Corneal cross-linking system and method

Abstract

The present disclosure provides a system capable of receiving data associated with a plurality of locations associated with a cornea of ​​an eye, adjusting at least one lens to set a diameter of a laser beam based on at least diameter information in the data associated with at least one of the plurality of locations, determining for each of the plurality of locations whether the eye has changed from a first position to a second position, adjusting at least one mirror based at least on the location if the eye has not changed from the first position to the second position, adjusting at least one mirror based at least on the location if the eye has changed from the first position to the second position and based at least on the second position, generating a laser beam, and directing the laser beam to the location for a period of time.

Description

[Technical Field]

[0001] The present disclosure relates to corneal cross-linking. [Background technology]

[0002] In the past, corneal cross-linking (CXL) was used to treat keratoconus. In this condition, a patient's cornea thins and weakens over time. Other conditions can cause similar corneal weakening. The weakened cornea can bulge into a cone or some other irregular shape. The cone shape can distort the eye's vision. If the cornea continues to weaken and / or becomes too thin, the eye may undergo a corneal transplant. With CXL, doctors use riboflavin and ultraviolet (UV) light to strengthen the corneal tissue. The source of the UV light is a UV lamp, which can generate UV light for a certain period of time. CXL can strengthen the bonds between the collagen fibers in the cornea. The bonds between the collagen fibers help stabilize the cornea. As the corneal tissue becomes stronger, the cornea may undergo one or more additional bulges and / or reduce one or more risks of corneal rupture. CXL can slow or stop the progression of progressive keratoconus. Summary of the Invention [Means for solving the problem]

[0003] The present disclosure provides a system capable of receiving data associated with a plurality of locations associated with a cornea of a patient's eye, and capable of adjusting at least one lens to set a diameter of a laser beam based on at least diameter information in the data associated with at least one of the plurality of locations. The system may include a laser that generates a laser beam. The laser beam may be an ultraviolet (UV) laser beam. A first portion of the cornea may be associated with the plurality of locations. A second portion of the cornea may be different from the first portion and not associated with the plurality of locations. The system may further determine, for each of the plurality of locations, whether the eye has changed from a first position to a second position different from the first position, and if the eye has not changed from the first position to the second position, further adjust at least one mirror based at least on the location, and if the eye has changed from the first position to the second position, further adjust at least one mirror based at least on the location and at least on the second position, and further generate a laser beam and further direct the laser beam to the location for a time period associated with the location.

[0004] To determine whether the eye has changed from a first ocular position to a second ocular position, the system can further determine whether an iris structure of the eye has changed from a first iris structure position to a second iris structure position. To generate the laser, the system can pulse the laser beam with a pulse duration. For example, the pulse duration can be, among others, a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration. A first period associated with a first one of the multiple locations can be different from a second period associated with a second one of the multiple locations, which is different from the first location. The system can further adjust at least one lens to set a second diameter of the laser beam based on at least second diameter information in the data associated with at least another one of the multiple locations. The system can further translate at least two of the multiple locations based on at least the first ocular position and the second ocular position when the eye has changed from the first ocular position to the second ocular position. Before the laser beam is generated, the system can generate an additional laser beam to incise at least one of a flap and a pocket in the cornea.

[0005] The present disclosure further includes a non-transitory computer-readable memory device having instructions that, when executed by the system's processor, cause the system to perform the steps described above. The present disclosure further includes the above-described systems and / or non-transitory computer-readable memory devices having one or more of the following functions, which may be used in combination with each other unless clearly mutually exclusive: i) receiving data associated with a plurality of locations associated with the cornea of a patient's eye; ii) adjusting at least one lens based on diameter information in the data associated with at least one of the plurality of locations to set a diameter of a laser beam; iii) determining whether the eye has changed from a first eye position to a second eye position different from the first eye position; iv) adjusting at least one mirror based at least on the location if the eye has not changed from the first eye position to the second eye position; v) adjusting at least one mirror based at least on the location and at least on the second eye position if the eye has changed from the first eye position to the second eye position; vi) generating a laser beam; and vii) directing the laser beam to the location for a time period associated with the location. viii) determining whether an iris structure of the eye has changed from a first iris structure position to a second iris structure position; ix) pulsing the laser beam with a pulse duration; x) adjusting at least one lens to set a second diameter of the laser beam based on second diameter information in the data associated with at least another one of the at least plurality of positions; xi) translating at least two of the plurality of positions based on at least the first eye position and the second eye position if the eye has changed from the first eye position to the second eye position; xii) generating another laser beam to incise at least one of a corneal flap and a pocket before generating the laser beam.

[0006] Any of the above systems may be capable of performing any of the above methods, and any of the above non-transitory computer-readable memory devices may be capable of causing a system to perform any of the above methods. Any of the above methods may be implemented in any of the above systems or using any of the above non-transitory computer-readable memory devices.

[0007] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the disclosure. In that regard, additional aspects, features, and advantages of the present disclosure will become apparent to those skilled in the art from the following detailed description. [Brief explanation of the drawings]

[0008] For a more complete understanding of the present disclosure and its features and advantages, reference is now made to the following descriptions taken in conjunction with the accompanying drawings, which are not to scale.

[0009] [Figure 1A] FIG. 1A illustrates an example of a medical system. [Figure 1B] FIG. 1B shows an example of a biometric device. [Figure 2] FIG. 2 shows an example of a laser system. [Figure 3] FIG. 3 shows an example of the layers of the cornea of the eye. [Figure 4A] FIG. 4A shows a second example of a medical system. [Figure 4B] FIG. 4B shows a third example of a medical system. [Figure 4C] FIG. 4C shows an example of a microscope-integrated display and several examples of surgical tool instruments. [Figure 5] FIG. 5 shows an example of a computer system. [Figure 6A] FIG. 6A shows several examples of eyes. [Figure 6B] FIG. 6B shows several examples of eyes. [Figure 6C]FIG. 6C shows several examples of eyes. [Figure 6D] FIG. 6D shows several examples of eyes. [Figures 6E-6F] 6E and 6F show several examples of eyes and coordinate systems. [Figures 6G-6H] 6G and 6H show several example eyes and coordinate systems. [Figure 7A] FIG. 7A illustrates an example of a method for operating a medical system. [Figure 7B] FIG. 7B illustrates another example of a method for operating a medical system. [Figure 8] FIG. 8 shows an example of data associated with multiple locations associated with the cornea of a patient's eye. [Figure 9A] FIG. 9A shows an example of a plane and multiple locations. [Figure 9B] FIG. 9B shows an example of a plane associated with an eye. [Figure 9C-9D] FIG. 9C shows an example of a location associated with a plane, and FIG. 9D shows an example of multiple locations associated with a plane. [Figure 9E-9F] FIG. 9E shows a second example of multiple locations associated with a plane, and FIG. 9F shows another example of multiple locations associated with a plane. [Figure 9G] FIG. 9G shows an example of multiple locations associated with a plane and a cornea. [Figure 9H] FIG. 9H shows an example of a portion of the cornea associated with multiple locations. DETAILED DESCRIPTION OF THE INVENTION

[0010] In the following description, details are set forth as examples to facilitate discussion of the disclosed subject matter, however, it should be apparent to those skilled in the art that the disclosed embodiments are examples and do not encompass all possible embodiments.

[0011] As used herein, a reference number refers to a class or type of entity, and any letter following such a reference number refers to a particular instance of a particular entity of that class or type. Thus, for example, a virtual entity referenced by "12A" may refer to a particular instance of a particular class / type, and the reference number "12" may refer generally to a set of instances belonging to that particular class / type or to any one instance of that class / type.

[0012] The medical systems may be utilized in performing a medical procedure on a patient. In one example, a first medical system may be utilized a first time in identifying one or more parts of the patient prior to the medical procedure. In a second example, a second medical system may be utilized a second time in performing the medical procedure. In another example, the second medical system may utilize one or more identifications each associated with one or more parts of the patient a second time. The second time may be a later time than the first time. In one example, the first medical system may be utilized in a doctor's office. In a second example, the second medical system may be utilized in a surgical facility. In another example, the second medical system may be utilized in a doctor's office.

[0013] A medical system may include an optical system. For example, a diagnostic system may include one or more optical systems, which may include an optical system. An optical system may include one or more optical devices. For example, an optical device may be or include a device that controls light (e.g., reflects light, refracts light, filters light, transmits light, polarizes light, etc.). An optical device may be made of any material that controls light as designed. For example, the material may include one or more of glass, quartz, metal, and semiconductor, among others. Examples of optical devices may include one or more of lenses, mirrors, prisms, optical filters, waveguides, wave plates, beam expanders, beam collimators, beam splitters, gratings, and polarizers, among others.

[0014] Medical procedures may include corneal cross-linking (CXL). CXL may be used to treat conditions and / or problems of the cornea of the eye. The condition and / or problem may cause the cornea to weaken or thin over time. For example, the condition and / or problem may be keratoconus. CXL may be achieved using an ultraviolet (UV) laser. A laser is or may include a device that generates a beam of coherent monochromatic light through stimulated emission of photons from excited atoms and / or molecules. The UV laser may be pulsed. For example, pulses of the laser beam may have any suitable range of pulse durations, such as the microsecond, nanosecond, picosecond, femtosecond, or attosecond range, among others. The UV laser beam may be directed at one or more locations associated with the cornea. For example, directing the UV laser beam at one or more locations associated with the cornea may include adjusting at least one mirror to direct the UV laser beam at one or more locations associated with the cornea. The one or more locations associated with the cornea may be utilized for corneal treatment. The diameter of the UV laser beam may be adjustable. For example, a beam expander can be used to adjust the diameter of a UV laser beam.

[0015] Each of at least two of the plurality of locations associated with the cornea can be associated with an intensity profile. In one example, a first location associated with the cornea can be associated with a first intensity profile. The first intensity profile can be associated with a first optical intensity of the laser beam. In another example, a second location associated with the cornea, different from the first location, can be associated with a second intensity profile different from the first intensity profile. The second intensity profile can be associated with a second optical intensity of the laser beam, different from the first optical intensity of the laser beam. The optical intensity of the laser beam can be optical power per unit area. For example, optical power per unit area can be expressed in watts per square centimeter (W / cm). 2) The light intensity of a laser beam can be the product of the photon energy and the photon flux.

[0016] Different intensity profiles can be utilized to compensate for intensity losses in particular regions (e.g., region boundaries). For example, an intensity profile associated with a region boundary can be associated with a greater light intensity than light intensity located closer to the center of the region. Different intensity profiles can be utilized to provide increased light intensity in one or more regions. For example, increased optical intensity in one or more regions can enhance one or more CXL effects. Different intensity profiles can be utilized to achieve different effects. For example, different effects can include one or more refractive changes in the cornea. One or more refractive changes in the cornea can be achieved without additional beam-shaping apertures and / or without additional optics.

[0017] At least two of the multiple locations associated with the cornea can each be associated with a laser beam diameter. In one example, a first location associated with the cornea can be associated with a first laser beam diameter. In another example, a second location associated with the cornea can be associated with a second laser beam diameter that is different from the first laser beam diameter. For example, a beam expander can be utilized to set and / or configure the laser beam diameter. The angle of laser beam expansion can be determined based on at least one or more laser beam parameters. For example, the irradiated area (e.g., laser beam diameter) can be determined based on at least the distance between the laser output aperture and the patient's eye.

[0018] The multiple locations associated with the cornea can be associated with a shape and / or pattern. For example, the multiple locations associated with the cornea can resemble elements of the shape and / or pattern. The elements of the shape and / or pattern can be associated with a diameter of the laser beam. The elements of the shape and / or pattern can be associated with a location of the laser beam on the cornea. The elements of the shape and / or pattern can be associated with an amount of photon irradiation. Two or more elements of the shape and / or pattern can at least partially overlap. Two or more elements of the shape and / or pattern can be non-overlapping.

[0019] The eye may change position or rotate before and / or during a medical procedure. In one example, if the eye changes position and / or rotates, the medical system can compensate for the change in position and / or rotation. The medical system can compensate for the change in position and / or rotation to direct the laser beam to multiple locations associated with the cornea. In another example, the medical system can alert one or more medical personnel, stop the medical procedure, and / or prevent the start of the medical procedure. The medical system can utilize one or more iris structures in determining whether the eye will change position and / or rotate.

[0020] The first medical system may determine an iris structure of the patient's eye. For example, determining the iris structure of the patient's eye may include identifying the iris structure of the patient's eye. The second medical system may use the iris structure of the patient's eye to determine whether the eye changes position and / or rotates. The second medical system may use the pupil of the patient's eye to determine whether the position of the eye changes.

[0021] The second medical system may include a UV laser that may be utilized in one or more CXL medical procedures. The second medical system may include a laser (e.g., a UV laser, a visible spectrum laser, an infrared laser, etc.) that can incise a pocket in the eye. The location of the pocket incision may be related to a location on the eye. As one example, the second medical system and the first medical system may be combined into a single medical system. As another example, the second medical system and the first medical system may be different medical systems.

[0022] A CXL procedure may be performed after another medical procedure. For example, as a preventative medical procedure, a CXL procedure may be performed after a corneal procedure. For example, a laser device may be utilized to perform the corneal procedure and then the CXL procedure. The corneal procedure and the CXL procedure may be different medical procedures. Utilizing a laser device for the corneal procedure and the CXL procedure may shorten the time for the corneal procedure and the CXL procedure. Utilizing a laser device for the corneal procedure and the CXL procedure may reduce the number of medical instruments required for the corneal procedure and the CXL procedure.

[0023] Referring now to FIG. 1A , an example of a medical system is shown. As shown, the medical system 110 may be utilized with a patient 120. As shown, the medical system 110 may include a computer system 112. The computer system 112 may be communicatively coupled to displays 116A and 116B. The computer system 112 may be communicatively coupled to a biometric device 114. In one example, the biometric device 114 may include one or more cameras. In another example, the biometric device 114 may include a three-dimensional scanner. The biometric device 114 may be utilized in biometric measurements of an eye 122 of a patient 120. As shown, the display 116A may display an image 130A associated with the eye 122 of the patient 120. As shown, the display 116B may display an image 130B associated with the eye 122 of the patient 120.

[0024] The user interface may be associated with one or more of computer system 112, display 116A, and display 116B, among other things. In one example, the user interface may include one or more of a keyboard, a mouse, a joystick, a touchscreen, an eye-tracking device, a voice recognition device, a gesture control module, a dial, and / or a button, among other input devices. In another example, the user interface may include a graphical user interface (GUI). A user (e.g., a medical professional) may input desired commands and / or parameters via the user interface.

[0025] The computer system 112 can determine eye-identification information. For example, the eye-identification information can include biometric information associated with the eye 122 of the patient 120. The biometric information associated with the eye 122 can include, among other things, one or more of a blood vessel pattern in the sclera of the eye 122, an iris structure of the eye 122, a position of the iris structure of the eye 122, a distance measurement from the cornea of the eye 122 to the lens of the eye 122, a distance measurement from the lens of the eye 122 to the retina of the eye 122, a topography of the cornea of the eye 122, a retinal pattern of the eye 122, and a wavefront measurement.

[0026] As shown, display 116B may display iris structures 134A-134C of eye 122. As shown, display 116B may display display areas 136A-136D. In one example, display area 136 may display a distance measurement from the cornea of eye 122 to the lens of eye 122, a distance measurement from the lens of eye 122 to the retina of eye 122, the position of iris structures 134, corneal topography information, or wavefront measurement information, among other biometric information associated with eye 122. In another example, display area 136 may display any information associated with patient 120.

[0027] A person 150 may operate the medical system 110. For example, the person 150 may be a medical professional. 112. The person 150 may enter identifying information associated with the patient 120 into the computer system 112. The identifying information associated with the patient 120 may include, among other things, one or more of the patient's 120 name, the patient's 120 address, the patient's 120 telephone number, the patient's 120 government-issued identification number, the patient's 120 government-issued identification string, and the patient's 120 date of birth.

[0028] Person 150 may provide medical procedure information associated with patient 120 to computer system 112. The medical procedure information may be associated with a medical procedure. The medical procedure information may be associated with identification information associated with patient 120. Computer system 112 may store the medical procedure information. For example, computer system 112 may store the medical procedure information for later use. The medical procedure information may be associated with a surgery. For example, the medical procedure information may be obtained before a surgery. The medical procedure information may be used during the medical procedure. For example, the medical procedure may include a surgery.

[0029] Referring now to FIG. 1B, an example of a biometric device is shown. As shown, the biometric device 114 may include image sensors 160A-160C. For example, the image sensor 160 may include a camera. The camera may include one or more digital image sensors. In one example, the digital image sensor may include a charge-coupled device (CCD). In another example, the digital image sensor may include a complementary metal-oxide-semiconductor (CMOS). The camera may convert light into digital data. The camera may utilize a Bayer filter mosaic. For example, the camera may utilize a Bayer filter mosaic in combination with an optical anti-aliasing filter. Combining the Bayer filter mosaic with the optical anti-aliasing filter may reduce aliasing due to reduced sampling of the various primary color images. The camera may utilize demosaicing. For example, the demosaicing process may be used to interpolate color information to create a complete array of red, green, and blue (RGB) image data.

[0030] As shown, the biometric device 114 may include light projectors 162A-162C. In one example, the light projector 162 may project visible light. In another example, the light projector 162 may project infrared light. The light projector 162 may project a circle and / or a dot onto the patient's eye. The image sensor 160 may receive a reflection of the circle and / or the dot projected onto the patient's eye. The computer system may determine one or more locations and / or one or more templates associated with the patient's eye based at least on the reflection of the circle and / or the dot projected onto the patient's eye. As shown, the biometric device 114 may include depth sensors 164A-164C. The depth sensor 164 may include the light projector 162. The depth sensor 164 may include an optical sensor. As shown, the biometric device 114 may include an optical low-coherence reflectometer (OLCR) device 166. As shown, the biometric device 114 may include a wavefront device 168 .

[0031] The wavefront device 168 may include, among other things, one or more of a light source and a wavefront sensor. The light source may send a first light wave to the eye 122. The wavefront sensor may receive a first perturbed light wave from the eye 122 based on at least the first light wave. In one example, the wavefront device 168 may determine a first optical correction based on at least the first perturbed light. In another example, a computer system may determine the first optical correction based on at least the first perturbed light. The wavefront device 168 may provide data to the computer system based on at least the first perturbed light wave. For example, the computer system may determine the first optical correction based on at least data from the wavefront device 168.

[0032] Any two or more of the image sensor 160, the light projector 162, the depth sensor 164, the OLCR device 166, and the wavefront device 168 may be combined. In particular, one or more of the image sensors 160A-160C, one or more of the light projectors 162A-162C, one or more of the depth sensors 164A-164C, the OLCR device 166, and / or the wavefront device 168 may generate data usable by a computer system.

[0033] 2, an example of a laser system is shown. The laser system 210 may be utilized to illuminate one or more portions of the eye 122. For example, the laser system 210 may be utilized to illuminate one or more portions of the eye 122 with UV light from a UV laser device. The laser system 210 may be utilized in a medical procedure. For example, a medical system may include the laser system 210. The medical procedure may include an ophthalmic procedure on at least a portion of the eye 122. While the optical system 210 may be utilized in a medical system, the laser system 210 may be utilized in any system.

[0034] The laser system 210 may include multiple optical devices. For example, the optical devices may be or include devices that control light (e.g., reflect light, refract light, filter light, transmit light, polarize light, etc.). The optical devices may be made of any material that controls light as designed. For example, the materials may include one or more of glass, quartz, metal, and semiconductor, among others. Examples of optical devices may include one or more of lenses, mirrors, prisms, optical filters, waveguides, wave plates, beam expanders, beam collimators, beam splitters, gratings, and polarizers, among others.

[0035] As shown, the laser system 210 may include a laser 220 (e.g., a laser device). The laser 220 may generate a laser beam 221. In one example, the laser 220 may be a device that generates a beam of coherent monochromatic light by stimulated emission of photons from excited atoms and / or molecules. In another example, the laser 220 may be a device that generates a laser beam including photons associated with multiple frequencies. The laser beam 221 may have any suitable wavelength, for example, a wavelength in the infrared (IR) range, the visible range, or the UV range. The pulses of the laser beam 221 may have pulse durations in any suitable range, for example, in the microsecond, nanosecond, picosecond, femtosecond, or attosecond range, among others. The laser beam 221 may deliver successive pulses having pulse durations for a certain period of time. A focal point of the laser beam 221 may be the focus of the laser beam 221. The laser beam 221 may represent one or more laser beams. For example, the laser 220 may be configured to generate one or more laser beams 221.

[0036] As shown, the laser system may include focusing optics 240. As shown, focusing optics 240 may include a beam expander 241, a scanner 244, and an objective lens 248. Objective lens 248 may include multiple lenses. In one example, objective lens 248 may be or include a compound lens. In another example, objective lens 248 may be or include an F-theta lens. As shown, beam expander 241 may include lenses 242A and 242B. Although beam expander 241 is shown with two lenses, beam expander 241 may include any number of lenses.

[0037] The focusing optics 240 can direct and / or focus the laser beam 221 onto the eye 122. The focusing optics 240 can direct and / or focus the laser beam 221 onto the cornea 310 of the eye 122, as shown in Figure 3. The focusing optics 240 can direct the focal point of the laser beam 221 onto the eye 122 parallel to or along the Z axis.

[0038] An optical device, such as lens 242A and / or a mirror, can control the Z position of the focal point of laser beam 221. Another optical device, such as lens 242B (e.g., in combination with lens 242A), can expand the diameter of laser beam 221. For example, beam expander 241 can be configured to control the focal point of laser beam 221.

[0039] The scanner 244 may include one or more optical devices that can control the direction of the laser beam 221 to control the XY position of the focal point. For example, to laterally deflect the laser beam 221, the scanner 244 may include a pair of galvanometrically actuated mirrors that can be tilted about mutually perpendicular axes. The scanner 244 may receive the laser beam 221 from the beam expander 241. The scanner 244 may steer the laser beam 221 to control the XY position of the focal point of the laser 221. The objective lens 248 may receive the laser beam 221 from the scanner 244. The objective lens 248 may direct the laser beam 221 toward the eye 122.

[0040] As shown, laser system 210 may include a computer system 250. Computer system 250 may execute instructions in implementing at least a portion of one or more systems, one or more flowcharts, one or more processes, and / or one or more methods described herein. Although laser system 210 is shown as including computer system 250, laser system 210 need not include computer system 250. For example, computer system 250 may be external to laser system 210. Computer system 250 may be communicatively coupled to laser system 210.

[0041] As shown, computer system 250 may be communicatively connected to laser 220. As shown, computer system 250 may be communicatively coupled to beam expander 241. As shown, computer system 250 may be communicatively connected to scanner 244. In one example, computer system 250 may receive information from one or more of laser 220, beam expander 241, and scanner 244, among other things. In another example, computer system 250 may provide information to one or more of laser 220, beam expander 241, and scanner 244, among other things. Computer system 250 may provide control information to one or more of laser 220, beam expander 241, and scanner 244, among other things.

[0042] The medical system may include a laser system 210. The laser system 210 may be utilized in one or more medical procedures. As one example, the laser system 210 may be utilized with the Dresden protocol. As a second example, the laser system 210 may be utilized with variations of the Dresden protocol (e.g., higher / lower energy settings, different exposure times, on / off "pulsed" exposure, different riboflavin application strategies, etc.). As a third example, the laser system 210 may be utilized with a created pocket (e.g., a corneal pocket, a post-refractive wrench extraction interface, a LASIK (laser ablation) flap, etc.) to apply riboflavin. As another example, the laser system 210 may be utilized in a CXL medical procedure.

[0043] Referring now to FIG. 3, examples of layers of the cornea of the eye are shown. As shown, cornea 310 can include layers 320-360. In one example, layer 320 can be the epithelium. In a second example, layer 330 can be Bowman's membrane. In a third example, layer 340 can be the stroma. In a fourth example, layer 350 can be Descemet's membrane. In another example, layer 360 can be the endothelium.

[0044] 4A, a second example of a medical system is shown. As shown, a surgeon 410 may utilize a surgical tool instrument 420. In one example, the surgeon 410 may utilize the surgical tool instrument 420 in a surgical and / or medical procedure involving the eye 122 of a patient 120. The medical system 400A may include an ophthalmic surgical tool tracking system. As shown, the medical system 400A may include a computer system 430, a display 440, and a microscope integrated display (MID) 450.

[0045] The computer system 430 may receive image frames captured by one or more image sensors. For example, the computer system 430 may perform various image processing on the one or more image frames. The computer system 430 may perform image analysis on the one or more image frames to identify and / or extract one or more images of the surgical tool instrument 420 from the one or more image frames. The computer system 430 may generate a GUI on which the one or more image frames may be overlaid. For example, the GUI may include, among other things, one or more indicators and / or one or more icons. The one or more indicators may include medical data such as one or more positions and / or one or more orientations. The one or more indicators may include one or more warnings. The GUI may be displayed to the surgeon 410 and / or other medical personnel via the display 440 and / or the MID 450.

[0046] The computer system 430, the display 440, and the MID 450 may be implemented in separate housings communicatively coupled to each other or in a common console or housing. A user interface may be associated with one or more of the computer system 430, the display 440, and the MID 450, among other things. For example, the user interface may include one or more of a keyboard, a mouse, a joystick, a touchscreen, an eye-tracking device, a voice recognition device, a gesture control module, a dial, and / or a button, among other input devices. A user (e.g., the surgeon 410 and / or other medical personnel) may input desired commands and / or parameters via the user interface. For example, the user interface may be utilized in controlling one or more of the computer system 430, the display 440, and the MID 450, among other things. As shown, the medical system 400A may include a laser system 210. For example, the surgeon 410 may utilize the laser system 210 in performing a CXL procedure on the eye 122. As an example, the MID 450 may include the laser system 210.

[0047] Referring now to FIG. 4B , a third example of a medical system is shown. As shown, a surgeon 410 may utilize the system 400B. For example, the surgeon 410 may use the system 400B in a surgery involving the eye 122 of the patient 120. The system 400B may include multiple systems. The system 400B may include an incision system. For example, the surgeon 410 may utilize the system 400B in an incision of the eye 122. The surgeon 410 may utilize the system 400B to incise a flap in the cornea 310 of the eye 122 of the patient 120 or to incise a pocket in the cornea 310 of the eye 122 of the patient 120. In one example, the system 400B may use a blade to incise a flap in the cornea 310 of the eye 122. In a second example, the system 400B may use a blade to incise a pocket in the cornea 310 of the eye 122. In a third example, the system 400B can incise a flap in the cornea 310 of the eye 122 using a laser beam generated by a laser device and / or laser system. In a fourth example, the system 400B can incise a flap in the cornea 310 of the eye 122 using a laser beam generated by a laser device and / or laser system. In another example, the system 400B can make any femtoincision in the cornea 310 of the eye 122 using a laser beam generated by a laser device and / or laser system. A fluid can be applied to one or more interior portions of the cornea 310 of the eye 122 through a flap or through a pocket. For example, the fluid can include riboflavin. The surgeon 410 can utilize the system 400B in removing a layer from the cornea 310 of the eye 122. For example, the surgeon 410 can utilize the system 400B in removing a layer 320 from the cornea 310 of the eye 122. As an example, removing layer 320 may include scraping layer 320 from cornea 310. After layer 320 of cornea 310 of eye 122 is removed, a fluid may be applied to one or more interior portions of the cornea of eye 122. For example, the fluid may include riboflavin.

[0048] As shown, system 400B may include laser system 210. For example, surgeon 410 may utilize laser system 210 in performing a CXL procedure on eye 122. As shown, system 400B may include display 440. As shown, system 400B may include MID 450. System 400B may include, among other things, one or more of image sensors 160A-160C, one or more of light projectors 162A-162C, one or more of depth sensors 164A-164C, OLCR device 166, and / or wavefront device 168.

[0049] The system 400B may include a laser, such as a femtosecond laser, that uses short laser pulses to ablate or dissect a series of small portions of corneal tissue to form a flap that can be lifted to expose an interior portion of the cornea 310 of the eye 122. The flap may be planned and dissected using one or both of the display 440 and the MID 450 in conjunction with the control device and computer system 430. A fluid may be dispensed under the flap. For example, a fluid may be dispensed inside the cornea 310 of the eye 122. The fluid may include riboflavin.

[0050] The system 400B may include a laser, such as a femtosecond laser, that can use short laser pulses to ablate or dissect a series of small portions of corneal tissue to create a pocket that can expose an interior portion of the cornea 310 of the eye 122. The pocket may be planned and dissected using one or both of the display 440 and the MID 450 in conjunction with the control device and computer system 430. A fluid may be dispensed underneath the pocket. For example, the fluid may be dispensed inside the cornea 310 of the eye 122. The fluid may include riboflavin.

[0051] As shown, system 400B may include computer system 430. For example, computer system 430 may be communicatively coupled to one or more of image sensors 160A-160C, one or more of light projectors 162A-162C, one or more of depth sensors 164A-164C, OLCR device 166, wavefront device 168, display 440, MID 450, laser, and / or laser system 210 of system 400B, in particular.

[0052] System 400B may include one or more control devices, such as one or more of an interactive display, such as a touchscreen display, a keyboard, a mouse, a touchpad, buttons, a joystick, foot pedals, a heads-up display, and virtual reality glasses, or other devices capable of interacting with a user, such as a healthcare professional.

[0053] System 400B may include at least one computer system configured to generate images presented on at least one of display 440 and MID 450, among other things. For example, the at least one computer system may include computer system 430. Computer system 430 may be communicatively coupled to a viewing device, such as a microscope, a camera, an optical coherence tomography (OCT) device, or a display, or another device capable of measuring the position of the eye during surgery. Computer system 430 may be communicatively coupled to one or more control devices.

[0054] In one example, computer system 430 may i) be communicatively coupled to a viewing device that views eye 122 when patient 120 is positioned with system 400B, ii) be communicatively coupled to one or more displays 440 and MID 450 for providing graphical information regarding the planned flap location and the planned resection area, and iii) be communicatively coupled to one or more control devices of system 400B. In a second example, computer system 430 may i) be communicatively coupled to a viewing device that views eye 122 when patient 120 is positioned with system 400B, ii) be communicatively coupled to one or more displays 440 and MID 450 for providing graphical information regarding the planned pocket location and the planned resection area, and iii) be communicatively coupled to one or more control devices of system 400B. In another example, the computer system may include, among other features and / or attributes, those described above with respect to computer system 430.

[0055] The computer systems of system 400 may be communicatively coupled by wire or wirelessly to other portions of system 400. One or more of the computer systems of system 400 may be communicatively coupled to databases stored locally on a remote computer system or a remote data center, or both, that store patient data, treatment plans, and / or other information associated with the treatment and / or system 400. In one example, the database may include a relational database. In a second example, the database may include a graph database. In another example, the database may include a "Not Only SQL" (NoSQL) database.

[0056] System 400 may input information regarding patient 120 and treatments to be administered to or that have actually been administered to patient 120. System 400 may allow a user to input and view information regarding patient 120 and treatments to be administered to patient 120. Such data may include, among other things, information regarding patient 120, such as identifying information, the patient's 120 medical history, and / or information regarding the eye 122 being treated. Such data may include, among other things, information regarding the treatment plan, such as the shape and location of the corneal incision, the shape and location of the ablation, and / or multiple locations associated with the CXL procedure.

[0057] Referring now to FIG. 4C , an example of a microscope-integrated display and several examples of surgical tool instruments are shown. A medical practitioner may utilize surgical tool instruments 420. As shown, surgical tool instrument 420A may be or include a scalpel. As shown, surgical tool instrument 420B may be or include a Q-tip. As shown, surgical tool instrument 420C may be or include tweezers. As shown, surgical tool instrument 420D may be or include an eye dropper. For example, an eye dropper may be utilized to dispense a fluid into the eye 122. The fluid may include riboflavin. Other surgical tool instruments not specifically illustrated may be utilized with one or more of the systems, processes, and / or methods described herein.

[0058] As one example, the surgical tool instrument 420 may be marked with one or more patterns. The one or more patterns may be utilized in identifying the surgical tool instrument 420. The one or more patterns may include one or more of a hash pattern, a stripe pattern, and a fractal pattern, among others. As another example, the surgical tool instrument 420 may be marked with a dye and / or paint. The dye and / or paint may reflect one or more of visible light, infrared light, and ultraviolet light, among others. In one example, the illuminator 478 may provide ultraviolet light, and the image sensor 472 may receive the ultraviolet light reflected from the surgical tool instrument 420. The computer system 430 may receive image data from the image sensor 472 based at least on the ultraviolet light reflected from the surgical tool instrument 420, and may utilize the image data based at least on the ultraviolet light reflected from the surgical tool instrument 420 to identify the surgical tool instrument 420 from other image data provided by the image sensor 472. In another example, the illuminator 478 may provide infrared light and the image sensor 472 may receive infrared light reflected from the surgical tool instrument 420. The computer system 430 may receive image data from the image sensor 472 based at least on the infrared light reflected from the surgical tool instrument 420 and may utilize the image data based at least on the infrared light reflected from the surgical tool instrument 420 to identify the surgical tool instrument 420 from other image data provided by the image sensor 472.

[0059] As shown, the MID 450 may include eyepieces 452A and 452B. As shown, the MID 450 may include displays 462A and 462B. The surgeon 410 can look through the eyepieces 452A and 452B. In one example, the display 462A can display one or more images through the eyepiece 452A. The left eye of the surgeon 410 can utilize the eyepiece 452A. In another example, the display 462B can display one or more images through the eyepiece 452B. The right eye of the surgeon 410 can utilize the eyepiece 452B. Although the MID 450 is shown with multiple displays, the MID 450 may include a single display 462. For example, the single display 462 can display one or more images through one or more of the eyepieces 452A and 452B. The MID 450 may be implemented with one or more displays 462.

[0060] As shown, the MID 450 may include image sensors 472A and 472B. In one example, the image sensors 472A and 472B may capture images. In a second example, the image sensors 472A and 472B may include cameras. In another example, the image sensors 472A and 472B may capture images via one or more of visible light, infrared light, and ultraviolet light, among others. One or more of the image sensors 472A and 472B may provide image data to the computer system 430. Although the MID 450 is shown with multiple image sensors, the MID 450 may include a single image sensor 472. The MID 450 may be implemented with one or more image sensors 472.

[0061] As shown, the MID 450 can include distance sensors 474A and 474B. For example, the distance sensor 474 can determine the distance to the surgical tool instrument 420. The distance sensor 474 can determine a distance associated with the Z axis. Although the MID 450 is shown with multiple image sensors, the MID 450 can include a single distance sensor 474. In one example, the MID 450 can be implemented with one or more distance sensors 474. In another example, the MID 450 can be implemented without a distance sensor.

[0062] As shown, the MID 450 may include lenses 476A and 476B. While the MID 450 is shown with multiple lenses 476A and 476B, the MID 450 may include a single lens 476A. The MID 450 may be implemented with one or more lenses 476A and 476B. As shown, the MID 450 may include illuminators 478A and 478B. For example, the illuminator 478 may provide and / or generate one or more of visible light, infrared light, and ultraviolet light, among others. While the MID 450 is shown with multiple illuminators, the MID 450 may include a single illuminator 478. The MID 450 may be implemented with one or more illuminators 478A and 478B. The MID 450 may include one or more devices, structures, and / or functions similar to those described with respect to the biometric device 114. In one example, the MID 450 may include the OLCR device 166. In another example, the MID 450 may include a wavefront device 168. The MID 450 may include a biometric device 114. As shown, the MID 450 may include a biometric device 114.

[0063] 5, an example of a computer system is shown. As shown, computer system 500 may include a processor 510, a volatile memory medium 520, a non-volatile memory medium 530, and an input / output (I / O) device 540. As shown, volatile memory medium 520, non-volatile memory medium 530, and I / O device 540 may be communicatively coupled to processor 510.

[0064] The term “memory medium” may refer to “memory,” “storage device,” “memory device,” “computer-readable medium,” and / or “tangible computer-readable storage medium.” For example, memory medium may include, without limitation, storage media such as direct access storage devices including hard disk drives, sequential access storage devices such as tape disk drives, compact discs (CDs), random access memory (RAM), read-only memory (ROM), CD-ROMs, digital versatile discs (DVDs), electrically erasable programmable read-only memory (EEPROM), flash memory, non-transitory media, and / or combinations of one or more of the foregoing. As shown, non-volatile memory medium 530 may include processor instructions 532. Processor instructions 532 may be executed by processor 510. In one example, one or more portions of processor instructions 532 may be executed via non-volatile memory medium 530. In another example, one or more portions of processor instructions 532 may be executed via volatile memory medium 520. One or more portions of processor instructions 532 may be transferred to volatile memory medium 520.

[0065] The processor 510 may execute the processor instructions 532 in implementing at least a portion of one or more systems, one or more flowcharts, one or more processes, and / or one or more methods described herein. For example, the processor instructions 532 may be configured, coded, and / or encoded with instructions according to at least a portion of one or more systems, one or more flowcharts, one or more methods, and / or one or more processes described herein. While the processor 510 is illustrated as a single processor, the processor 510 may be or include multiple processors. A processor may include one or more processor cores. One or more of the storage medium and memory medium may be a software product, a program product, and / or an article of manufacture. For example, the software product, the program product, and / or the article of manufacture may be configured, coded, and / or encoded with instructions executable by a processor according to at least a portion of one or more systems, one or more flowcharts, one or more methods, and / or one or more processes described herein.

[0066] Processor 510 may include any suitable system, device, or apparatus operable to interpret and execute program instructions stored on a memory medium and / or received over a network, process data, or both. Processor 510 may also include one or more microprocessors, microcontrollers, digital signal processors (DSPs), application specific integrated circuits (ASICs), or other circuitry configured to interpret and execute program instructions, process data, or both.

[0067] I / O device(s) 540 may include any means or means for facilitating input from and output to a user, thereby enabling, permitting, and / or enabling a user to interact with computer system 500 and its associated components. Facilitating input from a user may enable the user to operate and / or control computer system 500, and facilitating output to a user may enable computer system 500 to indicate the effects of the user's operation and / or control. For example, I / O device(s) 540 may enable a user to input data, instructions, or both into computer system 500 and otherwise operate and / or control computer system 500 and its associated components. I / O device(s) may include user interface devices, such as a keyboard, mouse, touchscreen, joystick, handheld lens, tool tracking device, coordinate input device, or any other I / O device suitable for use with the system.

[0068] The I / O devices 540 may include, among other things, one or more buses, one or more serial devices, and / or one or more network interfaces that can facilitate and / or allow the processor 510 to implement at least a portion of one or more systems, processes, and / or methods described herein. In one example, the I / O devices 540 may include a storage interface that can facilitate and / or allow the processor 510 to communicate with external storage devices. The storage interface may include, among other things, one or more of a Universal Serial Bus (USB) interface, a Serial ATA (SATA) interface, a Parallel ATA (PATA) interface, and a Small Computer System Interface (SCSI). In a second example, the I / O devices 540 may include a network interface that can facilitate and / or allow the processor 510 to communicate with a network. The I / O devices 540 may include one or more of a wireless network interface and a wired network interface. In a third example, the I / O device 540 may be a peripheral component interconnect (PCI) interface, a PCI Express (PCIe) interface, a serial peripheral interconnect (SPI) interface, and an inter-integrated circuit (IIC) interface, among others. 2 C) interfaces. In a fourth example, I / O device 540 may include circuitry that may allow processor 510 to communicate data with one or more sensors. In a fifth example, I / O device 540 may facilitate and / or allow processor 510 to communicate data with one or more of display 550 and MID 560, among others. In another example, I / O device 540 may facilitate and / or allow processor 510 to communicate data with imager 570. As shown, I / O device 540 may be coupled to network 580. For example, I / O device 540 may include a network interface.

[0069] Network 580 may include, among other things, a wired network, a wireless network, an optical network, or a combination of the foregoing. Network 580 may include and / or be coupled to various types of communication networks. For example, network 580 may include and / or be coupled to, among other things, a local area network (LAN), a wide area network (WAN), the Internet, a public switched telephone network (PSTN), a cellular network, a satellite telephone network, or a combination of the foregoing. WANs may include, among other things, a private WAN, a corporate WAN, a public WAN, or a combination of the foregoing.

[0070] The computer systems described herein may include one or more structures and / or one or more functions similar to those described with respect to computer system 500. In one example, computer system 250 may include one or more structures and / or one or more functions similar to those described with respect to computer system 500. In a second example, computer system 112 may include one or more structures and / or one or more functions such as those described with respect to computer system 500. In a third example, computer system 430 may include one or more structures and / or one or more functions such as those described with respect to computer system 500. In another example, the computer system of MID 450 may include one or more structures and / or one or more functions such as those described with respect to computer system 500.

[0071] 6A-6D, examples of eyes are shown. As shown in FIG. 6A, the eye 122 may be pointed upward. In one example, the eye 122 may be pointed upward without angling. In another example, the eye 122 may be pointed upward without rotating. In determining that the eye 122 is pointed upward, one or more of the iris structures 134A-134C may be utilized. For example, the computer system 430 may determine the respective positions of one or more of the iris structures 134A-134C. The computer system 430 may determine that the eye 122 is pointed upward based on at least the respective positions of one or more of the iris structures 134A-134C.

[0072] 6B, the eye 122 may be rotated. One or more iris structures 134A-134C may be utilized in determining that the eye 122 is rotating. For example, the computer system 430 may determine the respective positions of one or more of the iris structures 134A-134C. The computer system 430 may determine that the eye 122 is rotated by an angle based on at least the respective positions of the one or more iris structures 134A-134C.

[0073] 6C, the eye 122 may be angled. As shown, the eye 122 may be angled to the left. In determining that the eye 122 is angled, one or more of the iris structures 134A-134C may be utilized. For example, the computer system 430 may determine the respective positions of one or more of the iris structures 134A-134C. The computer system 430 may determine that the eye 122 is angled by an angle based at least on the respective positions of one or more of the iris structures 134A-134C.

[0074] 6D, the eye 122 may be angled. As shown, the eye 122 may be angled downward. In determining that the eye 122 is angled, one or more of the iris structures 134A-134C may be utilized. For example, the computer system 430 may determine the respective positions of one or more of the iris structures 134A-134C. The computer system 430 may determine that the eye 122 is angled by an angle based at least on the respective positions of one or more of the iris structures 134A-134C.

[0075] 6E-6H, examples of eyes and coordinate systems are shown. As shown in FIG. 6E, the eye 122 is angled θ from the Z axis with respect to the X axis. x The angle θ x θ can be positive or negative. As shown in FIG. 6F, the eye 122 is angled θ from the Z axis relative to the Y axis. y The angle θ y θ can be positive or negative. As shown in FIG. 6G, the eye 122 can be rotated by an angle φ. For example, the eye 122 can be rotated around the Z axis by an angle φ. The angle φ can be positive or negative. As shown in FIG. 6H, the eye 122 can be rotated around an arbitrary axis 610 by an angle φ. For example, the axis 610 can be a vector in a three-dimensional Cartesian coordinate system. The angle φ can be positive or negative. In one example, the axis 610 is rotated by at least an angle θ x In a second example, the axis 610 may be based on at least θ y In another example, the axis 610 may be based on at least an angle θ x and based on at least an angle θ y 6E-6H utilize a Cartesian coordinate system, however, any coordinate system may be utilized. The computer system 430 may determine one or more of the angle θx, the angle θy, the angle φ, and the axis 610 based on at least the respective positions of one or more of the iris structures 134A-134C.

[0076] Referring now to FIG. 7A, an example of a method of operating a medical system is shown. At 710, data associated with a plurality of locations associated with the cornea of a patient's eye may be received. For example, computer system 430 may receive data 810 (shown in FIG. 8) associated with a plurality of locations 910 associated with the cornea 310 of eye 122 of patient 120. Data 810 may include, among other things, one or more of data 815A-815M. In one example, data 815A-815M may be associated with a plurality of locations 910A-910M, respectively. In a second example, data 815A may be associated with location 910 shown in FIG. 9C. In another example, data 815A may be associated with location 910 shown in FIG. 9C, and data 815B and 815C may be associated with locations 910A and 910B, respectively, shown in any of FIGS. 9D-9F. The data associated with the multiple locations associated with the cornea of the patient's eye may include the location 910 of any of FIGS. 9C-9F. For example, the multiple data 815 may be utilized in any order. Data associated with locations 910A-910G shown in any of FIGS. 9D-9F may be utilized before data associated with the location 910 shown in FIG. 9C. Data associated with the location 910 shown in any of FIGS. 9C may be utilized before data associated with the locations 910A-910G shown in any of FIGS. 9D-9F. For example, one or more locations in the illustrations of FIGS. 9C-9F may be illuminated with a laser beam before another location in another of FIGS. 9C-9F may be illuminated with a laser beam. The data 810 may include information capable of describing, characterizing, and / or indicating this performance.

[0077] As shown in Figure 9A, plane 905 can be associated with multiple locations 910A-910M. Plane 905 can be orthogonal to laser 221 after laser 221 is transmitted through objective lens 248. Plane 905 can be associated with eye 122 as shown in Figure 9B. Multiple locations 910A-910M can be associated with cornea 310 of eye 122 of patient 120. Although only 14 locations are shown in Figure 9A, any number of locations can be utilized.

[0078] Furthermore, the locations 910 can be located anywhere. In one example, a single location 910 is shown in FIG. 9C . In a second example, multiple locations 910 can be associated with a plane 905, as shown in FIG. 9D . In a third example, multiple locations 910 can be associated with a plane 905, as shown in FIG. 9E . In another example, multiple locations 910 can be associated with a plane 905, as shown in FIG. 9F . As shown in FIG. 9G , multiple locations 910 can be associated with a cornea 310 of the eye 122. As shown in FIG. 9F , a first portion 920A of the cornea 310 is associated with the location 910. As shown in FIG. 9F , a second portion 920B of the cornea 310, unlike the first portion 920A, is not associated with the location 910. For example, one or more portions of the cornea 310 may be treated, while one or more other portions of the cornea 310 may not be treated.

[0079] As shown in FIG. 8 , data 810 may include data 815A-815M. For example, data 815A-815M may be associated with locations 910A-910M, respectively. Data 815 may include coordinate information 820. For example, coordinate information 820 may include XY coordinates. XY coordinates may be associated with an X axis and a Y axis. Data 815 may include diameter information 825. For example, diameter information 825 may include a diameter measurement of a laser beam associated with location 910. Data 815 may include duration information 830. For example, duration information 830 may include a duration for applying the laser beam at location 910. Data 815 may include pulse duration information 835. For example, pulse duration information 835 may include a pulse duration. By way of example, pulse duration may include a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration, among others. For example, the laser 220 may be configured with a pulse duration based at least on the pulse duration information 835 .

[0080] At 715, at least one lens can be adjusted based on the diameter information in the data associated with at least one of the plurality of locations to set the diameter of the laser beam. For example, at least one of lenses 242A and 242B can be adjusted based on the diameter information in the data associated with at least one of the plurality of locations to set the diameter of laser beam 221. The computer system can provide control information to beam expander 241 to adjust at least one of lenses 242A and 242B to set the diameter of laser beam 221. In one example, computer system 250 can provide control information to beam expander 241 to adjust at least one of lenses 242A and 242B to set the diameter of laser beam 221. In a second example, computer system 430 can provide control information to beam expander 241 to adjust at least one of lenses 242A and 242B to set the diameter of laser beam 221. In a third example, computer system 430 can provide control information to computer system 250. Computer system 250 can provide control information to beam expander 241 to adjust at least one of lenses 242A and 242B to set the diameter of laser beam 221. In another example, computer system 430 can be or include computer system 250. The control information can be based at least on diameter information of data associated with at least one of the plurality of locations.

[0081] Method elements 720-740 may be performed for each of a plurality of locations associated with the cornea of a patient's eye. For example, method elements 720-740 may be performed for each of a plurality of locations 910.

[0082] At 720, it may be determined whether the eye has changed from a first eye position to a second eye position that is different from the first eye position. For example, the computer system 430 may determine whether the eye 122 has changed from a first eye position to a second eye position that is different from the first eye position. As one example, the eye 122 may change from the first eye position shown in FIG. 6A to the second eye position shown in FIG. 6B. The eye 122 may have changed from the first eye position shown in FIG. 6A to the second eye position shown in FIG. 6B via one or more rotations. As a second example, the eye 122 may change from the first eye position shown in FIG. 6A to the second eye position shown in FIG. 6C. As a third example, the eye 122 may change from the first eye position shown in FIG. 6A to the second eye position shown in FIG. 6D. As another example, the eye 122 may change from a first position of the eye 122 shown in Figure 6C to a second position of the eye 122 shown in Figure 6D. Determining whether the eye has changed from the first position of the eye to a second position of the eye that is different from the first position of the eye may include determining whether a pupil of the eye has changed from a first position of the pupil to a second position of the pupil. Determining whether the eye has changed from the first position of the eye to a second position of the eye that is different from the first position of the eye may include determining whether a center of the pupil of the eye has changed from a first position of the pupil center to a second position of the pupil center.

[0083] Determining whether the eye has changed from a first eye position to a second eye position different from the first eye position may include determining whether at least one iris structure has changed from the first position of the at least one iris structure to the second position of the at least one iris structure. In one example, the iris structure 134A may be at the first position of the iris structure 134A shown in FIG. 6A, and the iris structure 134A may be at the second position of the iris structure 134A shown in FIG. 6B. In a second example, the iris structure 134A may be at the first position of the iris structure 134A shown in FIG. 6A, and the iris structure 134A may be at the second position of the iris structure 134A shown in FIG. 6C. In a third example, the iris structure 134A may be at the first position of the iris structure 134A shown in FIG. 6A, and the iris structure 134A may be at the second position of the iris structure 134A shown in FIG. 6D. In another example, iris structure 134A can be in the first position of iris structure 134A shown in FIG. 6C, and iris structure 134A can be in the second position of iris structure 134A shown in FIG. 6D. In these examples, one or more of iris structures 134B and 134C can be utilized instead of or in addition to iris structure 134A in the manner described. As one example, one or more of iris structures 134A-134C can be determined via medical system 110. As another example, one or more of iris structures 134A-134C can be determined via medical system 400.

[0084] If the eye has not changed from the eye first position to the eye second position, at least one mirror may be adjusted based at least on the location at 725. For example, if the eye 122 has not changed from the eye 122 first position to the eye 122 second position, at least one mirror of the scanner 244 may be adjusted based at least on the location 910. For example, the scanner 244 may include one or more mirrors that may be adjusted based at least on the location 910.

[0085] If the eye changes from a first eye position to a second eye position, at least one mirror may be adjusted 730 based at least on the location and at least on the second eye position. For example, if the eye 122 changes from a first eye position to a second eye position, at least one mirror of the scanner 244 may be adjusted based at least on the location 910 and at least on the second eye position. As an example, the scanner 244 may include one or more mirrors that may be adjusted based at least on the location 910 and at least on the second eye position.

[0086] When the eye 122 changes from a first eye position to a second eye position, the location 910 may be translated based at least on the second eye position. Adjusting the at least one mirror based at least on the location and at least on the second eye position may include adjusting the at least one mirror based at least on the location and at least on the translation of the location. The translation may be based at least on the second eye position. In one example, the translation based at least on the second position may include translation based on at least a second position of a center of the pupil of the eye 122. In a second example, the translation based at least on the second eye position may include translation based on at least a second position of an iris structure. The second position of the iris structure may be, in particular, a second position of iris structure 134A, a second position of iris structure 134B, or a second position of iris structure 134C. In another example, the translation based at least on the second eye position may include translation based on at least a second position of each of the plurality of iris structures. The second positions of each of the plurality of iris structures may include two or more of the second position of iris structure 134A, the second position of iris structure 134B, and the second position of iris structure 134C, among others.

[0087] The computer system can calculate one or more translations of one or more locations 910. For example, the computer system can calculate, among other things, the angle θ x , angle θ y, angle φ, and axis 610. The computer system may calculate the translation of location 910 based on at least one or more of the respective positions of one or more of iris structures 134A-134C. x , angle θ y , angle φ, and axis 610. In one example, the computer system may determine angle θ based on at least the first position of iris structure 134A and the second position of iris structure 134A. x , angle θ y , angle φ, and axis 610. In a second example, the computer system may determine angle θ based on at least the first position of iris structure 134B and the second position of iris structure 134B. x , angle θ y , angle φ, and axis 610. In another example, the computer system may determine angle θ based on at least the first position of the iris structure 134C and the second position of the iris structure 134C. x , angle θ y , angle φ, and axis 610 can be determined.

[0088] At 735, a laser beam may be generated. For example, laser 220 may generate laser beam 221. Laser beam 221 may be a UV laser beam. For example, laser 220 may be or may include a device that generates a beam of coherent monochromatic light in the UV spectrum by stimulated emission of photons from excited atoms and / or molecules. Generating the laser beam may include pulsing the laser beam with a pulse duration. For example, the pulse duration may be a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration, among others. The pulse duration may be configured and / or set based on pulse duration information 835 associated with at least location 910. In one example, the pulse duration may be configured and / or set based on pulse duration information 835A associated with at least location 910A. In another example, the pulse duration may be configured and / or set based on pulse duration information 835B associated with at least location 910B. A first pulse duration associated with a first location may be different from a second pulse duration associated with a second location. The pulse duration associated with location 910A may be different from the pulse duration associated with location 910B. The pulse duration associated with location 910A may be equal to the pulse duration associated with location 910B.

[0089] At least one of a flap and a pocket can be incised in the cornea of the eye before the laser beam is generated. In one example, a blade can incise the cornea of the eye. In another example, a separate laser can incise the cornea of the eye. Riboflavin can be applied to the interior of the cornea before the laser beam is generated. For example, riboflavin can be applied to the interior of the cornea through the incised flap or through the incised pocket. A layer of the cornea can be removed to expose the interior of the cornea before the laser beam is generated. Layer 320 shown in FIG. 3 can be removed. Riboflavin can be applied to the cornea after the layer of the cornea is removed and before the laser beam is generated.

[0090] At 740, the laser beam may be directed to a location for a time period associated with the location. For example, laser beam 221 may be directed to location 910 for a time period associated with location 910. Focusing optics 240 may direct laser beam 221 to location 910 for a time period associated with location 910. A first time period associated with a first location may be different from a second time period associated with a second location. For example, a time period associated with location 910A may be different from a time period associated with location 910B. The time period associated with location 910A may be indicated by time period information 830A. The time period associated with location 910B may be indicated by time period information 830B. The time period associated with the first location may be equal to a second time period associated with the second location. For example, a time period associated with location 910A may be equal to a time period associated with location 910B.

[0091] Directing the laser beam at a location for a period of time associated with the location can further strengthen bonds between collagen fibers in the cornea. For example, directing laser beam 221 at location 910 for a period of time associated with location 910 can strengthen bonds between collagen fibers in cornea 310 associated with location 910.

[0092] Bonds between collagen fibers can help stabilize the cornea 310. For example, bonds between collagen fibers associated with each of the locations 910 can help stabilize the cornea 310. The locations 910 can be determined based at least on the topography of the cornea 310. The locations 910 can be determined based at least on the thickness at each of a plurality of locations associated with the cornea 310. The locations 910 can be determined based at least on, among other things, refractive information associated with one or more of the cornea 310 and the eye 122. For example, among other things, one or more of methods 7A and 7B can be utilized to correct astigmatism in the cornea 310. The locations 910 can be determined based at least on a medical regimen that can mitigate or prevent problems and / or diseases that may weaken and / or thin the cornea 310. For example, the locations 910 can be determined based at least on a medical regimen that can mitigate or prevent the progression of progressive keratoconus.

[0093] Referring now to FIG. 7B, another example method of operating a medical system is shown. Method elements 710 and 720-740 may be performed as described with reference to FIG. 7A. In the method associated with FIG. 7B, method elements 715-740 may be performed for each of a plurality of locations associated with the cornea of a patient's eye. For example, method elements 715-740 may be performed for each of a plurality of locations 910. At 715, at least one lens may be adjusted based on diameter information in the data associated with at least the locations to set a diameter of the laser beam.

[0094] At least a first diameter associated with a first location may be different from a second diameter associated with a second location. In one example, the diameter associated with location 910A may be different from the diameter associated with location 910B. Diameter information 825A may indicate the diameter associated with location 910A. Diameter information 825B may indicate the diameter associated with location 910B. In a second example, the diameter associated with location 910A may be different from the diameter associated with location 910C. Diameter information 825A may indicate the diameter associated with location 910A. Diameter information 825C may indicate the diameter associated with location 910C. In another example, the diameter associated with location 910A may be equal to the diameter associated with location 910D. Diameter information 825A may indicate the diameter associated with location 910A. Diameter information 825D may indicate the diameter associated with location 910D.

[0095] One or more of the method and / or process elements and / or one or more portions of the method and / or processor elements may be performed in a different order, repeated, or omitted. Furthermore, additional, supplemental, and / or duplicate method and / or process elements may be implemented, instantiated, and / or performed as desired. Furthermore, one or more of the system elements may be omitted and / or additional system elements may be added as desired.

[0096] The memory medium may be and / or include an article of manufacture. For example, the article of manufacture may include and / or be a software product and / or program product. The memory medium may be coded and / or encoded with processor-executable instructions according to one or more of the flowcharts, systems, methods, and / or processes described herein to produce the article of manufacture.

[0097] The subject matter disclosed above should be considered illustrative, not limiting, and the appended claims are intended to cover all such modifications, extensions, and other implementations that fall within the true spirit and scope of the present disclosure. Accordingly, to the maximum extent permitted by law, the scope of the present disclosure should be determined by the broadest permissible interpretation of the following claims and their equivalents, and should not be limited or constrained by the above detailed description. According to aspect (1), there is provided a medical system, at least one processor; a laser communicatively coupled to at least one of the processors and configured to generate one or more laser beams; at least one lens; at least one mirror; a memory medium coupled to at least one of the processors, the memory medium, when executed by the at least one processor, providing to the medical system: receiving data associated with a plurality of locations associated with the cornea of the patient's eye; adjusting at least one of the lenses based on diameter information in the data associated with at least one of the plurality of locations to set a diameter of the laser beam; For each location of the plurality of locations, determining whether the eye has changed from a first position of the eye to a second position of the eye that is different from the first position of the eye; adjusting at least one of the mirrors based at least on the location if the eye has not changed from the first eye position to the second eye position; adjusting at least one of the mirrors when the eye changes from the first position of the eye to the second position of the eye based at least on the location and based at least on the second position of the eye; generating said laser beam; directing the laser beam to the location for a time period associated with the location; a memory medium containing instructions; It is a healthcare system that includes According to aspect (2), to determine whether the eye has changed from the first position of the eye to the second position of the eye, the instructions further cause the medical system to determine whether the iris structure of the eye has changed from the first position of the iris structure to the second position of the iris structure. According to aspect (3), the first portion of the cornea is associated with the plurality of locations, A second portion of the cornea, different from the first portion, is not associated with the plurality of locations. According to aspect (4), a first period associated with a first location of the plurality of locations is different from a second period associated with a second location of the plurality of locations, which is different from the first location. According to aspect (5), to generate the laser, the instructions further cause the medical system to pulse the laser beam with a pulse duration. According to aspect (6), the pulse duration is a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration. According to aspect (7), the laser beam is an ultraviolet (UV) laser beam. According to aspect (8), the instructions further include: At least one of the lenses is adjusted based on second diameter information in the data associated with at least another one of the plurality of locations to set a second diameter of the laser beam. According to aspect (9), the instructions further include: When the eye changes from the first eye position to the second eye position, at least two of the plurality of locations are translated based on at least the first eye position and the second eye position. According to aspect (10), the instructions further include: Before the laser beam is generated, another laser beam is generated to incise at least one of a flap and a pocket in the cornea. According to an aspect (11), there is provided a method of operating a medical system, comprising: receiving data associated with a plurality of locations associated with a cornea of the patient's eye; adjusting at least one lens based on diameter information in the data associated with at least one of the plurality of locations to set a diameter of the laser beam; For each location of the plurality of locations, determining whether the eye has changed from a first position of the eye to a second position of the eye that is different from the first position of the eye; adjusting at least one mirror based at least on the location if the eye has not changed from the first position of the eye to the second position of the eye; adjusting at least one of the mirrors when the eye changes from the first position of the eye to the second position of the eye based at least on the location and based at least on the second position of the eye; generating the laser beam; directing the laser beam at the location for a time period associated with the location; The method includes: According to aspect (12), determining whether the eye has changed from the first position of the eye to the second position of the eye includes determining whether the iris structure of the eye has changed from the first position of the iris structure to the second position of the iris structure. According to aspect (13), the first portion of the cornea is associated with the plurality of locations; A second portion of the cornea, different from the first portion, is not associated with the plurality of locations. According to aspect (14), a first period associated with a first location of the plurality of locations is different from a second period associated with a second location of the plurality of locations, which is different from the first location. According to aspect (15), generating the laser includes pulsing the laser beam with a pulse duration. According to aspect (16), the pulse duration is a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration. According to aspect (17), the laser beam is an ultraviolet (UV) laser beam. According to aspect (18), adjusting at least one of the lenses based on second diameter information of the data associated with at least another one of the plurality of locations to set a second diameter of the laser beam; Further includes: According to aspect (19), when the eye changes from the first position of the eye to the second position of the eye, translating at least two of the plurality of locations based on at least the first position of the eye and the second position of the eye; Further includes: According to aspect (20), before generating the laser beam, generating another laser beam to incise at least one of a flap and a pocket in the cornea; Further includes:

Claims

1. 1. A health care system comprising: at least one processor; a laser system communicatively coupled to at least one of the processors and configured to generate one or more laser beams to perform a corneal cross-linking procedure; at least one lens; at least one mirror; a memory medium coupled to at least one of the processors, the memory medium, when executed by the at least one processor, providing to the medical system: receiving data associated with a plurality of locations associated with a cornea of the patient's eye, the data including an intensity profile related to a light intensity that enhances a corneal cross-linking effect of the corneal cross-linking procedure, the data associated with the plurality of locations of the cornea of the patient's eye including, for each of the plurality of locations, coordinate information, diameter information, period information, and pulse duration information; adjusting at least one of the lenses based on diameter information in the data associated with at least one of the at least a plurality of the locations to set a diameter of the laser beam; For each said location of the plurality of said locations: determining whether the eye has changed from a first position of the eye to a second position of the eye that is different from the first position of the eye; adjusting at least one of the mirrors based at least on the location if the eye has not changed from the first position of the eye to the second position of the eye; or and when the eye changes from the first eye position to the second eye position, performing at least one of adjusting at least one of the mirrors based on at least the location and based on at least the second eye position, wherein the data of the location includes coordinate information, the coordinate information including an X axis, a Y axis, a Z axis, an angle θx from the Z axis to the X axis, an angle θy from the Z axis to the Y axis, and a rotation angle Φ around the Z axis; generating the laser beam according to the intensity profile; directing the laser beam to the location for a time period associated with the location to perform the corneal cross-linking procedure; a memory medium containing instructions; including the health care system.

2. 10. The medical system of claim 1, wherein the instructions further cause the medical system to determine whether an iris structure of the eye has changed from the first position of the eye to the second position of the eye.

3. the first portion of the cornea is associated with a plurality of the locations; a second portion of the cornea that is different from the first portion and is not associated with a plurality of the locations; The medical system of claim 1 .

4. 10. The medical system of claim 1, wherein a first time period associated with a first location of the plurality of locations is different from a second time period associated with a second location of the plurality of locations that is different from the first location.

5. The medical system of claim 1 , wherein the instructions further cause the medical system to pulse the laser beam with a pulse duration to generate the laser beam.

6. 6. The medical system of claim 5, wherein the pulse duration is a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration.

7. The medical system of claim 1 , wherein the laser beam is an ultraviolet (UV) laser beam.

8. The instructions may further include instructing the medical system to: adjusting at least one of the lenses based on second diameter information in the data associated with at least another one of the at least plurality of the locations to set a second diameter of the laser beam; The medical system of claim 1 .

9. The instructions may further include instructing the medical system to: and translating at least two of the plurality of locations based on at least the first eye position and the second eye position when the eye changes from the first eye position to the second eye position. The medical system of claim 1 .

10. The instructions may further include instructing the medical system to: generating another laser beam to incise at least one of a flap and a pocket in the cornea before the laser beam is generated; The medical system of claim 1 .

11. 1. A method of operating a medical system, comprising: a processor of a computer system receiving data associated with a plurality of locations associated with a cornea of an eye of a patient, the data including an intensity profile related to a light intensity that enhances a corneal cross-linking effect of a corneal cross-linking procedure, the data associated with the plurality of locations of the cornea of the eye of the patient including, for each of the plurality of locations, coordinate information, diameter information, period information, and pulse duration information; the processor of the computer system adjusting at least one lens based on diameter information in the data associated with at least one of the at least a plurality of the locations to set a diameter of the laser beam; For each said location of the plurality of said locations: the processor of the computer system determining whether the eye has changed from a first position of the eye to a second position of the eye that is different from the first position of the eye; and if the eye has not changed from the first position of the eye to the second position of the eye, the processor of the computer system adjusts at least one mirror based on at least the location; or and performing at least one of: adjusting at least one of the mirrors when the eye changes from the first eye position to the second eye position, based at least on the location and based at least on the second eye position, wherein the location data includes coordinate information, the coordinate information including an X axis, a Y axis, a Z axis, an angle θx from the Z axis to the X axis, an angle θy from the Z axis to the Y axis, and a rotation angle Φ around the Z axis; a laser generating the laser beam according to the intensity profile; directing the laser beam to the location for a time period associated with the location to perform the corneal cross-linking procedure; A method comprising:

12. 12. The method of claim 11, wherein determining whether the eye has changed from the first position of the eye to the second position of the eye comprises determining whether an iris structure of the eye has changed from the first position of the iris structure to the second position of the iris structure.

13. the first portion of the cornea is associated with a plurality of the locations; a second portion of the cornea that is different from the first portion and is not associated with a plurality of the locations; The method of claim 11.

14. 12. The method of claim 11, wherein a first time period associated with a first location of the plurality of locations is different from a second time period associated with a second location of the plurality of locations that is different from the first location.

15. The method of claim 11 , wherein the generating the laser beam comprises pulsing the laser beam with a pulse duration.

16. 16. The method of claim 15, wherein the pulse duration is microsecond duration, nanosecond duration, picosecond duration, femtosecond duration, or attosecond duration.

17. The method of claim 11 , wherein the laser beam is an ultraviolet (UV) laser beam.

18. adjusting at least one of the lenses by the processor of the computer system based on second diameter information in the data associated with at least another one of the at least plurality of the locations, such that the processor of the computer system sets a second diameter of the laser beam; The method of claim 11 further comprising:

19. when the eye changes from the first eye position to the second eye position, the processor of the computer system translates at least two of the plurality of locations based on at least the first eye position and the second eye position; The method of claim 11 further comprising:

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