WO2025040539A1 - Dispositif et procédé de création d'au moins une surface découpée, dispositif et procédé de création de données de commande - Google Patents

Dispositif et procédé de création d'au moins une surface découpée, dispositif et procédé de création de données de commande Download PDF

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Publication number
WO2025040539A1
WO2025040539A1 PCT/EP2024/072895 EP2024072895W WO2025040539A1 WO 2025040539 A1 WO2025040539 A1 WO 2025040539A1 EP 2024072895 W EP2024072895 W EP 2024072895W WO 2025040539 A1 WO2025040539 A1 WO 2025040539A1
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WIPO (PCT)
Prior art keywords
laser output
output beams
beam splitter
spots
laser
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PCT/EP2024/072895
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German (de)
English (en)
Inventor
Wolf Weimer
Gregor Stobrawa
Martin Kuehner
Jan Eulitz
Andreas Weyhausen
Beate Boehme
Michael Bergt
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Carl Zeiss Meditec AG
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Carl Zeiss Meditec AG
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Priority to CN202480053807.3A priority Critical patent/CN121752230A/zh
Publication of WO2025040539A1 publication Critical patent/WO2025040539A1/fr
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
    • A61F9/00827—Refractive correction, e.g. lenticle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00872—Cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00897—Scanning mechanisms or algorithms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
    • A61F9/00836—Flap cutting

Definitions

  • Device and method for generating at least one cutting surface Device and method for generating control data
  • the invention relates to a device for generating at least one cutting surface, in particular for correcting the refraction of an eye by means of corneal modification, an associated method, a device for generating control data, an associated method, a device for correcting the refraction of an eye, an associated method and a software product for carrying out the methods.
  • LASIK procedure a corneal lamella is first detached from the surface of the cornea on one side and folded to the side. In this way, the interior of the cornea is exposed, from which material is then vaporized using an ablating laser, also known as disruption or photodisruption. If the corneal lamella is then folded back again, the natural front surface of the cornea remains intact. Since material has been vaporized inside the cornea, the front of the cornea has a different curvature, which is dimensioned such that a previously existing visual impairment is corrected. The material is removed by ablation.
  • Ablation also known as photoablation, vaporizes tissue when laser radiation is absorbed when it hits the tissue surface. Pulsed laser radiation is used, and each pulse vaporizes a certain volume of material from the corneal tissue. A large number of shots are distributed over the exposed interior of the cornea so that the desired material is ablated overall. A distinction must be made between this ablation and the creation of a cutting surface inside the tissue according to WO 2005/01 1545 A1, which, for example, acts as a boundary surface to delimit a piece of tissue and make it removable. In contrast to ablation, laser radiation is used for this, which penetrates through the surface into the interior of the material, i.e. is not absorbed at the surface.
  • This laser radiation is bundled into a focus inside the tissue in the form of short pulses. This achieves a specific power density locally and temporally in the focus, so that tissue layers inside the tissue are separated. The separation essentially takes place in the focus or in the close spatial area around this focus.
  • a so-called optical breakthrough e.g. in the form of a plasma bubble
  • approaches which work without such a breakthrough, e.g. by overlapping several focus positions.
  • a cutting surface is created directly inside the tissue through a large number of optical focus positions. This is the only way to create a cut surface inside the cornea that acts as a boundary surface to delimit a piece of tissue and make it removable. Ablation cannot do this.
  • Control data (so-called "shot files”) from ablation-based procedures are also not suitable for creating a cut surface inside the tissue - simply because they do not contain any depth coordinates, since the ablating radiation is absorbed at the tissue surface.
  • ablation is also used in the state of the art to describe the proposal to vaporize tissue within the cornea using pulsed laser radiation.
  • the idea for example in US 5984916 A, was to dissolve a piece of tissue to be removed directly in the stroma of the cornea.
  • intrastromal ablation was used for this.
  • this vaporization caused unacceptably high gas pressures inside the cornea. This approach was therefore not pursued further and never put into practice.
  • a very successful procedure was developed by Carl Zeiss Meditec AG under the name SMILE (see e.g. DE 102007019813 A1). It uses pulsed laser radiation to isolate a lenticule in the cornea, which can then be removed from the cornea through a lateral opening incision that leads to the surface of the cornea and serves as a working channel.
  • suitable cutting surfaces are created in the tissue of the cornea using a large number of laser pulse foci. This large number is arranged in a specific pattern in the cornea, which ultimately defines the shape and position of the cutting surfaces.
  • the piece of tissue of the lenticule is structured and dimensioned in such a way that the front surface of the cornea changes its curvature as necessary for the correction. The procedure causes a subtractive correction because volume is removed.
  • Another approach inserts implants into the cornea.
  • a slit is made in the cornea into which the implant is inserted. It is designed to change the curvature of the front surface of the cornea in the desired way. This approach therefore produces an additive correction because volume is added.
  • an incision must be made inside the cornea. This is done by applying laser radiation.
  • Such systems have various disadvantages with regard to scanning time and cutting of arbitrary lenticule geometries, especially higher order ones (customized lenticels), since the distance between the multispots is too large to ensure effective interaction. In addition, the spot distance and the number of spots remain essentially constant.
  • the invention is based on the object of specifying a device and a method for generating at least one cutting surface, which enable a high degree of flexibility in the generation of cutting surfaces with a short scanning time.
  • the invention is characterized in the independent claims.
  • the dependent claims relate to preferred developments.
  • the movable focusing optics are preferably designed as a movable micro-lens.
  • the focusing optics contain, for example, one or more optical elements for focusing the laser output beams.
  • the entire focusing optics which can contain one or more optical elements, can be moved with the movement device. Furthermore, the movement of the focusing optics can be slow or fast.
  • the control device can also be designed to control the laser device.
  • the term "path of the focusing optics relative to the central home position axis" can include that the path is generated starting from the central home position axis, e.g. in the case of a spiral path.
  • the path and/or the scan path can be selected from a spiral, an ellipse, a circle, a pole scan path, a meandering scan path, in particular a contour line scan path, and a combination thereof.
  • the focusing optics can be moved on at least one path, e.g. on and/or along a spiral, an ellipse, a circle, a pole scan path and a meandering scan path, in particular a contour line scan path, and a combination thereof.
  • the focusing optics can be designed to be deflectable. This means that the focusing optics can be moved on and/or along the at least one path.
  • the focusing optics can, for example, be deflected with a motor around the home position axis of the laser system and rotated, i.e.
  • the focusing optics can be moved over the pole with slow pendulum movements starting from a latitude of the hemispherical scanning surface containing the pole, whereby the pendulum movement line is rotated 360° around the pole.
  • Multispots can be arranged laterally to the pendulum movement line, e.g. on the latitudes, with a fast pendulum movement.
  • the processing volume can be spatially aligned or alignable such that the central axis of the processing volume runs parallel to the z-direction.
  • the movement device can have at least one scanner selected from one or more x-y scanners, one or more z scanners, an azimuth radius scanner and a combination thereof.
  • the azimuth radius scanner is a scanner with which the entire focusing optics can be guided, e.g. on a circular and/or spiral path around an axis.
  • the beam splitter optics can be movable, e.g. suspended in a movable manner.
  • the movement device can be designed to move the beam splitter optics together with the focusing optics.
  • the beam splitter optics and the focusing optics can be firmly connected to one another.
  • the beam splitter optics can be immovable, ie stationary.
  • the beam splitter device and/or the control device can be designed to generate the laser output beams synchronized with the movement of the focusing optics. The latter is particularly advantageous in the case of a non-movable beam splitter optics.
  • the beam splitter optics can have at least one element selected from one or more semi-transparent mirrors, one or more prisms and one or more phase masks.
  • At least one dynamic x, y, z scanner in particular at least one harmonic x, y, z scanner, can be provided for dynamically moving at least one of the laser output beams in at least one of the x, y, z directions.
  • the at least one dynamic x, y, z scanner can be connected upstream or downstream of the beam splitter optics or integrated into the beam splitter optics.
  • the spots of different laser output beams can be moved equally dynamically.
  • the spots of different laser output beams can be moved dynamically in different ways.
  • at least two of the dynamic x, y, z scanners can be combined in such a way that the amplitudes of the two dynamic scanners add up in at least one of the x, y, z directions. This can be referred to as multiple wobbling, e.g. double wobbling. Wobbling can advantageously lead to more efficient evaporation and/or disruption of the transparent material, e.g.
  • the beam splitter device and/or the control device can be designed to synchronize and/or vary the distribution, the number and/or the spacing of the laser output beams depending on the movement and/or the radial position of the focusing optics. In this way, a homogeneous density of the plasma bubbles generated in the processing volume can be achieved.
  • the beam splitter device can have at least one element selected from one or more acoustic-optical modulation devices (AOM), one or more electrical-optical modulation devices (EOM) and one or more apertures for synchronizing and/or varying the laser output beams.
  • AOM acoustic-optical modulation devices
  • EOM electrical-optical modulation devices
  • the beam splitter device can be designed to provide several of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode.
  • the laser device can be designed to generate a pulsed laser beam.
  • the beam splitter device can be designed to provide several simultaneously pulsed laser output beams.
  • the laser device, the beam splitter device and/or the movement can be designed to be controllable.
  • the scanning path can be selected from a spiral, an ellipse, a circle, a pole scanning path and a meandering scanning path, in particular a contour line scanning path, and a combination thereof.
  • the distribution, the number and/or the spacing of the spots can thus be flexibly varied.
  • the control device can be designed to control the beam splitter device and the movement device by means of control data such that the spots of the several simultaneously pulsed laser output beams are arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement.
  • the control device can be designed to control at least the beam splitter device and the movement device such that the spots are arranged laterally to the direction of the scan path;
  • the scan path is designed as a spiral and the ratio of the number of spots in the inner region of the spiral to the number of spots in the outer region of the spiral is increased with increasing radial distances from the center;
  • the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; switching is made between the first operating mode for providing several of the laser output beams and the second operating mode for providing one of the laser output beams;
  • a scan regime is selected such that successively generated spots and/or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and/or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and/or when the
  • Switching between the first and second operating modes can also involve switching in reverse, ie between the second operating mode and the first operating mode.
  • a flap cut can be cut in a single-spot mode and curved cuts can be cut in a multi-spot mode.
  • a spiral scan can start in single-spot mode and additional spirals can be added as the radial distance from the center of the spiral and/or the optical zone of the eye to be cut increases. The scans for such scan paths can be performed with a short scan time.
  • a further embodiment relates to a device for generating control data for generating at least one cutting surface, in particular for correcting the refraction of an eye by corneal modification, for a device according to one of the preceding claims, comprising an interface for receiving data about a refraction correction requirement of the eye, and a calculation device which is connected to the interface.
  • the calculation device is configured
  • the cutting surface is generated by moving the spot of each laser output beam in the processing volume on and/or along at least one respective scan path and/or on at least one respective surface, also called scan surface.
  • the calculation device can be designed to generate the control data in such a way that the beam splitter optics are moved together with the focusing optics, the beam splitter optics being movable; the beam splitter device and/or the control device generates the laser output beams synchronized with the movement of the focusing optics, the beam splitter optics being movable or immovable; with the at least one dynamic x, y, z scanner (180), in particular at least one harmonic x, y, z scanner, at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions; with at least two of the dynamic x, y, z scanners, the amplitudes of the two dynamic scanners in at least one of the x, y, z directions are added during the dynamic movement of the laser output beams; the beam splitter device and/or the control device are used to synchronize and/or vary the distribution, the number and/or the spacing of the laser output beams depending on the movement and/or
  • the calculation device can be designed to generate the control data in such a way that the spots are arranged laterally to the direction of the scan path; the scan path is designed as a spiral and the ratio of the number of spots in the inner region of the spiral to the number of spots in the outer region of the spiral is increased with increasing radial distances from the center; the scan path is designed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; switching is made between the first operating mode for providing several of the laser output beams and the second operating mode for providing one of the laser output beams; a scan regime is provided with which successively generated spots and/or multispots of a cutting surface to be generated posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and/or multispots of a cutting surface to be generated anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and/or when the laser output beams are varied depending on a
  • a further embodiment relates to a device for correcting the refraction of an eye by corneal modification, comprising a device for generating at least one cut surface according to one of the above embodiments and modifications and a device for generating control data according to one of the above embodiments and modifications.
  • the device for correcting the refraction of an eye by corneal modification surprisingly enables a short treatment time required for correcting the refraction, a high degree of flexibility in generating the cut surfaces required for the correction, and a high quality of the cut surfaces and thus the correction of the refraction.
  • Another embodiment relates to a method for producing at least one cutting surface in a processing volume of a transparent material, in particular for correcting the refraction of an eye by corneal modification, with a device for producing at least one cutting surface according to one of the above embodiments and modifications.
  • the method comprises
  • the focusing optics are moved on at least one path selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis a, a path relative to a central axis of the processing volume and a combination thereof;
  • Controlling at least the beam splitter device and the movement device with the control device by means of control data and moving the spot of each laser output beam in the processing volume on and/or along at least one respective scan path and/or on at least one respective surface.
  • the at least one cutting surface can be generated in the process.
  • the path and/or the scan path can be selected from a spiral, an ellipse, a circle, a pole scan path, a meandering scan path, in particular a contour line scan path, and a combination thereof.
  • the processing volume can be spatially aligned such that the central axis of the processing volume runs parallel to the z-direction.
  • the beam splitter optics can be movable and/or the movement device can move the beam splitter optics together with the focusing optics. Alternatively, the beam splitter optics can be immobile, ie stationary.
  • the beam splitter optics can be moved or not moved and the beam splitter device and/or the control device can generate the laser output beams synchronized with the movement of the focusing optics.
  • the at least one dynamic x-, y-, z-scanner in particular at least one harmonic x-, y-, z-scanner, at least one of the laser output beams can be moved dynamically in at least one of the x-, y-, z-directions.
  • the Amplitudes of the two dynamic scanners are added in at least one of the x, y, z directions.
  • the beam splitter device and/or the control device can be used to synchronize and/or vary the distribution, number and/or spacing of the laser output beams depending on the movement and/or the radial position of the focusing optics.
  • the beam splitter device and/or the control device can be used to synchronize and/or vary the laser output beams.
  • the beam splitter device can be used to provide several of the laser output beams in a first operating mode and one of the laser output beams in a second operating mode.
  • a pulsed laser beam can be generated with the laser device.
  • the beam splitter device can provide a plurality of simultaneously pulsed laser output beams.
  • the scan path can be selected from a spiral, an ellipse, a circle, a pole scan path and a meandering scan path, in particular a contour line scan path, and a combination thereof.
  • the spots of the plurality of simultaneously pulsed laser output beams can be arranged as simultaneous spots, in particular as multispots, in a constant or varying arrangement.
  • the spots may be arranged laterally to the direction of the scanning path; the scanning path may be formed as a spiral and the ratio of the number of
  • the number of spots of the inner region of the spiral to the number of spots of the outer region of the spiral can be increased with increasing radial distances from the center; the scan path can be designed as a pole scan path and the number of spots with a smaller distance to the pole can be reduced; it is possible to switch between the first operating mode for providing several of the laser output beams and the second operating mode for providing one of the laser output beams; a scan regime can be selected with which successively generated spots and/or multispots of a cutting surface to be created posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and/or multispots of a cutting surface to be created anteriorly in the processing volume are generated in a sequence in the direction away from the central axis of the processing volume; and/or when varying the laser output beams, one or more laser output beams can be varied, in particular masked out, depending on a limit value of the laser beam exposure of a tissue in the processing volume.
  • a method for generating control data for generating at least one cutting surface in particular for correcting the refraction of an eye by corneal modification, is specified with a device for generating control data for generating at least one cutting surface, according to one of the above embodiments and modifications.
  • the method comprises
  • the control data can be generated such that the beam splitter optics are moved together with the focusing optics, wherein the beam splitter optics are movable; the beam splitter device and/or the control device generates the laser output beams synchronized with the movement of the focusing optics, wherein the beam splitter optics are movable or immovable; with the at least one dynamic x, y, z scanner, in particular at least one harmonic x, y, z scanner, at least one of the laser output beams is dynamically moved in at least one of the x, y, z directions, with at least two of the dynamic x, y, z scanners, the amplitudes of the two dynamic scanners in at least one of the x, y, z directions are added during the dynamic movement of the laser output beams; the beam splitter device and/or the control device are used to synchronize and/or vary the distribution, the number and/or the spacing of the laser output beams depending on the movement and/or
  • a pulsed laser beam (6) is generated with the laser device (5); a plurality of simultaneously pulsed laser output beams are provided with the beam splitter device; and/or the path and/or the scan path is selected from a spiral, an ellipse, a circle, a pole scan path and a meandering scan path, in particular a contour line scan path, and a combination thereof.
  • the control data can be generated such that the spots are arranged laterally to the direction of the scan path; the scan path is formed as a spiral and the ratio of the number of spots of the inner region of the spiral to the number of spots of the outer region of the spiral is increased with increasing radial distances from the center; the scan path is formed as a pole scan path and the number of spots with a smaller distance to the pole is reduced; switching is made between the first operating mode for providing a plurality of the laser output beams and the second operating mode for providing one of the laser output beams; a scanning regime is provided with which successively generated spots and/or multispots of a cutting surface to be created posteriorly in the processing volume are generated in a sequence in the direction of the central axis of the processing volume and successively generated spots and/or multispots of a cutting surface to be created anteriorly in the processing volume are generated in a sequence in the direction
  • a further embodiment relates to a method for correcting the refraction of an eye by corneal modification, comprising at least one method for generating control data for generating at least one cutting surface, in particular for correcting the refraction of an eye by corneal modification, according to one of the preceding embodiments and modifications.
  • a computer program product is provided with a program code which, when loaded into a computer, carries out at least one method of any of the above embodiments and modifications.
  • the computer may include a memory device for storing data.
  • the same advantages and functions can be realized as with the embodiments of the device for generating at least one cutting surface, in particular with identical and/or analogous features.
  • the described method for generating control data includes the preparation for generating at least one cutting surface for the purpose of correcting the refraction of an eye by modifying the cornea and does not yet require the generation of the cutting surface itself, i.e. in particular no surgical step. However, it can be supplemented by a step of generating the cutting surface. In this step, a laser device is then used to generate the cutting surface.
  • the method for generating at least one cutting surface can be carried out without intervention on the living human or animal body, e.g. to produce an implant (to be inserted later) from dead donor tissue or artificial tissue material. It is also possible to test, examine or demonstrate the generation of at least one cutting surface on dead material, e.g. enucleated animal eyes.
  • the generation of the cutting surface can preferably be further developed into a surgical method for correcting ametropia of the eye. A piece of tissue is then isolated and removed from the cornea to correct the ametropia.
  • the method for generating at least one cutting surface and/or the method for generating control data can be carried out in principle using a computer, in particular comprising a processor.
  • the computer for the method for generating control data can be designed as a planning station, as is otherwise known in the prior art.
  • the invention relates to a software product for carrying out the method for generating control data, the method for generating at least one cutting surface and/or the method for correcting ametropia of the eye, since the calculation of the cutting surface and the determination of control data for the device as well as the control of the device can be carried out without problems by appropriate software.
  • the above embodiment or modifications of the device for generating at least one cutting surface can be provided.
  • a data-conducting connection, wireless or wired can be present between the device for generating at least one cutting surface and the device for generating control data.
  • the above embodiment and modifications of the method for generating at least one cutting surface can include the above embodiment or modifications of the method for generating control data.
  • Fig. 1 is a schematic representation of a treatment device 1 for ophthalmic surgical refraction correction
  • Fig. 2 is a schematic representation of the effect of the laser radiation used in the treatment device of Fig. 1,
  • Fig. 3b is a schematic cross-sectional view of the cornea to illustrate the removal of a piece of corneal tissue in connection with ophthalmic surgical refraction correction
  • Fig. 3c schematically shows an example of essentially parallel spiral paths of several simultaneous spots
  • Fig. 3d schematically shows an example of a spiral scan
  • Fig. 3e shows a schematic example of a pole scan
  • Fig. 3f an example of the device 100 with a dynamic x-, y-, z-scanner 180 for dynamically moving at least one of the spots
  • Fig. 3g to 3n schematically show examples of exemplary scan modes generated with the device 100
  • Fig. 4a is a schematic representation of a focusing optics and a beam splitter device of an example of the device 100 for generating at least one cutting surface
  • Fig. 4b and 4c are schematic representations of an addition of amplitudes of dynamic x-, y-, z-scanners integrated in the beam splitter device shown in Fig. 4a,
  • Fig. 5 is a schematic representation of the planning device of the treatment device of Fig. 1,
  • Fig. 6 is a block diagram of an exemplary method for generating at least one cutting surface
  • Fig. 7 is a block diagram of an exemplary method for generating control data for generating at least one cutting surface
  • Fig. 8 schematically shows a variant of the example of the device 100 for producing at least one cutting surface.
  • the term "slow” movement can refer to a movement, e.g. a scanning movement and/or a movement with a movement speed of less than 100 mm/s, preferably between 0 and 80 mm/s, more preferably between 0.1 and 12 mm/s.
  • the terms "fast” movement or “dynamic” movement can refer to a movement, e.g. a scanning movement, with a movement speed equal to or more than 100 mm/s, preferably between 800 and 2500 mm/s, more preferably 900 to 2000 mm/s. The same applies to the terms "slow scanner” and "fast scanner”.
  • the deflectable focusing optics can be deflected and rotated by a motor around the home position axis of the laser system, i.e. guided on and/or along the path, and/or adjusted radially.
  • a constant rotation speed of the focusing optics in the range of 100 to 300 Hz, e.g. 200 Hz.
  • the movement of the micro-objective can be a rotational path, e.g. in the case of a circular path or spiral path.
  • the micro-objective can also be guided in a meandering manner over the processing volume.
  • the speed of the change in radius per unit time can be a slow scanning movement in the range of 0.1 to 1 mm/s, e.g. 0.5 mm/s.
  • the path speed ie the speed at which the focusing optics are guided along the path, can be a slow or fast scanning movement in the range of 0 to 20 m/s.
  • the path speed of the micro-objective on an outermost spiral arm can be e.g. 10 m/s.
  • the pendulum movement of the focusing optics can be carried out with a slow scanner at a speed of 8 to 50 mm/s, preferably 15 to 20 mm/s, a slow or fast scanning movement of the multispots can take place at a speed of 0 to 20 m/s and/or the pendulum movement line(s) can be rotated around the pole at a speed of e.g.
  • the pendulum is rotated 360 degrees once in approx. 5 to 16 s.
  • a lenticule cut can be created in the first 180 degrees.
  • a cap cut can be created in the second 180 degrees.
  • the orbital speed of the rotation of the pendulum focusing optics around the pole can be e.g. 2 mm/s.
  • the processing volume can, as mentioned, have a central axis.
  • the central axis of the processing volume can be identical in position to a home position axis of the laser system if the processing volume is aligned accordingly.
  • the home position of the laser system can be the position of the laser system and/or the focusing optics from which the operation of the device for generating at least one cutting surface is started.
  • the home position axis of the laser system can be the position of the laser system and/or the focusing optics.
  • the term "path in a direction determined by the directions x, y and z" can refer to a path calculated based on at least one of the directions x, y and z.
  • moving the movable focusing optics on a path in a direction determined by the directions x, y, z can mean that the focusing optics are deflected and/or moved at an angle in the relevant direction(s) starting from the home position axis of the laser system.
  • the term "moving the movable focusing optics on a path relative to the central home position axis a" can include that the focusing optics are radially deflected and/or moved on a path around the home position axis a, e.g. by a constant or varying angle, and/or moved starting from the central home position axis a.
  • the term "moving the movable focusing optics on a path relative to a central axis of the processing volume" can include that the focusing optics are radially deflected and/or moved on a path around the central axis A, e.g. by a constant or varying angle, and/or moved starting from the central axis.
  • the path can be selected from a spiral, an ellipse, a circle, a polar scan path, a meandering scan path, in particular a contour scan path, and a combination thereof.
  • scan path is also referred to here as scan path. The same applies to grammatical variations of these terms.
  • FIG. 1 An exemplary device 100 for creating at least one cut surface is shown in Fig. 1 as part of a treatment device 1 for eye surgery, i.e. in the present example as part of a device for correcting the refraction of an eye.
  • the treatment device 1 is designed for making cuts inside an eye 2 of a patient 3.
  • the device 100 has a laser system 110 with a laser device 4 that emits a laser beam 6 from a laser source, which is directed as a focused beam into the eye 2 or the cornea 17 as the processing volume.
  • the laser beam 6 is preferably a pulsed laser beam with a wavelength between 300 nanometers and 10 micrometers.
  • the pulse length of the laser beam 6 is in the range between 1 femtosecond and 100 nanoseconds, with pulse repetition rates of 50 to 20,000 kilohertz and pulse energies between 0.01 microjoules and 0.01 millijoules being possible.
  • the device 100 creates a cutting surface in the processing volume 17, i.e. in the present case in the cornea 17 of the eye 2, by deflecting the pulsed laser beam 6.
  • a radiation intensity modulator (not shown) can additionally be provided in the device 100.
  • the patient 3 is located, for example, on a couch 10 of the treatment device 1, which can be adjusted in three spatial directions in order to spatially align the eye 2 to match the incidence of the laser beam 6.
  • the couch is motor-adjustable.
  • An adjustment of the laser system 110 is alternatively possible for this purpose.
  • the processing volume 17 of the eye can be spatially aligned or alignable in such a way that the central axis A of the processing volume 17 runs parallel to the central basic position axis a of the laser system 110.
  • the control can be carried out in particular by a control device 11, which basically controls the operation of the devices 100 and 1 and is connected to the device 100 or the treatment device 1 via suitable data connections, for example connecting lines. Of course, this communication can also take place via other methods, for example fiber optic cables or radio.
  • the control device 1 1 carries out the corresponding settings and time control on the treatment device 1, in particular the laser device 4 and other controllable components of the device 100 and the treatment device 1.
  • the treatment device 1 can have a fixing device 15 which fixes the cornea 17 of the eye 2 in position relative to the laser device 4.
  • This fixing device 15 can be applied to the eye's cornea by means of negative pressure in order to fix it. In embodiments, it can also give the cornea a desired geometric shape. It is designed, for example, as a contact glass 45.
  • Such contact glasses are known to the person skilled in the art from the prior art, for example from DE 102005040338 A1. The disclosure content of this publication is fully incorporated here as far as the description of a design of the contact glass 45 possible for the treatment device 1 is concerned.
  • the treatment device 1 optionally further comprises a camera (not shown) which can record an image of the cornea 17 through the contact glass 45.
  • the illumination for the camera can be in both the visible and the infrared spectral range.
  • the control device 11 can have a device for generating control data, in this case a planning device 16, which will be explained in more detail later and which comprises a calculation device and optionally a data memory, which calculates the cutting surface(s) and/or control data, in particular control data for the treatment device, in preparation so that the cutting surface(s) can be generated in the surgical procedure.
  • Control data can be concrete control values for a movement device 8 for moving a movable focusing optics 18 of the device 100. They are output by the control device 11 as control signals for the corresponding drives of the movement device 8.
  • control data can also be, at a quasi higher control level, predetermined coordinates of target points and the sequence of these target points on which the laser radiation is to be focused.
  • the control data can in particular comprise one or more trajectories for the laser spots, also called scan paths, on and/or along which the focus position is to be adjusted.
  • Fig. 2 shows schematically the mode of action of the laser radiation incident on the cornea 17 using a laser output beam 90, which is generated together with further laser output beams 91 to 93 (not shown in Fig. 2) from the laser beam 6 by a beam splitter device 70 of the device 100.
  • the beam splitter device 70 is described further below.
  • the laser output beam 90 is focused by the focusing optics 18 into the cornea 17 of the eye 2.
  • the focusing optics are designed as a micro-objective and contain one or more optical elements, e.g. lenses, for focusing the laser output beams 90 to 93.
  • the focusing optics 18 are shown schematically in the form of a lens as an example only for the sake of simplicity.
  • the focusing optics 18 create a focus in the cornea 17, which is formed in the processing volume as the spot 19 of the laser output beam 90.
  • the laser radiation energy density is so high that, in combination with the pulse length of the pulsed laser radiation 6, a non-linear effect is created in the cornea 17. occurs.
  • each pulse of the pulsed laser radiation 6 in the spot 19 can generate an optical breakthrough in the cornea 17, which initiates a plasma bubble.
  • the tissue layer separation covers a larger area than the spot 19, although the conditions for generating the optical breakthrough are only achieved in the spot 19.
  • the energy density i.e. the fluence of the laser radiation, must be above a certain pulse length-dependent threshold value.
  • tissue-separating effect can also be achieved by pulsed laser radiation by emitting several laser radiation pulses in one area, with the focus spots overlapping. Several laser radiation pulses then work together to achieve a tissue-separating effect.
  • the type of tissue separation used by the treatment device 1 is, however, not further relevant for the following description; It is only essential that a cutting surface is created in the cornea 17 of the eye 2.
  • Several elements are relevant to the imaging properties of the eye, one of which is the curved cornea 17 of the eye 2.
  • the front of the cornea 17 refracts the light rays due to its curvature, which is why the radius of curvature of the cornea is particularly relevant to the imaging properties of the eye.
  • the focus of a parallel incident light beam is not on the retina of the eye 2 due to a (to be corrected) visual defect in the form of myopia or hyperopia, but in front of or behind it.
  • Other visual defects such as astigmatism, lead to distortions, i.e. a non-point-shaped focus.
  • Still other visual defects cause a visual defect that depends on where the focus is on the retina. Such visual defects are described overall by visual defect data.
  • the visual defect is corrected by modifying the front of the cornea in such a way that this specifically leads to a change in the refractive properties of the cornea 17. Due to the modification of the front of the cornea to the new front, the focus is shifted or changed in such a way that the preoperatively existing refractive error is corrected.
  • a piece of tissue referred to as a lenticule is removed from an area within the cornea 17 by means of the laser output beams 90, 91, 92, 93, which are simultaneously generated from the laser beam 6 by the beam splitter device 70, by separating tissue layers within the cornea, which isolate the piece of tissue within the cornea and then enable its removal.
  • the piece of tissue is delimited by a three-dimensionally shaped cutting surface.
  • the position of the spots 19 of the focused Laser output beams 90 to 93 are adjusted three-dimensionally in the cornea 17. This is shown schematically in Fig. 3a, in which only the laser output beams 90 and 91 are shown as examples.
  • the curvature of the front of the cornea 17 is specifically changed by removing the lenticule in order to achieve the refraction correction.
  • a piece of tissue of uniform thickness would not significantly change the curvature of the front of the cornea - hence the term lenticule.
  • Fig. 3a shows the device 100 for generating at least one cutting surface in the processing volume 17 of a transparent material, in particular for correcting the refraction of the eye 2 by corneal modification.
  • the device 100 comprises the laser device 4 for generating the laser beam 6; the beam splitter device 70 with a beam splitter optics 70a for generating the multiple simultaneous laser output beams 90 to 93 from the laser beam 6; the movable focusing optics 18 for focusing the laser output beams as simultaneous spots 19, in particular as offset spots, in the processing volume 17, which extends in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis a of the laser system 110; the movement device 8 for moving the focusing optics 18 on at least one path selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis a, a path relative to a central axis A of the processing volume 17 and a combination
  • the central axis A of the processing volume 17 and the central home position axis a of the laser system are in identical positions.
  • the movement device 8 can be designed to move the focusing optics 18 on at least one path selected from a path in a direction determined by the directions x, y and z, a path around the central home position axis a, a path around a central axis A of the processing volume 17 and a combination thereof, whereby, for example, circular paths or spiral paths can be generated.
  • the elements of the device 100 for producing at least one cutting surface are shown schematically only to the extent that they are necessary for understanding.
  • the laser beam 6 is bundled into simultaneous spots 19 of the laser output beams 90, 91 produced by the beam splitter device 70 in the cornea 19, and the position of the spots 19 in the cornea is adjusted so that focused energy from laser radiation pulses is introduced into the tissue of the cornea 17 at different locations to produce the cutting surface.
  • the laser radiation 6 is preferably provided as pulsed radiation by the laser device 4 and is split by the beam splitter device 70 into the offset laser output beams 90, 91.
  • the laser output beams 90, 91 reach the focusing optics 18.
  • a movement device 8 functionally connected to the focusing optics 18 as an actuator is provided.
  • the movement device 8 contains an actuator designed as an x, y, z scanner, which is constructed in two parts in the design of Fig. 3a and which contains an x, y scanner 8a which deflects the entire focusing optics 18 parallel to the x direction and/or y direction.
  • the laser output beams 90, 91 coming from the beam splitter device 70 can be deflected two-dimensionally.
  • the x, y scanner 8a thus causes an adjustment of the position of the spots 19 essentially perpendicular to the respective direction of incidence of the laser output beams.
  • a z scanner 8b is also provided for adjusting the depth of the spots 19, which is designed, for example, as an adjustable telescope with which the entire focusing optics 18 can be moved in the z direction, and/or as a unit for adjusting the z position of one or more optical elements of the focusing optics 18.
  • the z scanner 8b ensures that the z position of the position of the spots 19, i.e. their position parallel to the direction of incidence of the respective laser output beams, is changed.
  • the scanners 8a and 8b can move the spots 19 of each laser output beam, for example, on and/or along a respective three-dimensional scan path along which the laser pulses are emitted in order to form the cutting surface(s).
  • the movement device 8 is provided with a drive 8c as an actuator, which is designed as an xy scanner or as an azimuth radius scanner and serves to move the entire focusing optics 18 on a path around the central home position axis a of the laser system 110.
  • the path of the focusing optics can, for example, have the shape of a spiral, an ellipse, a circle, a meandering scan path or a combination thereof.
  • the laser pulses can be emitted on and/or along the path(s) in order to form the cutting surface(s).
  • the resulting scan path of the spots of each laser output beam then has the shape of a spiral, an ellipse, a circle, a meandering scan path or a combination thereof. This makes it possible to generate several offset, parallel scan paths of the spots of the laser output beams.
  • the movement of the focusing optics 18, ie the scanning movement caused by the scanners 8a and 8b and/or the movement caused by the drive 8c, can be carried out, for example, at a slow scanning speed of 10 mm/s.
  • the drive 8c may not be provided and only the x, y, z scanner 8a, 8b is provided.
  • the x, y scanner 8a may not be provided and only the drive 8c and the z scanner 8b are in further examples, a slow x, y scanner, a fast x, y scanner, a slow z scanner and/or the drive 8c are provided in the device 100.
  • a variant of the device 100 for generating at least one cutting surface is shown schematically in Fig. 8.
  • the z-scanner 8b and the drive 8c are provided in the movement device 8 of the device 100.
  • the z-scanner and the drive 8c are each designed as slow scanners.
  • the beam splitter optics 70a of the beam splitter device 70 is stationary and the focusing optics 18 can be moved with the scanners 8b and 8c on at least one path B.
  • deflecting mirrors 210 are provided in the beam splitter device 70.
  • the deflecting mirror 210 arranged directly in front of the focusing optics 18 can be moved and/or aligned according to the movement of the focusing optics 18, which is illustrated by the arrow U.
  • the focusing optics 18 can be guided, for example, on and/or along a spiral path B over the processing volume 17.
  • the simultaneous spots 19 focused into the processing volume with the focusing optics 18 can thus be moved on and/or along a respective spiral path 19a, 19b in the processing volume 17.
  • the control device 11 is wirelessly connected to the laser system 110 and to its components laser device 4, beam splitter device 70, movable focusing optics 18 and movement device 8 in a data-conducting manner.
  • Two-stage scanner structures can be used for the functional principle of the device 100.
  • Cartesian or non-Cartesian coordinate systems can be used to deflect or control the position of the spots 19. Examples of this are spherical coordinates or cylindrical coordinates.
  • the position of the spots 19 is controlled by the control device 1 1, which makes corresponding settings on the laser device 4, the optional modulator (not shown in Fig. 3a) and the movement device 8.
  • the control device 1 1 ensures suitable operation of the laser device 4, the beam splitter device 70 and the three-dimensional focus adjustment described here as an example, so that ultimately a cutting surface is formed that isolates a specific piece of corneal tissue that is to be removed or taken for refraction correction. It works according to predetermined control data.
  • the control data are specified, for example, as data for the beam splitter device 70, as data for the path of movement of the focusing optics, as target points for the focus adjustment and/or as data for a scan path 19a or for a surface 19c, also called scan surface 19c, on and/or along which the spots are to be moved.
  • the control data are usually summarized in a control data set. This specifies geometric specifications for the cutting surface to be formed, for example the coordinates of the target points as a pattern.
  • the control data set also contains concrete control values for the focus position adjustment mechanism, e.g. for the movement device 8 or an additional dynamic scanner.
  • the control data are based on control data which specify the cutting surface(s) to be created, as will be explained below.
  • the creation of the cutting surface with the device 100 is shown by way of example in Fig. 3b.
  • a piece of corneal tissue 121 in the cornea 17 is isolated by adjusting the spot 19 into which the laser output beam 90 is bundled.
  • At least one cutting surface is formed, which can also be made up of several parts, which is why the term “cutting surface(s)” is also used.
  • it has an anterior cutting surface 122 and a posterior lenticule cutting surface 123. These terms are to be understood as examples only and are chosen based on the conventional LASIK procedure.
  • the cutting surfaces 122 and 123 and any edge cuts (not further designated) which bring the cutting surfaces 122 and 123 together at their edges as necessary delimit and isolate the piece of corneal tissue 121.
  • the corneal tissue piece 121 can be removed through an opening incision 124, as provided for in the aforementioned SMILE procedure.
  • FIG. 3c An example of substantially parallel spiral scan paths of simultaneous spots 19 of multiple laser output beams for generating a cut surface in the cornea 17 is shown in Fig. 3c.
  • Switching between a first and a second operating mode of the device 100 can also involve switching in reverse, i.e. between the second operating mode and the first operating mode.
  • a flap cut can be cut in a single-spot mode and curved cuts can be cut in a multi-spot mode.
  • a spiral scan for example, it can be started in single-spot mode and further spirals can be added with increasing radial distance from the center of the spiral and/or the optical zone of the eye to be cut, as illustrated in Fig. 3d.
  • the scans for such scan paths can be carried out with a short scan time.
  • FIG. 3e An example of a pole scan path is shown in Fig. 3e.
  • the number of spots 19 with a smaller distance to the pole P can be reduced.
  • the beam splitter device and/or the control device synchronize the laser output beams with the movement of the focusing optics.
  • the focusing optics are guided over the pole P with slow pendulum movements starting from a latitude of the hemispherical scan surface 19c of the cornea 17 that has the pole and is to be generated, whereby the pendulum movement line(s) is/are rotated by 360° around the pole, which is illustrated by the arrow Q.
  • Lateral to Simultaneous spots 19 are generated as multispots with a quick movement along the pendulum movement line(s), eg on the latitudes.
  • the multispots can be moved dynamically in the x, y and/or z direction, ie wobbled, in order to form the spots.
  • Fig. 4a shows a schematic representation of the focusing optics 18 and the beam splitter device 70 of an example of the device 100 for generating at least one cutting surface.
  • the beam splitter optics 70a of the beam splitter device 70 can have at least one element selected from one or more semi-transparent mirrors, one or more prisms and one or more phase masks.
  • Such beam splitter devices are known to the person skilled in the art from the prior art, for example from WO2022194484 A1.
  • the disclosure content of this document is fully included here as far as the description of a design of the beam splitter device 70 possible for the device 100 is concerned.
  • the example of the beam splitter device 70 shown in Fig. 4a is designed to generate the laser output beams 90 to 93 from the laser beam 6, also called laser input beam or input beam.
  • the beam splitter optics 70a of this example includes a first beam multiplier element 20 for generating two intermediate beams 75, 76 from the laser input beam 6.
  • the first beam multiplier element 20 has a first polarizing beam splitter 22, a second polarizing beam splitter 24 and at least one first deflection element 26 for deflecting an intermediate beam 76 by a predetermined angle.
  • the beam splitter optics 70a are designed such that when the laser input beam 6 is radiated onto the first polarizing beam splitter 22 of the first beam multiplier element 20, the input beam 6 is split into the first intermediate beam 75 and the second intermediate beam 76 by means of the first polarizing beam splitter 22 of the first beam multiplier element 20, wherein the two intermediate beams 75, 76 span the xy plane, the second intermediate beam 76 is deflected by the first deflection element 26 by a predetermined angle, in particular approximately 90° or approximately 180°, and the first intermediate beam 75 and the second intermediate beam 76 are radiated onto the second polarizing beam splitter 24 of the first beam multiplier element 20 such that the first intermediate beam 75 and the second intermediate beam 76 are offset substantially parallel to one another.
  • a second beam multiplier element 40 with a first polarizing beam splitter 42, a first deflection element 46 and a second polarizing beam splitter 44 wherein the second beam multiplier element 40 is designed such that when the two intermediate beams 75, 7) are radiated onto the first polarizing beam splitter 42 of the second beam multiplier element 40, the two the intermediate beams 75, 76 are split into a first partial beam 80, 81 and a second partial beam 85, 86 by means of the first polarizing beam splitter 42 of the second beam multiplier element 40, the second partial beams 85, 86 are deflected in the second beam multiplier element 40 by a predetermined angle, in particular approximately 90° or approximately 180°; and the first partial beams 80, 81 and
  • At least one dynamic x, y, z scanner 180 can be provided in the device 100 for dynamically moving at least one of the laser output beams 90 to 93 in at least one of the x, y, z directions.
  • the at least one dynamic x, y, z scanner 180 can be designed as an x, y and/or z scanner, e.g. it can only scan in one or two of the x, y, z directions.
  • the at least one dynamic x, y, z scanner 180 can be connected upstream or downstream of the beam splitter device 70, in particular the beam splitter optics 70a, or can be integrated into the beam splitter optics 70a.
  • At least two of the dynamic x, y, z scanners can be combined in such a way that the amplitudes of the two dynamic scanners add up in at least one of the x, y, z directions. This can generate multiple wobbles, e.g. a double wobble.
  • Fig. 3f shows an example in which one of the dynamic x, y, z scanners 180 is arranged between the laser device 4 and the beam splitter device 70.
  • the dynamic x, y, z scanner 180 can contain an x, y scanner, which is implemented, for example, by two essentially orthogonally deflecting galvanometer mirrors, and/or a z scanner, which is designed, for example, as an adjustable telescope.
  • the x, y scanner deflects the laser beam 6 two-dimensionally in the x, y direction.
  • the z scanner ensures that the z position of the focus 19 is changed.
  • the dynamic movement can take place, for example, with a scanning speed between 800 and 2000 mm/s.
  • Fig. 4a shows as an example one of the dynamic x-, y-, z-scanners 180, also called scanner 180, integrated into the beam splitter optics 70a.
  • the scanner 180 is configured in this example as an x-, y-scanner in order to move the first deflection element 26 in at least one of the x-, y-directions, which is illustrated with the arrows 181 and 182.
  • Fig. 4b illustrates a further example in which, based on the example in Fig.
  • the second polarizing beam splitter 24 of the first beam multiplier element 20 is additionally provided with a further dynamic x, y scanner 180 and can thus be moved dynamically in at least one of the x, y directions.
  • Fig. 4b schematically shows the case in which both the intermediate beam 76 and the intermediate beam 75 are moved dynamically in both directions x and y.
  • the intermediate beam 75 is simply wobbled because it is dynamically moved by one of the scanners 180.
  • the intermediate beam 76 is wobbled several times because it is dynamically moved by the two scanners 180.
  • the amplitudes of the deflection of the intermediate beam 76 generated by the two scanners 180 are added together.
  • FIG. 4c illustrates exemplary parallel spiral paths 19a and 19b generated in this way, wherein the spot 19 of the spiral path 19a is wobbled by the dynamic movement of the intermediate beam 75 and thus also of the laser output beam generating the spot.
  • the spot 19 of the spiral path 19b is wobbled several times by the multiple dynamic movement of the intermediate beam 76 and thus also of the laser output beam generating the spot.
  • the dynamic movement of the intermediate beams 75 and/or 76 can be carried out, for example, with a scanning speed of between 800 and 2000 mm/s, whereby the rapid oscillatory movement of the associated laser output beams is achieved with essentially the same scanning speed.
  • spots are arranged laterally to the direction of the scan path, for example multispot lines are arranged transversely and/or lateral to the direction of movement of the focusing optics.
  • a multispot line is formed as a line of several simultaneous spots, whereby a two- or three-dimensional volume structure can be generated in the transparent material.
  • the spots are arranged transversely to the direction of movement of the micro lens.
  • the focusing optics are guided on and/or along the path of an ellipsoid spiral and the spots are arranged, for example, on and/or along a multispot line transversely and/or lateral to the spiral path. This is illustrated in Figs.
  • Fig. 3g schematically shows a spiral scan that was carried out using a single-spot scan mode.
  • Fig. 3h shows an example of a multispot scan mode of the device 100, in which constant partial areas 1 19 were generated with the multispots.
  • Fig. 3i schematically illustrates an example of a scan mode of the device 100, in which single spots were generated in the center of a spiral path and variable partial areas 1 19 or partial areas were generated with the multispots in the edge areas of the spiral path surrounding the center.
  • Fig. 3g schematically shows a spiral scan that was carried out using a single-spot scan mode.
  • Fig. 3h shows an example of a multispot scan mode of the device 100, in which constant partial areas 1 19 were generated with the multispots.
  • Fig. 3i schematically illustrates an example of a scan mode of the device 100, in which single spots were generated in the center of a spiral path and variable partial areas 1 19 or partial areas were generated with the multispots in the
  • 3j also schematically illustrates an example of a multispot scan mode of the device 100, in which variable circular partial areas 1 19 or spherical partial areas were generated with the multispots.
  • the partial areas 1 19 grow as the radius of the spiral path increases.
  • the length of the multispot lines is optimally adjusted depending on the position of the focusing optics.
  • the volume of simultaneously generated spots (or foci) forms a sub-volume of the entire processing volume.
  • the shape of this sub-volume can be arbitrary, e.g. a circle or a polygon in plan view or in cross section.
  • the shape of the sub-volume can be changed depending on the position of the micro-lens.
  • Fig. 3k shows an overlapping spot arrangement of non-simultaneous single spots 9, with which an area of the processing volume was disrupted.
  • Fig. 3I illustrates a multi-spot scan generated with the device 100, in which the simultaneous multispots 19 do not overlap so much to generate a sub-volume for photodisruption, so that this scan mode is more efficient compared to a single-spot mode.
  • the multispot sub-volume can be created in such a way that it has the shape of an isosceles trapezoid in plan view.
  • the ratio of the short to the long base side of the isosceles trapezoid can be larger inside the spiral than outside the spiral, e.g. to achieve dense coverage of a lenticule surface that is usually circular in plan view.
  • 3m and 3n illustrate exemplary scan modes generated with the device 100, which were generated using different wobbling methods.
  • overlapping simultaneous multispots were wobbled by dynamically moving the focusing optics 18 or the laser input beam 6 laterally, i.e. oscillating them.
  • non-overlapping simultaneous multispots were wobbled by dynamically oscillating each partial beam 90 to 93 laterally.
  • successively generated spots and/or multispots of a cutting surface to be generated posteriorly in the processing volume can be generated in a sequence in the direction of the central axis of the processing volume and successively generated Spots and/or multispots of a cutting surface to be created in the anterior processing volume can be created in a sequence in the direction away from the central axis of the processing volume.
  • a lenticule cut e.g. in the case of the posterior lenticule cutting surface 123 shown in Fig. 3b
  • this is called an out-in scan.
  • a cap cut to create the anterior cutting surface 122 this is called an in-out scan. This minimizes the time difference between different sub-volumes created simultaneously with the multispots in the center of the optical zone of the eye, which minimizes the risk of opaque bubble layers.
  • Fig. 5 shows a schematic example of part of the device 100 for generating at least one cutting surface, and this is used to explain in more detail the significance of the device 16 for generating control data, in this case the planning device 16.
  • the laser device 4 already described emits the laser beam 6.
  • the device 100 is operated fully automatically by the control device 1 1, as already described.
  • the laser device 4 starts generating the laser beam 6
  • the beam splitter device 70 generates the laser output beams 90 to 93
  • the movement device 8 moves the focusing optics 18.
  • Cutting surfaces are thus generated which are constructed in the manner described.
  • the laser device 4, the beam splitter device 70 and the movement device 8 receive the control signals required for operation from the control device 1 1, to which the corresponding control data was previously made available. This takes place, for example, B.
  • the planning device 16 which is shown in Fig. 5 merely as an example as a component of the control device 1 1.
  • the planning device 16 can also be designed independently and communicate with the control device 1 1 by wire or wirelessly. In this case, a corresponding data transmission channel is provided between the planning device 16 and the control device 1 1.
  • the planning device 16 comprises as a core element a calculation device 16a which, as explained below, calculates the cutting surface(s) that are to be created in the cornea 17 and determines the data required for these cutting surfaces.
  • the planning device 16 or directly the calculation device 16a generates the control data set from this, which is made available to the control device 11 for carrying out the ophthalmic surgical refraction correction.
  • the calculation device 16a uses measurement data about the cornea of the eye, which are designed as data about the refraction correction requirement. In the embodiment described here, these measurement data originate from a measuring device (not shown) that has previously measured the eye 2 of the patient 2. Of course, The measuring device can be designed in any way and transmit the corresponding measurement data to the interface 29 of the planning device 16.
  • the planning device 16 supports the operator of the device 100 in determining the cutting surface for isolating the corneal tissue piece 121. This can go as far as a fully automatic determination of the cutting surfaces 122, 123, 124, which can be brought about, for example, by the calculation device 16a determining the corneal tissue piece 121 to be removed from the measurement data, defining its boundary surface(s) as the cutting surface(s) and generating corresponding control data for the control device 11 from this.
  • the planning device 16 can provide input options where a user enters the cutting surfaces in the form of geometric parameters, etc. Intermediate stages provide suggestions for the cutting surfaces, which the planning device 16 automatically generates and which can then be modified by an operator.
  • Fig. 6 shows, as an example, a schematic block diagram of the method for generating at least one cutting surface with the device 100.
  • the method comprises the steps S1 generating the laser beam 6 with the laser device 4; S2 generating several simultaneous laser output beams 90 to 93 from the laser beam with the beam splitter device 70; S3 focusing the laser output beams 90 to 93 as spots, in particular simultaneous spots, into the processing volume 17, which extends in mutually orthogonal spatial directions x, y and z, wherein the z-direction runs parallel to a central home position axis a of the laser system 1 10, with the movable focusing optics 18; S4 moving the focusing optics 18 with the movement device 8, wherein the focusing optics are moved on at least one path selected from a path in a direction determined by the directions x, y and z, a path relative to the central home position axis a, a path relative to a central axis of the processing volume and a combination thereof; and S5 controlling at least
  • Fig. 7 shows, as an example, a schematic block diagram of the method for generating the control data for generating a cutting surface, e.g. for a visual impairment correction.
  • a step S1 visual impairment data of the eye, which indicate the refraction correction requirement of the eye, are received, which can be provided, for example, in a preceding step, which can in particular include a measurement of the eye.
  • the volume of the piece of tissue to be removed from the cornea is determined in a step S12. Since the thickness profile is very important for the correction of the refractive error (see explanations for Fig. 3b), there is still no concrete definition of the piece of tissue.
  • the piece of tissue i.e.
  • the cutting surface e.g. 122, 123, 124 and an edge surface
  • Appropriate control data is generated for this cutting surface in a step S15. These data then serve as control data for the device 100, whereby the data mentioned may well be at a higher control level, e.g. a definition of scan paths on and/or along which the spots are to be adjusted, and/or coordinates of target points, which are then converted - possibly only during operation of the device 100 - into corresponding control data for the device 100.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Optics & Photonics (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Laser Surgery Devices (AREA)

Abstract

L'invention concerne un dispositif de création d'au moins une surface découpée et un procédé associé. Le dispositif (100) sert à créer au moins une surface découpée dans un volume de traitement (17). Le dispositif comprend un système laser (110) ayant un dispositif laser (4) destiné à créer le faisceau laser (6) ; un dispositif diviseur de faisceau (70) ayant une unité optique de diviseur de faisceau (70a) destinée à créer une pluralité de faisceaux de sortie laser simultanés (90 à 93) ; une unité optique de focalisation mobile (18) destinée à focaliser les faisceaux de sortie laser dans le volume de traitement (17) sous forme de points (19) ; et un dispositif de déplacement (8) destiné à déplacer l'unité optique de focalisation (18) le long d'au moins une trajectoire (B) sélectionnée à partir d'une trajectoire dans une direction déterminée par les directions spatiales x, y et z, une trajectoire par rapport à un axe de position de base central (a) du système laser, une trajectoire par rapport à un axe central (A) du volume de traitement et une combinaison de ceux-ci. Le dispositif comprend un dispositif de commande (11) qui est conçu pour commander le dispositif diviseur de faisceau (70) et le dispositif de déplacement (8) de telle sorte que le point (19) de chaque faisceau de sortie laser (90 à 93) est déplacé dans le volume de traitement (17) sur et/ou le long d'une trajectoire de balayage respective (19a) et/ou sur une surface respective (19c).
PCT/EP2024/072895 2023-08-18 2024-08-14 Dispositif et procédé de création d'au moins une surface découpée, dispositif et procédé de création de données de commande Pending WO2025040539A1 (fr)

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CN202480053807.3A CN121752230A (zh) 2023-08-18 2024-08-14 用于生成至少一个切割面的装置和方法、用于生成控制数据的装置和方法

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DE102023122201.5 2023-08-18
DE102023122201.5A DE102023122201A1 (de) 2023-08-18 2023-08-18 Vorrichtung und Verfahren zum Erzeugen mindestens einer Schnittfläche, Vorrichtung und Verfahren zum Erzeugen von Steuerdaten

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