Adjustable Laser Pulse Control

Abstract

A system and method for flexibly controlling a laser pulse output from a laser system are disclosed. An exemplary surgical system includes a laser, an optical switching device, and a laser pulse controller. The optical switching control signal communicated by the laser pulse controller controls the length of a pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system. The number of laser pulses in each pulse picking cycle output from the laser system can be adjustable in a range including more than 50% of the laser pulses in each pulse picking cycle.

Description

Technical Field

[0001] The present disclosure is directed to systems and methods for controlling laser pulses output from a laser system.

Background Art

[0002] Lasers are used in many different medical procedures, including many different ophthalmic procedures. For example, a laser can be used in cataract surgery, such as to fragment a cataract lens. In some procedures, the laser is first used to fragment the lens, and then ultrasonic aspiration of the lens by an ultrasonic handpiece follows to complete the decomposition for removing the lens. In other procedures, the laser can be used to complete fragmentation of the lens and / or lens emulsification for removal without the need to separately apply ultrasonic energy. The laser can also be used in other steps of cataract surgery, such as to create a corneal incision and / or to incise the lens capsule.

[0003] Lasers can also be used in glaucoma surgery. For example, a laser can be used to form all or part of a flow path through trabecular meshwork or scleral tissue for draining aqueous humor from the eye.

[0004] Lasers can also be used in vitreoretinal surgery. In some procedures, the laser can be used in vitrectomy to cut or break vitreous fibers for removal. The laser can be incorporated into a vitrectomy probe and apply energy from the laser to the vitreous fibers to cut or break the vitreous fibers for removal.

[0005] In other vitreoretinal applications, the laser can be used for photocoagulation of retinal tissue. Laser photocoagulation can be used to treat problems such as retinal holes and / or the effects of diabetic retinopathy.

[0006] Patent Document 1 (U.S. Patent Application Publication No. 2018 / 0360657) discloses an example of an ophthalmic laser system. This application describes the use of a laser for forming incisions in surgery or photodisrupting eye tissue and for cataract surgery such as laser-assisted cataract surgery (LACS). Patent Document 2 (U.S. Patent Application Publication No. 2019 / 0201238) discloses another example of an ophthalmic laser system. This application describes the use of a laser in a vitreous cutter probe for cutting or breaking vitreous fibers. Patent Documents 1 and 2 are hereby expressly incorporated by reference in their entirety into this specification.

Prior Art Documents

Patent Documents

[0007]

Patent Document 1

Patent Document 2

Summary of the Invention

Problems to be Solved by the Invention

[0008] Some laser systems emit pulses having a desired duration and repetition rate. Operating the laser in pulses can achieve the desired power and energy characteristics for a particular application. Further, the energy of the beam emitted by the laser can be controlled by controlling the laser itself, but in some systems, it may be desirable to control the amount of energy of the laser beam downstream of the laser. Existing systems for laser pulse selection typically have one or more drawbacks such as power loss, complexity, cost, etc. There is a need for improved systems and methods for laser pulse control.

Means for Solving the Problems

[0009] The present disclosure is directed to an improved system and method for controlling laser pulses output from a laser system.

[0010] In some embodiments, a surgical system includes a laser configured to emit electromagnetic radiation as laser pulses, an optical switching device configured to switch between a first state that enables laser pulses emitted from the laser to be output from the laser system and a second state that prevents laser pulses emitted from the laser from being output from the laser system, and a laser pulse controller configured to communicate an optical switching control signal to the optical switching device. The optical switching control signal communicated by the laser pulse controller controls the length of a pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system, and the number of laser pulses in each pulse picking cycle output from the laser system is adjustable in a range including more than 50% of the laser pulses in each pulse picking cycle.

[0011] In some embodiments, the number of laser pulses in each pulse picking cycle output from the laser system can be adjustable in a range of 0% to 100% of the laser pulses in each pulse picking cycle. In some embodiments, when the laser system is set such that the number of laser pulses emitted by the laser in each pulse picking cycle is N, the number of laser pulses in each pulse picking cycle output from the laser system is adjustable in a range including 1 and N - 1.

[0012] In some embodiments, the optical switching control signal communicated by the laser pulse controller includes a first signal that controls the length of the pulse picking cycle and a second signal that controls the number of laser pulses in each pulse picking cycle output from the laser system. The first signal can be a synchronization signal.

[0013] In some embodiments, the optical switching device is further configured to control the amount of energy of the laser pulses emitted from the laser output from the laser system.

[0014] In some embodiments, the surgical system may further include an adjustable input device configured to be actuated over an operating range. The operating range of the adjustable input device may be configured to enable an operator to dynamically control the amount of energy of the laser pulses emitted from the laser output from the laser system. The operating range of the adjustable input device may be configured to enable an operator to dynamically control the rate of the laser pulses emitted from the laser output from the laser system. The adjustable input device may include a foot pedal configured to be actuated over an operating range.

[0015] In some embodiments, the optical switching device includes a shutter and a shutter motor. The shutter motor may be configured to alternately move the shutter between a first position corresponding to a first state of the optical switching device and a second position corresponding to a second state of the optical switching device. The shutter may include a mirror. In some embodiments, the shutter has a rotation axis and at least one opening region and at least one solid region disposed about the rotation axis of the shutter, and the shutter motor is configured to rotate the shutter about the rotation axis of the shutter, and the first state of the optical switching device corresponds to a position of the shutter where the solid region of the shutter is not in the path of the laser pulses emitted from the laser, and the second state of the optical switching device corresponds to a position of the shutter where the solid region of the shutter is in the path of the laser pulses emitted from the laser.

[0016] In some embodiments, the optical switching device may further include a laser energy control system configured to adjust the amount of electromagnetic energy of each laser pulse exiting the laser system. The laser energy control system may include a waveplate, a waveplate motor, and a polarizer, and the waveplate motor is configured to move the waveplate to different positions corresponding to different proportions of the laser electromagnetic energy allowed to pass through the laser energy control system. In some embodiments, the optical switching device includes a Pockels cell.

[0017] In some embodiments, a method of controlling a surgical system includes: (i) providing an input to the surgical system, the surgical system including a laser configured to emit electromagnetic radiation in laser pulses and an optical switching device configured to switch between a first state in which the optical switching device allows a laser pulse emitted from the laser to be output from the laser system and a second state in which the optical switching device prevents a laser pulse emitted from the laser from being output from the laser system, and a laser pulse controller configured to communicate an optical switching control signal to the optical switching device, the input to the surgical system including an input for controlling the length of a pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system, the number of laser pulses in each pulse picking cycle output from the laser system being adjustable in a range including more than 50% of the laser pulses in each pulse picking cycle; (ii) emitting electromagnetic radiation from the laser in laser pulses; and (iii) outputting laser pulses from the laser system according to the input for controlling the length of the pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system.

[0018] In some embodiments, the step of outputting a laser pulse from the laser system according to the input includes controlling the ratio of the laser pulses emitted from the laser that are output from the laser system. In some embodiments, the step of outputting a laser pulse from the laser system according to the input includes controlling the amount of energy of the laser pulses emitted from the laser that are output from the laser system.

[0019] Further examples and features of embodiments of the present invention will become apparent from the drawings and the detailed description.

[0020] The accompanying drawings illustrate exemplary implementations of the systems and methods disclosed herein and serve to explain the principles of the present disclosure in conjunction with the description.

Brief Description of the Drawings

[0021]

Figure 1

Figure 2

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Figures 7A-7C

Figures 8A-8C

Figures 9A-9D

Figures 10A-10D

DETAILED DESCRIPTION OF THE INVENTION

[0022] The accompanying drawings can be better understood by referring to the following detailed description.

[0023] Here, for the purpose of facilitating the understanding of the principles of the present disclosure, with reference to the implementation forms shown in the drawings, specific language is used to describe those implementation forms and other implementation forms. Nevertheless, it will be understood that it is not intended to limit the scope of the claims by the examples illustrated in the drawings or described in this specification. Any modifications and further amendments to the systems, devices, apparatuses or methods illustrated or described, as well as any further applications of the principles of the present disclosure, are fully contemplated as being commonly recalled by those skilled in the relevant technical field of the present disclosure. In particular, the features, components and / or steps described with respect to certain implementation forms of the present disclosure may be combined with the features, components and / or steps described with respect to other implementation forms of the present disclosure. For the sake of simplicity, in some cases, the same or similar parts are referred to using the same reference numbers throughout the drawings.

[0024] As used herein, the terms "first" and "second" are not intended to indicate or imply any particular position or other characteristic. Rather, when the terms "first" and "second" are used herein, they are used only to distinguish one component from another. Terms such as "attached", "connected", "coupled", etc. mean that a part is directly or indirectly attached, connected, coupled, etc. to another part, unless a direct or indirect attachment, connection, coupling, etc. is specified.

[0025] FIG. 1 shows an exemplary ophthalmic surgical console 100 to which a foot pedal 106 is connected. The exemplary ophthalmic surgical console 100 may be used in the systems and methods according to the present disclosure. The ophthalmic surgical console 100 may be similar to the ophthalmic surgical console shown and described in U.S. Patent No. 9,931,447, the entire disclosure of which is hereby expressly incorporated by reference herein. The ophthalmic surgical console 100 may be similar to known and already used ophthalmic surgical consoles, such as the CENTURION® Vision System available from Alcon Laboratories, Inc. (Fort Worth, Texas) or the CONSTELLATION® Vision System available from Alcon Laboratories, Inc. (Fort Worth, Texas) or any other ophthalmic surgical console suitable for use with the principles described herein.

[0026] As shown in FIG. 1, the exemplary ophthalmic surgical console 100 includes a housing 102 within which a computer system is disposed, and a related display screen 104 that shows data related to the operation and performance of the system during an ophthalmic surgical procedure.

[0027] The foot pedal 106 is an adjustable input device that an operator can operate over a certain range of motion to control one or more functions. The foot pedal 106 can be depressed to various positions within the range of motion to control functions as further described below. Although the foot pedal 106 is shown, other adjustable input devices, such as buttons or knobs that are manually operated, can be used. The foot pedal 106 or other adjustable input device can be connected to the surgical console 100 by a wired or wireless connection.

[0028] The surgical console 100 includes one or more systems that can be used during an ophthalmic surgical procedure. For example, the surgical console 100 may include a fluid system that includes an irrigation system for delivering fluid to the eye and a suction system for aspirating fluid from the eye.

[0029] Exemplary surgical systems according to the present disclosure may include a laser system suitable for one or more ophthalmic procedures. FIG. 2 shows an example of the architecture of a surgical system, including a surgical console 100, an adjustable input device, such as a foot pedal 106, and an exemplary laser system 200. The laser system 200 may include a laser 212, an optical switching device 214, and a laser pulse controller 216. In some embodiments, the laser system 200 may be housed within the surgical console 100. In other embodiments, the laser system 200 may be housed within a separate console that communicates with the surgical console 100. In other embodiments, one or more portions of the laser system 200, such as the laser 212 and the optical switching device 214, may be housed within a separate console that communicates with the surgical console 100, and one or more other portions of the laser system 200, such as the laser pulse controller 216, may be housed within the surgical console 100. In other embodiments, the laser system 200 may be within a standalone housing that receives input from the foot pedal or other adjustable input device 106 without the need for a separate surgical console 100.

[0030] In addition to the laser 212, the optical switching device 214, and the laser pulse controller 216, the laser system 200 may have other components. For example, the laser system 200 may include components for operating the laser, such as a power source, a laser pump, a laser energy control element, and a monitor. In addition, the laser system 200 may include other components, such as one or more lenses, mirrors, and optical fibers (not shown), within the optical path of the laser output.

[0031] In some embodiments, the laser system 200 may be suitable for cataract surgery. In some embodiments, the output energy of the laser system is suitable for fragmenting and / or emulsifying the cataract lens. In some examples, the laser output is used to fragment and / or emulsify the lens to an extent sufficient to remove the lens.

[0032] In some embodiments, the laser system 200 may be suitable for glaucoma surgery. In some embodiments, the output energy of the laser system is suitable for forming or promoting the formation of drainage channels in the eye tissue.

[0033] The laser 212 can be any type of laser suitable for the desired application. The laser 212 can output suitable electromagnetic radiation of any appropriate wavelength. For example, the laser 212 can emit electromagnetic radiation of one or more wavelengths within the visible, infrared, and / or ultraviolet wavelengths. The laser 212 can operate or be operated to emit a continuous beam of electromagnetic radiation. Alternatively, the laser 212 can operate or be operated to emit a pulsed beam.

[0034] In one example, the laser 212 operates in the infrared range. For example, the laser 212 can output electromagnetic radiation within the mid-infrared range, such as in the range of about 2.0 micrometers to about 4.0 micrometers. Examples of some wavelengths include from about 2.5 micrometers to 3.5 micrometers, such as about 2.775 micrometers, about 2.8 micrometers, or about 3.0 micrometers. Such lasers may be suitable, for example, for lens fragmentation or other procedures in cataract surgery.

[0035] The laser system 200 is designed to direct the laser electromagnetic radiation from the laser 212 towards the output port. The laser system 200 can direct the laser electromagnetic radiation from the laser 212 towards the output port through one or more optical components such as lenses and mirrors.

[0036] An instrument can be optically connected to the laser system 200 to receive laser electromagnetic radiation from the output port. The instrument can be, for example, a handpiece for an ophthalmic procedure. The instrument or handpiece can be connected to the laser system by a delivery optical fiber. The delivery optical fiber is flexible and can be relatively long, whereby the operator can obtain flexibility when operating the handpiece at a position somewhat distant from the laser system 200. The laser electromagnetic radiation is emitted from the laser system 200 and can propagate through the optical fiber and the handpiece to a desired target such as the lens or lens fragment in the patient's eye from the output tip of the handpiece.

[0037] The optical switching device 214 is a device that operates such that laser electromagnetic radiation such as a laser pulse emitted from the laser 212 is output from the laser system or laser electromagnetic radiation such as a laser pulse emitted from the laser 212 is not output from the laser system. The optical switching device 214 can reciprocally switch between these two states under the control of the laser pulse controller 216.

[0038] In some examples, the optical switching device 214 can include a shutter and a shutter motor. Examples of suitable optical switching devices are described and illustrated in U.S. Provisional Patent Application No. 63 / 186,387, which is incorporated herein by reference in its entirety, and U.S. Provisional Patent Application No. 63 / 222,521, which is incorporated herein by reference in its entirety.

[0039] For example, the optical switching device 214 may include a shutter that is moved into and out of the path of the laser electromagnetic radiation by a shutter motor to selectively enable or prevent the laser electromagnetic radiation from being output from the laser system. The shutter motor may be configured to alternately move the shutter between a first position corresponding to a first state of the optical switching device (a state that enables laser electromagnetic energy such as a laser pulse emitted from the laser to be output from the laser system) and a second position corresponding to a second state of the optical switching device (a state that prevents laser electromagnetic energy such as a laser pulse emitted from the laser from being output from the laser system). In one example, the shutter includes a mirror, and the shutter motor includes a galvanometer motor.

[0040] In another example, the optical switching device 214 may include (i) a shutter having a rotation axis and at least one open region and at least one solid region disposed around the rotation axis of the shutter, and (ii) a shutter motor configured to rotate the shutter about the rotation axis of the shutter. In such an example, the first state of the optical switching device (a state that enables laser electromagnetic energy such as a laser pulse emitted from the laser to be output from the laser system) corresponds to a shutter position in which the solid region of the shutter is not in the path of the laser pulse emitted from the laser, and the second state of the optical switching device (a state that prevents laser electromagnetic energy such as a laser pulse emitted from the laser from being output from the laser system) corresponds to a shutter position in which the solid region of the shutter is in the path of the laser pulse emitted from the laser.

[0041] The optical switching device 214 may further include a laser energy control system configured to adjust the amount of electromagnetic energy of each laser pulse exiting the laser system. For example, the laser energy control system may include a waveplate, a waveplate motor, and a polarizer, and the waveplate motor is configured to move the waveplate to different positions corresponding to different proportions of laser electromagnetic energy allowed to pass through the laser energy control system. Examples of such laser energy control systems are described and illustrated in U.S. Provisional Patent Application No. 63 / 186,387, which is incorporated herein by reference in its entirety, and U.S. Provisional Patent Application No. 63 / 222,521, which is incorporated herein by reference in its entirety, as described above.

[0042] In another alternative embodiment, the optical switching device 214 may include a Pockels cell. The Pockels cell optical switching device can reciprocally switch between a first state that allows a laser pulse emitted from the laser to be output from the laser system and a second state that prevents the laser pulse emitted from the laser from being output from the laser system under the control of the laser pulse controller 216. The Pockels cell optical switching device can also be operated stepwise to allow different proportions of the electromagnetic energy emitted by the laser to be output by the laser system.

[0043] The laser pulse controller 216 is configured to communicate an optical switching control signal to the optical switching device 214. The optical switching control signal is based on an input to the surgical system, including an input from an adjustable input device, such as the foot pedal 106, if provided.

[0044] FIG. 3 shows an example of a laser system 200 having components of an optical switching device 214. In the example shown, the optical switching device 214 includes a power control device 222 and a pulse picking device 224. The pulse picking device 224 can include any suitable pulse picking device, including but not limited to a shutter-based pulse picking device as described above. The power control device 222 can include any suitable power control device, including but not limited to a waveplate-based power control device as described above. In an alternative embodiment, a Pockels cell configuration can function as the pulse picking device 224 and / or the power control device 222. The laser system 200 can further include a beam polarizer 226. The laser pulse controller 216 transmits a laser power control signal and a pulse picking control signal to the optical switching device 214. As described above, the handpiece 228 can be connected to an output port of the laser system 200, for example, by a cable having an optical fiber. The output laser pulse train from the laser system 200 travels through the optical fiber and the handpiece 228 towards a target (e.g., a cataract lens, zonular fibers, scleral tissue, other tissue, etc.).

[0045] FIG. 4 shows an example of the architecture of the laser pulse controller 216. As will be understood by those skilled in the art, the use of a controller in a processing environment can be implemented in the form of software, firmware, hardware, or any suitable combination of software, firmware, and / or hardware, such as software loaded and executed on a processor. The laser pulse controller 216 can be implemented in the form of software, firmware, hardware, or any suitable combination of software, firmware, and / or hardware, such as software loaded and executed on a processor.

[0046] Exemplary laser pulse controller 216 includes a serial transmitter / receiver (Tx / Rx) module 231 that communicates with a serial communication (Tx / Rx) controller of surgical console 100 or a similar device (e.g., a similar UART, CAN bus, or Ethernet device). In use, surgical console 100 sends a packet of data to laser pulse controller 216, which is received by serial Tx / Rx module 231. As will be described in more detail below, the packet can include data that is at least partially based on an input from adjustable input device 106. Packet syntax analysis module 232 of laser pulse controller 216 is configured to analyze the packet data. In the example shown, packet syntax analysis module 232 sends the repetition rate data to repetition rate control module 233, the mode data to mode detection module 234, the power data to mode power control module 235, the pulse picking frequency data to pulse picking frequency control module 236, the pulse picking duty ratio data to pulse picking ratio control module 237, the pulse picking number data to pulse picking number control module 238, and the subrange data to subrange control module 239. Repetition rate control module 233 also receives a laser trigger input signal indicating the start timing of each laser pulse. Repetition rate control module 233 sends a signal indicating the repetition rate of the laser to output pulse control module 240, which can also receive the laser trigger input signal. Output pulse control module 240 also receives input signals based on the respective input data from mode detection module 234, mode power control module 235, pulse picking frequency control module 236, pulse picking ratio control module 237, pulse picking number control module 238, and subrange control module 239.

[0047] The output pulse control module 240 of the laser pulse controller 216 transmits an optical switching control signal to the optical switching device 214, and the optical switching control signal can be at least partially based on the input from the adjustable input device 106. The optical switching control signal communicated to the optical switching device 214 by the laser pulse controller 216 can include a pulse picking rate signal (e.g., Pulse_Picking_Sync signal or Pulse_Picking_Out signal) that controls the length of the pulse picking cycle. For example, the pulse picking rate signal can be a synchronization signal (e.g., Pulse_Picking_Sync) that is a timing signal corresponding to the pulse picking rate, and can be, for example, a signal that marks the start of each pulse picking cycle. The optical switching control signal communicated to the optical switching device 214 by the laser pulse controller 216 can also include a pulse control signal (e.g., Pulse_Picking_Duty signal or Pulse_Control_Out signal) that controls the ratio or number of laser pulses in each pulse picking cycle output from the laser system. The optical switching control signal communicated to the optical switching device 214 by the laser pulse controller 216 can also include a power level signal (e.g., Mode_Power_Data signal or Mode_Power_Out signal) that controls the amount of energy of the laser pulses output from the laser system. A repetition rate signal (e.g., Rep_Rate_Out) can be transmitted to control the repetition rate of the laser pulses emitted by the laser.

[0048] As described in detail below, a pulse control signal (e.g., Pulse_Picking_Duty) can enable the output of various pulses in each pulse picking cycle. As described in detail below, the number of laser pulses in each pulse picking cycle output from the laser system can be adjustable within a range including more than 50% of the laser pulses in each pulse picking cycle. In some embodiments, the number of laser pulses in each pulse picking cycle output from the laser system can be adjustable within a range of 0% to 100% of the laser pulses in each pulse picking cycle. In some embodiments, when the laser system is set such that the number of laser pulses emitted by the laser in each pulse picking cycle is N, the number of laser pulses in each pulse picking cycle output from the laser system can be adjustable within a range including 1 and N - 1 and optionally within a range including 0 and / or N (e.g., a range of 0 to N, a range of 1 to N, a range of 0 to N - 1, a range of 1 to N - 1, etc.). For example, when the laser system is set such that the number of laser pulses emitted by the laser in each pulse picking cycle is 10, the number of laser pulses in each pulse picking cycle output from the laser system can be adjustable within a range including 1 and 9 and in some embodiments within a range including 0 and / or 10. As another example, when the laser system is set such that the number of laser pulses emitted by the laser in each pulse picking cycle is 16, the number of laser pulses in each pulse picking cycle output from the laser system can be adjustable within a range including 1 and 15 and in some embodiments within a range including 0 and / or 16.

[0049] The output pulse control module 240 of the laser pulse controller 216 can also send a message confirmation signal to the packet framing module 241. The packet framing module 241 assembles the data from the message confirmation signal and sends it as a packet of data to the serial Tx / Rx module 231. Then, the Tx / Rx module 231 sends the packet of data based on the message confirmation signal to the serial Tx / Rx controller of the surgical console 100 to confirm the signal from the laser pulse controller 216.

[0050] Figure 5 shows an example of the operating range of an adjustable input device such as the foot pedal 106. The foot pedal 106 or other adjustable input device can be actuated by the operator over the operating range to control the laser output. In the example of the foot pedal, the operator depresses the foot pedal by a desired amount to move the foot pedal to a desired region of the operating range. In other examples, such as a hand-operated button or knob, the operator moves or adjusts the input device to a desired region of the operating range. In some embodiments, the foot pedal or other adjustable input device is adjustable in real time during a surgical procedure, allowing the operator to dynamically control the laser pulses output from the laser system during the procedure.

[0051] Many examples of various functions across the operating range are possible. In the illustrated example, the operating range includes three sub-ranges, although more or fewer sub-ranges may be used.

[0052] The following is an explanation for one of many examples. When the adjustable input device is moved or adjusted to sub-range 1, the surgical console can be actuated for certain functions such as perfusion without laser output. When the adjustable input device is moved or adjusted to sub-range 2, the surgical console can be actuated for another function such as suction without laser output. The perfusion function can continue to operate in sub-range 2. When the adjustable input device is moved or adjusted to sub-range 3, the laser system can be actuated to output laser electromagnetic energy. The perfusion and / or suction functions can continue to operate in sub-range 3. By moving or adjusting the adjustable input device within sub-range 3, the operator can dynamically adjust the laser output as described below.

[0053] Many variations are possible. For example, sub-ranges 2 and 3 in the above example can be reversed, and laser control can be performed in sub-range 2 and suction can be performed in sub-range 3.

[0054] In one example, the adjustment of the adjustable input device controls the proportion of the electromagnetic energy of the output laser pulse. That is, the laser emits a laser pulse with a specific energy, and the input from the adjustable input device is used to adjust the laser energy control system of the optical switching device 214 to control the proportion of the energy of the laser pulse output from the laser system. Based on the input from the adjustable input device, the power level signal (e.g., Mode_Power_Data) sent to the optical switching device 214 by the laser pulse controller 216 can be adjusted to control the amount of energy of the laser pulse output from the laser system. For example, the top of sub-range 3 may correspond to 0% laser energy output, the bottom of sub-range 3 may correspond to 100% laser energy output, and the positions in between may correspond to increments within the range of 0% to 100%. In other examples, the operating range of the adjustable input device is configured to enable an operator to dynamically control the proportion of the laser pulses emitted from the laser that are output from the laser system. In other examples, adjusting the adjustable input device to sub-range 3 or a specific point in sub-range 3 can function as an on-off switch to trigger the operation of the laser system at a set output.

[0055] For example, one or more inputs to the system from a touch screen (having a graphical user interface), button, dial, knob, foot pedal, adjustable input device, or other input device can be used to control a laser system to output only certain laser pulses of the laser pulses emitted by a laser. That is, the laser emits laser pulses at a specific repetition rate, and the input is used to control an optical switching device 214 to reciprocate between a first state that allows the laser pulses emitted from the laser to be output from the laser system and a second state that prevents the laser pulses emitted from the laser from being output from the laser system. One or more of the inputs to the system can include or be part of a console 100, an adjustable input device 106, and / or an external control system (e.g., having its own touch screen (having a graphical user interface), button, dial, knob, or other input device).

[0056] In certain embodiments, the user input controls a pulse picking frequency that controls the length of a pulse picking cycle and a pulse picking duty ratio. Based on the input, a laser pulse controller sends signals (e.g., Pulse_Picking_Sync signal and Pulse_Picking_Duty signal) to the optical switching device to control the pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system. For example, if the repetition rate of the laser is 1000 Hz and the pulse picking rate is 100 Hz, 10 pulses are obtained per cycle. By selecting an input that controls the pulse picking duty ratio, a range of different numbers of pulses per cycle (e.g., ranges such as 1 - 9, 1 - 10, 0 - 9, 0 - 10, etc.) can be output, thereby controlling the ratio of the laser pulses output.

[0057] In some examples, the repetition rate of the laser and the energy output of the laser (including different laser energy outputs as required) can be selected by an adjustable input device or another input device such as a touch screen, button, dial, knob, or other input.

[0058] Figure 6 shows an example of an instruction packet for sending to a laser pulse controller. The packet includes the following data: header, mode, mode power, repetition rate, pulse picking frequency, pulse picking duty ratio, pulse picking number, sub-range 1, sub-range 2, sub-range 3, and end. The header identifies the start of the packet. The mode identifies which operating mode is selected. The mode power identifies the selected power output of the laser. The repetition rate identifies the rate of the pulses emitted from the laser. The pulse picking frequency identifies the length of the pulse picking cycle. The pulse picking duty ratio identifies the number or ratio of the pulses output in each pulse picking cycle. The pulse picking number identifies the maximum number of laser pulses that can be selected in each pulse picking cycle. Sub-range 1, sub-range 2, and sub-range 3 identify the position where the adjustable input device is moved or adjusted, including the notch position (e.g., 0 - 100) within that range.

[0059] Figure 7A shows an example of a laser pulse emitted from a laser, and each upward arrow represents a laser pulse. This shows the repetition rate of the laser pulses emitted by the laser, which is 1KHz in this example.

[0060] Figure 7B shows an example of a static pulse control signal. The power level signal (e.g., Mode_Power_Data) is set to 100%. In the static mode, as shown, this power level is constant. In the variable mode, this power level is adjustable, for example, by an adjustable input device (e.g., a foot pedal).

[0061] FIG. 7C shows the output of laser pulses by the static pulse control signal of FIG. 7B. As can be seen from the figure, all laser pulses are output at 100% power.

[0062] FIG. 8A shows an example of laser pulses emitted from a laser, similar to FIG. 7A. Similar to FIG. 7A, this shows the repetition rate of the laser pulses emitted by the laser, which is 1 KHz in this example.

[0063] FIG. 8B shows an example of a first pulse picking frequency at which 50% of the pulses emitted by the laser are output from the laser system. In this example, the pulse picking frequency is 100 Hz, and if the repetition rate is 1 KHz, 10 laser pulses can be obtained per pulse picking cycle. The pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled with S, which marks the start of each pulse picking cycle. When the duty ratio is 50%, 5 pulses are output from the system per pulse picking cycle. That is, a pattern in which 5 laser pulses are output and then 5 laser pulses are not output is repeated.

[0064] FIG. 8C shows an example of a second pulse picking frequency at which 50% of the pulses emitted by the laser are output from the laser system. In this example, the pulse picking frequency is 50 Hz, and if the repetition rate is 1 KHz, 20 laser pulses can be obtained per pulse picking cycle. Similar to FIG. 8B, the pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled with S, which marks the start of each pulse picking cycle. When the duty ratio is 50%, 10 pulses are output from the system per pulse picking cycle. That is, a pattern in which 10 laser pulses are output and then 10 laser pulses are not output is repeated.

[0065] The operating modes of FIGS. 7A-7C and FIGS. 8A-8C are similar in output to the operating modes described and shown in U.S. Provisional Patent Application No. 63 / 256,071, which is hereby incorporated by reference in its entirety. For example, FIG. 7C shows an output similar to the sculpt mode described and shown in that application, and FIGS. 8B and 8C show outputs similar to the quad mode described and shown in that application. FIGS. 9A-9D and FIGS. 10A-10D show how embodiments herein enable further flexibility in the percentage of laser pulses that can be output in each pulse picking cycle. In certain embodiments herein, the number of laser pulses in each pulse picking cycle output from the laser system is adjustable in a range that includes more than 50% of the laser pulses in each pulse picking cycle. In certain embodiments herein, up to 100% of the laser pulses can be output in a pulse picking cycle. When operating with 100% of the laser pulses output, such embodiments are similar to sculpt mode embodiments. When operating with less than 100% of the laser pulses output, such embodiments are similar to quad mode embodiments.

[0066] FIG. 9A, like FIGS. 7A and 8A, shows an example of a laser pulse emitted from a laser. Like FIGS. 7A and 8A, this shows the repetition rate of the laser pulses emitted by the laser, which in this example is 1 KHz.

[0067] FIG. 9B shows an example in which the laser system is adjusted to output one of the ten laser pulses emitted by the laser. In this example, the pulse picking frequency is 100 Hz, and if the repetition rate is 1 KHz, ten laser pulses can be obtained per pulse picking cycle. The pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled with S that marks the start of each pulse picking cycle. The duty ratio signal (e.g., Pulse_Picking_Duty) establishes the number or ratio of laser pulses in each pulse picking cycle in which the output from the system is allowed. In the example of FIG. 9B, the duty ratio is 10% or one out of ten pulses. As a result, one pulse is output from the system per pulse picking cycle. That is, a pattern in which one laser pulse is output and then nine laser pulses are not output is repeated.

[0068] FIG. 9C shows an example in which the laser system is adjusted to output five of the ten laser pulses emitted by the laser. Similar to FIG. 9B, in this example, the pulse picking frequency is 100 Hz, and if the repetition rate is 1 KHz, ten laser pulses can be obtained per pulse picking cycle. Similar to FIG. 9B, the pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled with S that marks the start of each pulse picking cycle. The duty ratio signal (e.g., Pulse_Picking_Duty) establishes the number or ratio of laser pulses in each pulse picking cycle in which the output from the system is allowed. In the example of FIG. 9C, the duty ratio is 50% or five out of ten pulses. As a result, five pulses are output from the system per pulse picking cycle. That is, a pattern in which five laser pulses are output and then five laser pulses are not output is repeated.

[0069] FIG. 9D shows an example where the laser system is adjusted to output 9 out of 10 laser pulses emitted by the laser. Similar to FIGS. 9B and 9C, in this example, the pulse picking frequency is 100 Hz, and if the repetition rate is 1 KHz, 10 laser pulses can be obtained per pulse picking cycle. Similar to FIGS. 9B and 9C, the pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled S that marks the start of each pulse picking cycle. The duty ratio signal (e.g., Pulse_Picking_Duty) establishes the number or ratio of laser pulses in each pulse picking cycle where the output from the system is allowed. In the example of FIG. 9D, the duty ratio is 90% or 9 out of 10 pulses. As a result, 9 pulses are output from the system per pulse picking cycle. That is, a pattern where 9 laser pulses are output and then 1 laser pulse is not output is repeated.

[0070] FIG. 10A shows an example of a laser pulse emitted from a laser, similar to FIGS. 7A, 8A, and 9A. Similar to FIGS. 7A, 8A, and 9A, this shows the repetition rate of the laser pulses emitted by the laser, which is 1 KHz in this example.

[0071] Figure 10B shows an example where the laser system is adjusted to output one of the 16 laser pulses emitted by the laser. In this example, the pulse picking frequency is 62.5 Hz, and if the repetition rate is 1 KHz, 16 laser pulses can be obtained per pulse picking cycle. The pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled with S that marks the start of each pulse picking cycle. The duty ratio signal (e.g., Pulse_Picking_Duty) establishes the number or ratio of laser pulses in each pulse picking cycle where the output from the system is allowed. In the example of Figure 10B, the duty ratio is 6.25% or 1 out of 16 pulses. As a result, 1 pulse is output from the system per pulse picking cycle. That is, a pattern where 1 laser pulse is output and then 15 laser pulses are not output is repeated.

[0072] Figure 10C shows an example where the laser system is adjusted to output eight of the 16 laser pulses emitted by the laser. Similar to Figure 10B, in this example, the pulse picking frequency is 62.5 Hz, and if the repetition rate is 1 KHz, 16 laser pulses can be obtained per pulse picking cycle. Similar to Figure 10B, the pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled with S that marks the start of each pulse picking cycle. The duty ratio signal (e.g., Pulse_Picking_Duty) establishes the number or ratio of laser pulses in each pulse picking cycle where the output from the system is allowed. In the example of Figure 10C, the duty ratio is 50% or 8 out of 16 pulses. As a result, 8 pulses are output from the system per pulse picking cycle. That is, a pattern where 8 laser pulses are output and then 8 laser pulses are not output is repeated.

[0073] FIG. 10D shows an example where the laser system is adjusted to output 15 out of 16 laser pulses emitted by the laser. Similar to FIGS. 10B and 10C, in this example, the pulse picking frequency is 62.5 Hz, and if the repetition rate is 1 KHz, 16 laser pulses can be obtained per pulse picking cycle. Similar to FIGS. 10B and 10C, the pulse picking frequency can be established by a synchronization signal (e.g., Pulse_Picking_Sync) labeled S that marks the start of each pulse picking cycle. The duty ratio signal (e.g., Pulse_Picking_Duty) establishes the number or ratio of laser pulses in each pulse picking cycle where the output from the system is allowed. In the example of FIG. 9D, the duty ratio is 93.75% or 15 out of 16 pulses. As a result, 15 pulses are output from the system per pulse picking cycle. That is, a pattern where 15 laser pulses are output and then 1 laser pulse is not output is repeated.

[0074] The maximum number of pulses that can be selected for output in each pulse picking cycle is based on both the repetition rate of the laser and the pulse picking rate. The following table shows how the maximum number of pulses that can be selected for output in each pulse picking cycle changes when the pulse picking rate is adjusted for repetition rates of 1100 Hz and 1000 Hz and certain exemplary pulse picking rates.

[0075] [Table 1]

[0076] Any repetition rate suitable for the desired application can be used. As an additional example, the following table shows how the maximum number of pulses that can be selected for output in each pulse picking cycle changes when the pulse picking rate is adjusted for repetition rates of 1500 Hz and 2000 Hz and certain exemplary pulse picking rates.

[0077]

Table 2

[0078] By selecting and / or adjusting the repetition rate, pulse picking rate, and pulse picking duty ratio, any desired sequence can be selected to output laser pulses and to prevent the output of laser pulses. With the adjustable input devices and systems and methods disclosed herein, an operator can flexibly control the laser pulse output.

[0079] An exemplary method of controlling a surgical system as described herein is as follows. The operator selects inputs for the operating mode, maximum power, laser repetition rate, pulse picking rate, and duty ratio. In some embodiments, specific options may be provided for selection, and depending on the operator's selection, the surgical system sets the operating mode, maximum power, laser repetition rate, pulse picking rate, and / or duty ratio. Alternatively, any of these parameters may be preset. The operator operates the system and directs the laser output of the handpiece to a desired location (e.g., a cataract lens, zonular fibers, scleral tissue, other tissue, etc.). Based on the input and optionally other parameters, a control signal is sent (e.g., by a packet as in FIG. 6) to the laser pulse controller. Based on the input, the laser pulse controller sends an optical switching control signal to the optical switching device to control the laser output. The laser emits electromagnetic radiation from the laser as laser pulses. Based on the input, the optical switching device selectively allows certain laser pulses to be output and prevents certain laser pulses from being output. In some embodiments, the operator actuates an adjustable input device (e.g., a foot pedal) over an operating range to dynamically control the power of the laser pulses output from the laser system.

[0080] The optical switching control signal may include a pulse picking frequency signal that controls the length of the pulse picking cycle and a pulse picking duty ratio signal that controls the number of laser pulses in each pulse picking cycle output from the laser system. The operator may dynamically adjust an adjustable input device in real time to adjust the power output, i.e., the power level signal may be based on the dynamic input from the adjustable input device. The operator may adjust the adjustable input device dynamically in real time to adjust the power level signal and thus the amount of energy of the laser pulses that will be output from the laser system. In other examples, the operator may dynamically adjust an adjustable input device in real time to adjust the number or rate of laser pulses emitted from the laser output from the laser system.

[0081] The operator can switch the input. The input selected may be based on the type of treatment, stage of treatment, status, or other factors.

[0082] The ability to selectively output laser pulses and / or control laser output energy is useful in procedures where laser control is advantageous. For example, in cataract surgery, it may be desirable to operate the laser system at a high power to initially break up the lens. Lower energy levels may be preferred as it may be desirable to operate the laser system at a lower power to break up smaller fragments. Control of the number of laser pulses and / or the pulse energy level allows for the appropriate level of force to be applied to smaller particles that can be displaced before they can be aspirated from the eye by the handpiece irrigation system, which would not be possible without such control. As another example, in the treatment of glaucoma, it may be desirable to operate the laser system with a single laser pulse or only a few laser pulses to form a flow path through the eye tissue. In such procedures, a longer pulse picking frequency may be desirable. For example, with a long pulse picking cycle and a low duty ratio, the system can be configured such that the operator can emit one or only a few laser pulses at a time. For example, in some embodiments, the operator can use a foot pedal to emit one or only a few laser pulses at a time. It may also be desirable to use soft or low energy for certain glaucoma procedures.

[0083] As will be appreciated by those skilled in the art, the systems and methods disclosed herein have advantages over conventional systems and methods. For example, the systems and methods as described herein allow for simple, flexible, and / or dynamic control of laser pulses and energy, improving the ease, time, efficiency, accuracy, outcome, and / or cost of the procedure.

[0084] Those skilled in the art will appreciate that the embodiments encompassed by the present disclosure are not limited to the specific exemplary embodiments described above. Although the exemplary embodiments have been illustrated and described, a wide range of modifications, changes, and substitutions to the foregoing present disclosure are contemplated. It should be understood that such variations to the foregoing may be made without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly and in harmony with the present disclosure.

Claims

1. a laser configured to emit electromagnetic radiation as laser pulses, an optical switching device configured to switch between a first state that enables laser pulses emitted from the laser to be output from a laser system and a second state that prevents laser pulses emitted from the laser from being output from the laser system, a laser pulse controller configured to communicate an optical switching control signal to the optical switching device A surgical system comprising: the optical switching control signal communicated by the laser pulse controller controls the length of a pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system, the number of laser pulses in each pulse picking cycle output from the laser system is adjustable within a range including more than 50% of the laser pulses in each pulse picking cycle. A surgical system.

2. The surgical system according to claim 1, wherein the number of laser pulses in each pulse picking cycle output from the laser system is adjustable within a range of 0% to 100% of the laser pulses in each pulse picking cycle.

3. When the laser system is set such that the number of laser pulses emitted by the laser in each pulse picking cycle is N, the number of laser pulses in each pulse picking cycle output from the laser system is adjustable within a range including 1 and N-1. The surgical system according to claim 1.

4. The surgical system according to claim 1, wherein the optical switching control signal communicated by the laser pulse controller includes a first signal that controls the length of the pulse picking cycle and a second signal that controls the number of laser pulses in each pulse picking cycle output from the laser system.

5. The surgical system according to claim 4, wherein the first signal is a synchronization signal.

6. The surgical system according to claim 1, wherein the optical switching device is further configured to control the amount of energy of the laser pulse emitted from the laser output from the laser system.

7. The surgical system according to claim 1, further comprising an adjustable input device configured to be actuated over an operating range.

8. The operating range of the adjustable input device is configured to enable an operator to dynamically control the amount of energy of the laser pulse emitted from the laser output from the laser system, according to claim 7.

9. The operating range of the adjustable input device is configured to enable an operator to dynamically control the ratio of the laser pulses emitted from the laser output from the laser system, according to claim 7.

10. The surgical system according to claim 7, wherein the adjustable input device includes a foot pedal configured to be actuated over the operating range.

11. The surgical system according to claim 1, wherein the optical switching device includes a shutter and a shutter motor.

12. The shutter motor is configured to alternately move the shutter between a first position corresponding to the first state of the optical switching device and a second position corresponding to the second state of the optical switching device, according to claim 11.

13. The surgical system according to claim 12, wherein the shutter includes a mirror.

14. The shutter has a rotation axis, and at least one opening region and at least one solid region arranged around the rotation axis of the shutter, The shutter motor is configured to rotate the shutter around the rotation axis of the shutter, The first state of the optical switching device corresponds to a position of the shutter where the solid region of the shutter is not in the path of the laser pulse emitted from the laser, The second state of the optical switching device corresponds to a position of the shutter where the solid region of the shutter is in the path of the laser pulse emitted from the laser, according to claim 11.

15. The surgical system according to claim 11, wherein the optical switching device further includes a laser energy control system configured to adjust the amount of electromagnetic energy of each laser pulse exiting the laser system.

16. The laser energy control system includes a wave plate, a wave plate motor, a polarizing plate The surgical system according to claim 15, wherein the wave plate motor is configured to move the wave plate to different positions corresponding to different proportions of laser electromagnetic energy allowed to pass through the laser energy control system.

17. The surgical system according to claim 1, wherein the optical switching device includes a Pockels cell.

18. A method of controlling a surgical system, comprising: (i) providing an input to the surgical system, the surgical system including a laser configured to emit electromagnetic radiation as laser pulses, an optical switching device configured to switch between a first state in which the optical switching device allows a laser pulse emitted from the laser to be output from the laser system and a second state in which the optical switching device prevents a laser pulse emitted from the laser from being output from the laser system, and a laser pulse controller configured to communicate an optical switching control signal to the optical switching device The input to the surgical system includes an input for controlling the length of a pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system, the number of laser pulses in each pulse picking cycle output from the laser system being adjustable in a range including more than 50% of the laser pulses in each pulse picking cycle, and providing; (ii) emitting electromagnetic radiation from the laser as laser pulses; (iii) outputting laser pulses from the laser system according to the input for controlling the length of the pulse picking cycle and the number of laser pulses in each pulse picking cycle output from the laser system A method including.

19. ​ The step of outputting a laser pulse from the laser system according to the input includes controlling a ratio of the laser pulses emitted from the laser that are output from the laser system, the method of controlling a surgical system according to claim 18. **Claim 20** The step of outputting a laser pulse from the laser system according to the input includes controlling an amount of energy of the laser pulses emitted from the laser that are output from the laser system, the method of controlling a surgical system according to claim 18.

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