therefore be used to create different focal lengths orTo achieve focal planes for the visible light and the infrared light. Optionally, a chromatic aberration of the contact element can be used to sharply image the visible light in a different object plane, i.e., in a different plane in the patient's eye, than the visible light. Optionally, exclusively dispersive optical properties of the contact element and / or one or more other optical elements in the beam path of the imaging can be used to achieve the imaging of the visible light and the infrared light with different focal lengths. In other words, the different focal lengths for the visible light and the infrared light can optionally be provided partially or exclusively by the optical properties of the contact element.Optionally, refractive and / or diffractive properties of the contact element can be used to provide the different focal lengths for visible light and infrared light.

[0038] Alternatively, the optical system can be designed such that all the light from an object plane is imaged to an image plane.

[0039] The at least one light source can comprise at least a first light source for providing exclusively visible light and / or a second light source for providing exclusively infrared light. This can offer the advantage that both light sources can be precisely tuned to the respective spectral range. Furthermore, this can offer the advantage that the selective activation and / or deactivation of the illumination with the visible light or the infrared light can be facilitated and can be implemented independently of each other.

[0040] The first light source may comprise a light-emitting diode configured to emit white light and / or provide multiple emission wavelengths in a spectral range from 400 nm to 500 nm and optionally from 400 nm to 600 nm. Alternatively, the first light source may be configured to provide an emission spectrum covering the spectral range from 400 nm to 500 nm and optionally from 400 nm to 600 nm.

[0041] The second light source may comprise a light-emitting diode configured to provide a spectral component in a spectral range from 700 nm to 1000 nm and optionally in a spectral range from 700 nm to 800 nm. Alternatively or additionally, the second light source may be configured to provide an emission spectrum covering the spectral range from 700 nm to 800 nm and optionally from 700 nm to 1000 nm.

[0042] Optionally, the at least one light source can comprise at least one spectrally broadband light source configured to provide visible light and infrared light. In other words, the light source can be configured to have such a broadband emission spectrum that both visible light and infrared light can be provided by the light source. Optionally, spectral filters can be used to spectrally isolate only the visible light or only the infrared light, if required, and use it as illumination light. Alternatively or additionally, if required, the eye can be illuminated with both visible light and infrared light, and the light reflected from the eye, which is imaged onto the detector, can be spectrally filtered.

[0043] The optical system can comprise a camera. The detector can form part of the camera. Optionally, the camera can be a digital camera, i.e. a camera in which images are captured using an electronic detector. The detector can optionally be designed as a CMOS or CCD array or comprise such a device. Optionally, the camera and / or the detector can be integrated into a confocal image capture system of the ophthalmic laser system. The optical system can be designed such that the visible light and the infrared light have different focal planes on the object side. Optionally, the focal plane of the visible light can at least partially capture the cornea of ​​the patient's eye and / or the focal plane of the infrared light can at least partially capture the structure in and / or on the patient's eye, optionally the iris.This can offer the advantage that the different spectral ranges of the illuminating light can be focused on those structures of the patient's eye which are to be identified by illumination with the illuminating light of the respective spectral range.

[0044] The optical system can comprise a contact element for coupling the patient's eye to the ophthalmic laser system. The contact element can also be referred to as a contact glass and correspond to a conventional contact glass known in the art. The contact element, and optionally an optical element of the contact element, can optionally be made of glass or another optically transparent material, such as a plastic, such as PMMA. Optionally, the contact element can have normal dispersion, i.e. the refractive index of the contact element is higher for shorter wavelengths than for longer wavelengths. Accordingly, the contact element can have a higher refractive index for the visible illumination light than for the infrared illumination light. This can lead to the visible light being sharp or blurred in a different object plane when the detector is focused.is focused than the infrared illumination light. Due to normal dispersion, a plane of maximum sharpness for the infrared illumination light can be further away from the detector than a plane of maximum sharpness for the visible illumination light. The dispersive properties of the contact element can therefore help to sharply image the cornea of ​​the patient's eye with the visible illumination light and to sharply image the structure in and / or on the patient's eye, optionally the iris or pupil of the patient's eye, with the infrared illumination light. Optionally, the ophthalmic laser system can have one or more spectral filters. These can be used to spectrally filter part of the illumination light incident on the eye and / or part of the light imaged from the eye onto the detector.Optionally, a spectral filter can be configured to transmit infrared light and reflect and / or absorb visible light, or vice versa. A spectral filter can optionally comprise a stained-glass filter and / or an interference filter, or be configured as one of the aforementioned filter types. The ophthalmic laser system can optionally be configured to move the one or more spectral filters and, optionally, to arrange them in the beam path for spectral filtering of the light or to remove them from the beam path as needed.

[0045] The ophthalmic laser system can further comprise a femtosecond laser for refractive surgical treatment of the patient's eye. Optionally, the ophthalmic laser system can be configured to perform a refractive surgical SMILE treatment of the patient's eye, in which a lenticule is removed from the patient's eye, which is docked to the laser system via the contact element, using femtosecond laser pulses.

[0046] Optionally, recognition of the structure in and / or on the patient's eye, optionally the iris and / or pupil, can be performed at least partially automatically, for example, using a computer-implemented method. Optionally, the control device can be configured to recognize the structure in and / or on the patient's eye in the acquired image data. This can reduce the workload for the physician or operator of the ophthalmic laser system.

[0047] Optionally, the image of the patient's eye illuminated with visible light is displayed in such a way that, apart from identifying the structure in and / or on the patient's eye determined using infrared light and / or the position of the structure in and / or on the patient's eye, no further preprocessing of the acquired image data takes place. This can offer the advantage that the image can be displayed very quickly, i.e., displayed with a very short time delay relative to the acquisition of the image, and accordingly, optionally, the image can be displayed in real time, i.e., the user optionally does not notice any time delay between the detection or acquisition of the image with the detector and the display of the image.Optionally, image data based on the captured image can be submitted to automated further processing and / or evaluation in parallel with the image display, which can optionally be performed using one or more image processing algorithms. This can offer the advantage that, in addition to displaying the image with its structure identified, further information can be extracted from the image in an automated manner.

[0048] Optionally, the energy share of the image of the patient's eye illuminated with visible light is approximately 85% and the energy share of the image of the patient's eye illuminated with infrared light is approximately 15%.

[0049] Optionally, the method further comprises adjusting a spectral composition by adjusting a proportion of the visible light and / or the infrared light in such a way that a contrast of the image is thereby improved or optimized. Adjusting the spectral composition can optionally comprise real-time contrast control based on a variable spectral composition of the illumination light.

[0050] Optionally, the structure in and / or on the patient's eye and / or the position of the structure in and / or on the patient's eye in the detected image of the patient's eye can be determined using the detected infrared light by means of image analysis. The image analysis can be performed using a computer program and optionally include determining one or more parts in the detected image that can be assigned with at least a predetermined probability to the structure in and / or on the patient's eye and / or the position of the structure in and / or on the patient's eye.

[0051] Determining the structure in and / or on the patient's eye may include determining a position and / or orientation and / or extent of the structure in and / or on the patient's eye.

[0052] Any disclosure provided for the method shall also be deemed to be disclosed for the control device and the ophthalmic laser system and vice versa.

[0053] Further details and advantages will now be explained in more detail using the following examples and optional embodiments with reference to the figures.

[0054] They show:

[0055] Fig. 1 is a schematic representation of an ophthalmic laser system according to an optional embodiment;

[0056] Fig. 2 is a schematic representation of a contact element according to an optional embodiment;

[0057] Fig. 3 shows a method for implementation by a control device according to an optional embodiment;

[0058] Fig. 4 shows a method according to an optional embodiment for visualizing a patient's eye through a contact element of an ophthalmic laser system;

[0059] Figs. 5A - 7C show a comparison of representations of images of the patient's eye illuminated with light in different spectral ranges. In the following figures, identical or similar elements in the various embodiments are designated by the same reference numerals for the sake of simplicity.

[0060] Figure 1 shows a schematic representation of an ophthalmic laser system 10 for performing refractive surgical treatments on an eye 12 of a patient 14 according to an optional embodiment. The ophthalmic laser system 10 can also be referred to as a refractive surgical laser system. The eye 12 can also be referred to as the patient's eye.

[0061] The laser system 10 has a contact element 16, by means of which the laser system 10 can dock onto the patient's eye 12. For this purpose, the patient 14, according to the embodiment shown, is positioned lying on a couch 15 so that their gaze is directed upwards and the laser system 10 can contact and fixate the patient's eye 12 vertically from above using the contact element 16 (see also Figure 2).

[0062] In addition, the laser system 10 includes a femtosecond laser 17 integrated into the laser system 10. The laser beam provided by the femtosecond laser 17 is used for refractive surgical treatment of the patient's eye 12 of the patient 14 and can be applied to the eye 12 through the contact element 16.

[0063] Optionally, the laser system 10 comprises a display unit 18, by means of which the user of the laser system 10, for example a physician, can be shown an image of the eye 12 of the patient 14 to be treated. The image can be provided by a confocal image acquisition system 19. The confocal image acquisition system can comprise a camera with a detector and can be configured and arranged such that images of an image of the patient's eye 12 can be captured through the contact element 16. Furthermore, the laser system 10 optionally comprises a planning device 20 according to an optional embodiment, which is designed to provide control data for generating a cutting pattern for a refractive surgical treatment of an eye 12 docked to a contact element of an ophthalmic laser system.The control data can then optionally be provided to a control device 22 of the laser system 10, which can then cause the laser system 10 to create one or more cuts in the eye 12 according to the cutting pattern provided by means of the control data.

[0064] The ophthalmic laser system 10 has, in particular, an interface for coupling the contact element 16 to the ophthalmic laser system 10 such that a laser beam of the ophthalmic laser system can be coupled into the contact element. Furthermore, the ophthalmic laser system has a scanning device 24 for moving the focus of the laser beam within a predetermined volume range. The focus can be moved in the x-direction, y-direction, and z-direction, as illustrated by the exemplary coordinate system in Figure 1. The confocal image acquisition system 19 of the ophthalmic laser system serves to acquire optical images through the coupled contact element 16.

[0065] The ophthalmic laser system 10 is configured to measure a thickness of a contact element 16 coupled to the interface using the scanning device 24 and the confocal image acquisition system 19, and to determine a property of the coupled contact element 16 based on the measured thickness. Determining the property of the coupled contact element 16 may include determining a design of the coupled contact element 16.

[0066] The ophthalmic laser system can comprise at least one light source 26 for illuminating the patient's eye with visible light and infrared light. Furthermore, the ophthalmic laser system 10 comprises an optical system and a detector, wherein the optical system is configured to image the illuminated patient's eye 12 onto the detector through the contact element 16, and wherein the detector is configured to detect the visible light and the infrared light. The optical system and the detector can be implemented in the form of a confocal image acquisition system.

[0067] The control device 22 of the ophthalmic laser system 10 is configured to use the images acquired by the detector to determine a structure in and / or on the patient's eye, optionally a pupil and / or an iris, and / or a position of the structure in and / or on the patient's eye, optionally a position of the pupil and / or the iris, in a detected image of the patient's eye 12 based on the detected infrared light. Furthermore, the control device is configured to output a signal to the display unit 18 for displaying an image of the patient's eye 12 illuminated with the visible light in such a way that the structure in and / or on the patient's eye determined based on the detected infrared light and / or the position of the structure in and / or on the patient's eye determined based on the detected infrared light are identified in the display.

[0068] The optical system can be configured such that the visible light and the infrared light have different focal planes on the object side. The focal plane of the visible light can at least partially capture the cornea of ​​the patient's eye, while the focal plane of the infrared light at least partially captures the structure in and / or on the patient's eye, optionally the iris.

[0069] The optical system may include the contact element 16 for coupling the patient's eye 12 to the ophthalmic laser system 10.

[0070] Figure 2 shows a schematic representation of a contact element 16 having two light sources 26a and 26b. The contact element 16 also has an optical element 28, which can form the body of the contact lens 16 and can contribute to the imaging of the patient's eye 12 onto the detector. The at least one light source 26 can have at least a first light source 26a for providing exclusively visible light and / or a second light source 26b for providing exclusively infrared light. According to the embodiment shown, the light sources 26a and 26b are arranged in and / or on the contact element 16. According to other optional embodiments, they can be formed in and / or on another element of the ophthalmic laser system 10.

[0071] The first light source 26a may comprise a light-emitting diode configured to emit white light and / or to provide multiple emission wavelengths in a spectral range from 400 nm to 500 nm and optionally from 400 nm to 600 nm and / or to provide an emission spectrum covering the spectral range from 400 nm to 500 nm and optionally from 400 nm to 600 nm.

[0072] The second light source 26b may comprise a light-emitting diode configured to provide a spectral component in a spectral range from 700 nm to 1000 nm and optionally in a spectral range from 700 nm to 800 nm and / or to provide an emission spectrum covering the spectral range from 700 nm to 800 nm and optionally from 700 nm to 1000 nm.

[0073] Alternatively or additionally, the at least one light source 26 may comprise at least one spectrally broadband light source designed to provide the visible light and the infrared light.

[0074] The optical system may include a camera, and the detector may form part of the camera. The optical system and the detector may optionally be implemented by the confocal image acquisition system 19.

[0075] The optical system and the contact element can be configured such that the visible light is sharply imaged onto the detector in a first focal plane 100, and the infrared light 102 is sharply imaged onto the detector from a second focal plane 102. The second focal plane 102 can be farther away from the detector than the first focal plane 100. The different focal planes can be caused by the dispersion of the contact element 16.

[0076] The control device 19 may further be connected to the confocal image acquisition system 19 to control it and / or to receive images acquired by the confocal image acquisition system.

[0077] The control device 22 may be configured to perform the following steps described with reference to Figure 3:

[0078] Controlling 302 the at least one light source 26 such that the at least one light source 26 illuminates the patient's eye 12 with visible light and with infrared light.

[0079] Controlling 304 a detector of the ophthalmic laser system 10 such that the detector detects the visible light and the infrared light of an image of the illuminated patient eye 12.

[0080] Determining 306 a structure in and / or on the patient's eye, optionally the pupil and / or the iris, and / or a position of the structure in and / or on the patient's eye, optionally a position of the pupil and / or the iris, in the image of the patient's eye 12 detected by the detector based on the detected infrared light.

[0081] Outputting 308 a signal for a display unit 18 for displaying the image of the patient's eye 12 illuminated with the visible light such that the structure in and / or on the patient's eye determined on the basis of the detected infrared light and / or the position of the structure in and / or on the patient's eye determined on the basis of the detected infrared light are identified in the display.

[0082] The ophthalmic laser system 10 may be configured to perform the method 400 explained below with reference to Figure 4 according to an optional embodiment.

[0083] Figure 4 shows a schematic representation of the method 400 for visualizing a patient's eye 12 through a contact element 16 of an ophthalmic laser system 10.

[0084] The method 400 comprises, in a step 402, illuminating the patient's eye 12 with visible light and with infrared light.

[0085] In a step 404, the method 400 includes imaging the illuminated patient eye 12 through the contact element 16 onto a detector configured to detect the visible light and the infrared light.

[0086] The method 400 further comprises, in a step 406, determining a structure in and / or on the patient's eye and / or a position of the structure in and / or on the patient's eye, optionally a pupil and / or iris, in the detected image of the patient's eye 12 based on the detected infrared light.

[0087] In addition, the method comprises, in a step 408, displaying the image of the patient's eye 12 illuminated with the visible light, wherein the structure in and / or on the patient's eye determined on the basis of the detected infrared light and / or a position of the structure in and / or on the patient's eye are identified in the display.

[0088] The illumination 402 of the patient's eye with the visible and infrared light can occur at least partially simultaneously and optionally completely simultaneously. The illumination 402 of the patient's eye 12 and / or the imaging of the illuminated patient's eye 12 onto the detector can include spectral filtering such that the visible light is blocked for at least one captured image and the infrared light is blocked for at least one other image.

[0089] The detector may have at least one separate color channel for detecting visible light and at least one separate color channel for detecting infrared light.

[0090] The visible light may comprise white light and optionally cover a spectral range from 400 nm to 500 nm, optionally from 400 nm to 600 nm, and optionally from 380 nm to 700 nm. The infrared light may have at least one spectral component in a spectral range from 700 nm to 1000 nm and optionally in a spectral range from 700 nm to 800 nm.

[0091] The illumination 402 of the patient's eye 12 can be carried out at least partially in such a way that the illumination occurs alternately with the visible light and infrared light, wherein a time interval between a start of the illumination with the visible light and the infrared light is 10 s or less and optionally 1 s or less.

[0092] Image acquisition by the detector may optionally be synchronized with the illumination of the patient's eye 12 such that at least one image of the patient's eye 12 is acquired by the detector in a state illuminated exclusively with the visible light and one image of the patient's eye 12 is acquired by the detector in a state illuminated exclusively with the infrared light.

[0093] The imaging of the illuminated patient's eye 12 onto a detector can be performed such that the visible light and the infrared light have different focal planes on the object side. The focal plane of the visible light can at least partially capture the cornea of ​​the patient's eye 12 and / or the focal plane of the infrared light can at least partially capture the structure in and / or on the patient's eye, optionally the iris of the patient's eye 12.

[0094] Figures 5A to 5C show exemplary representations of images of the patient's eye 12 through the contact element based on illumination with light from different spectral ranges.

[0095] Figure 5A shows an illustration of the patient's eye 12 illuminated with visible light. The patient's eye can be seen with many details and optionally in a true-to-original color reproduction, but optionally in the case of a dark color, the iris 30 can only stand out from the pupil 32 with very little contrast, so that recognition of the pupil 32 can be made more difficult.

[0096] For comparison, Figure 5B shows an image of the patient's eye 12 illuminated with infrared light. Even when darkened, the iris 30 exhibits a very high contrast with the pupil 32, which facilitates recognition of the pupil 32 in the image. However, the patient's eye 12 cannot be viewed in a true-to-original color reproduction in this image. Furthermore, the recognition of some details may be difficult (see, for example, Figure 7B).

[0097] Figure 5C shows an image of the patient's eye 12 illuminated with visible light, wherein the structure in and / or on the patient's eye determined using the detected infrared light and / or the position of the structure in and / or on the patient's eye, in this case the iris 30, is identified in the image. In other words, the image of the patient's eye 12 illuminated with visible light has been provided with information from the image of the patient's eye 12 illuminated with infrared light. This can offer the advantage that the iris 30 or pupil 32 can be reliably recognized due to a high contrast, and at the same time, the advantages of displaying the image of the patient's eye 12 illuminated with visible light can also be utilized.It may also be advantageous if the image of the patient's eye 12 with visible light has maximum sharpness in a plane of the cornea, while the image of the patient's eye 12 with infrared light has maximum sharpness in a plane of the iris 30. This can optionally be achieved by utilizing the dispersive properties or the chromatic aberration of the contact element 16.

[0098] Figures 6A to 6C show, similar to Figures 5A to 5C, exemplary representations of images of the patient's eye 12 through the contact element 16 based on illumination with light from different spectral ranges as the contact element 16 approaches the patient's eye. A reflection 500 of the underside of the contact element 16, which can be seen in the illustration, can be used for this purpose and can be aligned to position the contact element 16 relative to the patient's eye 12. Figure 6A corresponds to visible light, Figure 6B to infrared light, and Figure 6C to the mixed image, in which the representation of the image of the patient's eye 12 illuminated with visible light is provided with information from the image of the patient's eye 12 illuminated with infrared light. A representation of the mixed image according to Figure 6C again offers the user the advantages of illuminating the patient's eye 12 with both spectral ranges.

[0099] Figures 7A to 7C show, by way of example, a section of representations of images of the patient's eye 12 through the contact element 16 based on illumination with light from different spectral ranges, which shows a "bubble carpet" caused by the refractive surgical treatment of the patient's eye 12. The bubble carpet represents a flat incision generated by the laser beam, by means of which a lenticule to be removed from the cornea is separated from the surrounding corneal tissue.It can be seen that in the case of illumination with visible light and in the case of the mixed image, in which the representation of the image of the patient's eye 12 illuminated with visible light is provided with information from the image of the patient's eye 12 illuminated with infrared light, the details of the bubble carpet can be significantly better recognized than in the representation of the image of the patient's eye 12 illuminated only with infrared light.

[0100] List of reference symbols

[0101] 10 ophthalmic laser system

[0102] 12 patient's eye

[0103] 14 patients

[0104] 15 loungers

[0105] 16 Contact element

[0106] 17 femtosecond lasers

[0107] 18 Display unit

[0108] 19 confocal image acquisition system

[0109] 20 Planning device

[0110] 22 Control unit

[0111] 24 Scanning device

[0112] 25 Interface

[0113] 26, 26a, 26b Light source

[0114] 28 optical element

[0115] 30 Iris

[0116] 32 pupil

[0117] 100 focal plane of visible light

[0118] 102 Focal plane of infrared light

[0119] 302 - 306 Procedural steps

[0120] 400 Methods for visualizing a patient’s eye through a

[0121] Contact element of an ophthalmic laser system

[0122] 402 - 408 Process steps

[0123] 500 Reflection of the contact element

Claims

Patent claims 1 . Method (400) for visualizing a patient's eye (12) through a contact element (16) of an ophthalmic laser system (10), the method (400) comprising: - illuminating (402) the patient's eye (12) with visible light and with infrared light; - imaging (404) the illuminated patient's eye (12) through the contact element (16) onto a detector designed to detect the visible light and the infrared light; characterized in that the method (400) further comprises: - determining (406) a structure in and / or on the patient's eye (12) and / or a position of the structure in and / or on the patient's eye (12) in the detected image of the patient's eye (12) based on the detected infrared light; - displaying (408) the image of the patient's eye (12) illuminated with the visible light, wherein the structure in and / or on the patient's eye (12) determined on the basis of the detected infrared light and / or the position of the structure in and / or on the patient's eye (12) are identified in the display.

2. Method (400) according to claim 1, wherein the imaging of the illuminated patient's eye (12) onto a detector is carried out in such a way that the visible light and the infrared light have different focal planes (100, 102) on the object side.

3. Method according to claim 2, wherein the mutually different focal planes are caused at least partially and optionally completely on the basis of a chromatic aberration of the contact element (16).

4. Method (400) according to claim 2 or 3, wherein the focal plane (100) of the visible light at least partially covers the cornea of ​​the patient's eye (12) detected and / or wherein the focal plane (102) of the infrared light at least partially detects the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12).

5. The method according to claim 3 or 4, wherein the chromatic aberration of the contact element (16) is adapted such that the focal plane (100) of the visible light at least partially covers the cornea of ​​the patient's eye (12) and / or wherein the focal plane (102) of the infrared light at least partially covers the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12).

6. The method (400) according to any one of the preceding claims, wherein an energetic portion of the image of the patient's eye illuminated with visible light is approximately 85% and an energetic portion of the image of the patient's eye illuminated with infrared light is approximately 15%.

7. The method (400) according to any one of the preceding claims, further comprising adjusting a spectral composition by adjusting a proportion of the visible light and / or the infrared light such that a contrast of the image is thereby improved or optimized.

8. The method (400) of claim 7, wherein adjusting the spectral composition comprises real-time contrast control based on a variable spectral composition of the illumination light.

9. Method (400) according to one of the preceding claims, wherein the determination (406) of the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12) in the detected image of the patient's eye (12) is carried out on the basis of the detected infrared light by means of an image evaluation.

10. The method (400) according to claim 9, wherein the image evaluation is carried out by means of a computer program and comprises determining one or more parts in the detected image which can be assigned with at least a predetermined probability to the structure in and / or on the patient's eye and / or the position of the structure in and / or on the patient's eye (12).

11. Method according to one of the preceding claims, wherein determining the structure in and / or on the patient's eye comprises determining a position and / or orientation and / or extent of the structure in and / or on the patient's eye.

12. The method (400) according to claim 11, wherein the structure in and / or on the patient's eye (12) comprises one or more of the following elements: a pupil (32), an iris (30), an intra-corneal foreign body, and an irregularity in a tissue of the patient's eye (12).

13. The method (400) according to claim 11 or 12, wherein the illumination (402) of the patient's eye (12) with the visible and infrared light occurs at least partially simultaneously and optionally completely simultaneously, preferably completely simultaneously.

14. The method (400) of claim 13, wherein illuminating the patient's eye (12) and / or imaging the illuminated patient's eye (12) onto the detector comprises spectral filtering such that visible light is blocked for at least one captured image and infrared light is blocked for at least one further image.

15. The method (400) according to any one of the preceding claims, wherein the detector has at least one separate color channel for detecting the visible light and at least one separate color channel for detecting the infrared light.

16. Method (400) according to one of the preceding claims, wherein the visible light comprises a white light and optionally has a spectral range of 400 nm to 500 nm, optionally from 400 nm to 600 nm, and optionally from 380 nm to 700 nm.

17. Method (400) according to one of the preceding claims, wherein the infrared light has at least one spectral component in a spectral range from 700 nm to 1000 nm and optionally in a spectral range from 700 nm to 800 nm.

18. Method (400) according to one of the preceding claims, wherein the illumination (402) of the patient's eye (12) is carried out at least partially in such a way that the illumination (402) is carried out alternately with the visible light and infrared light, wherein a time interval between a start of the illumination with the visible light and the infrared light is 10 s or less, and optionally 1 s or less.

19. The method (400) according to claim 18, wherein image acquisition by the detector is synchronized with the illumination (402) of the patient's eye (12) such that at least one image of the patient's eye (12) is acquired by the detector in a state illuminated exclusively with the visible light and one image of the patient's eye (12) is acquired by the detector in a state illuminated exclusively with the infrared light.

20. Control device (22) for an ophthalmic laser system (10) with a contact element (16) and at least one light source (26) for illuminating a patient's eye (12), wherein the control device (22) is configured to carry out the following steps: - controlling (302) the at least one light source (26) such that the at least one light source (26) illuminates the patient's eye (12) with visible light and with infrared light; - controlling (304) a detector of the ophthalmic laser system (10) such that the detector detects the visible light and the infrared light of an image of the illuminated patient's eye (12); characterized in that the control device (22) is further configured to perform the following steps: - determining (306) a structure in and / or on the patient's eye (12) and / or a position of the structure in and / or on the patient's eye (12) in the image of the patient's eye (12) detected by the detector based on the detected infrared light; - Outputting (308) a signal for a display unit (18) for displaying the image of the patient's eye (12) illuminated with the visible light in such a way that the structure in and / or on the patient's eye (12) determined on the basis of the detected infrared light and / or the position of the structure in and / or on the patient's eye (12) determined on the basis of the detected infrared light are identified in the display.

21. An ophthalmic laser system (10) for refractive surgical treatment of a patient's eye (12), the ophthalmic laser system (10) comprising: - at least one light source (26) for illuminating the patient's eye (12) with visible light and with infrared light; - an optical system and a detector, wherein the optical system is configured to image the illuminated patient eye (12) onto the detector through a contact element (16), and wherein the detector is configured to detect the visible light and the infrared light; and - a control device (22); characterized in that the control device (22) is designed to: - to determine a structure in and / or on the patient's eye (12) and / or a position of the structure in and / or on the patient's eye (12) in a detected image of the patient's eye (12) using the detected infrared light; and - to output a signal for a display unit (18) for displaying an image of the patient's eye (12) illuminated with the visible light in such a way that the structure in and / or on the patient's eye (12) determined on the basis of the detected infrared light and / or the position of the structure in and / or on the patient's eye (12) determined on the basis of the detected infrared light are identified in the display.

22. Ophthalmic laser system (10) according to claim 21, wherein the optical system is configured to image the illuminated patient's eye (12) onto the detector in such a way that the visible light and the infrared light have different focal planes (100, 102) on the object side.

23. Ophthalmic laser system (10) according to claim 22, wherein the optical system is configured such that the mutually different focal planes are caused at least partially and optionally completely on the basis of a chromatic aberration of the contact element (16).

24. Ophthalmic laser system (10) according to claim 22 or 23, wherein the optical system is configured such that the focal plane (100) of the visible light at least partially detects the cornea of ​​the patient's eye (12) and / or wherein the focal plane (102) of the infrared light at least partially detects the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12).

25. Ophthalmic laser system (10) according to claim 23 or 24, wherein the chromatic aberration of the contact element (16) is adapted such that the focal plane (100) of the visible light at least partially covers the cornea of ​​the patient's eye (12) and / or wherein the focal plane (102) of the infrared light at least partially covers the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12).

26. Ophthalmic laser system (10) according to one of claims 21 to 25, wherein the ophthalmic laser system (10) is configured such that an energetic portion of the image of the patient's eye illuminated with visible light is approximately 85% and an energetic portion of the image of the patient's eye illuminated with infrared light is approximately 15%.

27. The ophthalmic laser system (10) according to any one of claims 21 to 26, wherein the ophthalmic laser system (10) is further configured to adjust a spectral composition by adjusting a portion of the visible light and / or the infrared light such that a contrast of the image is thereby improved or optimized.

28. The ophthalmic laser system (10) of claim 27, wherein the ophthalmic laser system (10) is further configured such that adjusting the spectral composition comprises real-time contrast control based on a variable spectral composition of the illumination light.

29. Ophthalmic laser system (10) according to one of claims 21 to 28, wherein the ophthalmic laser system (10) is further configured such that the determination (406) of the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12) in the detected image of the patient's eye (12) is carried out on the basis of the detected infrared light by means of an image evaluation.

30. Ophthalmic laser system (10) according to claim 29, wherein the ophthalmic laser system (10) is further configured such that the image evaluation is carried out by means of a computer program and comprises determining one or more parts in the detected image which can be assigned with at least a predetermined probability to the structure in and / or on the patient's eye and / or the position of the structure in and / or on the patient's eye (12).

31. Ophthalmic laser system (10) according to one of claims 21 to 30, wherein the ophthalmic laser system (10) is further configured such that determining the structure in and / or on the patient's eye comprises determining a position and / or orientation and / or extent of the structure in and / or on the patient's eye.

32. Ophthalmic laser system (10) according to one of claims 21 to 31, wherein the at least one light source (26) comprises at least a first light source (26a) for providing exclusively visible light and / or a second light source (26b) for providing exclusively infrared light.

33. The ophthalmic laser system (10) according to claim 32, wherein the first light source (26a) comprises a light-emitting diode configured to emit white light and / or to provide a plurality of emission wavelengths and / or in a spectral range from 400 nm to 500 nm and optionally from 400 nm to 600 nm and / or to provide an emission spectrum covering the spectral range from 400 nm to 500 nm and optionally from 400 nm to 600 nm.

34. Ophthalmic laser system (10) according to claim 32 or 33, wherein the second light source (26b) comprises a light-emitting diode which is designed to provide a spectral component in a spectral range from 700 nm to 1000 nm and optionally in a spectral range from 700 nm to 800 nm and / or to provide an emission spectrum which covers the spectral range from 700 nm to 800 nm and optionally from 700 nm to 1000 nm.

35. The ophthalmic laser system (10) according to any one of claims 21 to 34, wherein the at least one light source (26) comprises at least one spectrally broadband light source configured to provide the visible light and the infrared light.

36. Ophthalmic laser system (10) according to one of claims 21 to 35, wherein the optical system comprises a camera and wherein the detector forms part of the camera.

37. Ophthalmic laser system (10) according to one of claims 21 to 36, wherein the optical system is designed such that the visible light and the infrared light have different focal planes (100, 102) on the object side.

38. Ophthalmic laser system (10) according to claim 37, wherein the focal plane (100) of the visible light at least partially covers the cornea of ​​the patient's eye (12) and / or wherein the focal plane (102) of the infrared light at least partially covers the structure in and / or on the patient's eye (12) and / or the position of the structure in and / or on the patient's eye (12) of the patient's eye (12).

39. Ophthalmic laser system (10) according to one of claims 21 to 38, wherein the optical system comprises a contact element (16) for coupling the patient's eye (12) to the ophthalmic laser system (10).

40. Ophthalmic laser system (10) according to one of claims 21 to 39, further comprising a femtosecond laser (17) for refractive surgical treatment of the patient's eye (12).

Images