Controlling corneal temperature during ophthalmic surgery

Abstract

An ophthalmic surgical system for controlling a temperature of a cornea of ​​an eye for a surgical procedure includes a fluid management system and a computer. The fluid management system manages a fluid in a channel structure created in the cornea of ​​the eye. The computer commands one or more of the controllable components to create a channel structure in the cornea. The channel structure provides a passageway between an interior of the eye and an exterior of the eye and is in proximity to a treatment site. The computer commands the fluid management system to manage a fluid in the channel structure to control a temperature of the cornea of ​​the eye.

Description

Technical Field

[0001] The present disclosure generally relates to ophthalmic surgical systems and methods, and more particularly to temperature control of the cornea during ophthalmic surgery.

Background Art

[0002] Ophthalmic laser systems are used to perform surgical procedures on eye tissue. Generally, the laser delivers laser pulses to the eye tissue. In some procedures, the pulses may cause photoablation that forms photoablated regions such as incisions. In other procedures, the pulses may cauterize and shape the tissue. During the procedure, the laser pulses raise the temperature of the tissue. This temperature increase may cause damage that adversely affects the healing process and / or treatment outcome.

[0003] To avoid such damage, the operating room temperature can be lowered or a cooling solution can be applied to the surface of the eye. However, these efforts may fail to provide adequate cooling. The laser pulses can be applied at lower energy, smaller spot size, or lower frequency to reduce the temperature rise of the tissue. However, these efforts may risk prolonging the treatment time of the procedure.

Summary of the Invention

Means for Solving the Problems

[0004] According to a particular embodiment, an ophthalmic surgical system for controlling the temperature of the cornea of ​​the eye for surgical procedures comprises controllable components, a fluid management system, and a computer. The controllable components include a laser source, a scanner, and an objective lens. The laser source generates a laser beam with ultrashort pulses, the propagation direction of the laser beam defining the z-axis. The scanner guides the focus of the laser beam to the xy-plane perpendicular to the z-axis. The objective lens focuses toward the cornea of ​​the eye. The fluid management system manages the fluid within channel structures created in the cornea of ​​the eye. The computer instructs one or more of the controllable components to create channel structures in the cornea. The channel structures provide a passage between the inside and outside of the eye, and the channel structures are located near the treatment site. The computer instructs the fluid management system to manage the fluid within the channel structures in order to control the temperature of the cornea of ​​the eye.

[0005] Embodiments may not include any of the following features, or may include one, some, or all of them. The channel structure comprises a first passage between the outside and inside of the eye, a second passage between the inside and outside of the eye, and an internal portion passing through the inside of the eye that provides circulation between the first and second passages. The internal portion may be posterior to the treatment site, and the first passage, the internal portion, and the second passage may have substantially the same cross-sectional area. The internal portion may be posterior to the treatment site, and the internal portion may have a substantially elliptical shape in the xy plane. The internal portion may have a shape designed with respect to the treatment site. The internal portion may have an anterior and a posterior side, and the anterior side may be connected to the posterior side by tissue at one or more locations. The channel structure comprises a first passage between the outside and inside of the eye, a second passage between the inside and outside of the eye, and an internal portion passing through the inside of the eye that provides circulation between the first and second passages. The internal portion may comprise a channel. One or more channels may provide flow between a first passage and a second passage. The channels may be located posterior to the treatment site. At least one of the channels may be located near the z position of at least a portion of the treatment site. The channel structure comprises a first passage between the outside of the eye and the anterior chamber of the eye, and a second passage between the anterior chamber of the eye and the outside of the eye. The fluid management system may remove aqueous humor from the anterior chamber of the eye. The fluid management system comprises a fluid dispenser configured to dispense fluid into the channel structure. The fluid management system comprises a fluid aspirator configured to aspirate fluid from the channel structure.

[0006] According to a particular embodiment, a method for controlling the temperature of the cornea of ​​the eye for an ophthalmic surgical procedure includes determining that a channel structure is designed according to the surgical procedure, the channel structure provides a passage between the inside and outside of the eye, and the channel structure is located near the treatment site of the surgical procedure, creating the channel structure in the cornea of ​​the eye, performing the surgical procedure, and managing the fluid within the channel structure to control the temperature of the cornea of ​​the eye, which includes managing the fluid within the channel structure by dispensing the fluid into the channel structure and aspirating the fluid from the channel structure.

[0007] Embodiments may not include any of the following features, or may include one, some, or all of them. Dispensing fluid into a channel structure includes dispensing fluid into a channel structure using a fluid dispenser of a fluid management system. Aspirating fluid from a channel structure includes aspirating fluid from a channel structure using a fluid aspirator of a fluid management system. The channel structure comprises a first passage between the outside and inside of the eye, a second passage between the inside and outside of the eye, and an internal portion passing through the inside of the eye that provides flow between the first and second passages. The channel structure comprises a first passage between the outside and the anterior chamber of the eye, and a second passage between the anterior chamber and the outside of the eye. Aspirating fluid from a channel structure may include removing aqueous humor from the anterior chamber of the eye.

[0008] According to a particular embodiment, an ophthalmic surgical system for controlling the temperature of the cornea of ​​the eye for surgical procedures comprises controllable components, a fluid management system, and a computer. The controllable components include a laser source, a scanner, and an objective lens. The laser source generates a laser beam having ultrashort pulses, the direction of propagation of the laser beam defining the z-axis. The scanner guides the focal point of the laser beam in the xy-plane perpendicular to the z-axis. The objective lens focuses toward the eye. The fluid management system manages the fluid within a channel structure created in the cornea of ​​the eye. The fluid management system comprises a fluid dispenser configured to dispense fluid into the channel structure and a fluid aspirator configured to aspirate fluid from the channel structure. The computer commands one or more of the controllable components to create a channel structure in the cornea, the channel structure providing a passage between the inside and outside of the eye, and the channel structure being near the treatment site, and commands the fluid management system to manage the fluid within the channel structure to control the temperature of the cornea of ​​the eye. The channel structure is selected from the group consisting of a first channel structure and a second channel structure. The first channel structure comprises a first passage between the outside and inside of the eye, a second passage between the inside and outside of the eye, and an internal portion passing through the inside of the eye that provides circulation between the first and second passages. The first channel structure has a shape according to a design selected from the group consisting of first to fifth designs. In the first design, the internal portion is located posterior to the treatment site, and the first passage, the internal portion, and the second passage have substantially the same cross-sectional area. In the second design, the internal portion is located posterior to the treatment site, and the internal portion has a substantially elliptical shape in the xy plane. In the third design, the internal portion comprises multiple channels, one or more of which provide circulation between the first and second passages. In the fourth design, the internal portion has a shape designed with respect to the treatment site. In the fifth design, the internal portion has an anterior side and a posterior side, the anterior side being connected to the posterior side by tissue at one or more locations. The second channel structure comprises a first passage between the outside of the eye and the anterior chamber of the eye, and a second passage between the anterior chamber of the eye and the outside of the eye. [Brief explanation of the drawing]

[0009] [Figure 1] An example of an ophthalmic surgical system configured to control the temperature of the cornea of ​​the eye, according to a specific embodiment, is shown. [Figure 2] Figure 1 shows an example of a channel structure that can be created in the cornea of ​​the eye using the ophthalmic surgical system. [Figure 3] A simple example of a channel structure is shown. [Figure 4A-4B] An example of an elliptical interior portion that is substantially elliptical is shown. [Figure 5] An example of an internal portion having a tissue connection section that connects the anterior and posterior sides of a channel structure is shown. [Figure 6] An example of an internal section with multiple channels is shown. [Figure 7] An example of an internal section with two channels providing circulation between the entrance and exit is shown. [Figure 8] Figure 1 shows another example of a channel structure that can be created in the cornea of ​​the eye using the ophthalmic surgical system. [Figure 9] Figure 1 shows an example of a method for controlling the temperature of the cornea of ​​the eye during ophthalmic surgery, which can be performed using the ophthalmic surgical system. [Modes for carrying out the invention]

[0010] Herein, examples of embodiments of the disclosed apparatus, systems, and methods are described in detail with reference to the description and drawings. The description and drawings are not intended to be exhaustive, nor are they intended to limit the claims to any particular embodiment shown in the drawings and disclosed in the description. The drawings represent possible embodiments, but they are not necessarily to scale, and certain features may be simplified, exaggerated, omitted, or partially divided to better illustrate the embodiments.

[0011] Generally, ophthalmic surgical systems perform laser surgical procedures on the treatment area of ​​the cornea. During the procedure, the pulses raise the temperature of the corneal tissue. The surgical system can control the temperature to avoid thermal damage to the tissue without extending the treatment time.

[0012] Figure 1 shows an example of an ophthalmic surgical system 10 configured to control the temperature of the cornea of ​​an eye 22 according to a specific embodiment. In the embodiment, a laser creates a channel structure in the cornea near the treatment site. A fluid management system manages the fluid within the channel structure to control the temperature of the cornea. The surgical system 10 can control the temperature to avoid thermal damage to the tissue while minimizing or avoiding any extension of the treatment time.

[0013] In the illustrated example, system 10 includes a laser device 15, a patient interface 20, a camera 38, a fluid management system 40, and a control computer 30, all coupled as shown. The laser device 15 includes controllable components such as a laser source 12, a scanner 16, one or more optical elements 17, and / or a focusing objective lens 18, all coupled as shown and controlled by a computer such as the computer 30. The patient interface 20 includes a contact portion 24 (having a contact surface 26) and a sleeve 28, all coupled as shown. The computer 30 includes logic 31, memory 32 (storing a computer program 34), and a display 36, all coupled as shown.

[0014] In general, the ophthalmic surgical system 10 controls the temperature of the cornea of ​​the eye 22 during the surgical procedure. The ophthalmic surgical system 10 can perform any appropriate surgical procedure, such as corneal refractive surgery or other ophthalmic laser surgery. The surgical procedure may have a treatment pattern that describes the target location of the laser pulses within the cornea. The treatment pattern defines the treatment site, i.e., the location of the cornea to be treated by the laser pulses.

[0015] In summary, the laser source 12 can generate a laser beam having ultrashort pulses, where the propagation direction of the laser beam defines the z-axis and / or z-direction. The scanner 16 focuses the laser beam in the xy-plane perpendicular to the z-axis. The objective lens 18 focuses toward the cornea of ​​the eye 22. The fluid management system 40 can manage the fluid within the channel structure created in the cornea. The computer 30 commands one or more controllable components to create the channel structure in the cornea. The channel structure provides a passage between the inside and outside of the eye 22 and is located near the treatment site. The computer 30 commands the fluid management system to manage the fluid within the channel structure in order to control the temperature of the cornea.

[0016] Turning to the components of system 10, the laser source 12 generates a laser beam having ultrashort pulses. Ultrashort pulses refer to optical pulses with a duration of less than nanoseconds, such as on the order of picoseconds, femtoseconds, or attoseconds. The laser beam can have any suitable wavelength in the range of 300 to 1500 nanometers (nm), e.g., 300 to 650, 650 to 1050, 1050 to 1250, and / or 1250 to 1500 nm, e.g., 340 to 350 nm, e.g., 347 nm ± 1 nm. The focus of the laser beam can cause laser-induced optical breakdown (LIOB) within tissue (e.g., cornea), resulting in optical cutting within the tissue. The laser beam can be precisely focused to produce precise optical cutting, reducing or avoiding unnecessary cutting of other tissues.

[0017] The scanner 16 directs the laser beam to focus in the longitudinal and transverse directions. The longitudinal direction refers to the direction of laser beam propagation, i.e., the z-direction. The scanner 16 may direct the laser beam to focus in the longitudinal direction in any suitable manner. For example, the scanner 16 may be equipped with a longitudinally adjustable lens, a variable refractive power lens, or a deformable mirror that can control the z-position of the focal point.

[0018] The transverse direction means the direction perpendicular to the beam propagation direction, i.e., the x and y directions. The scanner 16 can direct the laser beam in the transverse direction in any suitable way. For example, the scanner 16 can include a pair of galvanometrically driven scanner mirrors that can tilt around axes perpendicular to each other. As another example, the scanner 16 may include an electro-optic crystal that can electro-optically manipulate the laser beam.

[0019] One (or more) optical elements 17 direct the laser beam towards the focusing objective lens 18. The optical element 17 can act on the laser beam (e.g., transmit, reflect, refract, diffract, collimate, adjust, shape, focus, modulate, and / or act). Examples of optical elements include lenses, prisms, mirrors, diffractive optical elements (DOEs), holographic optical elements (HOEs), and spatial light modulators (SLMs). In this example, the optical element 17 is a mirror. The focusing objective lens 18 focuses the focus of the laser beam towards a point on the eye 22 through the patient interface 20. In this example, the focusing objective lens 18 is an objective lens, such as an f-theta objective lens.

[0020] The patient interface 20 interfaces with the cornea of the eye 22 and couples the eye 22 to the laser device 15. In this example, the patient interface 20 has a sleeve 28 coupled to the contact portion 24. The sleeve 28 is removably coupled to the focusing objective lens 18. The contact portion 24 may be translucent or transparent to the laser beam and has a contact surface 26 that joins with the cornea. The contact surface 26 may have any suitable shape, such as a flat surface, a convex surface, or a concave surface.

[0021] Fluid management system 40 manages fluid within a channel structure created in the cornea of eye 22. In certain embodiments, fluid management system 40 includes a fluid dispenser that dispenses fluid into the channel structure and / or a fluid aspirator that aspirates fluid from the channel structure. The dispenser and aspirator can dock to different channels or a common channel to respectively dispense and aspirate fluid. The dispenser and aspirator can dock to one or more channels by mechanical pressure or vacuum pressure. Fluid management system 40 can be integrated with any suitable part of system 10, such as a mirror, laser head, suction ring, or cone of the patient interface, the tube system of the cannula, other embodiments disposed in the vicinity of the eye.

[0022] In certain embodiments, fluid management system 40 provides a fluid, such as a coolant, to the channel structure to cool tissue. The coolant has a high specific heat capacity. Examples of coolants include cooled liquids (e.g., balanced salt solution (BSS)), gels, gases, alcohols, or other harmless fluids having suitable fluid properties and thermal conductivity.

[0023] Camera 38 records an image of the movement of eye 22, including the movement of a marker created within eye 22. Examples of camera 38 include a video, optical coherence tomography (OCT), or a gaze tracking camera. Camera 38 outputs image data representing the recorded image of eye 22 to computer 30. Computer 30 may use the image data, for example, to facilitate the creation of the channel structure.

[0024] Computer 30 controls controllable components (e.g., laser source 12, scanner 16, optical element 17, and / or focusing objective lens 18) according to instructions (which may be stored in computer program 34) to photoablate corneal tissue to create channels in the cornea. The channel structure provides a passage between the interior and exterior of eye 22 and is in the vicinity of the treatment site. "In the vicinity of" can refer to a distance having a value in the range of 0 - 10, 10 - 100, 100 - 200, and / or 200 - 400 micrometers.

[0025] In certain embodiments, the channel structure includes a first passage, a second passage, and an internal portion. The first passage lies between the inside and outside of the eye 22 and may be an entrance from the outside to the inside. The second passage lies between the outside and inside of the eye 22 and may be an exit from the inside to the outside. The internal portion extends through the interior and provides flow between the first passage and the second passage. The internal portion may be posterior to the treatment site, near the z-depth of the treatment site, or partially posterior and partially near the z-depth. Examples of channel structure designs will be described in more detail with reference to Figures 3 to 8.

[0026] In certain embodiments, the computer 30 determines the size and / or shape ("size / shape") of the channel structure according to the surgical procedure. For example, the computer 30 may design the size / shape of the internal portion of the channel structure according to the treatment site, which may be defined by the treatment pattern of the procedure. In these cases, the size / shape of the internal portion may substantially match the size / shape of the treatment site, be slightly larger than the treatment site (e.g., less than 200 micrometers, extending beyond the site boundary), or be slightly smaller than the treatment site (e.g., less than 200 micrometers, roughly reaching the boundary). Alternatively, the size / shape of the internal portion may match, be slightly larger than, or be slightly smaller than the size / shape of the treatment site in some parts, but not in others.

[0027] As another example, the computer 30 may select a design based on the heat expected to be generated by the procedure. The heat can be predicted from the treatment pattern of the procedure. Generally, areas with a larger amount of laser pulses tend to get hotter. For procedures where a large amount of heat generation is expected, the computer 30 may select a design that allows for a large and / or high-speed fluid flow through the channel structure, and for procedures where a small amount of heat generation is expected, it may select a design that allows for a small and / or low-speed fluid flow through the channel structure. In addition, for procedures where a large amount of heat generation is expected, the computer 30 may select a design that allows for a large and / or high-speed fluid flow through parts of the channel structure, and for procedures where a small amount of heat generation is expected, it may select a design that allows for a small and / or low-speed fluid flow through parts of the channel structure.

[0028] Computer 30 instructs the fluid management system 40 to manage the fluid within the channel structure to control the temperature of the cornea. Computer 30 may manage the fluid in any appropriate manner. In certain embodiments, the flow of cold fluid into the channel structure and / or the removal of hot fluid lowers the temperature of the corneal tissue. If it is necessary to lower the temperature of the tissue, the amount of cold fluid flowing into the channel structure is increased (for example, by initiating or increasing the flow of cold fluid into the tissue), and / or the amount of hot fluid removed from the channel structure is increased (for example, by initiating or increasing the flow of hot fluid from the tissue). In addition, the temperature of a specific part of the treatment site can be controlled. For example, if a particular area of ​​the site is expected to generate more heat, the fluid can be managed to increase the flow of cold fluid and / or the removal of hot fluid in that area.

[0029] Figure 2 shows an example of a channel structure 50 that can be created in the cornea 23 of an eye 22 by the ophthalmic surgical system 10 of Figure 1. As laser radiation 60 is applied to the laser treatment site 56 of the cornea 23, heat 62 is generated at the treatment site 56. In this example, the channel structure 50 provides a fluid passage between the inside 52 and the outside 54 of the eye 22, through the inside 52 near the laser treatment site 56. In this example, the channel structure 50 includes a first passage between the outside 54 and the inside 52 (e.g., an inlet 70 from the outside 54 to the inside 52), a second passage between the outside 54 and the inside 52 (e.g., an outlet 74 from the inside 52 to the outside 54), and an internal portion 72 between the first and second passages passing through the inside 52. As a coolant 76 flows through the structure 50, heat 62 is removed from the treatment site 56.

[0030] Figures 3 to 7 show the channel structure 50 as an example of various embodiments of the internal portion 72. In the example, the channel structure 50 is shown in the xy plane.

[0031] Figure 3 shows a simple channel structure 50 as an example. In this example, the inlet 70, the internal portion 72, and the outlet 74 have substantially the same cross-sectional area. In a particular case, there is no substantial difference in cross-sectional area throughout the entire channel structure 50. The internal portion 72 may be located posterior to the treatment site 56, i.e., at position z posterior to the site 56.

[0032] Figures 4A and 4B show an example of an elliptical interior portion 72 having a substantially elliptical shape (e.g., oblong or circular) in the xy-plane. The interior portion 72 may be located posterior to the treatment site 56, i.e., at a z position posterior to the site 56. Figure 5A shows an oblong interior portion 72. The oblong interior portion 72 may have any suitable dimensions, for example, a major axis in the range of several micrometers to several millimeters (e.g., 100 μm to 10 mm) and a minor axis in the range of several micrometers to several millimeters (e.g., 100 μm to 10 mm).

[0033] Figure 5B shows the circular interior portion 72. The circular interior portion 72 may have any suitable dimensions, for example, a diameter ranging from a few micrometers to a few millimeters (e.g., from 100 μm to 10 mm). Figure 5 shows an example of an internal portion 72 having tissue connectors 80 connecting the anterior and posterior sides of a channel structure 50. In this example, the internal portion 72 has an anterior side 82 and a posterior side 84. The anterior side 82 is connected to the posterior side 84 by one or more tissue connectors 80. The tissue connectors may be formed in a position that does not optically cut the anterior side 82 and the posterior side 84 and / or separate them from each other. The internal portion 72 may be located posterior to the treatment site 56 or at a substantially the same z position as the treatment site 56.

[0034] Figure 6 shows an example of an internal portion 72 having multiple channels 86. In this example, the internal portion 72 comprises multiple channels 86. One or more of the channels 86 provide flow between the inlet 70 and the outlet 74. In this example, the channels 86 are located posterior to the treatment site (i.e., at position z posterior to the site 56).

[0035] Figure 7 shows an example of an internal portion 72 having two channels 86 that provide flow between an inlet 70 and an outlet 74. In this example, the channels 86 are located at substantially the same z position as the treatment site 56 and may surround the site 56.

[0036] Figure 8 shows another example of a channel structure 50 that can be created in the cornea 23 of an eye 22 by the ophthalmic surgical system 10 of Figure 1. As laser radiation 60 is applied to the laser treatment site 56 of the cornea 23, heat 62 flows away from the site 56. In this example, the channel structure 50 provides a fluid passage between the anterior chamber 90 of the eye 22 and the outside 54 of the eye 22 near the laser treatment site 56. In this example, the channel structure 50 includes a first passage (e.g., an inlet 70 from the outside 54 to the anterior chamber 90) and a second passage (e.g., an outlet 74 from the anterior chamber 90 to the outside 54). The fluid management system 40 provides a coolant 76 to the channel structure 50 and / or extracts the coolant 76 and aqueous humor to cool the tissue.

[0037] Figure 9 shows an example of a method for controlling the temperature of the cornea of ​​an eye 22 during an ophthalmic surgical procedure, which can be performed by the ophthalmic surgical system 10 of Figure 1. The method is initiated in step 110, where the computer 30 receives input describing the surgical procedure. The input may include the type of procedure and the treatment pattern.

[0038] In step 112, the design of the channel structure is determined. The design may be determined according to the size / shape of the surgical procedure, for example, the treatment site and / or the heat expected to be generated by the treatment. In certain embodiments, the channel structure includes a first passage and a second passage. The first passage is between the outside and inside of the eye 22 and may be an entrance from the outside to the inside. The second passage is between the outside and inside of the eye 22 and may be an exit from the inside to the outside. In certain embodiments, the channel structure also includes an internal portion. The internal portion extends through the interior and provides flow between the first passage and the second passage. In step 114, the channel structure is created according to the design.

[0039] In step 115, the computer 30 performs a surgical procedure according to a treatment pattern. For example, a corneal refractive surgery is performed. In step 116, a fluid is dispensed into the channel structure, for example by a fluid dispenser. The fluid may include, for example, a coolant. In step 120, the fluid is aspirated from the channel structure, for example by a fluid aspirator.

[0040] The procedure may be completed at step 124. If the procedure is not completed, the method returns to step 115, and the computer 30 continues to perform the surgical procedure. When the procedure is completed, the method proceeds to step 124 and completes the procedure. The method then terminates.

[0041] The components of the systems and apparatus disclosed herein (such as computer 30) may include interfaces, logic, and / or memory, any of which may include computer hardware and / or software. Interfaces can receive inputs to a component and / or transmit outputs from a component and are typically used to exchange information between software, hardware, peripherals, users, and combinations thereof. A user interface (e.g., a graphical user interface (GUI)) is a type of interface that can be used for a user to interact with a computer. Examples of user interfaces include displays, touchscreens, keyboards, mice, gesture sensors, microphones, and speakers.

[0042] Logic can perform the actions of components. Logic may include one or more electronic devices that process data, for example, by executing instructions to produce an output from an input. Examples of such electronic devices include computers, processors, microprocessors (e.g., central processing units (CPUs)), and computer chips. Logic may also include computer software that encodes instructions that can be executed by the electronic devices to perform actions. Examples of computer software include computer programs, applications, and operating systems.

[0043] Memory may include a tangible, computer-readable and / or computer-executable storage medium capable of storing information. Examples of memory include computer memory (e.g., random-access memory (RAM) or read-only memory (ROM)), mass storage media (e.g., hard disks), removable storage media (e.g., compact discs (CDs) or digital video or multi-purpose discs (DVDs)), databases, network storage (e.g., servers), and / or other computer-readable media. Certain embodiments may involve memory encoded using computer software.

[0044] While this disclosure has described specific embodiments, modifications to the embodiments (e.g., altered, replaced, added, omitted, and / or other modifications) will be apparent to those skilled in the art. Thus, modifications to the embodiments can be made without departing from the scope of the invention. For example, modifications can be made to the systems and apparatus disclosed herein. As will be apparent to those skilled in the art, the components of the systems and apparatus can be integrated or separated, or the operation of the systems and apparatus can be performed by more, fewer, or other components. As another example, modifications can be made to the methods disclosed herein. As will be apparent to those skilled in the art, the methods may include more, fewer, or other steps, and the steps may be performed in any suitable order.

[0045] To assist the Patent Office and readers in interpreting the claims, the applicant notes that, unless the words “means for” or “step for” are expressly used in any particular claim, neither the claim nor any claim element is intended to evoke Section 112(f) of the U.S. Patent Act. Any other term used in the claims (e.g., “mechanism,” “module,” “device,” “unit,” “component,” “element,” “member,” “apparatus,” “machine,” “system,” “processor,” or “controller”) is understood by the applicant to refer to a structure known to those skilled in the art in the relevant field and is not intended to be subject to Section 112(f) of the U.S. Patent Act. Furthermore, this disclosure includes the following inventions. The first aspect is, An ophthalmic surgical system for controlling the temperature of the cornea of ​​the eye for surgical procedures, Multiple controllable components, A laser source configured to generate a laser beam having multiple ultrashort pulses, wherein the propagation direction of the laser beam defines the z-axis, A scanner configured to guide the focus of the laser beam to the xy plane perpendicular to the z-axis, and An objective lens configured to focus toward the cornea of ​​the eye. Includes multiple controllable components, A fluid management system configured to manage the fluid within a channel structure created in the cornea of ​​the eye, It is a computer, Commanding one or more of the controllable components to create the channel structure in the cornea, wherein the channel structure provides a passage between the inside and outside of the eye, and the channel structure is located near the treatment site, and To control the temperature of the cornea of ​​the eye, the fluid management system is instructed to manage the fluid within the channel structure. A computer configured to perform the following actions: This is an ophthalmic surgical system equipped with [specific features / features]. The second aspect is, The channel structure described above is A first passage between the outer and inner parts of the eye, A second passage between the inside of the eye and the outside of the eye, An internal portion passing through the inside of the eye provides circulation between the first passage and the second passage, This is an ophthalmic surgical system in a first embodiment, comprising the following: The third aspect is, The aforementioned internal portion is located posterior to the treatment site. The ophthalmic surgical system in a second embodiment is characterized in that the first passage, the internal portion, and the second passage have substantially the same cross-sectional area. The fourth aspect is, The aforementioned internal portion is located posterior to the treatment site. The aforementioned internal portion is an ophthalmic surgical system in a second embodiment, having a substantially elliptical shape in the xy-plane. The fifth aspect is, The internal portion comprises a plurality of channels, one or more of which provide flow between the first passage and the second passage, in a second embodiment of the ophthalmic surgical system. The sixth aspect is, The internal portion comprises a plurality of channels, one or more of which provide flow between the first passage and the second passage, and the channels are located behind the treatment site, in a second embodiment of the ophthalmic surgical system. The seventh aspect is, The internal portion comprises a plurality of channels, one or more of which provide flow between the first passage and the second passage, and at least one of the channels is located near the z position of at least a portion of the treatment site, in a second embodiment of the ophthalmic surgical system. The eighth aspect is, The internal portion is an ophthalmic surgical system in a second embodiment, having a shape designed with respect to the treatment site. The ninth aspect is, The aforementioned internal portion has a front side and a rear side. The anterior side is connected to the posterior side by tissue at one or more locations, in a second embodiment of the ophthalmic surgical system. The tenth aspect is, The channel structure described above is A first passage between the external part of the eye and the anterior chamber of the eye, A second passage between the anterior chamber of the eye and the exterior of the eye, This is an ophthalmic surgical system in a first embodiment, comprising the following: The eleventh aspect is, The fluid management system is an ophthalmic surgical system in a tenth embodiment, configured to remove aqueous humor from the anterior chamber of the eye. The twelfth aspect is, The fluid management system is an ophthalmic surgical system in a first embodiment, comprising a fluid dispenser configured to dispense fluid into the channel structure. The 13th aspect is, The fluid management system is an ophthalmic surgical system in a first embodiment, comprising a fluid aspirator configured to draw fluid from the channel structure. The 14th aspect is, A method for controlling the temperature of the cornea of ​​the eye for ophthalmic surgical procedures, Receiving input describing the aforementioned surgical procedure, The design of the channel structure is determined in accordance with the surgical procedure, wherein the channel structure provides a passage between the inside and outside of the eye, and the channel structure is located near the treatment site of the surgical procedure. Creating the channel structure in the cornea of ​​the eye, Performing the aforementioned surgical procedure, Controlling the fluid within the channel structure to control the temperature of the cornea of ​​the eye, Dispensing fluid into the channel structure, and To draw fluid from the channel structure. By doing so, the fluid within the channel structure is controlled, This method includes [something]. The 15th aspect is, Dispensing the aforementioned fluid into the channel structure is A method in a 14th embodiment, comprising dispensing a fluid into the channel structure using a fluid dispenser of a fluid management system. The 16th aspect is, Suction of fluid from the channel structure is A method in a 14th embodiment, comprising using a fluid aspirator of a fluid management system to aspirate fluid from the channel structure. The 17th aspect is, The channel structure described above is A first passage between the outer and inner parts of the eye, A second passage between the inside of the eye and the outside of the eye, An internal portion passing through the inside of the eye provides circulation between the first passage and the second passage, This is a method in a 14th embodiment, comprising the following: The 18th aspect is, The channel structure described above is A first passage between the external part of the eye and the anterior chamber of the eye, A second passage between the anterior chamber of the eye and the exterior of the eye, This is a method in a 14th embodiment, comprising the following: The 19th aspect is, To draw the fluid from the channel structure is A method in 18th aspect, comprising removing aqueous humor from the anterior chamber of the eye. The 20th aspect is, An ophthalmic surgical system for controlling the temperature of the cornea of ​​the eye for surgical procedures, Multiple controllable components, A laser source configured to generate a laser beam having multiple ultrashort pulses, wherein the propagation direction of the laser beam defines the z-axis, A scanner configured to guide the focus of the laser beam to the xy plane perpendicular to the z-axis, and An objective lens configured to focus toward the cornea of ​​the eye. Includes multiple controllable components, A fluid management system configured to manage fluid within a channel structure created in the cornea of ​​the eye, wherein the fluid management system is A fluid dispenser configured to dispense fluid into the channel structure, and A fluid aspirator configured to draw fluid from the channel structure. A fluid management system equipped with, It is a computer, Commanding one or more of the controllable components to create the channel structure in the cornea, wherein the channel structure provides a passage between the inside and outside of the eye, and the channel structure is located near the treatment site, and To control the temperature of the cornea of ​​the eye, the fluid management system is instructed to manage the fluid within the channel structure. A computer configured to perform the following actions: The channel structure is provided with, The first channel structure is, A first passage between the outer and inner parts of the eye, A second passage between the inside of the eye and the outside of the eye, An internal portion of the eye that passes through the interior of the eye, providing circulation between the first passage and the second passage. The first channel structure comprises, A first design wherein the internal portion is located behind the treatment site, and the first passage, the internal portion, and the second passage have substantially the same cross-sectional area. A second design, wherein the internal portion is located behind the treatment site, and the internal portion has a substantially elliptical shape in the xy plane. A third design, wherein the internal portion comprises a plurality of channels, one or more of the channels providing flow between the first passage and the second passage. A fourth design, wherein the internal portion has a shape designed with respect to the treatment site, and A fifth design, wherein the internal portion has a front side and a rear side, and the front side is connected to the rear side by an organization at one or more locations. A first channel structure having a shape according to a design selected from the group consisting of, The second channel structure is, A first passage between the exterior of the eye and the anterior chamber of the eye, The second passage between the anterior chamber of the eye and the exterior of the eye. A second channel structure comprising, This is an ophthalmic surgical system selected from a group consisting of the following:

Claims

1. An ophthalmic surgical system for controlling the temperature of the cornea of ​​the eye for surgical procedures, Multiple controllable components, A laser source configured to generate a laser beam having multiple ultrashort pulses, wherein the propagation direction of the laser beam defines the z-axis, and the z-axis defines a z-direction parallel to the z-axis, A scanner configured to guide the focus of the laser beam to the xy plane perpendicular to the z-axis, and An objective lens configured to focus toward the cornea of ​​the eye, wherein the cornea of ​​the eye is located anterior to the lens of the eye in the z-direction, and the lens is located posterior to the cornea of ​​the eye in the z-direction. Includes multiple controllable components, A fluid management system configured to manage fluid within a channel structure created in the cornea of ​​the eye, wherein the channel structure is A first passage between the outside of the eye and the anterior chamber of the eye, A fluid management system comprising a second passage between the anterior chamber of the eye and the exterior of the eye, It is a computer, Commanding one or more of the controllable components to create the channel structure in the cornea, wherein the channel structure provides a passage between the inside and outside of the eye, and the channel structure is located near the treatment site, and To control the temperature of the cornea of ​​the eye, the fluid management system is instructed to manage the fluid within the channel structure. A computer configured to perform the following actions: An ophthalmic surgical system equipped with [specific features / equipment].

2. The channel structure described above is A first passage between the outer part of the eye and the inner part of the eye, A second passage between the inside and outside of the eye, An internal portion passing through the inside of the eye provides circulation between the first passage and the second passage, The ophthalmic surgical system according to claim 1, comprising:

3. The aforementioned internal portion is located posterior to the treatment site. The ophthalmic surgical system according to claim 2, wherein the first passage, the internal portion, and the second passage have substantially the same cross-sectional area, and the cross-section of the channel structure is perpendicular to the longitudinal axis of the channel structure.

4. The aforementioned internal portion is located posterior to the treatment site. The ophthalmic surgical system according to claim 2, wherein the internal portion has a substantially elliptical shape in at least the xy plane.

5. The ophthalmic surgical system according to claim 2, wherein the internal portion comprises a plurality of channels, and one or more of the channels provide flow between the first passage and the second passage.

6. The ophthalmic surgical system according to claim 2, wherein the internal portion comprises a plurality of channels, one or more of the channels providing flow between the first passage and the second passage, and the channels are located behind the treatment site.

7. The ophthalmic surgical system according to claim 2, wherein the internal portion comprises a plurality of channels, one or more of the channels providing flow between the first passage and the second passage, and at least one of the channels is located near the z position of the treatment site.

8. The ophthalmic surgical system according to claim 2, wherein the internal portion has a shape designed with respect to the treatment site.

9. The aforementioned internal portion has a front side and a rear side. The ophthalmic surgical system according to claim 2, wherein the anterior side is connected to the posterior side by tissue at one or more locations.

10. The ophthalmic surgical system according to claim 1, wherein the fluid management system is configured to remove aqueous humor from the anterior chamber of the eye.

11. The ophthalmic surgical system according to claim 1, wherein the fluid management system comprises a fluid dispenser configured to dispense fluid into the channel structure.

12. The ophthalmic surgical system according to claim 1, wherein the fluid management system comprises a fluid aspirator configured to draw fluid from the channel structure.

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