Spatial light modulation targeting of therapeutic lasers for the treatment of ophthalmic diseases

Abstract

Therapeutic lasers used to treat ophthalmic diseases can be modulated by spatial light modulation devices to focus the therapeutic laser simultaneously at multiple target locations.

Description

Technical Field

[0001] Related Applications This application claims priority to Canadian Patent Application No. 3100460, filed Nov. 24, 2020, with the title "Spatial Light Modulation Targeting of Therapeutic Lasers for Treatment of Ophthalmological Conditions", the entire content of which is incorporated herein by reference.

[0002] Technical Field The present disclosure relates to a laser irradiation system for ophthalmology, and particularly to the targeting of a laser for irradiation to one or more target positions.

Background Art

[0003] Background For example, ophthalmological diseases including diabetic retinopathy, age-related macular degeneration, vitreomacular traction, holes, retinal detachment, holes, glaucoma, vein occlusion, choroidal detachment, diabetic macular edema, posterior vitreous detachment, cataracts, and edema may include treatment options where a laser is focused at one or more locations. The irradiated / focused laser light is absorbed by the tissue eye, causing some change to the eye, such as photocoagulation, tissue incision, resection, etc. Laser treatment can be used to treat various eye conditions, but the treatment process may often require laser treatment at multiple different locations.

[0004] It takes time to irradiate / focus the treatment laser on each treatment site, and it is necessary to accurately track the eyeball so that the movement of the eyeball is surely performed during the irradiation of the laser light. Further, laser treatment at one location may change or affect other treatment locations, and re-planning of the treatment may be required. Further, since laser treatment is unpleasant for the patient, it may not be desirable to treat each target position individually.

[0005] Masking techniques have been used to filter treatment laser light and target multiple treatment sites simultaneously. However, masking has problems focusing on each individual target location. Furthermore, masking can be difficult to position and align in relation to the patient.

[0006] Additional, novel, and / or improved systems and methods are desired for targeting therapeutic lasers for the treatment of ophthalmic conditions. [Overview of the Initiative]

[0007] overview A therapeutic laser irradiation system for ophthalmic use is provided in accordance with this disclosure, the system comprising: a therapeutic laser irradiation optical path including at least one input port for receiving therapeutic laser light and an output port for irradiating at least a portion of the therapeutic laser light onto an ophthalmic target; a spatial light modulation (SLM) device arranged to modulate the therapeutic laser light irradiated onto the ophthalmic target to control the target position of the ophthalmic target to which the therapeutic laser light is irradiated / focused; and at least one processor configured to determine the target position and control the SLM device to modulate the therapeutic laser light to irradiate / focus onto the determined target position.

[0008] In a further embodiment of the system, the system includes a targeting laser irradiation path for irradiating an ophthalmic target with targeting laser light, and the SLM device is further arranged to modulate the targeting laser light to irradiate / focus it at a target position on the ophthalmic target.

[0009] In a further embodiment of the system, the targeting laser irradiation path includes an alignment path that aligns and inputs the targeting laser beam to at least one input port of the therapeutic laser irradiation path.

[0010] In a further embodiment of the system, the system further includes an imaging system for capturing images of ophthalmic targets.

[0011] In a further embodiment of the system, the image captured by the imaging system captures the target laser light focused by the SLM device.

[0012] In a further embodiment of the system, the captured image is processed to compare the captured targeting laser beam, focused by the SLM device, with the target position.

[0013] In a further embodiment of the system, the comparison of the targeting laser beam captured in the image with the target position is used as feedback for controlling the SLM device.

[0014] In a further embodiment of the system, the imaging system includes one or more of the following: a fundus camera system, a scanning laser ophthalmoscope (SLO) imaging system, and an optical coherence tomography system.

[0015] In a further embodiment of the system, the imaging system includes a tracking system for tracking eye movements.

[0016] In a further embodiment of the system, the determined target position includes multiple simultaneous treatment positions for the therapeutic laser light.

[0017] In a further embodiment of the system, the SLM device is controlled to simultaneously irradiate / focus a portion of the therapeutic laser light onto each of multiple simultaneous treatment locations.

[0018] In a further embodiment of the system, a portion of the therapeutic laser light irradiated / focused on each of the simultaneously treated locations has its own power.

[0019] In a further embodiment of the system, the power of each portion of the treatment laser light irradiated / focused on at least one of the simultaneous treatment locations is different from the power of each portion of at least one of the simultaneous treatment locations.

[0020] In a further embodiment of the system, at least one processor is further configured to control the SLM device to shape pulses of therapeutic laser light.

[0021] In a further embodiment of the system, the SLM device includes one or more of the following: a liquid crystal-based SLM device, a microelectromechanical micromirror-based SLM device, a film mirror-based SLM device, and an active or passive metasurface.

[0022] In a further embodiment of the system, the target position of the ophthalmic target is located in one or more of the following areas: the sclera of the ophthalmic target, the iris of the ophthalmic target, the pupil of the ophthalmic target, the cornea of ​​the ophthalmic target, the retina of the ophthalmic target, and the vitreous humor of the ophthalmic target.

[0023] In a further embodiment of the system, irradiation / focusing of a therapeutic laser at a target location is used to treat one or more of the following: diabetic retinopathy, age-related macular degeneration, vitreomacular traction, tearing, retinal detachment, holes, glaucoma, venous occlusion, choroidal detachment, diabetic macular edema, posterior vitreous detachment, cataracts, edema, and dry eye.

[0024] In accordance with the present disclosure, there is provided a method of targeting a treatment laser to an ophthalmic target, comprising: determining a plurality of target positions of an ophthalmic device; controlling a spatial light modulation (SLM) device to focus a targeting laser at each of the plurality of determined target positions; capturing an image of the targeting laser focused at the plurality of determined target positions; comparing the positions of the focused targeting laser captured in the image with the determined target positions; and controlling the SLM device based on feedback from the comparison of the positions of the focused targeting laser captured in the image with the determined target positions.

[0025] In a further embodiment of the method, determining the plurality of target positions comprises capturing one or more images of the ophthalmic target and processing the one or more images to determine the plurality of target positions.

Brief Description of the Drawings

[0026] Further features and advantages of the present disclosure will become apparent from the following detailed description when taken in conjunction with the accompanying drawings.

[0027] [Figure 1] FIG. 1 depicts an ophthalmic system for focusing a treatment laser. [Figure 2] FIG. 2 shows a further ophthalmic system for focusing a treatment laser. [Figure 3] FIG. 3 depicts a method of targeting a treatment laser to an ophthalmic target. [Figure 4] FIG. 4 depicts a further method of targeting a treatment laser to an ophthalmic target.

Mode for Carrying Out the Invention

[0028] Detailed Description Ophthalmic therapeutic lasers can be irradiated and / or focused by spatial light modulation (SLM) devices, allowing the therapeutic laser to be irradiated and / or focused on multiple locations simultaneously. For example, a therapeutic laser can be irradiated or focused on multiple different locations to excise, incise, and / or photocoagulate tissue. The laser light does not need to be focused and may be irradiated onto the eyeball, for example, as transscleral light-mediated biostimulation of the spongia of the patient's eyeball used in the treatment of glaucoma or ocular hypertension. SLM devices allow for simultaneous treatment of multiple locations. Since laser treatment is painful, reducing the number of treatment sessions required is beneficial. By irradiating and / or focusing the therapeutic laser on multiple sites simultaneously, treatment can be performed in one go without requiring multiple laser treatments. Conventional techniques treated individual sites sequentially, requiring tracking of eye movements between individual treatments. By treating multiple sites simultaneously, the amount of eye tracking required can be reduced, thus reducing the potential errors in treatment. Furthermore, since laser treatment of individual sites may affect other sites, re-evaluation of the treated site may be necessary after each treatment. In contrast, treating multiple locations simultaneously allows all locations to be treated without the need for further re-evaluation. In addition to irradiating / focusing the treatment laser on multiple locations, SLM devices can control the shape, wavephase, wavepolarization, wavefront tilt, diffraction, wavefront helicity, orbital angular momentum order, and the generation of non-diffracting light beams (e.g., Bessel light beams and self-healing light beams) of the irradiated / focused treatment laser.

[0029] Figure 1 shows an ophthalmic system for irradiating / focusing a therapeutic laser. System 100 comprises a therapeutic laser source 102 that provides a source of laser light used for ophthalmic treatment. The therapeutic laser source 102 may be provided by a range of various laser sources, including, for example, a femtosecond laser. The therapeutic laser may be coupled to an optical path which may include one or more optical components schematically depicted by a lens 104. Optical components may include, for example, optical lenses, mirrors, filters, beam splitters, gratings, polarizers, etc. System 100 further includes an electronically addressable SLM device 106 that can controllably modulate light from the therapeutic light source. The SLM device 106 may be a liquid crystal-based SLM device, such as a liquid crystal on silicon (LCoS) device, in which the phase of the laser light can be controllably modulated pixel by pixel. For example, an LCoS SLM consists of a panel of pixel elements such as 1920×1080, 3840×2160, each of which can be controlled to modulate the phase of the incident light. The SLM elements can be controlled in a variety of ways. For example, an SLM device is driven by an electrical signal similar to those used to drive an LCD panel. While the above describes an SLM element using liquid crystal, other SLM elements may be employed. For example, a micromirror-based SLM device may be provided. In this SLM device, the phase of the incident laser beam can be modulated pixel by pixel, thereby controlling the pattern of the laser beam illuminating / focusing on the eyeball target. The SLM device is digitally controllable to impart some kind of spatially varying phase modulation to the light beam reflected from or transmitted through it.

[0030] System 100 may further include additional optical components for irradiating an optical target with modulated laser light. These additional optical components are schematically depicted as mirrors 108, but may include, for example, lenses, filters, polarizers, etc. The optical target is the patient's eyeball 110. The SLM device can irradiate / focus the laser light at multiple target locations, one of which is indicated as location 112. The target location 112 to which the laser light is irradiated / focused is a location determined for treatment. For example, in the treatment of age-related macular degeneration, the target location may be a subretinal drusen. However, regardless of what the specific target is, the SLM device can modulate the laser light so that it irradiates / focuses at multiple target locations simultaneously.

[0031] Although depicted and described as individual locations, the target location does not need to be limited to individual points. The SLM device may irradiate / focus the laser beam in a determined shape. For example, in the treatment of vitreomacular traction, the shape of the irradiated / focused laser beam may be a cup-shaped surface or other similar shape that cuts the strand causing the traction. In another example, in the treatment of glaucoma, the laser beam is irradiated into the peripheral region of the eyeball, where the irradiated laser spot is spatially configured into a specific shape to irradiate the reticular cavernosa of the eyeball.

[0032] The system 100 further includes one or more controllers, schematically depicted as a computer 114, which control system components, including an SLM device and optionally a therapeutic laser source. One or more controllers may be configured to provide system control functions 116. One or more controllers may be configured, for example, by executing instructions stored in memory. The system control functions 116 may include planning functions 118 that enable the planning of treatments. The planning functions 118 may be provided in a wide variety of ways, such as a manual process that allows a user to load an image of a patient's eye and specify a target location on the image. In addition, or alternatively, the planning functions may process the image to automatically or semi-automatically determine the target location. This processing may be based on a specified eye condition to be treated, or it may determine an eye condition present in the image and determine a treatment location to treat that condition. In addition to planning treatment locations, the planning functions may also determine or specify treatment parameters at each location, such as laser power, duration, repetition, pulse shape, wavelength, wavefront, and other relevant parameters.

[0033] The SLM treatment function 120 can control the SLM device and, optionally, the treatment laser light source, using information from the planning function 118, particularly the treatment position and treatment parameters. For example, the SLM planning function can generate control signals to drive the SLM device to irradiate / focus laser light according to the treatment plan.

[0034] Figure 2 shows a further ophthalmic system for irradiating / focusing a therapeutic laser. This system 200 is similar to system 100, and similar components will not be described in further detail. In addition to the optics for the therapeutic laser and SLM device, system 200 is depicted to have an additional targeting laser source 250 and imaging system 260. Although system 200 is described to include both the targeting laser source and the imaging system, it is also possible for the system to incorporate only one of the components. Furthermore, although depicted as a single imaging system, the system may include multiple different imaging and targeting systems. Canadian Patent Application No. 3096285, filed on 16 October 2020, titled “Ophthalmological Imaging And Laser Delivery Device, System and Methods,” describes a device that can irradiate a therapeutic laser and includes multiple imaging systems as well as a targeting laser. The entire contents of Canadian Patent Application No. 3096285 are incorporated herein by reference for any purpose. The device described in Canadian Patent Application No. 3096285 uses a scanning optical system to enable the irradiation / focusing of a therapeutic laser to different locations. While the device described in Canadian Patent Application No. 3096285 can irradiate / focus the therapeutic laser light to any desired treatment site, it cannot irradiate / focus the therapeutic laser to multiple target locations simultaneously. By incorporating an SLM device for irradiating the therapeutic laser, it becomes possible to modulate the phase of the therapeutic laser and irradiate / focus the laser to multiple locations simultaneously.

[0035] As depicted, in addition to the treatment laser 102 and SLM device 106, the system 200 includes a targeting laser source 250 passing through an optical path consisting of various optical components 252, and a beam splitter / combiner 254 for combining the targeting laser with the treatment laser. The optical components 252 may include, for example, optical components and sensors for aligning the targeting laser so that the path of the targeting laser aligns with the path of the treatment laser after it has been combined by the splitter / combiner 254. The targeting laser light is modulated by the SLM device in the same way as the treatment light, but the targeting laser does not affect biological eye tissue. The targeting laser may have the same wavelength as the treatment laser or a different wavelength. If the wavelengths of the targeting laser and the treatment laser are different, the phase modulation can be digitally corrected. The targeting laser can function as a preview of where the treatment laser will actually be targeted, and as such, it can be used to validate treatment planning before actual treatment with the treatment laser.

[0036] An imaging system may consist of one or more systems for imaging a patient's eyeball 110, each comprising a light source 262 which may include a laser, and each optical component 264 which may include lenses, scanning optics, splitters, combiners, etc. An imaging system may include, for example, a fundus imaging camera system, a scanning laser ophthalmoscope (SLO) system, an optical coherence tomography (OCT) system, or other imaging systems. One or more splitters / combiners 266 may be used to direct the imaging light from the imaging light source of each respective system to the eye and back to the imaging sensor of a particular imaging system. Separate imaging systems may share one or more optical components.

[0037] Although not shown in Figure 2, system 200 includes one or more controllers configured to provide the system control functions described above. The control functions may control the targeting laser, as well as the imaging system. The control functions may control a system including, for example, an SLM device 106, based on information from one or more imaging systems. For example, the imaging system may capture the position of the targeting laser irradiated / focused by the SLM device. The actual position of the irradiated / focused targeting laser can be compared to a desired treatment position, such as a position provided by the planning function, and the results of the comparison are used as feedback to control the SLM device and target the intended position more accurately.

[0038] Furthermore, one or more imaging systems may be used as eye-tracking systems to track eye movements and update the targeting position based on those movements. The SLM device may be controlled in real time, for example, at a certain frequency f, to adjust the irradiation / focus position of the targeting laser and / or therapeutic laser, taking eye movements into account.

[0039] Figure 3 illustrates a method for targeting a therapeutic laser to an ophthalmic target. Method 300 begins with determining the target location (302). Determining the target location can be done in various ways, including, for example, displaying one or more images of the patient's eye and allowing the individual to specify the target location on the image. In addition or alternatively, the target location may be determined automatically by processing images of the patient's eye, such as using artificial intelligence (Al) or machine learning (ML) algorithms or engines. Automatic or semi-automatic determination of the target location may include acquiring images such as fundus images, SLO images and / or OCT images (318) and processing the images with an Al engine trained to identify the target location (320). The target location may include a specific spatial location of the target as well as therapeutic parameters for a particular location, such as laser power, treatment repetitions, wavelength, and pulse shape. Regardless of how the target location is determined, once the target location is determined, the SLM device is controlled to irradiate / focus the targeting laser to the determined location (304). A targeting laser can be irradiated / focused onto a determined treatment location by the SLM device, but the targeting laser does not have the same parameters (such as power) as the treatment laser. One or more images are captured including the irradiated / focused location of the targeting laser (306). The captured images are processed to identify the actual target location of the targeting laser and to compare the captured location with the determined treatment location (308). Any discrepancy between the targeted location and the determined treatment location can be used as feedback to control the SLM to more accurately target the treatment location (310). As the SLM device is adjusted, additional images of the targeting laser (312) are captured and used to determine whether the targeted location is in an acceptable position relative to the desired treatment location (314). If the target location of the targeting laser is unacceptable (No in 314), the SLM controls are adjusted again (310) and the targeting process continues.If the target location is acceptable (Yes in 314), the treatment laser can be controlled to treat the location according to the treatment plan (316).

[0040] Figure 4 illustrates a further method for targeting a therapeutic laser to an ophthalmic target. Method 400 captures an image of the patient's eye (402). This image can be acquired using a variety of different imaging techniques, including a fundus camera, SLO imaging system, OCT imaging system, or other imaging techniques. Two exemplary images of patients' eyes, 402a and 402b, are depicted in Figure 4. The patient in image 402a has several microaneurysms, and the patient in image 402b has glaucoma. Once the images are captured, they are processed to identify the treatment location (404). Images 402a and 402b are processed to identify the areas requiring treatment, as highlighted in Figures 404a and 404b. The treatment locations are highlighted with arrows in the figures. Identification of the treatment location can be done manually, automatically, or semi-automatically, requiring manual confirmation of the treatment location. The treatment location can be used to control the SLM device so that the therapeutic laser beam is simultaneously directed to the target location.

[0041] The SLM device can be controlled to irradiate the treatment area with laser light simultaneously (406). The treatment area can be confirmed by first irradiating it with a targeting laser whose shape has been adjusted by the SLM device. The location irradiated by the targeting laser can be captured by an imaging system and compared with the desired treatment area. If the targeted area is acceptable (Yes in 408), i.e., if the targeting laser has irradiated the area necessary to perform the treatment, the treatment area can be irradiated with the treatment laser (410), and the shape of the treatment laser is adjusted by the SLM device so that it irradiates all treatment areas simultaneously. If the targeted area is unacceptable, the SLM device can be controlled to adjust the treatment area (412), and the targeting laser (406) can be irradiated again to the adjusted treatment area.

[0042] The above describes a system and method for simultaneously irradiating / focusing laser light to one or more locations within a patient's eyeball using an SLM device. The SLM device is digitally controllable to impart some form of spatial phase modulation to the light passing through or reflected from the SLM device. The spatial phase modulation provided by the SLM device allows for control over the shape of the laser light, enabling simultaneous irradiation / focusing of the laser light to multiple locations within the eyeball. SLM devices can be provided by different types of devices, including, for example, translucent or transmissive SLM devices or reflective SLM devices. Translucent or transmissive SLM devices may be provided using liquid crystal display (LCD) technology, and reflective SLM devices may be provided using liquid crystal on silicon (LCoS) technology. Other techniques for providing SLM devices capable of controllably imparting some form of spatial modulation to light include, for example, micro-electromechanical micromirror-based SLM devices, membrane mirror-based SLM devices, and active or passive metasurfaces. Regardless of the type of SLM device, the laser light is directed / focused onto various areas of the eyeball, including the sclera, iris, pupil, cornea, retina, vitreous humor, or other areas. Laser irradiation / focusing can be used to treat a variety of eye diseases, including, for example, diabetic retinopathy, age-related macular degeneration, vitreomacular traction, tearing, retinal detachment, holes, glaucoma, venous occlusion, choroidal detachment, diabetic macular edema, posterior vitreous detachment, cataracts, edema, and dry eye.

[0043] Those skilled in the art will understand that the systems and components shown in Figures 1 to 4 may include components not shown in the drawings. For the sake of simplification and clarity of the illustration, the elements in the figures are not necessarily to scale and are only schematic, illustrating the element structure in a non-limiting manner. It will be apparent to those skilled in the art that numerous modifications and alterations can be made without departing from the scope of the invention as defined in the claims.

[0044] While specific components and steps have been described, it is intended that, like the steps themselves, the individually described components may be combined into fewer components or steps, or that the steps may be executed sequentially, non-sequentially, or concurrently. Furthermore, although described above as being performed in a specific order, a person skilled in the art considering the present teachings will understand that the specific order of certain steps relative to other steps may be changed. Similarly, individual components or steps may be provided by multiple components or steps. A person skilled in the art considering the present teachings will understand that the components and processes described herein may be provided by various combinations of software, firmware, and / or hardware, in addition to the specific implementations described herein as examples.

[0045] The techniques of various embodiments can be carried out using software, hardware, and / or a combination of software and hardware. Various embodiments are directed to devices, such as nodes that may be used in communication systems or data storage systems. Various embodiments are also directed to non-transient machines, such as computers, and machine-readable media, such as ROM, RAM, CDs, and hard disks, which include machine-readable instructions for controlling a machine, such as a processor, to carry out one, more, or all of the described methods or steps of the methods.

[0046] Some embodiments are directed to a computer program product including a computer-readable medium containing code for causing a computer, or multiple computers, to perform various functions, steps, actions, and / or operations, such as one, one, or all of the steps described above. Depending on the embodiment, the computer program product may, and may optionally, contain different code for each step to be performed. Thus, the computer program product may, and may optionally contain, code for each individual step of a method, such as a method for operating a communication device, such as a wireless terminal or node. The code may be in the form of executable instructions stored in a computer-readable medium, such as RAM (Random Access Memory), ROM (Read Only Memory), or other types of storage devices, such as a computer. In addition to being directed to a computer program product, some embodiments are directed to a processor configured to perform one or more of the various functions, steps, actions, and / or operations of one or more of the methods described above. Thus, some embodiments are directed to a processor, such as a CPU, configured to perform some or all of the steps of the method described herein. The processor may, for example, be for use in the communication device or other devices described herein.

[0047] Numerous additional variations of the methods and apparatus of the various embodiments described above will be apparent to those skilled in the art in consideration of the above description. Such variations are considered to be within the scope of the art.

Claims

1. An ophthalmic treatment laser irradiation system, An SLO system configured to generate SLO light for SLO (scanning laser ophthalmoscope) imaging, An OCT system configured to generate OCT light for OCT (Optical Coherence Tomography) imaging, A therapeutic laser configured to generate therapeutic laser light and irradiate an ophthalmic target with at least a portion of the therapeutic laser light through a therapeutic laser irradiation path, An SLM (Spatial Light Modulation) device is positioned within the treatment laser irradiation path and modulates the treatment laser light, and is configured to split the treatment laser light into multiple treatment laser beams and irradiate multiple target positions simultaneously. A processor configured to determine multiple target positions and control the SLM device to modulate therapeutic laser light to treat intravitreal floaters of ophthalmic targets, and Includes, The SLM device is configured to control one or more properties of the therapeutic laser light, such as shape, wave phase, wave polarization, wavefront tilt, diffraction, wavefront helicity, and orbital angular momentum order. system.

2. Furthermore, A targeting laser comprising a targeting laser configured to generate targeting laser light and irradiate an ophthalmic target through a therapeutic laser irradiation path, The SLM device is further configured to modulate the targeting laser beam, splitting it into multiple targeting laser beams and irradiating them onto multiple target positions. The system according to claim 1.

3. The targeting laser irradiation path includes an alignment optical path that aligns and inputs the targeting laser light into the treatment laser irradiation path. The system according to claim 2.

4. Furthermore, Includes an imaging system for capturing images of the aforementioned ophthalmic target, The system according to claim 2 or 3.

5. The image captured by the imaging system captures the multiple targeting laser beams irradiated by the SLM device. The system according to claim 4.

6. The captured image is processed to compare the captured multiple targeting laser beams irradiated by the SLM device with the target position. The system according to claim 5.

7. The comparison of the target positions of the multiple targeting laser beams captured in the aforementioned image is used as feedback for controlling the SLM device. The system according to claim 6.

8. Furthermore Including a fundus camera system, The system according to any one of claims 4 to 7.

9. The system according to any one of claims 4 to 8, wherein the imaging system comprises a tracking system for tracking eye movements.

10. The determined multiple target positions include multiple simultaneous treatment positions of the treatment laser light. The system according to any one of claims 1 to 9.

11. The SLM device is controlled to simultaneously irradiate each of the multiple simultaneous treatment locations with a portion of the treatment laser light. The system according to claim 10.

12. A portion of the treatment laser light irradiated to each of the aforementioned simultaneous treatment positions has a respective power. The system according to claim 11.

13. The power of each portion of the treatment laser light irradiated to at least one of the simultaneous treatment positions is different from the power of each portion of at least one of the other simultaneous treatment positions. The system according to claim 12.

14. At least one processor is further configured to control the SLM device to shape the pulses of the therapeutic laser light. The system according to any one of claims 1 to 13.

15. The aforementioned SLM device LCD-based SLM devices and Micro-electromechanical micromirror-based SLM devices, A film mirror-based SLM device, Active metasurfaces and Passive metasurface and Including one or more of the following: The system according to any one of claims 1 to 14.

16. The target location of the ophthalmic target is The sclera, an ophthalmic target, The iris, an ophthalmic target, The pupil, an ophthalmic target, The cornea, an ophthalmic target, The retina, an ophthalmic target, The vitreous humor and the ophthalmic target Located in one or more of the following: The system according to any one of claims 1 to 15.

17. The irradiation of the treatment laser light at the target location is Diabetic retinopathy and Age-related macular degeneration and Vitreous macular traction and, Tears and, Retinal detachment and The hall and, Glaucoma and, Venous occlusion and Choroidal dissection and, Diabetic macular edema, Posterior vitreous detachment and Cataracts and, Floating objects and, Dry eyes and Used to treat one or more of the following: The system according to any one of claims 1 to 16.

18. The system according to any one of claims 1 to 17, wherein all of the plurality of target positions are located on a single floating object within the ophthalmic target.

19. A method of targeting an ophthalmic target with therapeutic laser light, The processor determines multiple target positions for receiving the targeting laser beam, The processor controls an SLM (Spatial Light Modulation) device to split the targeting laser into multiple targeting laser beams and simultaneously irradiate multiple determined target positions. The processor performs the steps of capturing images of the targeting lasers irradiated onto the plurality of determined target positions, The processor performs the steps of comparing the positions of the multiple targeting laser beams captured in the image with the positions of the multiple determined targets, The processor controls the SLM device based on feedback from comparing the positions of the multiple targeting laser beams captured in the image with the positions of the multiple determined targets. Includes, The SLM device is configured to receive therapeutic laser light and split the therapeutic laser light into multiple therapeutic laser beams. method.

20. The image is Captured using at least one of the following: OCT (Optical Coherence Tomography) system, fundus camera, or SLO (Scanning Laser Ophthalmoscope) system. The method according to claim 19.

Images