Assembly for laser treatment of ocular opacities

Abstract

The assembly for the laser treatment of ocular opacities comprises a measurement system for acquiring depth information about ocular structures, a laser system, an eye tracking unit, a display unit, and a control and processing unit. According to the present invention, the control and processing unit is configured to determine from the depth profile the depth of the ocular structures relative to the depth of the laser focus, and to determine block zones for the laser treatment, particularly for the retina and lens capsule. Furthermore, the control and processing unit is configured to generate at least one tag for at least the block zones of the retina and lens capsule and the laser focus, in each case having characteristics corresponding to a specific depth within the eye, display these tags on the display unit, and superimpose them on a live image. The present invention relates to a partially automated treatment device for the laser treatment of ocular opacities, in which a two-dimensional image of the eye is combined with three-dimensional imaging from the measurement system.

Description

[Technical Field]

[0001] The present invention relates to an apparatus for the laser treatment of ocular opacities. [Background technology]

[0002] The vitreous is a normally clear, gel-like substance found inside the eye between the lens and the retina. In young people, the vitreous is completely transparent and in contact with the retina. Over the course of a person's life, the vitreous liquefies and gradually detaches from the retina, a process called posterior vitreous detachment. This is a normal aging process that usually occurs after the age of 50. Detached vitreous components collect inside the eye, leaving vitreous skeletal material and clusters visible to the patient. These may move across the visual field and are therefore also called floaters. Floaters are often caused by the presence of membrane-like structures on the posterior side of the vitreous after vitreous detachment, and may even contain blood debris if retinal damage occurs during vitreous detachment. In rare cases, floaters may also be present as crystalline precipitates within the vitreous in the presence of metabolic disorders.

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

[0004] This opacity is particularly noticeable against bright backgrounds, for example, when working at a computer, reading, or looking at blue skies or snow, and interferes with visual function. Floaters that move in and out of the central field of vision as a result of reading movements can be particularly bothersome.

[0005] Because they often have the morphology of "flying gnats," they are described using the technical term "flying flies," which is derived from the French. However, opacities can also take on various shapes, for example, branch-like, ring-like, or star-like, or may exist as a cloud of dots. In the following description, the term "floaters" is used for the vitreous opacities being treated, regardless of the type or form of the vitreous opacity being treated.

[0006] Generally, floaters do not disappear without treatment because the immune system does not recognize them as abnormal and therefore does not destroy them. However, affected individuals can hardly ignore or overlook them. Certain types of floaters, such as those caused by residual blood after retinal hemorrhage, are partially absorbed back into the body, even if it takes weeks or months.

[0007] In what is known as a vitrectomy, the vitreous is partially (core vitrectomy) or completely crushed, aspirated, and removed after an incision is made in the eye using a cutting tool. While such interventions are routinely performed in cases of retinal detachment or epiretinal membrane detachment, they are generally considered a disproportionate treatment for removing localized vitreous opacities. Furthermore, vitrectomy is invasive, requires a stay in the clinic, and carries the risks associated with surgical interventions, particularly the frequent risk of cataract formation, rare risk of retinal detachment, and, very rarely, endophthalmitis.

[0008] So-called laser vitreolysis (German: Laser-Vitreolyse, English: laser vitreolysis) is now offered as a low-risk alternative treatment. Laser vitreolysis is a gentle, low-risk, and painless laser treatment that can atomize or vaporize vitreous opacities without incision in the eye.

[0009] In laser vitreolysis, short laser light pulses are applied to the vitreous opacity using high laser intensity at the focal point to induce optical or photodisruption of the vitreous opacity. The floaters and the surrounding vitreous absorb the laser energy, forming a cutting or expanding laser plasma, which vaporizes and / or shatters the floaters, potentially dissolving them. The treatment is virtually painless and poses no risk of infection. Laser vitreolysis offers a safe method for the gentle treatment of troublesome vitreous opacities, provided it is possible to ensure that critical and sensitive ocular tissues, such as the lens capsule, lens, or retinal regions (especially the macula), are not damaged by the laser.

[0010] However, the success of treatment varies depending on the type of floater. Treatment is particularly effective in the case of so-called Weiss rings. The tissue bundles can be cut, eradicating the mass that causes the disturbing shadow.

[0011] For over 30 years, floaters have been treated with YAG lasers (especially 1064 nm Nd:YAG lasers) (Non-Patent Document 1). However, even with current high-end devices, only the anterior region of the vitreous can be accurately and reliably targeted and treated. These lasers are not precise enough in deeper vitreous regions. However, most vitreous opacities are found in the posterior vitreous, which is often the result of posterior vitreous detachment. YAG lasers are often used in ophthalmology for iridotomy in glaucoma disease and for post-cataract treatment, i.e., to remove opacities or even posterior cataract membranes resulting from cellular overgrowth during intraocular lens implantation. Frequency-doubled YAG lasers with laser radiation in the green range (532 nm) are also used for retinal coagulation, for example, in cases of hemorrhage or retinal detachment. YAG lasers are also used less frequently for phacoemulsification in cataract surgery, i.e., liquefaction of the cloudy, hardened natural lens. However, in this case this tends to be an Er:YAG laser, which has a wavelength of 2940 nm and a higher water or tissue absorption rate, and which often has to be introduced in a difficult way into the eye by endoscopic laser introduction with a mirror guide.

[0012] According to the known prior art, numerous solutions already exist for performing laser surgery on ocular tissue, in particular the vitreous body. Thus, Patent Document 1 describes an apparatus and method for femtosecond laser surgery on tissue, particularly tissue within the vitreous body of the eye. The apparatus comprises an ultrashort pulse laser having a pulse length in the range of approximately 10 fs to 1 ps (particularly approximately 300 fs), a pulse energy in the range of approximately 5 nJ to 5 μJ (particularly approximately 1 to 2 μJ), and a pulse repetition rate of approximately 10 kHz to 10 MHz (particularly 500 kHz). The laser system is coupled to a scanner system that allows spatial variation of the focal point in three dimensions. In addition to the optics of this therapeutic laser scanner, the apparatus further comprises a navigation system coupled thereto.

[0013] Patent Document 2 describes a system and method for creating incisions in ocular tissue at various depths. The system and method focuses light onto different focal points located at different depths within the ocular tissue, possibly in a pattern. Multiple focal points can be created simultaneously using a segmented lens. Optimal incisions can be achieved by focusing light at different depths, either sequentially or simultaneously, and by creating a beam with an extended plasma column and an extended waist. The techniques described in this case can also be used, inter alia, to perform novel ophthalmic procedures or to improve existing procedures, including the incision of tissue in the posterior pole of the retina, for example, in floaters, membranes, and the like.

[0014] Patent Document 3 also describes a system and method for treating target tissue in the vitreous of the eye, which includes a laser unit for generating a laser beam and a detector for generating an image of the target tissue. The system also includes a computer that forms a focal path for emulsifying the target tissue. A comparator connected to the computer then controls the laser unit to shift the focus of the laser beam. This focus shift is performed to treat the target tissue while minimizing deviation of the focus from the formed focal path.

[0015] Patent Document 4 similarly relates to a system and method for using a computer-controlled laser system to perform partial vitrectomy of the vitreous body of the eye. In operation, an optical channel through the vitreous body is first formed. Vitreous-like deposits and suspended deposits (floaters) within the optical channel are then ablated and, in some cases, removed (e.g., aspirated) from the optical channel. In some cases, a clear liquid can be introduced into the optical channel to replace the ablated material, thereby establishing clear transparency within the optical channel. Generally, the present invention relates to systems and methods for ophthalmic laser surgery. In particular, the present invention relates to systems and methods that use a pulsed laser beam to remove what are known as floaters.

[0016] Patent Document 5 similarly describes a method and system for intraocular ophthalmological intervention. Undesirable features are identified based on an image of at least a portion of the eye. The undesirable features in the vitreous cavity are considered to be examples of vision-impairing vitreous opacities, such as floaters. After floaters are identified and located by an image processing system, following confirmation by a physician, they are automatically "irradiated" with a laser pulse. The laser energy vaporizes at least a portion of the vitreous-like opacity. This procedure is repeated until the vitreous opacity is removed. The entire procedure is repeated for each instance of opacity in the vitreous until the vitreous fluid is considered sufficiently clear.

[0017] The method described by ELLEX (Ellex Medical Pty Ltd. Product Brochure; "Tango Reflex-Laser Floter Treatment"; PB0025B; 2018; http: / / www.ellex.com) provides for the use of a pulsed nanosecond laser (YAG) to break down vitreous opacities or completely remove them by gas transition. A pilot laser beam is used to target the target area (floaters), which is then "irradiated" using one or more therapeutic laser pulses. In this case, both the pilot laser beam and the therapeutic laser pulses are manually triggered by the user. Such manual laser treatments typically consist of two separate treatments, each lasting 20 to 60 minutes.

[0018] Unpublished German patent applications No. 102019007147.6 and No. 102019007148.4 describe systems for laser vitreolysis of floaters that enable safe and precise atomization of vitreous opacities (floaters) based on the combination of a therapeutic laser with an OCT or OCDR system. Here, OCDR (optical coherence domain reflectometry) systems are understood to mean systems for interferometric acquisition of one-dimensional scattering profiles, and OCT (optical coherence tomography) is understood to mean two-dimensional or three-dimensional imaging. In both cases, variations with recording sequences (i.e., film) are also included. In this process, a minimum distance to sensitive eye tissue is ensured, and laser activation is preferably only permitted when the focal point of the therapeutic laser and the floaters to be treated are positioned with sufficient precision relative to each other.

[0019] The disadvantage of both approaches is that the physician must constantly combine the available two-dimensional frontal view of the eye with the three-dimensional image of the OCT or OCDR system using their spatial imagination, which is very difficult in situations of time-sensitive or rapid interaction with the patient.

[0020] The use of laser energy within the scope of laser vitreolysis is non-invasive and avoids the drawbacks of surgical intervention, but is also associated with drawbacks and risks. For example, aiming the laser can be difficult. Because the physician views the vitreous along the beam path, it can be difficult to determine the depth of the retina, the depth of the vitreous opacity, or other relevant characteristics. As a result, the vitreous opacity may be missed and / or the eye may be at risk of injury.

[0021] In particular, treatment of mostly transparent floaters, which change position and are difficult to recognize, but which can nevertheless produce troublesome shadows on the retina as phase objects, has proven difficult.

[0022] The application of laser energy may also cause further migration of vitreous opacities, making treatment more difficult. Therefore, the doctor may need to readjust the laser after each application of laser energy, which may require a lot of time. Therefore, treatment with laser energy is complicated and stressful for both the patient and the doctor.

[0023] A further potential problem relates to incomplete vitreous detachment, which can result in localized vitreous traction leading to retinal detachment. Intravitreal laser treatment can result in a change in the balance of forces within the vitreous due to shock waves propagating as a result of the treatment, thereby causing tension on the retina, for example.

[0024] Finally, treatment of floaters located near sensitive structures of the eye has also proven particularly difficult, as laser radiation can cause damage to the retina, lens, or macula. [Prior art documents] [Patent documents]

[0025] [Patent Document 1] German Patent Application Publication No. 102011103181 [Patent Document 2] US Patent Application Publication No. 2006 / 195076 [Patent Document 3] US Patent Application Publication No. 2014 / 257257 [Patent Document 4] US Patent Application Publication No. 2015 / 342782 [Patent Document 5] US Patent Application Publication No. 2018 / 028354 [Non-patent literature]

[0026] [Non-Patent Document 1] Brasse, K., Schmitz-Valckenberg, S. Juenemann, A. et al., Ophthalmologe (2019) 116:73. Internet (URL: https: / / doi.org / 10.1007 / s00347-018-0782-1) Summary of the Invention

[0027] The present invention is based on the objective of developing a solution for the laser treatment of eye opacities that overcomes the drawbacks of known technical solutions and provides the possibility of combining a two-dimensional image of the eye with a three-dimensional image of a measurement system in a simple manner, thus facilitating its handling for the operator. Furthermore, this solution should be easy to implement, economically cost-effective, and allow for a simpler, faster, and above all safer treatment of troublesome vitreous opacities by laser vitreolysis.

[0028] The object is to provide an apparatus for laser treatment of eye opacities, comprising a measurement system for obtaining depth information about eye tissue, a laser system having optical elements for coupling the measurement system and the laser system, an eye tracking unit, a display unit, and a control and processing unit, wherein the measurement system is configured to make available depth information about eye tissue in the form of a depth profile, the laser system is configured to break up eye opacities, the eye tracking unit is configured to detect on-axis eye movements, the display unit is configured to display at least one 2D image representation of the eye as a live image, and the control and processing unit is configured to determine from the depth profile the depth of the eye tissue relative to the depth of the laser focus and to determine exclusion zones for the laser treatment, in particular exclusion zones for the retina and the lens capsule, the control and processing unit is further configured to generate at least one marker for at least each of the retina and lens capsule exclusion zones and the laser focus, characteristics of the markers corresponding to respective depths within the eye in order to display these markers on the display unit and superimpose them on the live image.

[0029] In this case, the deflection unit can be realized using known electromechanical deflection mirrors (e.g., galvo scanners or MEMS scanners) or by simple manually operated deflection and / or displacement of the laser beam, e.g., using a handheld contact lens and a displaceable and pivotable laser slit lamp.

[0030] According to the invention, the control and processing unit is configured to locate floaters and tissues in the eye and to determine exclusion zones for the laser treatment, in particular exclusion zones for the retina and the lens capsule. Furthermore, the control and processing unit is configured to generate markers for at least the retina and lens capsule exclusion zones and the laser spot, the size of the markers corresponding to the respective depth information within the eye in order to display these markers on the display unit and superimpose them on the live image and / or scan.

[0031] According to the invention, the object is achieved by the features of the independent claims. Preferred developments and embodiments are the subject of the dependent claims. A first advantageous embodiment relates to a measurement system that is an OCDR or OCT system for obtaining depth information of the eye.

[0032] A second group of advantageous embodiments relates to an eye tracking unit in which a reference mark placed in the anterior region of the eye, preferably the iris, the lens capsule, the lens, or the anterior or posterior surface of the cornea, a contact lens, or in the vitreous by laser treatment, serves as a reference for the eye tracking unit.

[0033] A third group of advantageous embodiments relates to a display unit configured to display a further image representation, in particular a scan with ocular depth information and / or the appearance of current settings and / or operating elements, where it is particularly advantageous for the display unit to be a touchscreen.

[0034] A further advantageous configuration relates to a control and processing unit that is also configured to locate retinal landmarks, in particular the fovea, the macula, the optic disc, or blood vessels, generate markers, and additionally display these markers on the display unit for laser treatment.

[0035] In this case, the markers generated by the control and processing unit differ in terms of color and / or structure. Particularly preferably, the marker generated for the laser spot changes color and / or structure when the laser spot approaches or enters one of the exclusion zones or retinal landmarks.

[0036] The control and processing unit is further configured to switch off the laser system when the laser focal point approaches or enters one of the exclusion zones or the retinal landmarks. Different tolerances for switching off the laser system upon approaching or entering can be assigned to the two exclusion zones and the retinal landmarks.

[0037] According to a particularly advantageous embodiment, the device for laser vitreolysis of vitreous opacities is integrated into a slit lamp. The present invention relates to a device for the laser treatment of ocular opacities. A partially automated treatment system is proposed in which a two-dimensional image of the eye is combined with depth information (depth profile) to make it easier for the operator to use when locating floaters over the course of treatment.

[0038] The invention is explained in more detail below on the basis of exemplary embodiments. [Brief explanation of the drawings]

[0039] [Figure 1] FIG. 1 shows a representation of a fundus image with markers superimposed thereon. [Figure 2] FIG. 10 shows a representation of a fundus image with markers superimposed for different focal positions of the laser spot. [Figure 3] FIG. 10 shows a representation of a scan with markers for the exclusion region and laser spot. DETAILED DESCRIPTION OF THE INVENTION

[0040] The proposed device for laser treatment of eye opacities, for laser vitreolysis of vitreous opacities, consists of a measurement system for acquiring depth information of the eye, a laser system with a deflection unit, optical elements for coupling the measurement system and the laser system, an eye tracking unit, a display unit, and a control and processing unit.

[0041] In particular, the measurement system is configured to provide depth information of the eye in the form of a scan. On-axis eye movements are detected and corrected by an eye tracking unit. The display unit is configured to display at least one 2D image representation of the eye as a live image. A refresh rate of 5 Hz, preferably 10 Hz, and particularly preferably 20 Hz, and a latency of less than 200 ms, preferably less than 100 ms, and particularly preferably less than 35 ms, are used for the live image.

[0042] According to the present invention, the control and processing unit is configured to determine the depth of the ocular opacity relative to the depth of the laser focus, generate a plurality of markers relating to the relative position of the ocular opacity relative to the laser focus, and display these markers on the display unit.

[0043] Furthermore, the control and processing unit is configured to locate ocular structures in the scan provided by the measurement system and determine exclusion zones for the laser treatment, in particular for the retina and lens capsule.

[0044] In particular, the control and processing unit is further configured to generate markers for at least the retinal and lens capsule exclusion zones and the laser spot, the size of which corresponds to the respective depth information within the eye in order to display these markers on the display unit and overlay them on the live image.

[0045] The physician is given the option to manually treat floaters by positioning the laser focal point relative to the ocular tissue to protect these ocular tissues from the created exclusion zone, which prevents the laser focal point from entering and damaging the ocular tissue.

[0046] According to an advantageous embodiment, the control and processing unit is further configured to determine the depth of the ocular opacity relative to the depth of the laser focus, generate a plurality of markers relating to the relative position of the ocular opacity relative to the laser focus, and display these markers on the display unit.

[0047] There is an option to automatically treat floaters by further determining the location of ocular opacities (floaters) relative to the ocular tissues to be protected or relative to the exclusion zones created for these ocular tissues.

[0048] Similarly, previously available manual treatment is simplified by the physician being able to at least approximately estimate the location of the laser focus relative to the floater. In the device proposed in this specification, an OCDR system or an OCT system is used as a measurement system for obtaining depth information of the eye, which measurement system is preferably combined with a YAG laser system equipped with a deflection unit.

[0049] If an OCDR system is used, the A-scan and, with the aid of an additional image recording unit, an additional image of the fundus are recorded, and the position of the OCDR measurement beam relative to the fundus is known by calibration. The fundus image is preferably recorded using IR or NIR illumination between 780 nm and 1060 nm.

[0050] In contrast, when an OCT system is used, a 3D volume scan is recorded and eye movements are detected and corrected for by an eye tracking unit during recording of the 3D volume scan. Eye movement correction is necessary because acquiring a 3D volume scan can take up to 2 seconds and eye movements distort the scan.

[0051] While eye tissue can be relatively easily detected in OCDR or OCT signals, the situation is different for floaters. The discrimination is preferably performed such that the vitreous scattering signal level is first determined. If the structure is: -having a signal value 2 dB, preferably 5 dB, higher than the average vitreous signal; - have a minimal axial size (e.g., greater than 15 pm in tissue) or have an equivalent optical path with an assumed refractive index of 1.36, in which case the signal still originates posteriorly at the vitreous; or - if the signal characteristics correspond to known floaters stored in a database using size or position ratios; The structures are identified as floaters. The eye-tracking unit is configured to detect and correct on-axis eye movements.

[0052] In particular, the anterior region of the eye serves as a reference, preferably the anterior or posterior surface of the lens capsule, the lens or the cornea. The retina is not typically used as a reference because it may be more obscured by floaters, and therefore more anterior regions are preferred for tracking on-axis eye movements relative to floaters.

[0053] However, it is also possible to use a fiducial mark placed in the vitreous by a contact lens or laser treatment as a fiducial for the eye tracking unit. If a contact lens is used as a fiducial, fiducialization in the form of a functional coating is conceivable to enable stable tracking.

[0054] According to the invention, the display unit is configured to display, in addition to the 2D image representation of the eye as a live image, further image representations, in particular scans with depth information of the eye, and / or the appearance of current settings and / or operating elements. In this connection, it is particularly advantageous if the display unit is a touchscreen.

[0055] According to the present invention, binoculars, 3D monitors, HMDs, etc., are also provided as display units. Furthermore, the configuration of the control and processing unit is important to the present invention. In particular, the control and processing unit generates markers for the retinal and capsular exclusion zones and the laser spot for displaying them on the display unit and superimposing them on the live image and / or scan. In particular, floaters themselves can also be marked in the process.

[0056] The control and processing unit is further configured to locate retinal landmarks, in particular the fovea, macula, optic disc, or blood vessels, generate individual markers for each of these, and optionally display these on the display unit and overlay them on the live image and / or scan.

[0057] To avoid damage, laser treatment can be interrupted if the laser beam is aimed at one of several retinal landmarks. Furthermore, according to the present invention, in order to avoid stresses that may cause retinal detachment during further laser treatment, local changes in retinal height are monitored, for which purpose important local points can also be marked as described.

[0058] According to the invention, the markers generated by the control and processing unit differ in terms of color and / or structure. In this regard, Figure 1 shows a representation of a fundus image with overlaid markers, both of which are colored in color. From outside to inside, the markers indicate the lens capsule 1, the anterior exclusion zone boundary 2, the laser focus 3, the floaters 4, the posterior exclusion zone boundary 5, the retina 6, and the laser direction 7.

[0059] Additionally, the marker generated by the control and processing unit for the laser spot changes color and / or structure when the laser spot approaches one of the exclusion zones or retinal landmarks.

[0060] It is also possible to acoustically and / or optically alert the operator or switch the laser system off if the laser focus approaches or enters one of the exclusion zones or retinal landmarks.

[0061] In this regard, Figure 2 shows a representation of a fundus image with markers superimposed for different focal positions of the laser spot; in this case, both the fundus image and the markers are actually colored. For clarity, only the markers for the retina 6, the laser focus 3, and the lens capsule 1 are shown in the fundus image shown in Figure 2. In the top two figures, laser treatment is possible because the laser focus 3 is located in the "safe" zone between the retina 6 and the lens capsule 1, whereas in the bottom two figures, laser treatment is impossible because the laser focus 3 is too close to the retina 6 or the lens capsule 1 and is located in the respective exclusion zone (not shown) in each case.

[0062] Figure 3 shows a representation of the scan with markers for the exclusion zone and laser spot. From this representation of the depth scan 9, the user can very quickly and reliably identify the depth at which the laser focus 3 is located relative to the retina 6 and lens 8 (or lens capsule 1). Additionally, the posterior exclusion zone 5 and anterior exclusion zone 2 are also shown in Figure 3.

[0063] Furthermore, the control and processing unit is configured to assign different tolerances to the proximity of both the exclusion zones and the retinal landmarks. In a particularly advantageous embodiment, the device for laser vitreolysis of vitreous opacities is integrated into a slit lamp, although the laser vitreolysis concept proposed herein is equally applicable in the case of a surgical microscope.

[0064] The proposed device is also suitable for displaying the type of treatment history, for example by marking and storing the irradiation depth and irradiation position. It is also possible to display the incremental change in the position of floaters (as a trajectory) and to display the retinal areas (local height markers) that are incrementally irradiated with the laser.

[0065] The solution according to the invention makes available a device for the laser treatment of eye opacities that overcomes the drawbacks of known technical solutions and offers the possibility of combining in a simple manner a two-dimensional image of the eye with a three-dimensional image of a measurement system, thus making its handling easier for the operator. Furthermore, the solution is easy to implement, economically cost-effective, and allows for a simpler, faster and, above all, safer treatment of troublesome vitreous opacities by laser vitreolysis.

[0066] According to the present invention, depth information obtained from an OCDR or OCT system regarding the location of sensitive ocular tissue, the laser focus, and possibly moving floaters to be treated is processed in such a way that it can be combined in an intuitively processable way with 2D images that are familiar to the physician.

Claims

1. 1. An apparatus for laser treatment of eye floaters, comprising:

1. An apparatus comprising: a measurement system for obtaining different depth position information for each ocular tissue in an eye along an optical axis direction; a laser system comprising optical elements for coupling said measurement system with a laser system; an eye tracking unit; a display unit; and a control and processing unit, wherein said measurement system is configured to make the different depth position information for each ocular tissue available in the form of a depth profile showing successively the different depth position information, said laser system configured to break up ocular floaters; said eye tracking unit configured to detect on-axis eye movements; and said display unit configured to display at least one 2D image representation of the eye as a live image, and wherein said control and processing unit is configured to determine from the depth profile a depth position of each ocular tissue relative to a depth position of a laser focus and to determine an exclusion zone for laser treatment, the control and processing unit is further configured to generate at least one marker for at least each of the exclusion zone and the laser focus, characteristics of the markers corresponding to depth positions of individual tissues within the eye for displaying the markers on the display unit and overlaying them on the live image.

2. The device described in claim 1, characterized in that the exclusion zone for laser treatment is an exclusion zone for laser treatment of the retina and lens capsule.

3. 2. The device of claim 1, wherein the control and processing unit is configured to determine a depth position of eye floaters relative to a depth position of the laser focus, generate a plurality of markers relating to the relative positions of the eye floaters relative to the laser focus, and display these markers on the display unit.

4. 4. The device according to claim 3, characterized in that the control and processing unit is adapted to vary the properties of the generated markers in terms of color, shape and depth value.

5. The device described in claim 3, characterized in that the control and processing unit is configured to vary the characteristics of the generated marker with respect to the size of the marker.

6. 10. The apparatus of claim 1, wherein the control and processing unit is configured to generate a plurality of markers having depth-dependent sizes for the retina, the lens capsule, the lens, the laser focus, and eye floaters, the plurality of markers being positioned around a lateral laser focus position.

7. The device described in claim 1, characterized in that the control and processing unit is configured to generate a plurality of markers having depth-dependent sizes for the retina, lens capsule, lens, laser focus, and eye floaters, and the plurality of markers are centered about the lateral laser focus position.

8. The device of claim 1 , wherein the eye-tracking unit is configured to compensate for on-axis eye movements.

9. 10. The device of claim 1, wherein one 2D image representation is an en face image representation of the back of the eye displayed as a live image with a refresh rate of 5 Hz and a latency of less than 200 ms.

10. The device described in claim 1, characterized in that one 2D image representation is an en face image representation of the back of the eye displayed as a live image having a refresh rate of 10 Hz and a latency of less than 100 ms.

11. The device described in claim 1, characterized in that one 2D image representation is an en face image representation of the back of the eye displayed as a live image having a refresh rate of 20 Hz and a latency of less than 35 ms.

12. 2. The device of claim 1, wherein the measurement system for obtaining depth position information of the eye is an OCDR system.

13. The device of claim 1 , wherein the front region of the eye serves as a reference for the eye tracking unit.

14. The device of claim 1 , wherein the anterior or posterior surface of the eye's lens capsule, lens, or cornea serves as a reference for the eye-tracking unit.

15. The device of claim 1 , wherein a fiducial mark placed in the vitreous by a contact lens or laser treatment serves as a reference for the eye tracking unit.

16. 10. The device according to claim 1, wherein the OCDR system is configured to record A-scans and is provided with an image recording unit for recording the fundus, and the position of the OCDR measurement beam relative to the fundus is known by calibration.

17. 10. The apparatus of claim 1, wherein the OCT system is configured to record a 3D volume scan, and wherein the eye tracking unit is configured to correct eye movements detected during recording of the 3D volume scan.

18. 2. The device of claim 1, wherein the display unit is configured to display a further graphical representation.

19. The device described in claim 1, characterized in that the display unit is configured to display a scan with eye depth position information and / or current settings and / or an appearance of operating elements.

20. 18. The device according to claim 1, wherein the display unit is a touch screen.

21. 2. The apparatus of claim 1, wherein the control and processing unit is configured to display the generated markers for the exclusion zones of the retina and lens capsule and the laser focus on the display unit and overlay them on the scan.

22. The device of claim 1 , wherein the control and processing unit is configured to locate retinal landmarks and generate markers for the retinal landmarks.

23. The device described in claim 1, characterized in that the control and processing unit is configured to locate retinal landmarks including the fovea, macula, optic disc or blood vessels and generate markers for the retinal landmarks.

24. 4. The device according to claim 3, characterized in that the markers generated by the control and processing unit differ in terms of color and / or structure.

25. 2. The device of claim 1, wherein the marker generated by the control and processing unit for the laser spot changes color and / or structure when the laser spot approaches one of the exclusion zones or retinal landmarks.

26. 10. The device of claim 1, wherein the control and processing unit is configured to acoustically and / or optically alert an operator when the laser system approaches one of the exclusion zones or retinal landmarks.

27. 10. The apparatus of claim 1, wherein the control and processing unit is configured to turn off the laser system when the laser system approaches or enters one of the exclusion zones or retinal landmarks.

28. 2. The device according to claim 1, characterized in that the control and processing unit is configured to be able to assign different tolerances for switching off the laser system when approaching two exclusion zones and retinal landmarks.

29. 2. The device according to claim 1, wherein the device for laser vitreolysis of vitreous floaters is integrated into a slit lamp.

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