Modular laser treatment devices

Abstract

The present invention relates to a modular laser treatment device (MLTD) for use by ophthalmologists in ophthalmic surgery, which integrates three of the most frequently used treatment devices into a single compact unit, allowing treatment using capsulorhexis, vitreolysis, and iridotomy with selective laser trabeculoplasty and photocoagulation. Along with the provision of such a modular laser device, a method is provided for optomechanically coupling different ophthalmic modules into a single unit using two laser sources.

Description

Technical Field

[0001] The present invention relates to a modular laser therapy device (MLTD) used in ophthalmic surgery by ophthalmologists, which integrates three most frequently used therapeutic devices enabling treatments using capsulotomy, vitreolysis, and iridotomy by selective laser trabeculoplasty and photocoagulation into a single compact unit.

Background Art

[0002] a) Introduction to Therapeutic Procedures and Ophthalmic Laser Therapy a1) Photodisruptor (PD) Procedure One of the most frequent eye diseases is cataract, which occurs as turbidity of the lens inside the eye, causing a change in refractive power, resulting in scattering of incident light and a decrease in the light intensity reaching the retina. Cataract is deeply related to biological aging, and about 75% of people over 75 years old suffer from lens turbidity. Cataract can be effectively treated by surgical intervention to replace the opaque lens with an intraocular lens. It is estimated that about 20 million cataract surgeries are performed worldwide every year. However, within 5 years after lens replacement, there is a risk of turbidity occurring in the posterior capsule of the lens in 30% of patients. Such posterior capsule turbidity and postoperative late lens capsule expansion syndrome, called posterior capsular cataract, are the most common postoperative complications of cataract surgery and have an adverse effect on vision.

[0003] Posterior capsule opacification is treated by laser posterior capsule incision using a photosection device (PD). This PD includes an Nd:YAG pulsed laser with a wavelength of 1064 nm and an energy of 0.5 to 10 millijoules. The excitation pulse is focused typically 100 to 200 micrometers posterior to the intraocular lens and posterior capsule. This high-intensity laser pulse induces optical dielectric breakdown, resulting in a micro-explosion initiated by plasma formation. Following plasma expansion, various laser-induced phenomena occur, such as shock waves and cavitation bubbles, which contribute to posterior capsule incision in a small area around the focal point. To clarify the visual axis and improve the patient's visual acuity, a central opening in the opacified posterior capsule is created by 30 to 50 pulses focusing at different positions, most commonly forming a cross. This creates an opening on the posterior surface of the lens capsule, through which normal visual acuity is achieved.

[0004] Nd:YAG laser pulses are emerging as a precise, non-invasive method of microsurgery (tissue fragmentation) within the eye, and are becoming the second most important therapeutic laser application in ophthalmology after photocoagulation. Nd:YAG lasers can also be used in vitreoresis, enabling safe and effective treatment in patients with symptomatic vitreous floaters in the posterior segment. Another application is iridotomy, a procedure that creates a small opening in the iris to treat and prevent acute angle-closure glaucoma.

[0005] a2) Selective Laser Trabeculoplasty (SLT) Procedure Glaucoma is a progressive neurodegenerative disease that threatens the vision of more than 50 million people worldwide, with a significant increase in the number of cases per year, and is the second most common cause of blindness in developed countries. It is characterized by the irreversible loss of retinal ganglion cells and their axons, resulting in structural changes in the retinal nerve fiber layer and optic disc. The most significant risk factors for developing glaucoma are age, family history, and elevated intraocular pressure (IOP). Currently, elevated IOP is the only treatable risk factor associated with glaucoma. In addition to drug therapy with eye drops, microsurgical or laser-based interventions are also increasingly being used.

[0006] Selective laser trabeculoplasty (SLT) is the most frequently used technique for targeting the trabecular meshwork tissue. The underlying mechanism of SLT is not fully understood. The SLT procedure uses extremely short pulses from an Nd:YAG laser, frequency-duplicated to 532 nm, with a duration of 1 to 5 nanoseconds and an energy of 0.2 to 1.5 mJ, to target a 400 μm area within the trabecular meshwork. These specific treatment settings limit thermal damage and protect the trabecular meshwork. Such laser pulses induce selective photothermolysis of intracellular melanin granules in trabecular meshwork cells, resulting in the release of cytokines that trigger a targeted macrophage response. This reduces the resistance to fluid outflow within the meshwork, subsequently leading to a decrease in IOP in patients with open-angle glaucoma.

[0007] SLT is an improved version of the previously used technique called argon trabeculoplasty (ALT). The ALT method uses a thermal effect to coagulate the trabecular meshwork, thus improving aqueous humor flow. Due to the thermal effect, the ALT method irreversibly damages the meshwork and can only be applied once or twice at most. Surgery using SLT uses laser pulses shorter than 5 ns, in which case the thermal effect is negligible and it can be repeated any number of times.

[0008] Another laser microsurgical procedure that can be used to treat glaucoma is laser peripheral iridotomy. In this procedure, laser-induced periiridoplasty is used to create holes in the iris to increase fluid drainage and lower intraocular pressure.

[0009] a3) Photocoagulation device (PC) procedure Laser-induced photocoagulation is a preferred standard treatment that can reduce or prevent severe visual impairment in age-related macular degeneration, proliferative diabetic retinopathy, diabetic macular edema, and other exudative forms of vitreoretinal diseases.

[0010] Age-related macular degeneration (AMD) is an age-related eye disease that is the leading cause of blindness in developed countries. Its first stage, called age-related maculopathy (ARM), is characterized by changes in pigment distribution in the retinal pigment epithelium and the formation of drusen. This stage progresses to progressive stages called atrophic AMD (dry AMD) and exudative AMD (wet AMD). Atrophic AMD accounts for 85% of AMD cases and is characterized by irreversible, progressive structural changes that result in geographical atrophy and the appearance of depigmented areas with increasing diameter. Currently, there is no suitable treatment for AMD or atrophic ARM. In 25% of AMD patients, the disease progresses to the form of exudative AMD, characterized by the formation of neovascularization in the choroid beneath the retina. These vessels are very fragile and leaky, leading to edema, retinal pigment epithelial detachment, and / or hemorrhage, which can dramatically reduce the quality of vision. Laser-assisted photocoagulation (PC) is widely used to treat these symptoms of exudative AMD.

[0011] Diabetic retinopathy is a late-stage complication of diabetes and the most common cause of blindness in the working-age population in developed countries. In its non-proliferative stage, increased capillary permeability leads to punctate hemorrhages, the development of microaneurysms, and macular edema. In the advanced stage, abnormal blood vessels, multiple hemorrhages, retinal detachment, and / or microinfarcts appear in the retina and / or optic disc. If left untreated, 50% of patients are at risk of blindness within a few years.

[0012] Laser-induced photocoagulation (PC) is a preferred standard treatment that can reduce or prevent serious visual impairment in proliferative diabetic retinopathy, diabetic macular edema, and other vitreoretinal diseases.

[0013] Photocoagulation uses a continuous laser power source to target small areas of the retina and abnormal blood vessels beneath the macula, causing burns. When energy from a 532 nm frequency-duplicated Nd:YAG laser source is absorbed by the retinal pigment epithelium (RPE), that energy is converted into thermal energy.

[0014] When the temperature rises above 65°C, coagulation necrosis occurs due to the denaturation of cellular proteins. The burn forms scar tissue that seals the blood vessels, preventing leakage and thus slowing down the increase in fluid beneath the retina, the growth of scar tissue, and the growth of abnormal membranes beneath the retina, which distorts the shape and position of the macula. All of these increases in fluid, scar tissue growth, and abnormal membrane growth damage cells in the macula, leading to loss of central vision.

[0015] Effective retinal photocoagulation requires that the retinal tissue be visible and not obscured, so that light can be absorbed by pigments within the retinal tissue. The degree of laser energy absorption in the retinal layers and structures depends largely on the wavelength used, and one of the major absorbing chromophores in RPE cells is melanin. Melanin absorbs green, yellow, red, and infrared wavelengths; xanthophyll in the macula absorbs blue and slightly yellow or red wavelengths, while hemoglobin absorbs blue, green, and yellow and slightly red wavelengths. Current retinal lasers use wavelengths that are strongly absorbed by melanin in RPE cells, but the duration of the laser pulses currently used gives time for thermal diffusion from the RPE cells to adjacent structures, particularly damaging the neuroretina and resulting in permanent loss of visual function at the treatment site. Green 532 nm lasers or yellow 577 nm lasers are typically used to generate 50 μm to 500 μm spots with burn width spacings of 0.5 to 1 μm from each other, using exposure durations of 0.1 to 0.2 seconds. Alternatively, laser transmission via indirect optometry provides better penetration through vitreous hemorrhage, which has a better laser absorption rate.

[0016] b) Description of related technologies (prior art) The main ophthalmic devices used to treat the aforementioned eye diseases are selective laser trabeculoplasty (SLT) devices for glaucoma treatment, photosection devices (PD) for posterior capsule opacification, vitreoresis, and iridotomy, and photocoagulation devices (PC) for retinal treatment.

[0017] While most of these devices are used as individual ophthalmic devices, some related prior art solutions disclose a combination of two therapeutic ophthalmic modes within a single integrated device. These laser systems are designed for use by ophthalmologists to perform SLT and PD procedures for the treatment of glaucoma and posterior capsule opacification, respectively. However, none of the prior art discloses a therapeutic ophthalmic device that allows for the integration of SLT and PD with PC within a single device.

[0018] Patent Document 1 (ALCON PHARMA) discloses an ophthalmic laser device using two laser modules and three optical paths, designed for use by ophthalmologists to perform SLT and PD procedures for the treatment of glaucoma and posterior capsule opacification, respectively. Only one laser module, i.e., a YAG laser emitting 1064 nm pulses, is the therapeutic power source, while the other laser light source generates a aiming beam. The integration of the two ophthalmic therapeutic modules is achieved by a dichroic beam splitter that allows two optical paths, a transmission path and a reflection path, to be obtained from a single laser light source. Therefore, this solution does not allow for the integration of additional optical paths required to integrate additional therapeutic or diagnostic modules. This solution does not allow for the addition of PC modes. Another problem with this prior art is that it uses parallel plane plates as the substrate for the dichroic beam splitter in the focusing beam. Such a solution produces a large amount of aberration and cannot meet the requirements for high-quality imaging. Therefore, it is very difficult to implement this successfully in practice. Another problem not addressed in this prior art is that collimating a frequency-doubling wavelength of 532 nm within a small solid multimode optical fiber can damage the solid core of the fiber. Newer photonic hollow fibers with much higher damage thresholds did not exist at the time of this prior art. Therefore, it should be noted that the proposed laser system in this prior art could never have functioned at the time of its invention.

[0019] Patent Document 2 (FRANS J VAN DE VELDE) discloses a combination of a confocal scanning laser ophthalmoscope and an external laser light source for microphotocoagulation of the retina or for measuring wavefront aberrations of eye optics. In this prior art, an opticomechanical coupling device having a beam splitter enables independent positioning of the rotation center point of the laser of the scanning laser ophthalmoscope and the rotation center point of the non-scanning external laser beam. In this case as well, the optical configuration of the beam splitter positioned within the focused beam and the parallel planar plates used as the substrate generates a large amount of aberration, and therefore this prior art cannot meet the requirements for high-quality imaging.

[0020] Patent Document 3 (Ellex) discloses an ophthalmic laser system that generates a first wavelength pulse suitable for performing SLT procedures and selectively generates a second wavelength pulse suitable for PD procedures. This laser system can select to direct either the first or second beam to the patient's eye. A Q-switched Nd:YAG laser source generates short pulses with a pulse length shorter than 5 ns at a wavelength of 1064 nm, and the second beam is frequency-doubled to 532 nm in a KTP doubling crystal. Integration of two ophthalmic treatment modules using the first beam for PD mode and the second beam for SLT mode is achieved by a polarizing beam splitter. To set the energy in the light sectioning device mode, a polarizer is rotated to linearly attenuate the pulse energy from 0.3 mJ to 10 mJ. By rotating the polarizer in this way, the laser beam is deflected away from the polarizer in the optical path to another axis intended for generating frequency-doubling pulses for selective laser trabeculoplasty. By rotating the polarization in the polarizer and applying different deflections, this solution can operate in two different optical paths: a first path in PD mode and a second path in SLT mode. In this solution, the basic laser beam is redirected to a different optical axis by the deflection in the polarizer, and frequency doubling of the laser beam occurs along this axis. Thus, the second optical path is used for operation in SLT mode. This solution makes it possible to obtain two optical paths—a transmission path and a reflection path—from a single laser source. Therefore, this solution cannot integrate additional optical paths for additional therapeutic modules. Consequently, this solution cannot add a PC mode.

[0021] Patent document 4 (Lumenis) discloses a dual-path ophthalmic laser system designed for use by ophthalmologists to perform SLT and PD procedures for the treatment of glaucoma and posterior capsule opacification, respectively. The integration of the two ophthalmic treatment modules is achieved by a dichroic beam splitter that allows two optical paths—a transmission path and a reflection path—to be obtained from a single laser source. Therefore, this solution does not allow for the integration of additional optical paths required to integrate additional treatment or diagnostic modules. This solution does not allow for the addition of PC mode.

[0022] Patent documents 5 and 6 (Optotek), which are patents for combined ophthalmic laser devices, disclose a single-path ophthalmic laser system designed for use by ophthalmologists to perform PD and SLT at a laser wavelength of 1064 nm and a frequency-doubling wavelength of 532 nm, respectively. The subject of this invention is a laser device for ophthalmic surgery used by ophthalmologists for treatments using capsulotomy and iridotomy, and a device for selective laser trabeculoplasty. The essence of the combined ophthalmic laser device of this invention is that the device has a single laser with one optical path for both the fundamental wavelength of 1064 nm and the frequency-doubling wavelength of 532 nm. Switching between the two wavelengths is performed by a polarization direction switch. Frequency doubling is inactive at the 1064 nm wavelength and active at the 532 nm wavelength. At the 532 nm wavelength, an additional optical element that attenuates and collimates the laser pulse is switched on. This solution does not allow for the addition of a PC mode. [Prior art documents] [Patent Documents]

[0023] [Patent Document 1] European Patent Application Publication No. 0458681 [Patent Document 2] International Publication No. 99 / 58047

Patent Document 3

Patent Document 4

Patent Document 5

Patent Document 6

Summary of the Invention

Problems to be Solved by the Invention

[0024] An object of the present invention is to provide a modular laser treatment device (MLTD) for ophthalmic surgery by an ophthalmologist, which integrates three most frequently used treatment devices enabling treatments using capsulotomy, vitreolysis, and iridectomy by selective laser trabeculoplasty and photocoagulation into a single compact unit.

Means for Solving the Problems

[0025] The present invention provides a modular laser treatment device for ophthalmic surgery by an ophthalmologist, which integrates three most frequently used treatment devices for treatment by a photoablation device mode (PD) using capsulotomy, vitreolysis, and iridectomy, a selective laser trabeculoplasty (SLT) mode for glaucoma treatment, and a photocoagulation (PC) mode for coagulation treatment techniques on the retina into a single compact unit.

[0026] The proposed innovative approach enables a single device enabling different treatment modes to be used for the treatment of a number of eye diseases that are the most common causes of blindness worldwide and have a very large impact on health management, society, and the economy. Cataract is the main cause of blindness accounting for 50% of all cases worldwide, followed by glaucoma (8%) and age-related macular degeneration (5%) (WHO (2012): Global data on visual impairments 2010).

[0027] The present invention enables the use of a modular laser therapy device (MLTD) by providing a solution for optically and mechanically coupling different ophthalmic modules into a single modular laser therapy device using two laser sources. The first laser source emits pulses with a first wavelength of 1064 nm for treatment using capsulotomy, vitreolysis, and iridotomy in photosection (PD) mode. The pulses from this first laser source can be frequency-duplicated to a wavelength of 532 nm for treatment using selective laser trabeculoplasty (SLT) in SLT mode by a selective laser trabeculoplasty (SLT) module. The second laser source emits a continuous wave with a second wavelength of 532 nm for treatment using photocoagulation in photocoagulation (PC) mode. The photosection (PD) mode is enabled, for example, by integrating an Nd-Yag pulsed laser as the first laser source into a single optical path with an energy meter / targeting beam module, a PD module, and an output objective lens module. SLT mode is enabled by optically coupling the first laser source with the SLT module, energy meter / aiming beam module, scanning module, and output objective lens module. PC mode is enabled by optically coupling the 532 nm continuous wave laser module with the PC module, scanner module, and output objective lens module. All three devices are integrated into a single modular laser treatment device (MLTD) with the same output objective lens for imaging and waist formation in the patient's eye. In SLT and PC modes, scanning in the image plane is enabled by the scanning module incorporating a Lisley prism pair or, alternatively, a scanning mirror.

[0028] Switching between the three different modes of the MLTD (PD, SLT, and PC) is achieved through electromechanical control, electronic control, and microprocessor control. [Explanation of Symbols]

[0029] 10. First (PD / SLT) laser module 11 Nd-Yag pulsed laser 12 Variable Attenuator 13. Optical path of the first laser pulse 20 Energy Meter / Aiming Beam Modules 21 Beam Splitter Mirror 22 Energy Meters 23 Safety shutter 24 Beam Combiner 25 Polarizing Beam Splitter / Combiner 26. Aiming Beam PD 26A Aperture Double PD 27 Aiming Beam SLT 30 PD Modules 31 Beam-formed lenses 32 Beam-formed lenses 40 SLT modules 41 KTP crystal 42A Pass-Through Filter 42B SLT Attenuator 43 Folding Mirror 1 44 Folding Mirror 2 45 Beam-formed lens 46 Beam-formed lenses 50 PC modules 15. Second (PC) laser module 16 Optical Fibers 54 PC Zoom Optics Module 55 Beam-formed lens 56 Beam-formed lenses 57 Miller 60 scanning modules 61. Movable Mirror 61A Switchable Off Mirror 62 Mirror 63 Correction Prism 64. The First Lizley Prism 65. The Second Lizley Prism 70 Output Objective Lens Module 71. The patient's eye PD focal plane of 72 75 72A 75 SLT focal plane 72B 75 PC focal plane 73A SLT Add-on Lens 73B PC Add-on Lens 74 PD beam path 74A SLT beam path 74B PC beam path 75 Output objective lens 77 Dichroic Mirror 78 Binoculars 79 The examiner's eye 80 SLT / PC Platform 80A PD / SLT / PC Single Platform

[0030] In one embodiment, the present invention provides an ophthalmic laser system comprising: a first laser module 10 for generating a beam (e.g., pulse) of a first wavelength; a second laser module 15 for generating a beam of a second wavelength; a first beam path 74 incorporating beam-shaping optics 31, 32 and an output objective lens module 70 for guiding the first wavelength beam to the patient's eye 71; a second beam path 74A incorporating a frequency-changing (e.g., frequency-doubling) component 41 for converting the first wavelength beam to a third wavelength beam, beam-shaping optics 45, 46 and the output objective lens module 70 for guiding the third wavelength beam to the patient's eye 71; and a third beam path 74B incorporating beam-shaping optics 55, 56 and the output objective lens module 70 for guiding the second wavelength beam to the patient's eye 71. The beam paths are realized by a beam path arrangement including components and modules. According to one embodiment, such components and / or modules are movably mounted or mounted on a movable platform such that the components and / or modules can be switched in and out of a beam path using linear or rotational motion of the components, modules and / or platform.

[0031] In one embodiment, the present invention provides an ophthalmic laser system comprising a movable-mounted laser module, therapeutic optical module, and other electro-optical and / or optical modules and components, or in which all components and some of the modules are mounted on a movable platform, such that the linear or rotational motion of the components, modules and / or platform allows a laser pulse or beam from the laser module to be aligned with a desired therapeutic module and other such modules, as well as an output objective lens module for imaging and waist formation in the patient's eye.

[0032] According to one embodiment having a laser module equipped with a laser light source, each of the three beam paths is realized by photoelectric means, optical means and optics-mechanical means, and linear or rotational electromechanical motion of components, modules and / or platforms. Each of the three beam paths is as follows: - A first beam path, comprising aligning a first laser module that generates a pulse of the first wavelength with PD beam shaping optics and an output objective lens module, in order to guide a pulse of the first wavelength into the patient's eye for PD-mode therapy of capsulotomy, vitreolysis, and iridotomy; - A second beam path by aligning a first laser module that generates a pulse of a first wavelength with a frequency changing (e.g., frequency doubling) component that converts the pulse of the first wavelength to a pulse of the third wavelength, SLT beam shaping optics, scanning module and output objective lens module, in order to guide a pulse of a third wavelength into the patient's eye for treatment using the SLT mode for glaucoma treatment; and - A third beam path is formed by aligning a second laser module that generates a second wavelength beam with PC beam shaping optics, a scanning module and an output objective lens module in order to guide a second wavelength beam into the patient's eye for treatment using PC mode for retinal coagulation therapy.

[0033] Switching between the three different treatment modes (PD, SLT, and PC) can be achieved through electromechanical control, optics-mechanical control, electronic control, and microprocessor control.

[0034] According to one embodiment, the core therapeutic modules can be fixed or movably mounted on two platforms, such that the PD module is mounted on a fixed platform and the SLT module and PC module are mounted on a movable platform. Switching between three different therapeutic modes (PD, SLT, and PC) can be achieved by linearly or rotationally moving the movable platform, consisting of the SLT module, PC module, and scanning module, within the optical path of the fixed platform, thereby deactivating the PD mode and enabling the coupling of the desired therapeutic module, which is either the SLT module or the PC module, with the respective laser light source, which is either the first laser module or the second laser module, and the output objective lens module for imaging and waist formation in the patient's eye.

[0035] Alternatively, the three core therapeutic modules, namely the PD module, SLT module, and PC module, can be mounted on a single movable platform, and switching between the three different therapeutic modes (PD, SLT, and PC) can be achieved by linearly or rotationally moving the components and / or modules on such a single platform, enabling the coupling of each laser light source with the desired therapeutic module and the output objective lens module for imaging and waist formation in the patient's eye.

[0036] According to one embodiment, the ophthalmic laser module consists of the following two modules. -A first laser module comprising a laser light source that generates pulses of a first wavelength of 1064 nm for therapeutic use in PD mode. The pulses from this laser light source can be frequency-duplicated to a third wavelength of 532 nm by the SLT module for therapeutic use in SLT mode; and - A second laser module equipped with a laser light source that generates a second wavelength continuous wave beam in the 440 nm to 650 nm range for therapeutic use in PC mode.

[0037] The first laser module includes, for example, a pulsed Nd-YAG laser with a first wavelength nominally 1064 nm. The first wavelength is for the treatment of posterior capsule opacification (and is suitable for the treatment of posterior capsule opacification), while a frequency doubling of the first wavelength to a third wavelength nominally 532 nm is for the treatment of glaucoma (and is suitable for the treatment of glaucoma).

[0038] The second laser module comprises, for example, a continuous-wave laser with a nominal wavelength of 532 nm (suitable for therapeutic use) using photocoagulation, or a CW laser diode having a third wavelength of 440 nm to 680 nm. This wavelength range may relate to the aiming beam generating laser diode.

[0039] According to one embodiment, the ophthalmic laser system is - A first beam path incorporating an output objective lens module that guides pulses from a first laser module of a first wavelength to the patient's eye, - A second beam path incorporating a frequency conversion (e.g., frequency doubling) component that converts pulses from a first laser module of a first wavelength to pulses of a third wavelength, and an output objective lens module that guides the pulses of the third wavelength to the patient's eye, - A third beam path incorporating an output objective lens module that guides the beam from the second laser module of the second wavelength to the patient's eye, It is equipped with.

[0040] The first beam path may further incorporate PD beam shaping optical systems, and / or the second beam path may further incorporate SLT beam shaping optical systems, and / or the third beam path may further incorporate PC beam shaping optical systems.

[0041] A beam deflection means can be incorporated into the second beam path to deflect pulses of a third wavelength toward SLT beam shaping optical devices within the second beam path.

[0042] The first beampath and / or the second beampath may further incorporate a safety / aiming beam module that shuts off the beampath whenever the safety / aiming beam module detects an unsafe condition.

[0043] The first beampath and / or the second beampath may further incorporate optical devices including a safety / targeting beam module having two separate targeting beam generators, a targeting beam PD deliverer and a targeting beam SLT deliverer, both having double apertures, and a beam splitter / combiner that enables the projection of the PD targeting beam or SLT targeting beam and the therapeutic laser pulse on the same line in the first beampath and / or the second beampath.

[0044] According to one embodiment, an internal power meter and a safety shutter that shuts off a third beam path whenever such an internal power meter detects an unsafe condition are integrated within the CW PC laser module.

[0045] According to one embodiment, a targeting beam PC emitter, a beam combiner, and a fiber collimating lens for collimating the PC beam and the targeting beam into an optical fiber are integrated within a CW PC laser module.

[0046] Using the present invention, for each therapeutic optical path, and therefore for each therapeutic wavelength, each targeting beam (visible wavelength) is projected onto the therapeutic optical path on the same straight line.

[0047] A second beam path and / or a third beam path may further incorporate a scanning module. This scanning module may be movable and consists of multiple prisms, in particular, for example, Risley prisms, and / or one or more mirrors that enable scanning along the x and y axes in the image plane of the patient's eye.

[0048] According to one embodiment, a first laser module is optically aligned with a first or second beam path by linear or rotational motion of a movable optical module and / or platform, and the second laser module is provided with a fiber coupling that selectively operates or enables a third beam path. Note that the operation of the laser (beam path) here, and generally the operation of the laser (beam path) in the specification according to the present invention, means the use or function of the laser (beam path), and therefore refers to how the laser (beam path) is actually used, enabled, or operated. In other words, operation does not refer to, for example, surgery, but rather that the use of the laser (beam path) results in a medical treatment or therapy.

[0049] In one aspect of the present invention, a method is provided for operating, i.e., using, an ophthalmic laser system as described above, wherein at least one of the ophthalmic modules is movably mounted, or all components of the therapeutic beam path and / or part of the modules are mounted on a movable platform.

[0050] Selective switching between the first, second, or third beampath can be enabled by electromechanical and opticsmechanical couplings applicable to all components and / or at least some of the modules and / or the platform, and by electromechanical, electronic, and / or microprocessor control.

[0051] In one aspect of the present invention, a method is provided for operating an ophthalmic laser system as described above. This method includes the step of selectively switching between three different treatment modes (PD, SLT, and PC) by linear or rotational motion of modules and / or a platform to enable coupling of a first or second laser module with a desired treatment module, and optionally coupling of a scanning module with an output objective lens module for imaging and waist formation in the patient's eye. The three different treatment modes are defined as: (i) a photosection (PD) mode in which a first beam path is operable using a first laser module of a first wavelength aligned with the PD module; (ii) a selective laser trabeculoplasty (SLT) mode in which a second beam path is operable using a first laser module of a third wavelength aligned with the SLT module and the scanning module; and (iii) a photocoagulation (PC) mode in which a third beam path is operable using a second laser module of a second wavelength aligned with the PC module and the scanning module. Switching between the three different modes (PD, SLT, and PC) can be achieved through electromechanical control, optics-mechanical control, electronic control, and microprocessor control.

[0052] The main difference from the prior art is that the present invention uses each of the three different optical paths for separate therapeutic operating modes that target different parts of the eye, namely the lens capsule and trabecular meshwork in the anterior part of the eyeball and the retina in the posterior part of the eyeball, respectively.

[0053] According to one embodiment, the ophthalmic laser system comprises components and modules for operating the first beam path 74 mounted on a first platform including the first laser module 10, and components and modules for operating the second beam path 74A mounted on a second platform, wherein at least one of the platforms is movable for selective operation of the first beam path 74 or the second beam path 74A and selective operation between those beam paths. The ophthalmic laser system may further comprise components and modules for operating the third beam path 74B, which may also be provided on the first platform or the second platform. The second laser module 15 may be provided with a fiber coupling for selective operation of the third beam path 74B. At least one of the components or modules may be movable or mounted on a movable platform for selective operation of the first beam path 74 or the second beam path 74A or the third beam path 74B and selective operation between those beam paths. Switching and / or selecting between different laser light sources and optical paths is made possible by specific positioning of the movable module or its components and / or movable platform, and by performing this positioning simultaneously, it is prevented that unwanted light from one of the other laser light sources that is not in use may reach the eye.

[0054] For MDs or physicians, the advantage of the present invention is that it provides a single, compact unit that saves on cost and space requirements while enabling three different treatment procedures.

[0055] For manufacturers of ophthalmic (laser) devices or systems, the advantage is that they can produce simpler and more cost-effective products with fewer optical elements.

[0056] The modular laser treatment device of the present invention will be described in more detail with reference to the following figures. [Brief explanation of the drawing]

[0057] [Figure 1] This figure shows one embodiment of a block diagram of an MLTD consisting of two platforms in a photocutting device (PD) mode according to the present invention. [Figure 2] This figure shows one embodiment of a block diagram of a MLTD consisting of two platforms in a selective laser trabeculoplasty (SLT) mode according to the present invention. [Figure 3] This figure shows one embodiment of a block diagram of an MLTD consisting of two platforms in a photocoagulation apparatus (PC) mode according to the present invention. [Figure 4] This figure shows one embodiment of a block diagram of an MLTD integrated on a single platform in PD mode according to the present invention. [Figure 5] This figure shows one embodiment of a block diagram of an MLTD integrated on a single platform in SLT mode according to the present invention. [Figure 6] This figure shows one embodiment of a block diagram of an MLTD integrated on a single platform in PC mode according to the present invention. [Modes for carrying out the invention]

[0058] The technically unresolved issue is a single modular laser treatment device that combines all the techniques described above. This modular laser treatment device (MLTD) can be used in all three modes, namely PD mode, SLT mode, and PC mode, by optically and mechanically switching different movable optical modules in and out of the optical path.

[0059] The present invention provides a solution that enables the integration of three therapeutic ophthalmic devices into a single modular laser therapeutic device (MLTD) that can be used to treat a variety of eye diseases as described above.

[0060] These solutions allow the optical path of the laser module 10 or 15 to be combined with the optical path of a core optical module integrated on one or two platforms to enable the desired operating mode. These core therapeutic modules are a PD module 30 for PD operating mode, an SLT module 40 for SLT operating mode, and a PC module 50 for PC operating mode, all having the same optical path of the output objective lens module 70 for imaging and waist formation in the patient's eye 71.

[0061] Switching between the three different treatment modes (PD, SLT, and PC) of the MLTD is achieved by linear or rotational movement of a platform that allows a first or second treatment laser source to be coupled with the desired treatment module and the same output objective lens module 70 for imaging and waist formation in the patient's eye 71. Switching between the three different treatment modes (PD, SLT, or PC) of the MLTD is made possible by electromechanical control, electronic control, and microprocessor control.

[0062] The combined modular laser therapy device (MLTD) of the present invention uses two laser source modules. The first laser module 10 includes a pulsed laser source having a fundamental wavelength of 1064 nm for PD mode. The pulses from this laser source can be frequency-duplicated to a wavelength of 532 nm for SLT mode. In contrast, the second (PC) laser module 15 is in the range of 440 nm to 650 nm for therapy using PC mode and emits a continuous wave nominally at 532 nm.

[0063] MLTD uses three core optical modules to achieve the desired operating mode. These core modules are a PD module 30 for PD operating mode, an SLT module 40 for SLT operating mode, and a PC module 50 for PC operating mode. The laser beam from the laser light source module passes through a collinearly positioned core optical therapeutic module, which is one of the PD module 30 for PD operating mode, the SLT module 40 for SLT operating mode, or the PC module 50 for PC operating mode. The PD optical module 30, SLT optical module 40, and PC optical module 50 can be integrated on two platforms or one single platform, thus optimizing the number of optical components required.

[0064] Each energy meter / targeting beam module 20 is either incorporated as a core optical module or within a laser module 15.

[0065] In SLT mode and PC mode, the scanning module 60 enables scanning in the image plane by using a fixed correction prism 63 and a pair of Risley prisms 64, 65. The correction prism 63 allows the beam to be shifted outside the singularity zone of the Risley prism. Alternatively, a scanning mirror 62 can be used.

[0066] The integration of three therapeutic ophthalmic devices into a single modular laser treatment device can be achieved in two different ways.

[0067] 1) Optical solution using two platforms (see Figures 1, 2, and 3 for details) The PD module 30 is located on a separate (e.g., fixed) platform, while the SLT module and PC module are integrated onto a single (e.g., movable) SLT / PC platform. Switching between PD mode and SLT mode or PC mode is performed by mechanically moving the SLT / PC platform 80, which consists of the SLT module 40, PC module 50, and scanner module 60, into the optical path 13 of the platform having the PD module 30.

[0068] The PD mode (Figure 1) is enabled by integrating the Nd-Yag pulsed laser module 10 into a single optical path, i.e., the first beam path 74, with the energy meter / aiming beam module 20, the PD module 30, and the output objective lens module 70. The device operates in PD mode when the mechanically movable SLT / PC platform 80, consisting of the SLT module 40, the PC module 50, and the scanner module 60, is moved outside the optical path 13 of the laser pulse of the first wavelength 1064 nm pulsed Nd:YAG laser source 10.

[0069] SLT mode (Figure 2) is activated when a mechanically movable SLT / PC platform 80, consisting of an SLT module 40, a PC module 50, and a scanner module 60, is moved into the optical path 13 of the PD module 30 using linear or rotational motion, thus enabling coupling into the second beam path, i.e., 74A, of the output objective lens module 70. Moving the SLT module 40 and scanner module 60 into the optical path 13 of the laser pulse of the first wavelength 1064 nm pulsed Nd:YAG laser 10 enables: 1. frequency doubling to 532 nm by a nonlinear crystal 41; 2. integration of the frequency-doubling laser pulse with the SLT aiming beam in the energy meter / aiming beam module 20; 3. bypassing the PD module 30, which has lenses 31, 32 forming a Galileo beam expander, by two fixed mirrors 43, 44, and subsequently focusing on the mirror 61 in the scanning module 60 via two beam-shaping lenses 45, 46 forming the SLT Galileo beam expander. Alternatively, this bypass of the PD beam expander can be achieved by using a photonic cable and two collimating lenses (not shown in Figure 2). In SLT mode, the switching mirror 61 is in the switched-on position and reflects pulses from the SLT module 40 to a fixed mirror 62, a corrective prism 63, and a pair of Risley prisms 64, 65, enabling scanning along the x and y axes within the image plane 72A of the patient's eye 71. The corrective prism 63 allows the beam or pulse to be shifted outside the singularity zone of the Risley prism. Alternatively, scanning can be achieved without the corrective prism and Risley prism by replacing the fixed mirror 62 with a scanning mirror (not shown in Figure 2).

[0070] The PC mode (Figure 3) is enabled by optically coupling the 532 nm continuous wave (CW) laser module 15 with the PC module 50, scanner module 60, and output objective lens module 70 into a third beam path, i.e., 74B. The PC mode is enabled when the electromechanically movable SLT / PC platform 80, consisting of the SLT module 40, PC module 50, and scanner module 60, is moved into the optical path 13 of the PD module's laser pulses, and the PD mode is switched outward by the shutter 23, while the SLT mode is disabled by positioning the switchable mirror 61 to a position 61A outside the SLT optical path, thus enabling the optical coupling of the CW laser beam from the PC laser module 15 via the optical fiber 16 with the PC module 50, scanner module 60, and output objective lens module 70. When the MLTD is operating in PC mode, PD mode and SLT mode are disabled by closing the safety shutter 23 of the energy meter / aiming beam module 20 and switching the mirror 61 of the scanner module 60 to position 61A. Within module 60, a fixed mirror 62 reflects the beam to a compensating prism 63 and a pair of Risley prisms 64, 65, which enable scanning along the x and y axes in the image plane 72B of the patient's eye 71. The compensating prism 63 allows the beam to be shifted outside the singularity zone of the Risley prism. Alternatively, scanning can be achieved without the compensating prism and Risley prism by replacing the fixed mirror 62 with a scanning mirror (not shown in Figure 3).

[0071] 2) Optical solution using a single platform (see Figures 4, 5, and 6 for details) The PD module 30, SLT module 40, and PC module 50 are integrated on a single platform 80A, which also includes the energy meter / aiming beam module 20 and the scanning module 60. Within module 60, the corrective prism 63 and Risley prism pair 64, 65, which enable scanning along the x and y axes in the image plane of the patient's eye 71, can have two individual positions: a position aligned with the optical path of module 40 when operating in SLT mode, and a second position aligned with the optical path of module 50 when operating in PC mode. The corrective prism 63 allows the beam to be shifted outside the singularity zone.

[0072] Switching between desired operating modes (PD mode, SLT mode, or PC mode) is achieved by linear or rotational motion of the entire platform 80A, which allows each therapeutic laser light source (either 10 or 15) to be coupled with the appropriate optical module (30, 40, or 50, respectively) and the same output objective lens module 70 for imaging and waist formation in the patient's eye 71.

[0073] The PD mode (Figure 4) is enabled by moving the platform 80A to a position where the optical path 13 of the laser pulse of the first wavelength 1064 nm Nd-Yag pulsed laser module 10 is aligned with the energy meter / targeting beam module 20, the PD module 30 having lenses 31 and 32 that form a Galileo beam expander, and the exit objective lens module 70, thereby creating a single optical path, i.e., the first beam path 74.

[0074] The SLT mode (Figure 5) is enabled by moving platform 80A to a position where the optical path 13 of the first wavelength 1064 nm Nd-Yag pulsed laser module 10 is collinear with the optical path of the SLT module 40, thereby enabling: 1. frequency doubling to 532 nm by a nonlinear crystal 41; 2. integration of the frequency-doubling laser pulse and the SLT aiming beam within the energy meter / sight beam module 20; 3. focusing of the therapeutic beam and aiming beam through two beam-shaping lenses 45, 46 forming an SLT Galileo beam expander; 4. coupling with the scanning module 60 by sliding a correction prism 63 and a pair of Risley prisms 64, 65 in the optical path; and 5. coupling with the optical path of the exit objective lens module 70 to form a single optical path, i.e., a second beam path 74A.

[0075] The PC mode (Figure 6) is enabled by moving the platform 80A to a position that allows the 532 nm CW laser beam from the PC laser module 15 to be optically coupled via the fiber cable 16 to the PC module 50, the scanning module 60, and the output objective lens module 70, creating a single optical path, i.e., a third beam path 74B.

[0076] When the MLTD is operating in PC mode, PD mode and SLT mode are disabled by closing the safety shutter 23 of the energy meter / aiming beam module 20.

[0077] Detailed description of the embodiment Figure 1 shows a modular laser therapy device (MLTD) operating in photosection device (PD) mode.

[0078] The PD mode is enabled by integrating the Nd-Yag pulsed laser module 10 into a single optical path, i.e., the first beam path 74, with the energy meter / aiming beam module 20, the PD module 30, and the output objective lens module 70. When the MLTD is operating in PD mode, the SLT mode and PC mode are disabled by electromechanically switching the SLT / PC platform 80 out of the PD optical path.

[0079] The Nd-YAG pulsed laser module 10 consists of an Nd:YAG laser light source 11 and a variable attenuator 12. The Nd-YAG pulsed laser is pumped by a flash or diode that emits short laser pulses of 1 ns to 5 ns, delivering energy of 0.3 mJ to 10 mJ in the infrared region at a wavelength of 1064 nm with a constant polarization orientation. These short, linearly polarized pulses exit the laser module 10 through an attenuator 12, which allows for adjustment of the output energy by a coupled polarization rotor and a fixed polarizer. The attenuator 12 consists of a λ / 2 plate and a polarization filter. The rotational position of the λ / 2 plate can be electromechanically set to adjust how much of the input pulse is transmitted through the polarizer, thereby enabling energy setting of the PD.

[0080] A pulsed laser beam with a wavelength of 1064 nm then passes through the energy meter / targeting beam module 20. The energy meter / targeting beam module 20 consists of a beam splitter mirror 21, an energy meter 22, a safety shutter 23, a beam combiner 24, a polarizing beam splitter / combiner 25, and two separate targeting beam generators, namely, a targeting beam PD sender 26 and a targeting beam SLT sender 27, both having double apertures 26A. As a short laser pulse leaves the Nd-Yag pulsed laser module 10 and enters the energy meter / targeting beam module 20, the beam splitter 21 initially reflects a small portion of the pulse toward the energy meter 22, while the majority of the pulse passes through the safety shutter 23 and exits the module 20 through the beam combiner 24. By positioning the safety shutter 23 behind the energy meter, automatic closing of the shutter is possible when the energy meter detects a higher energy pulse while the MLTD is operating in PD mode, and when the energy meter detects any light while the PD mode is switched off. The beam combiner 24 allows for the colinear reflection of a PD aiming beam having wavelengths of 635 nm to 650 nm into the optical path of a therapeutic laser pulse having wavelength 1064 nm. The PD aiming beam is generated by an aiming beam PD emitter 26 that uses diodes to emit a collimated S-polarized beam having wavelengths of 635 nm to 680 nm. This S-polarized beam is then transmitted through a double aperture 26A, thus generating two aiming beams for PD mode. These two aiming beams are then reflected from a polarizing beam splitter / combiner 25, which has high reflectivity to S-polarization, to a beam combiner 24, which has high reflectivity to 635 nm for both S-polarization and P-polarization.The beam combiner 24 projects the therapeutic beam and two PD aiming beams collinearly onto a PD module 30 having lenses 31, 32 that form a Galileo beam expander from which the two aiming beams are expanded. These beams are then reflected by a dichroic mirror 77 and focused onto a single 20 μm to 40 μm spot in the focal plane 72 of the patient's eye 71. If there is a deviation from the focal plane, this deviation is shown not as a single spot, but as two out-of-focus spots. Such two PD aiming beams enable precise focusing in PD mode.

[0081] Within the PD module 30, the therapeutic beam and both targeting beams are expanded by the first passage through a Galileo beam expander, which consists of a negative lens 31 that diverges the laser pulse and the PD targeting beam, and a positive lens 32 that collimates the 1064 nm pulse and the PD targeting beam to infinity focus mode.

[0082] Within the output objective lens module 70, the 1064 nm pulse and PD aiming beam are then reflected by the dichroic mirror 77 and focused by the output objective lens 75 at the laser focal point 72 in the patient's eye 71, where optical dielectric breakdown occurs. The dichroic mirror 77 reflects the PD mode wavelength (nominal 1064 nm) or SLT mode wavelength (nominal 532 nm) of the laser pulse and transmits the visible wavelength of light from the slit lamp that is being reflected or scattered from the patient's eye, so that the ophthalmologist 79 can observe the patient's eye 71 through binoculars 78. The aiming beam allows the ophthalmologist 79 to observe through binoculars 78 the point where optical dielectric breakdown occurs in the patient's eye 71.

[0083] Optical dielectric breakdown achieved in PD mode is used in capsule surgery to remove posterior capsule opacification, vitrectomy, or iridotomy to remove symptomatic floaters.

[0084] Figure 2 shows a modular laser therapy device (MLTD) operating in selective laser trabeculoplasty (SLT) mode.

[0085] SLT mode is enabled by optically coupling an electromechanically movable SLT / PC platform 80 so that the SLT module 40 is inserted into the optical path 13 of the laser pulses coming out of the Nd-Yag pulsed laser module 10. SLT mode first allows the pulse frequency doubling, then transmits the 532 nm laser pulse through the energy meter / targeting beam module 20, changes the optical path using two fixed mirrors 43, 44, bypasses the optical path around the PD module 30 which has lenses 31, 32 forming a Galileo beam expander, and then transmits the pulse through two beam shaping lenses 45, 46 forming an SLT Galileo beam expander to the mirror 61 which has been switched to SLT mode, and transmits it through the scanning module 60 to the output objective lens module 70 which is integrated into a second beam path, i.e., 74A. The electromechanically movable SLT / PC platform 80 is moved into the optical path 13 of the laser pulses sent out outside the Nd-Yag pulsed laser module 10 using linear or rotational motion.

[0086] Instead of diverting the SLT laser pulses by reflecting them using two folding mirrors 45, 46 and bypassing the Galileo beam expander lenses 31, 32 in the PD module 30, the laser pulses can be transmitted via an optical photonic cable (not shown in Figure 2). Photonic core glass fibers with a silver reflective coating enable convenient transmission of high-energy pulsed lasers. Coupling efficiency can be nearly 100%, and pulse dispersion can be ignored. Such fibers have been used to transmit a 50 mJ / 5 ns pulsed laser beam with a wavelength of 532 nm over a length of 5 m. The present invention can use shorter hollow photonic fibers with typical hollow core diameters of 300 μm, 500 μm, 700 μm, or 1000 μm. The output of the hollow core is imaged to an exit objective lens 75, which, using an exit collimating lens, produces a magnification of nearly -0.8x for a 500 μm diameter hollow fiber and forms a relay optical system that generates an image with a diameter of 400 μm on the focal plane 72A. An optical photonic cable with an inlet focusing lens and an exit collimating lens replaces the folding mirror 44 and SLT Galileo beam expander lenses 45, 46, simplifying the optical path within the SLT module by collimating the laser pulses back to the mirror 61 (not shown in Figure 2).

[0087] The laser pulse for SLT mode is generated and tuned by the Nd-Yag pulsed laser module 10, as described in detail below Figure 1. The pulsed beam then passes through the first part of the electromechanically movable SLT / PC module 40, which includes a KTP crystal 41 and a pass filter 42A and an attenuator 42B. The laser pulse, with an initial wavelength of 1064 nm, is frequency-doubled to a wavelength of 532 nm by transmission through the nonlinear crystal 41. This optical system utilizes a frequency-doubling module consisting of one or two nonlinear crystals 41. The advantage of using one nonlinear crystal is that linear output polarization is preserved, but the doubling stability is less favorable than that of a configuration with two nonlinear crystals. On the other hand, the advantage of using two nonlinear crystals is that the energy of the frequency doubling is more stable, while the disadvantage is that the output polarization is unclear. The remainder of the 1064 nm wavelength that was not converted in the nonlinear crystal 41 is absorbed by the pass filter 42A. The bandpass filter 42A transmits wavelengths of 532 nm and absorbs wavelengths of 1064 nm, thus enabling operation without the presence of interfering wavelengths. The SLT attenuator 42B allows for adjustment of the SLT energy output.

[0088] The frequency-doubling pulse then passes through the energy meter / targeting beam module 20. Within this module 20, a beam splitter 21 initially reflects a small portion of the 532 nm pulse toward the energy meter 22, while the majority of the pulse passes through a safety shutter 23 and exits the module 20 through a beam combiner 24. The beam combiner 24 is a dichroic mirror that allows for the colinear reflection of the targeting beam, having wavelengths of 635 nm to 650 nm, into the optical path of the therapeutic SLT laser pulse having wavelength 532 nm. The targeting beam is generated by the targeting beam SLT sender 27 and transmitted onto the beam combiner 24 by a polarizing beam splitter / combiner 25. The beam combiner 24 transmits the therapeutic 532 nm pulse colinearly and reflects the targeting beam toward the SLT module. The beam is first reflected by two fixed mirrors 43, 44, then transmitted to a switchable mirror 61 via two beam-shaping lenses 45, 46 that form an SLT Galileo beam expander, and then transmitted to a fixed mirror 62, a corrective prism 63, and a pair of Risley prisms 64, 65, enabling scanning along the x and y axes within the image plane 72A of the patient's eye 71. The corrective prism 63 is incorporated to avoid both the singular blind spots of the Risley prism pair 64, 65. The corrective prism 63 thus provides the Risley prism pair 64, 65 with additional degrees of freedom and shifts the singularity off-axis. The continuous orientation of the corrective prism 63 allows tracking of a target through a singularity such that the Risley control equations have infinitely many solutions, not just two, for the same altitude and azimuthal target angles. The Risley prisms 64, 65 are positioned at the maximum deflection position where the pulse is deflected most from the optical path, i.e., the second beam path 74A.

[0089] Alternatively, scanning can be achieved without a correction prism and a Risley prism by replacing the fixed mirror 62 with a scanning mirror (not shown in Figure 2).

[0090] Within the output objective lens module 70, the laser pulse is reflected by the dichroic mirror 77 and focused on the focal plane 72A in the patient's eye 71 by the output objective lens 75 and the add-on lens 73A. The dichroic mirror 77 reflects the PD mode wavelength (nominal 1064 nm) or SLT mode wavelength (nominal 532 nm) of the laser pulse, and also transmits the visible wavelengths of the aiming beam and the light from the slit lamp that is back-reflected or scattered from the patient's eye, so that the ophthalmologist 79 can observe the patient's eye 71 through binoculars 78.

[0091] The PC mode is disabled by an internal safety shutter of the laser light source 15 and a switchable mirror 61 that blocks the beam from the PC zoom optical devices 54.

[0092] Figure 3 shows a modular laser therapy device (MLTD) operating in photocoagulation (PC) mode.

[0093] The PC mode is enabled by positioning the SLT / PC platform 80 in the optical path 13 of the laser pulse of the PD module 30, thereby optically coupling the 532 nm continuous wave PC laser module 15 with the PC module 50, the scanner module 60, and the output objective lens module 70. The SLT / PC platform 80 consists of the SLT module 40, the PC module 50, and the scanner module 60. The PC module 50 includes an output optical system consisting of a transmission laser beam optical fiber 16, a zoom optical system 54, and beam shaping lenses 55, 56 and a mirror 57 that form a PC Galileo beam expander / compressor. When the MLTD is operating in PC mode, the PD mode is disabled by positioning the SLT / PC platform 80 in the optical path of the PD module 30, while the SLT mode is disabled by positioning the switchable mirror 61 at a position 61A outside the optical path of the SLT laser beam. In addition, when the MLTD is operating in PC mode, the PD mode and SLT mode are disabled by closing the safety shutter 23 of the energy meter / aiming beam module 20. Switching between the three different modes of the MLTD (PD, SLT, and PC) is achieved by electromechanical control, electronic control, and microprocessor control.

[0094] The 532 nm CW PC laser module 15 consists of a 532 nm CW PC laser light source with an internal power meter, a safety shutter, a targeting beam PC emitter, a beam combiner, and a fiber collimating lens that collimates the PC beam and the targeting beam to the optical fiber 16 and the zoom optical system 54 of the PC module 50.

[0095] Depending on the specific ophthalmic treatment mode, different PC laser sources 15 that emit a 532 nm continuous wave laser beam can be used, such as a CW frequency-doubling Nd:YAG laser with a wavelength of 532 nm, a diode-pumping solid-state laser with a wavelength of 532 nm, a power of 50 mW to 2.5 W, and an exposure time of 0.001 s to 3 s, or a diode-pumping solid-state laser with a wavelength of 577 nm, a power of 50 mW to 2.5 W, and an exposure time of 10 μs to 5 s.

[0096] A small portion of the 532 nm or 577 nm continuous wave laser beam emitted from the laser source 15 is reflected toward the internal power meter by an internal beam splitter, while the majority of the beam passes through an internal safety shutter and is transmitted to the fiber collimating lens via an internal beam combiner. Whenever the internal power meter detects an unsafe condition, the internal safety shutter blocks a third beam path before the therapeutic laser beam leaves the laser module 15, thus preventing damage to the patient's eyes. The beam combiner allows for the colinear reflection of a targeting beam having a wavelength of 635 nm to 650 nm into the optical path of the therapeutic PC laser beam having a wavelength of 532 nm. The targeting beam is generated by an internal targeting laser beam PC emitter. The targeting laser beam PC emitter can appropriately generate the desired targeting beam as a CW with a wavelength in the 635 nm to 650 nm range, which has a lower power density compared to the therapeutic laser beam from the laser source 15. For example, a solid-state diode laser providing a 635 nm red beam can be used. The aiming beam can have an average continuous wave output power of 1 mW or less.

[0097] The aiming beam is reflected by an internal beam combiner to a fiber collimating lens that is collinear with the therapeutic PC laser beam. Therefore, the therapeutic beam and the aiming beam are transmitted collinearly via the optical fiber 16 to the zoom optical system 54. The size of the relevant laser beam is largely determined by the core diameter and numerical aperture (NA) of the laser beam transmission fiber 16. Typical transmission fibers in ophthalmic laser systems have a 50 μm diameter core with an NA of 0.12. With a fiber diameter of 50 μm, the image spot diameter is typically 50 μm to 1000 μm at magnifications of 1x to 20x. While the minimum spot size desired by the ophthalmic therapeutic laser market is 50 μm, the required NA for the laser transmission system is 0.06 to 0.09.

[0098] A typical optical fiber with a core diameter of 50 micrometers and an NA of 0.12 acts as a beam homogenizer, and therefore, at the exit, this fiber sends a top-hat profile laser beam to the zoom optical system 54, which magnifies the beam size from 1x to 20x.

[0099] Instead of using a fiber to couple with the laser light source and zoom optical devices 54 that generate 532 nm CW, a CW laser diode with wavelengths of 440 nm to 680 nm can be integrated into module 50 and directly coupled to the zoom optical devices 54 without using fiber 16. Such a configuration is even more compact and does not have an external fiber cable that could be damaged (not shown in Figure 3).

[0100] The zoom optics 54 transmits an infinity-focus beam to beam-shaping lenses 55, 56 that form small PC Galileo beam expanders / compressors that adjust the beam size and spot size, and this infinity-focus beam is then reflected from mirror 57 to scanning module 60. When the switching mirror 61 is moved to a position 61A outside the optical path, the CW beam is then reflected by a fixed mirror 62 and directed towards the exit objective lens module 70 via a corrective prism 63 and a pair of Risley prisms 64, 65. Alternatively, the fixed mirror 62, corrective prism 63 and Risley prisms 64, 65 can be replaced with scanning mirrors to allow scanning along the x and y axes in the image plane 72B on the retina of the patient's eye 71 (not shown in Figure 3). In PC mode, the CW laser beam is guided to the patient's eye along the optical path, i.e., the third beam path 74B.

[0101] Within the output objective lens module 70, the CW beam is reflected by a dichroic mirror 77 and focused on the focal plane 72B in the patient's eye 71 by the output objective lens 75 and add-on lens 73B. The dichroic mirror 77 reflects the PD mode wavelength (nominal 1064 nm) or SLT mode wavelength (nominal 532 nm) of the laser pulse, and also transmits the wavelengths of the aiming beam and the light from the slit lamp that is reflected or scattered from the back of the patient's eye, so that the ophthalmologist 79 can observe the patient's eye 71 through binoculars 78.

[0102] Figure 4 shows the integrated devices on a single platform operating in photocutting (PD) mode.

[0103] The PD mode is enabled by moving platform 80A to a position where the optical path 13 of the laser pulse of the first wavelength 1064 nm Nd-Yag pulsed laser module 10 aligns with one optical path, i.e., the first beam path 74, with the energy meter / targeting beam module 20, the PD module 30 having lenses 31, 32 that form a PD Galileo beam expander, and the exit objective lens module 70.

[0104] When the MLTD is operating in PD mode, the SLT mode is disabled because it is not collinear with the laser light source module 10, while the PC mode is disabled by shutting off the PC laser module 15.

[0105] The Nd-YAG pulsed laser module 10, consisting of an Nd:YAG laser light source 11 and a variable attenuator 12, is described in detail below in Figure 1.

[0106] A short laser pulse of 1 ns to 5 ns, with an energy of 0.3 mJ to 10 mJ and a constant polarization direction in the infrared region at a wavelength of 1064 nm, passes through the energy meter / targeting beam module 20. The energy meter / targeting beam module 20 consists of a beam splitter mirror 21A, an energy meter 22, a safety shutter 23, a beam combiner 24A, and two separate targeting beam generators, namely a targeting beam PD emitter 26, a double aperture 26A, and a targeting beam SLT emitter 27. When a short laser pulse with a wavelength of 1064 nm leaves the Nd-Yag pulsed laser module 10 and enters the energy meter / targeting beam module 20, the beam splitter 21A initially reflects a small portion of the pulse toward the energy meter 22, while the majority of the pulse passes through the safety shutter 23 and exits the module 20 through the beam combiner 24A. By positioning the safety shutter 23 behind the energy meter, the shutter can be automatically closed if the energy meter detects a higher energy level when the MLTD is operating in PD mode, and if the energy meter detects any light when the PD mode is switched off. The beam combiner 24 enables the colinear reflection of a PD targeting beam with wavelengths of 635 nm to 650 nm into the optical path of a therapeutic laser pulse with a wavelength of 1064 nm.

[0107] The PD aiming beam is generated by an aiming beam PD emitter 26 that uses a diode to emit a collimated beam having wavelengths of 635 nm to 680 nm. This beam is then transmitted through a double aperture 26A, thus generating two aiming beams for the PD mode. These aiming beams are then reflected by a beam combiner 24A. The beam combiner 24A transmits the therapeutic beam or therapeutic pulse and the PD aiming beam colinearly to the PD module 30. In the PD module 30, both of these aiming PD beams are expanded by Galileo beam expander lenses 31, 32, reflected by a dichroic mirror 77, and focused into a single 20 μm to 40 μm spot in the focal plane 72. If there is a deviation from the focal plane, this deviation is shown not as a single spot, but as two out-of-focus spots. Such two PD aiming beams enable precise focusing in the PD mode.

[0108] Within the PD module 30, the therapeutic 1064 nm pulse and both targeting beams pass through the Galileo beam expander. Specifically, they first pass through a negative lens 31 that diverges the laser pulse and the PD targeting beam, and then through a positive lens 32 that collimates the 1064 nm pulse and the PD targeting beam to infinity focus mode.

[0109] Within the output objective lens module 70, the 1064 nm pulse and the PD aiming beam are then reflected by the dichroic mirror 77 and focused by the output objective lens 75 at the laser focal point 72 in the patient's eye 71, where optical dielectric breakdown occurs. The dichroic mirror 77 reflects the PD mode wavelength (nominal 1064 nm) or SLT mode wavelength (nominal 532 nm) of the laser pulse and transmits the wavelengths of the aiming beam and the light from the slit lamp that is back-reflected or scattered from the patient's eye, so that the ophthalmologist 79 can observe the patient's eye 71 through binoculars 78. The aiming beam allows the ophthalmologist 79 to observe through binoculars 78 the point where optical dielectric breakdown occurs in the patient's eye 71.

[0110] The optical dielectric breakdown achieved in PD mode is used in capsule surgery or iridotomy to remove posterior capsule opacification.

[0111] Figure 5 shows the integrated device on a single platform operating in selective laser trabeculoplasty (SLT) mode.

[0112] The SLT mode is enabled by linearly moving or rotating the platform 80A to a position where the optical path 13 of the laser pulse of the first wavelength 1064 nm Nd-Yag pulsed laser module 10 is collinear with the optical path of the SLT module 40, thereby enabling: 1. frequency doubling to 532 nm by the nonlinear crystal 41; 2. integration of the frequency-doubling laser pulse with the SLT aiming beam within the energy meter / sight beam module 20; 3. focusing of the therapeutic beam and the aiming beam through two beam-shaping lenses 45, 46 forming the SLT Galileo beam expander; 4. coupling with the scanning module 60 by moving the correction prism 63 and the Lisley prism pair 64, 65 in the optical path; and 5. coupling with the optical path of the output objective lens module 70, i.e., the second beam path 74A.

[0113] The laser pulse for SLT mode is generated and tuned by the Nd-Yag pulsed laser module 10, as described in detail below Figure 1. The laser pulse, having an initial wavelength of 1064 nm, is frequency-duplicated to a third wavelength of 532 nm in the SLT module 40 by transmission through the nonlinear crystal 41, as described in more detail below Figure 2. The remainder of the 1064 nm wavelength that was not converted in the nonlinear crystal 41 is absorbed by the pass filter 42A, thus enabling operation without the presence of interfering wavelengths, while the SLT attenuator 42B allows for adjustment of the SLT energy output.

[0114] A frequency-doubling pulse having a wavelength of 532 nm then passes through an energy meter / targeting beam module 20. Within this module 20, a beam splitter 21B initially reflects a small portion of the 532 nm pulse toward the energy meter 22, while the majority of the pulse passes through a safety shutter 23 and exits module 20 through a beam combiner 24B. The beam combiner 24B is a dichroic mirror that allows for the colinear reflection of a targeting beam having wavelengths of 635 nm to 680 nm into the optical path of a therapeutic SLT laser pulse having a wavelength of 532 nm. The targeting beam is generated by a targeting beam SLT emitter 27 that uses a diode to emit a collimated beam having wavelengths of 635 nm to 650 nm, thus generating a single targeting beam in SLT mode, which then forms a 0.4 mm spot in the focal plane 72A of the patient's eye 71.

[0115] The beam combiner 24B transmits a 532 nm pulse for treatment along the same line and reflects the targeting beam directly onto a corrective prism 63 and a pair of Risley prisms 64, 65 via two beam-shaping lenses 45, 46 that form the SLT Galileo beam expander. These prisms enable scanning along the x and y axes within the image plane 72A of the patient's eye 71. The corrective prism 63 allows the beam to shift outside the singularity zone of the Risley prism.

[0116] Within the output objective lens module 70, the laser pulse is reflected by the dichroic mirror 77 and focused on the focal plane 72A in the patient's eye 71 by the output objective lens 75 and the add-on lens 73A. The dichroic mirror 77 reflects the PD mode wavelength (nominal 1064 nm) or SLT mode wavelength (nominal 532 nm) of the laser pulse, and also transmits the wavelengths of the aiming beam and the light from the slit lamp that is reflected or scattered from the back of the patient's eye, so that the ophthalmologist 79 can observe the patient's eye 71 through the binoculars 78.

[0117] The PC mode is disabled by switching the laser light source 15 off, while the PD mode is disabled by positioning it outside the optical path of the laser light source module 10.

[0118] Figure 6 shows the integrated devices on a single platform operating in photocoagulation (PC) mode.

[0119] The PC mode is enabled by moving the platform 80A, which includes all three core optical modules, to a position that allows for the optical-mechanical coupling of the 532 nm CW laser beam from the PC laser module 15 with the PC module 50, which is collinear with the scanning module 60 and the output objective lens module 70, via a fiber cable 16, thereby enabling a third beam path 74B. When the MLTD is operating in PC mode, the PD mode and SLT mode are disabled by switching off the laser light source in module 10 or by closing the safety shutter 23 of the energy meter / aiming beam module 20.

[0120] The 532 nm continuous wave PC laser module 15 consists of a 532 nm CW PC laser light source with an internal power meter, a safety shutter, a targeting beam PC emitter, a beam combiner, and a fiber collimating lens that collimates the PC beam and the targeting beam via an optical fiber 16 with the zoom optical system 54 of the PC module 50.

[0121] Instead of using a fiber to couple with the laser light source and zoom optical devices 54 that generate 532 nm CW, a CW laser diode with wavelengths of 440 nm to 680 nm can be integrated into module 50 and directly coupled to the zoom optical devices 54 without using fiber 16. Such a configuration is even more compact and does not have an external fiber cable that could be damaged (not shown in Figure 6).

[0122] The characteristics of the PC laser light source 15 and the emitted 532 nm continuous wave laser beam, as well as the generation and characteristics of the aiming beam and the characteristics of the transmission optical fiber, are described in more detail below the explanation in Figure 3.

[0123] The therapeutic beam and aiming beam are transmitted colinearly via optical fiber 16 to the zoom optics 54 of the PC module 50. The zoom optics 54 transmits the infinite focus beam to beam shaping lenses 55, 56, which form a small PC Galileo beam expander / compressor that adjusts the beam size and spot size projected onto the scanning module 60, which is colinear with the exit objective lens module 70. Within module 60, corrective prisms 63 and Risley prism pairs 64, 65, which enable scanning along the x and y axes in the image plane 72B of the patient's eye 71, are aligned with the optical path of module 50 when operating in PC mode. The fixed corrective prism 63 allows the beam to be shifted outside the singularity zone of the Risley prism.

[0124] Within the output objective lens module 70, the CW beam is reflected by a dichroic mirror 77 and focused on the focal plane 72B in the patient's eye 71 by the output objective lens 75 and add-on lens 73B. The dichroic mirror 77 reflects the PD mode wavelength (nominal 1064 nm) or SLT mode wavelength (nominal 532 nm) of the laser pulse, and also transmits the wavelengths of the aiming beam and the light from the slit lamp that is reflected or scattered from the back of the patient's eye, so that the ophthalmologist 79 can observe the patient's eye 71 through binoculars 78.

Claims

1. A first laser module (10) that generates a beam of a first wavelength, A second laser module (15) that generates a beam of a second wavelength, A first beam path (74) incorporating an output objective lens module (70) that guides the beam of the first wavelength to the patient's eye (71), A second beam path (74A) incorporating a frequency changing component (41) that converts the beam of the first or second wavelength into a beam of the third wavelength, and an output objective lens module (70) that guides the beam of the third wavelength into the patient's eye (71), A third beam path (74B) incorporating the output objective lens module (70) that guides the beam of the second wavelength to the patient's eye (71), Equipped with, Both the first laser module (10) and the second laser module (15) are configured for treating the patient's eye (71), On the other hand, either the first laser module (10) or the second laser module (15) is used during treatment of the patient's eye (71), and a beam of the first wavelength, the second wavelength, or the third wavelength is directed to the patient's eye (71) to treat the patient's eye (71), in an ophthalmic laser system.

2. The ophthalmic laser system according to claim 1, wherein the first, second, and third beam paths (74, 74A, 74B) are configured for the treatment of the patient's eye (71), and / or further comprises at least one aiming beam module or aiming beam emitter.

3. The ophthalmic laser system according to claim 1 or 2, wherein each of the first beam paths (74) further incorporates beam shaping optical devices (31, 32), and / or the second beam path (74A) further incorporates beam shaping optical devices (45, 46), and / or the third beam path (74B) further incorporates beam shaping optical devices (55, 56).

4. The ophthalmic laser system according to any one of claims 1 to 3, wherein the second wavelength and / or the third wavelength is nominally half of the first wavelength.

5. An ophthalmic laser system according to any one of claims 1 to 4, wherein one laser module comprises a first type of laser, and the other laser module comprises a second type of laser different from the first type.

6. The ophthalmic laser system according to claim 5, wherein the first type of laser comprises a pulsed laser light source, and / or the second type of laser comprises a continuous-wave laser light source.

7. The ophthalmic laser system according to any one of claims 1 to 5, wherein the first laser module comprises a pulsed Nd-YAG laser with a first wavelength of nominal 1064 nm suitable for the treatment of posterior capsule opacification, while a conversion of the first wavelength to a third wavelength of nominal 532 nm is suitable for the treatment of glaucoma, and / or the second laser module comprises a continuous-wave laser or laser diode with a second wavelength of nominal 532 nm in the range of 440 nm to 650 nm, suitable for treatment using photocoagulation.

8. An ophthalmic laser system according to any one of claims 1 to 7, wherein the first beam path (74) and / or the second beam path (74A) further incorporate a safety module (20) that shuts off the beam paths (74, 74A) whenever the safety module (20) detects an unsafe condition, and / or the third beam path (74B) incorporates a safety module integrated within the second laser module (15) that shuts off the third beam path (74B) whenever the internal power meter of the second laser module (15) detects an unsafe condition.

9. The ophthalmic laser system according to any one of claims 1 to 8, wherein the second beam path (74A) and / or the third beam path (74B) further incorporate a scanning module (60) comprising a plurality of prisms (63, 64, 65), in particular, for example, a Risley prism, and / or one or more mirrors.

10. An ophthalmic laser system according to any one of claims 1 to 9, comprising adaptable opticomechanical coupling of at least some of all components and modules, and electromechanical, electronic, and / or microprocessor control of selective operation for and between the first beam path (74), the second beam path (74A), or the third beam path (74B).

11. The ophthalmic laser system according to any one of claims 1 to 9, wherein one of the laser modules is movable and / or is provided with fiber couplings for the first beam path (74), the second beam path (74A), or the third beam path (74B) and for selective operation between these paths.

12. The ophthalmic laser system according to claim 11, wherein the first laser module (10) is movable and / or the fiber coupling is provided on the second laser module (15).

13. An ophthalmic laser system according to any one of claims 1 to 10, wherein the components and modules for operating the first beam path (74) are mounted on a first platform including the first laser module (10), and the components and modules for operating the second beam path (74A) are mounted on a second platform, and at least one of the platforms is movably mounted for selective operation of either the components and modules of the first platform including the first laser module (10) for operating the first beam path (74), or the components and modules of the second platform for operating the second beam path (74A), by linear and / or rotatable movement of the platform.

14. The ophthalmic laser system according to claim 13, wherein components and modules for operating the third beam path (74B) are also mounted on the second platform, and the second laser module (15) is provided with fiber coupling for selective operation of the third beam path (74B).

15. The ophthalmic laser system according to claim 13 or 14, which is capable of performing linear and / or rotational motion of the at least one movable platform.

16. The ophthalmic laser system according to any one of claims 13 to 15, further comprising additional cavity deflection means (43, 44) for selectively deflecting the beam of the second beam path (74A) of the third wavelength toward beam shaping optical devices (45, 46) of the second beam path (74A).

17. A method for selectively switching between three different operating modes of an ophthalmic laser system according to any one of claims 1 to 16 before treating the eye (71) of the patient, The modes are defined as (i) a photosection device mode in which the first beam path (74) is operable using the first laser module (10) of the first wavelength, (ii) a selective laser trabeculoplasty mode in which the second beam path (74A) is operable using the first laser module (10) of the third wavelength, and (iii) a photocoagulation device mode in which the third beam path (74B) is operable using the second laser module (15) of the second wavelength. A method wherein at least one of the laser modules is movable, or all components of the beam path and some of the modules are mounted on a movable platform.

18. The method according to claim 17, wherein the selective switching is enabled by adaptable optico-mechanical coupling of at least some of the components and modules of the beampath and by electromechanical control, electronic control and / or microprocessor control.

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