DE102014012631A1 - Eye surgery system - Google Patents

Abstract

An eye surgery system 1 for the treatment of an eye 3 comprises an optic 7, at least one laser light source 31, 59, a measuring module 57 with at least one light detector 69 and a controller 21; wherein the optic is configured to focus laser light generated by the laser light source in a focus plane 33 of the optic at a plurality of locations 47; the optic being further configured to guide light emanating from the locations 47 to the measurement module and to focus on the measurement module; and wherein the controller 21 is configured to set a position of the focal plane 33 in the eye in response to a detection signal 70 output from the at least one light detector.

Description

The present invention relates to an eye surgery system for the treatment of an eye, and more particularly to such an eye surgery system which facilitates the performance of a capsulorhexis. Furthermore, the invention relates to methods for preparing and method for performing a Kapsulorhexis.

In cataract surgery, the opacified natural eye lens is removed, leaving structures of the elastic capsular bag in the eye to support the artificial intraocular lens (IOL). An essential step in such an operation is called capsulorhexis and involves creating a hole in the capsular bag to allow removal of the natural lens. In addition, the intraocular lens is inserted into the capsular bag through this hole. According to prevailing theory, this hole in the capsular bag should have a circular shape and a diameter adapted to the diameter of the intraocular lens. Conventionally, capsulorhexis is performed using a surgical tool such as a forceps or a needle. This procedure is difficult and requires an experienced surgeon to reliably achieve good results.

It has been considered to use a high performance femtosecond laser to modify and weaken the tissue of the capsular bag along a circular line which bounds the hole to be created in the capsular bag. It would then also be possible for less experienced surgeons to reliably remove the tissue inside the circular line. However, a high power femtosecond laser is very expensive.

It has recently been proposed to apply a light absorbing agent to the anterior capsular bag and to use a low power CW laser to scan a focused laser beam to modify the tissue along a line that defines the hole to be created in the capsular bag. The light absorbing agent absorbs the laser light to create a thermal effect on the tissue of the capsular bag which modifies the tissue to weaken it. The tissue inside the closed line can subsequently be removed.

It is feared that in such an intervention laser light with a high intensity per unit area will encounter tissue of the eye other than the capsular bag, so that such other tissue is undesirably modified and damaged. In particular, damage to the retina of the eye is feared.

It is an object of the present invention to propose an eye surgery system and a method for performing a capsulorhexis, with which laser light can be focused in the area of the capsular bag of an eye.

Embodiments of the invention provide a method for performing capsulorhexis, which comprises applying a light-absorbing agent to a capsular bag of an eye. The agent may be, for example, trypan blue. An eye surgery system is then used to modify the tissue of the capsular bag with laser light along an elongate line. For example, the elongated line may be closed in a circular fashion, and along that line, the tissue of the capsular bag may be modified so that it is weakened and the tissue within the line can be easily removed.

This method includes a method for preparing a capsulorhexis, which does not necessarily have to be performed by a surgeon and can be performed, for example, by a wizard. The procedure for preparing the capsulorhexis is carried out after the light-absorbing agent has been applied to the capsular bag of the eye. The method of preparation essentially involves an adjustment of the eye surgery system such that in the subsequent performance of the capsulorhexis the laser beam is reliably focused in the region of the capsular bag in order to be able to provide a high laser power per unit area in the area of the capsular bag and tissue different from the capsular bag conserve.

According to exemplary embodiments, the ophthalmic surgery system includes an optic, a laser light source, a measurement module with at least one light detector, and a controller. In this case, the optics are configured to focus laser light generated by the laser light source in a focal plane of the optics at a plurality of locations which lie within an eye. Thus, the optic is configured to guide laser light generated by the laser light source to an eye so that the laser light is focused at locations that lie on a surface in the eye. In an ideal setting, the area within which the locations at which the laser light is focused, that is the focal plane of the optics, may coincide with the area of the capsular bag to which the light absorbing agent has been applied. Thus, the laser light is focused where the light-absorbing agent is disposed, namely on the surface of the capsular bag, so that the laser light can subsequently produce an effective local thermal effect at these locations, which modifies the tissue of the capsular bag.

The ophthalmic surgery system supports its adjustment such that the focal plane in which the locations at which the laser light is focused can be positioned relative to the eye such that the focal plane substantially coincides with the capsular bag, for example. For this purpose, the optics is configured by guiding light, which emanates from the capsular bag, to the measuring module and focused there. At least part of the light focused in the region of the measuring module impinges on the at least one light detector of the measuring module, which outputs a detection signal corresponding to the incident light. The controller is configured to drive components of the eye surgery system in response to the detection signal to adjust the position of the focal plane in which the laser light is focused relative to the eye. For example, the controller may change and adjust the position of the focal plane based on the detection signal until an intensity of the light striking the at least one light detector is maximum.

According to an exemplary embodiment, the optic is a variable optic including an actuator to change a focal plane distance from the optic. For example, the actuator may move an optical element of the optic relative to other optical elements of the optic to change the distance of the focal plane from the optic. The controller may then be configured to control this actuator in response to the detection signal output from the at least one light detector.

According to another exemplary embodiment, the ophthalmic surgery system includes a tripod that holds the optic relative to the eye, the tripod including an actuator to change a distance between the optic and the eye. For example, the actuator may be a motor drive which generates a translatory or rotational movement on a component or a pair of components of the stand. The controller is configured to control this actuator in response to the detection signal output from the at least one light detector.

According to exemplary embodiments, the measurement module comprises a beam-limiting detection aperture, which is arranged in a beam path between the focal plane within the eye and the at least one light detector, so that the light detector can only detect light that has passed through the detection aperture. Here, the optics may be configured to focus light emanating from locations in the focal plane at the detection aperture. The detection aperture may be formed, for example, as an opaque plate having a circular aperture through which the light detected by the light detector may pass. The opening may have a diameter of, for example, 0.001 mm or 0.02 mm.

According to exemplary embodiments, the optic is configured to map locations in the focal plane to the detection aperture. Thereby, the effect can be obtained that the majority of the light detected by the light detector emanates from the locations in the eye where the laser light is also focused. The measuring module is thus configured to selectively detect light emanating from the locations within the focal plane arranged in the eye. In this way, the controller can also position this focal plane within the eye with high precision such that the focal plane substantially coincides with the capsular bag, which in this way becomes detectable after the application of the light-absorbing agent.

According to exemplary embodiments, the detection signal represents an intensity of the light striking the light detector, and the controller may then be configured to adjust the position of the focal plane in the eye in response to the detection signal so that the intensity of the light striking the light detector becomes maximum ,

According to a further embodiment, the measuring module has a first light detector and a second light detector, both of which receive light emanating from the focal plane within the eye. For example, a beam splitter can be provided to divide the beam path so that each light detector is arranged in a part of the beam path. The measuring module further has a first detection aperture, which is arranged in the beam path between the focal plane and the first light detector, and a second detection aperture, which is arranged in the beam path between the focal plane and the second light detector, wherein the two detection apertures along the beam paths with are arranged at different distances from the focal plane. The first and second detection apertures can each be designed as a detection aperture, as has already been explained above.

According to exemplary embodiments herein, the detection signal of the first light detector represents a light intensity incident on the first light detector, and the detection signal of the second light detector represents a light intensity incident on the second light detector, wherein the controller is configured to adjust the position of the focal plane in the eye. that the one striking the first light detector Light intensity and the incident on the second light detector light intensity have a predetermined ratio and are in particular the same. In the latter case, the optics may image the focal plane within the eye to a location along the optical path located between the first and second detection apertures. This means that, for example, the first detection aperture in the beam path is arranged in front of the image of the focal plane and the second detection aperture is arranged in the beam path behind the image of the focal plane. Such an arrangement with two detection apertures and two light detectors allows a fast and reliable adjustment of the optics and the focal plane defined by this optic within the eye relative to the eye.

According to further exemplary embodiments, the measurement module comprises a plurality of light detectors, which are arranged along the beam path at different distances from the focal plane within the eye. Each of the light detectors may provide a detection signal representing a light intensity of the light striking the respective light detector. According to exemplary embodiments herein, the measurement module comprises an astigmatic optical element, such as a cylindrical lens, which focuses light along a line that emanates from a location within the focal plane within the eye. The plurality of light detectors may then be arranged so that their distance from the area within the eye in the line direction of the line focus increases, so that simultaneously several of the light detectors are illuminated with measuring light. Those light detectors, which are arranged along the line at the position of the beam path where an optical image of the location in the focal plane within the eye is formed, will detect a maximum light intensity, and conversely from this position, the position of the focal plane within the eye is closed can be.

According to exemplary embodiments, the eye surgery system comprises a beam-limiting illumination aperture, which is arranged in the beam path between the laser light source and the focal plane within the eye so that only laser light can reach the surface which has passed through the illumination aperture. The illumination aperture may be formed like the detection aperture, that is, for example, as a plate having a circular opening.

According to exemplary embodiments, the optics is designed to image the illumination aperture onto the focal plane within the eye, so that a high light intensity can be generated at the location in the focal plane on which the illumination aperture is imaged in order to modify the tissue of the capsular bag there ,

According to exemplary embodiments, the optic includes at least one deflector configured to relocate the location at which the laser light passes through the focal plane within the focal plane, wherein the controller may be configured to displace the location along an elongated line that the laser light is sequentially focused at the locations which lie on the elongated line. In other words, the focused laser light is scanned along the elongated line.

According to exemplary embodiments, the optic is configured to focus the laser light that has penetrated the illumination aperture simultaneously into the focal plane at a plurality of locations lying on an elongate, in particular circular, line.

According to exemplary embodiments herein, the optic comprises an optical element configured to generate a hollow beam, wherein the optical element is in particular an axicon and / or a hologram and / or a field of controllable micromirrors ("digital mirror array", DMD). may include.

According to exemplary embodiments, the ophthalmic surgery system has two modes of operation, wherein in a first mode of operation the low intensity laser light is focused at the locations in the focal plane and the light emanating from the locations is detected with the measurement module about the position of the focal plane within the eye and wherein in a second mode of operation the laser light is focused at a high intensity at the locations to modify the tissue of the eye. In an exemplary embodiment herein, the controller is configured to adjust, in the second mode of operation, the intensity of the laser light focused at the locations and / or a speed of displacement of the location along the line in response to the detection signal. In this way, it can be achieved that in all locations on a capsule bag colored with a light-absorbing agent, a same thermal effect of the laser beam is generated, even if the locations differ with respect to a concentration of the light-absorbing agent applied there.

Embodiments of the invention will be explained in more detail with reference to figures. Hereby shows:

1 a schematic representation of a first embodiment of an eye surgery system;

2 a schematic representation of a measuring module of a second embodiment of an eye surgery system;

3 a schematic representation of a measuring module of a third embodiment of an eye surgery system;

4 a schematic representation of a plan view of a light detector of the measuring module of 3 ;

5 a schematic representation for explaining an optics, which focuses laser light along an elongated line;

6 a schematic representation of a fourth embodiment of an eye surgery system;

7 a schematic representation of a fifth embodiment of an eye surgery system;

8th a schematic representation of a sixth embodiment of an eye surgery system;

9 a flowchart for explaining a first embodiment of a method for performing a Kapsulorhexis; and

10 a flowchart for explaining a second embodiment of a method for performing a Kapsulorhexis.

1 schematically shows an eye surgery system 1 to perform a capsulorhexis. It is believed that one eye 3 a patient has developed a cataract, leaving one in a capsular bag 5 of the eye 3 Contained opaque natural lens of the eye by an intraocular lens (IOL) is to replace as an implant. For this purpose, a capsulorhexis is carried out, which involves the creation of an opening in the capsular bag. The natural eye lens is removed through this opening and the intraocular lens is inserted into the capsular bag. The eye surgery system 1 is used to support the performance of capsulorhexis. In particular, the eye surgery system 1 emit a laser beam that focuses laser light at a plurality of locations along a closed line on the capsular bag to modify the tissue of the capsular bag to weaken it. The closed elongated line circumscribes the opening to be formed in the capsular bag and the tissue within the closed line can be removed after weakening the tissue to form the opening in the capsular bag. The method of generating capsulorhexis described herein comprises applying a light absorbing agent to the capsular bag. Background information on such a method can be found in the US 8,409,182 B2 are obtained, the disclosure of which is incorporated by reference in the present application in its entirety.

The light absorbing agent used in the embodiments discussed herein is trypan blue, available from Sigma-Aldrich, St. Louis, MO.

The eye surgery system 1 includes an optical part 7 which is in a housing 9 can be accommodated. The optical part 7 is from a tripod 11 worn on a ceiling, wall or floor 13 a room can be moored. Since the patient rests with his head and eye on a fixed relative to the space pad, the tripod includes 11 several mutually movable components 15 which are displaceable relative to each other to the optical part 7 relative to the eye 3 to position. The tripod 11 can also have one or more actuators 17 include to the movable components 15 relocate relative to each other and which via a control line 19 from a controller 21 be controlled so that a position of the optics 7 relative to the eye 3 through the controller 21 is adjustable. The control 21 may include one or more electronic circuits, such as a processor and memory devices, within the housing 9 or outside the housing and at a distance from the optical part 7 can be arranged. The control 15 For example, it may be implemented as a computer operating control software and to various components of the ophthalmic surgical system 1 is connected to control these.

The optical part 7 can a microscope 23 with an objective lens 25 and two eyepieces 27 in which a surgeon can see with his two eyes to observe the procedure.

The optical part 7 further comprises a laser treatment and measuring part 28 to deliver laser light to modify the capsular bag. The laser treatment and measuring part 28 includes one from the controller 21 via a control line 29 controlled treatment laser 31 which generates laser light which is in a focal plane 33 is focused to there the tissue of the capsular bag 5 to modify. The laser 31 provides laser light with a light absorber adapted to the Wavelength, which may be in the range of 580 nm to 610 nm when using trypan blue, for example. The laser light gives the laser 31 over a fiberglass 35 out, at the end 36 the laser light emerges. The end 36 the fiberglass 35 thus acts as a point light source for a laser beam 37 that of a lens 38 is collimated. Thereafter, the laser beam passes through two semitransparent mirrors 39 and 40 , is at a deflecting mirror 41 reflected and from a lens 43 to a laser beam 44 shaped, which at one below the objective lens 25 arranged mirrors 45 is reflected, so that the beam 44 in the focal plane 33 in one place 47 is focused. The optics from the lenses 38 and 43 forms the fiber end 36 to the place 47 in the focal plane 33 from. Instead of the laser beam 44 at the below the objective lens 25 arranged mirrors 45 towards the object field of the microscope 23 It is also possible to reflect a corresponding mirror in 1 above the objective lens 25 to arrange at which the laser beam towards the object field of the microscope 23 is reflected and also the objective lens 25 interspersed. The objective lens 25 then contributes to the focusing of the laser beam, so that the lens 43 can be equipped with a correspondingly smaller refractive power or omitted.

The deflecting mirror 41 is pivotable in two spatial directions, as indicated by arrows 49 in 1 is indicated. The pivoting position of the deflection mirror 41 is from an actuator 51 set, which of the controller 21 via a control line 52 is controlled. By pivoting the deflection mirror 41 it is possible the place 47 at which the laser light is focused, within the focal plane 33 to relocate. Instead of a pivoting mirror, which is displaceable in two spatial directions, two pivoting mirrors can be used, which are arranged one behind the other in the beam path and in each case one spatial direction can be displaced by one actuator.

The control 21 is configured to use the laser 31 turn on and the place 47 along a closed circular line in the focal plane 33 to move. Since the capsular bag is colored with the light-absorbing agent, laser power is absorbed there and its thermal action modifies the tissue of the capsular bag along the circular line. For this it is essential that the focal plane 33 in which the places 47 are arranged, on which the laser light is focused, substantially coincident with the surface of the colored capsular bag. For then the thermal effect of the laser beam on the capsular bag is maximum and the load on other parts of the eye 3 correspondingly minimal by the laser light. To adjust the optics so that the focal plane 33 with the surface of the capsular bag 5 are substantially coincident, are in the embodiment of the 1 illustrated two possibilities. For one, the controller 21 the actuator 17 Press to set a distance of the optical part 7 from the eye 3 and thus the location of the focal plane 33 within the eye 3 to change. The other is the lens 43 a movable optical component, which in the direction of the beam path of the laser beam 44 is displaceable, as indicated by an arrow 53 in 1 is indicated. The movement of the lens 43 is through an actuator 54 caused, which via a control line 55 from the controller 21 is controlled. By shifting the lens 43 can change the position of the focal plane 33 be changed in the eye, without the position of the optics 7 to change relative to the eye.

The control 21 actuates the actuator 17 and / or the actuator 54 in response to detection signals from a measurement module 57 be generated. The measuring module 57 includes one from the controller 21 via a control line 58 controlled alignment laser 59 , which laser light over a glass fiber 61 delivers, leaving an end 62 the fiberglass 61 forms a point light source for the laser light for adjustment. That from the fiber end 62 escaping light is from a lens 63 collimated and on the semipermeable mirror 39 reflected so that it matches the beam path of the laser 31 generated laser light 37 is superimposed. The fiber end 62 and the lens 63 are arranged so that an optical image of the acting as a point light source fiber end 62 also at the place 47 in the plane 33 arises. There is the incident light of Justagelasers 49 is absorbed, scattered or reflected by the tissue of the eye and the light-absorbing agent. Part of the scattered or reflected light is at the mirror 45 reflects, penetrates the lens 43 , is at the deflecting mirror 41 and subsequently on the semi-transparent mirror 40 reflected and from a lens 65 on an opening 67 an aperture plate 68 focused. The opening 67 forms a detection aperture of the measuring module 57 , The Lens 65 and the aperture plate 68 are arranged so that at the opening 67 an optical image of the place 47 in the plane 33 arises. Light, which is the opening 67 interspersed, is by a light detector 69 which detects a detection signal representing the intensity of the detected light via a signal line 70 to the controller 21 supplies. Due to the optical image of the place 47 in the plane 33 on the aperture 67 the light detector detects 69 essentially only light, which is from the place 47 in the focal plane 33 has gone out, where the laser light is focused. The control 21 then can the actuators 17 and or 54 Press until the light detector 69 delivered and the detected light intensity representing detection signal is maximum. Then it is assumed that the plane 33 with the surface of the capsular bag 5 coincides and the light of the treatment laser 31 with maximum intensity can be focused on the capsular bag to modify the tissue there. The controller may then switch from a first mode of operation in which the light of the Justagelasers 59 is directed to the eye and the actuators 17 and or 54 be adjusted in response to the detected light, be switched to a second mode of operation, in which the light of the treatment laser 31 by pivoting the mirror 41 by means of the control 21 controlled actuator 51 is guided along the circular line on the capsular bag.

In the foregoing illustrated embodiment, a treatment laser becomes 31 for modifying the tissue and an alignment laser 59 used for adjustment. However, it is also possible for this only the treatment laser 31 used when operating in the first operating mode for adjustment with a lower intensity so as not to modify the tissue of the capsular bag during the adjustment. This can be done by operating the laser in an operating mode in which it generates light of lesser intensity, or by introducing a laser light attenuating element into the beam path of the laser light 37 is moved.

In the basis of 1 explained embodiment, a point light source is optically on the place 47 imaged on the capsular bag. Such a point light source may be generated by a beam-limiting illumination aperture which is embodied as an opening in an aperture plate which is illuminated with laser light from one side, so that on the other side of the aperture plate the light exits through the aperture as from a point light source. Such a illumination aperture is also referred to as a pinhole. In the in 1 As illustrated, such a steel-limiting aperture will be from the end 36 the fiberglass 35 formed, from which the light also emerges as from a point light source.

The following are variants of the ophthalmic surgery system 1 explained. In this case, components corresponding to one another with regard to their structure or function are designated by corresponding numbers, which are provided with an additional letter for differentiation. To understand such components, reference should be made to the entire foregoing and following disclosure.

In the embodiment of the 1 become the point light source 36 for the laser light for modifying the tissue and the point light source 62 for the laser light for adjustment to the place 47 shown in the focal plane. Conversely, the place becomes 47 in the focal plane on the detection aperture 67 displayed. This means that the point light source 36 and the detection aperture 67 are arranged confocally to each other. Likewise, the point source of light 62 and the detection aperture 67 arranged confocally to each other.

In this case, it can be prevented by suitable filters and / or polarizing elements that light from one laser is reflected back into the same or the other laser or the other detector.

2 shows a variant of a measuring module 57a , The measuring light coming back from the eye is from a lens 65a focused, being in a beam path behind the lens 65a a beam splitter 81 is arranged so that the beam is split and in two levels 82 ₁ and 82 ₂ each a beam focus arises. In each of the split beams, a detection aperture is arranged. However, a first detection aperture with an aperture plate 68a ₁ and an opening provided therein 67a ₁ in the beam path in front of the plane 82 _{1 of} the focus, while in the other beam path, a detection aperture with an aperture plate 68a ₂ and an opening provided therein 67a ₂ in the beam path behind the plane 82 _{2 of} the focus is arranged. In the beam path behind the detection aperture 67a ₁ is a light detector 69a ₁ , which can only detect light which is the detection aperture 67a ₁ interspersed, and in the beam path behind the detection aperture 67a ₂ is a detector 69a ₂ , which can only detect light which is the detection aperture 67a ₂ interspersed.

Thus, in the desired setting of the eye surgery system, neither of the two detection apertures 67a ₁ and 67a _{2 arranged} exactly in the focus on which a location of the capsular bag is mapped. However, those of the light detectors 69a ₁ and 69a ₂ output detection signals are still used by the controller to control the level ( 33 in 1 ), in which the laser light is focused to modify the tissue and to adjust, to position within the eye. For example, the controller may adjust the level within the eye based on a ratio of the two of the two light detectors 69a ₁ and 69a _{Set 2} supplied detection signals. A particularly precise adjustment is possible when the components of the optics are positioned to each other so that the planes 82 ₁ and 82 ₂ , in which the image of the focal plane 33 arises at equal distances from the detection apertures 67a ₁ and 67a ₂ are arranged.

This in 2 shown measuring module can in the basis of the 1 explained eye surgery system can be used.

The 3 and 4 show a further variant of a measuring module 57b , The measuring light returning from the eye will not, as in the 2 illustrated embodiment in a plane 82b focused in one point but through a cylindrical lens 65b along a line in a plane 82b , A light detector 69b comprises a plurality of detection elements which may be arranged in a row along a line or as a field within a surface. The line or surface is transverse to the plane 82b and arranged transversely to the beam path of the measuring light coming back from the eye. The 4 shows a plan view of the detector 69b and an intensity distribution of the incident light there. In a waisted area 83 the surface meets light while in areas 84 on both sides of the waisted area 83 essentially no light hits the detector. The level 82b In which the line focus is arranged, the area of the detector intersects where a width D of the waisted area 83 is the smallest. There is also the intensity of the incident light greatest. The position of the plane 82b along the beam path can thus be done by evaluating the detection signals of the detector elements. If the detectors are arranged in a row along a line, the location of the plane can be 82b be determined where the detection element is arranged, which detects the largest light intensity. If a field of detector elements is arranged in a surface, the exposed area can additionally be used 83 and the unexposed areas 84 be determined to determine the location where the width D of the area 83 is minimal. From a control of the eye surgery system can thus by evaluating the detection signals, the position of the plane 82b can be determined, and by changing the settings of actuators of the eye surgery system, the controller can control the level 82b position so that it is confocal to a laser light source for generating treatment light or for generating Justagelicht is arranged.

That in the figures 3 and 4 shown measuring module can in the basis of the 1 explained eye surgery system can be used.

5 shows a schematic representation of an optic, which the light of a point light source 36c not focused again at one point but at the same time along a circular line 48 in a plane 33c , For this purpose, the optics comprises a lens system of lenses 38c and 43c which in turn may each comprise two lens elements. The lenses 38c and 43c would, without further components in the beam path, the point light source 36c Imagine again in a point near the plane 33c is arranged. However, in the beam path between the point light source 36c and the lens 38c an optical element 75 arranged, which from that of the point light source 36c emitted beam 37c a ring beam 77c shaped. A display element I1 in 5 represents the cross section of the beam 77c in the area of the optical element 75 , There is the beam 37a still no ring beam, and the intensity of the beam has within the in 5 illustrated cross section of the beam, for example, a substantially constant or Gaussian intensity distribution. A display element I2 in 5 represents the cross section of the ring beam 77c at a location along the beam path between the lens 43c and the plane 33c , There, the cross section of the beam is limited by an outer edge with radius r2 and an inner edge with a radius r1. A display element I3 in 5 represents the beam cross section of the ring beam 77c at a location of the beam path between the lens 43c and the plane 33c which closer to the plane 33c is arranged as the position represented by the display element I2. The ring beam 77c is in turn bounded by an outer edge of radius r2 and an inner edge of radius r1, wherein a difference between the two radii r2 and r1 is reduced compared to the display element I2. A display element I4 in 5 represents the cross section of the ring beam 77c in the plane 33c , There, the ring beam is in turn limited by an outer edge with radius r2 and an inner edge with radius r1, although the difference between the two radii r2 and r1 is very small, so that the light intensity of the ring beam 77 essentially along a closed line 48 is focused. Outside the line 48 Essentially no laser light hits the plane 33c ,

The optical element 75 for generating the ring beam 77c may include several elements suitable for this purpose. In the example of 5 is the optical element 75 is formed as an axicon, which is an element made of glass, which is penetrated by the beam path and whose one surface is a plane surface, while the other surface has the shape of a conical surface. Further examples of suitable optical elements 75 are a holographic element that is designed to be out of the beam 73c forms a ring beam with the solid cross-section shown in the display element I1. Further, for example, a mirror with a conical mirror surface or a field of controllable micromirrors ("digital mirror array", DMD) as an optical element 75 be used. With an appearance similar to a structure based on the 5 Having illustrated optics, it is possible to focus light, a laser along an annular line on a capsular bag of an eye to simultaneously modify the tissue of the capsular bag along this line. In particular, it is then not necessary to use a laser beam focused at only one location along the scan the desired line with the help of deflecting mirrors, as indicated by the 1 was explained.

Conversely, light scattered or reflected at the capsular bag, which is from the line 48 goes out, in the place of the light source 36a focused.

6 schematically shows an eye surgery system 1d for performing a Kapsulorhexis, which has a similar structure, as the basis of the 1 explained eye surgery system. Unlike the ophthalmic surgery system 1 uses the eye surgery system 1d not a laser beam focused at a point in the focus plane of the optics, which is scanned along a closed line by means of a pivotable deflecting mirror, but an optical element 75d for generating a ring beam, as he said 5 has been explained to simultaneously focus the laser beam along the closed line. A pivotable deflecting mirror in the embodiment of the 1 corresponding deflecting mirror 41d can be a non-pivoting, fixed deflection mirror. Otherwise, the eye surgery system points 1d a in the 1 illustrated eye surgery system corresponding structure, which will not be described in detail below to avoid repetition.

The laser light for treatment, that is to modify the tissue of a capsular bag, is a laser 31d over a fiberglass 35d out, whose end 36d as a point light source for a laser beam 37d , works. The laser beam 37d is from the optical element 75d to a ring beam 77d shaped. The ring beam 77d will be at the mirror 41d reflects, penetrates a lens 43d and gets at one in front of an objective lens 25d a microscope 23d arranged mirrors 45d reflected, so that the ring beam 77d in a focal plane 33d on a circle (cf. 5 ) is focused.

A controller 21d actuates the actuator 17d and / or the actuator 54d in response to detection signals from a measurement module 57d be generated. The measuring module 57d includes one from the controller 21d via a control line 58d controlled alignment laser 59d , which laser light over a glass fiber 61d supplies, whose end 62d forms a point light source for the laser light for adjustment. The laser light to adjustment is superimposed with the beam path of the laser light for treatment. That is why the light of Justagelasers 59d through the optical element 75d shaped into a ring-shaped, in the plane 33d is focused on the circular line. In the plane 33d becomes the incident light of the Justagelasers 49d is absorbed, scattered or reflected by the tissue of the eye and the light-absorbing agent. Part of the light scattered or reflected on the capsular bag becomes the mirror 45d reflected and after passing through the optical element 75d at an opening 67d an aperture plate 68d focused.

Light, which is the opening 67d interspersed, is by a light detector 69d which detects a detection signal representing the intensity of the detected light via a signal line 70d to the controller 21d supplies. The control 21d in a first mode of operation, in which the light of Justagelasers 59d directed to the eye, the actuators 17d and or 54d as a function of the detected light so that the focal plane substantially coincides with the capsular bag. Thereafter, the controller can be switched to a second mode of operation, in which the light of the treatment laser 31d is focused on the circular line on the capsular bag, there to modify the tissue of the capsular bag.

The following are variants of the ophthalmic surgery system 5 and 6 explained, which use a ring beam.

7 shows another embodiment of an eye surgery system 1e , which has a similar structure, as the basis of the 6 explained eye surgery system. In contrast, the eye surgery system 1e but no separate laser 59d in 6 to generate measuring light, which is used in a first operating mode to a focal plane 33e in which the laser light is focused within an eye 13e to relocate. The eye surgery system 1e has a single laser 31e on which in the plane 33e laser light focused along the circular line to modify the capsular bag 5e of the eye in the second mode of operation. In the first operating mode for setting the focal plane 33e in the eye controls a controller 21e of the eye surgery system 1e the laser 31e so that only laser light with sufficiently low intensity in the plane 33e is focused so as not to modify the tissue there. In this first mode of operation is by a detector 69e generates a detection signal indicating the control 21e used to make the settings as they are based on the 1 and 6 were explained. In the one of the laser 31e to the plane 33ce extending beam path as well as in the plane 33e to the detector 69e extending beam path is in turn an optical element 75e arranged to form the ring beam.

In the basis of the 6 and 7 In the illustrated embodiments, a single optical element is provided for forming a ring beam, which differs from both the laser light for modifying the tissue and the detected light is enforced. 8th is a schematic representation of another embodiment of an eye surgery system 1f , which for these two purposes separate optical elements 75f1 and 75f2 having.

In contrast to the embodiment of the 6 in which the optical element 75d in the common part of the two through the partially transparent mirror 40d split beam paths is located in the eye surgery system 1f of the 8th an optical element 75f1 for forming a ring beam between a laser 31f and a semitransparent mirror 40f as well as another optical element 75f2 in a beam path between the partially transmissive mirror 40f and a detector 69f arranged to the ring beam at an aperture 67f an aperture plate 68f to focus. Otherwise, the structure and function of the components of the eye surgery system 1f similar to that of the ophthalmic surgery system of 6 ,

As in the embodiment of 1 which focuses laser light at a point in the focal plane are also used in the ring beam generating embodiments of 6 . 7 and 8th , the point light source for modifying the tissue or for adjustment to locations of an annular line in the focal plane, while again the annular line in the focal plane is imaged onto the detection apertures, so that here the point light sources and detection apertures are arranged confocal to each other.

Furthermore, the basis of the 2 . 3 and 5 explained measuring modules in the basis of 6 . 7 and 8th described eye surgery systems are used to generate the at least one detection signal.

9 FIG. 10 is a flowchart for explaining an embodiment of a method of performing capsulorhexis. FIG.

A light-absorbing agent becomes in one step 101 applied to a capsular bag of an eye. In one step 103 An ophthalmic surgery system is placed in a first mode of operation and low intensity laser light is directed to the eye for adjustment. In one step 105 the light coming back from the eye is detected. In a decision step 107 it is determined whether the light-absorbing agent has been correctly applied to the capsular bag. If this is the case, in one step 109 places the ophthalmic surgery system in a second mode of operation in which high intensity laser light is directed to the eye to modify the tissue of the capsular bag. If this is not the case, it will come with a step 111 continued, in which the switching to the second mode of operation is prevented.

This procedure can be used with any of the 1 to 4 described eye surgery system in which in the first operating mode with the laser light of low intensity, the place 47 along the line along which the tissue of the capsular bag is subsequently to be weakened in the second mode of operation is displaced and, in dependence on the displacement, the intensity of the light returning from the eye with the detector 69 is detected. If substantially equal intensities are detected along the line, it can be concluded that the light-absorbing agent has been applied as desired. On the other hand, if differences between maximum and minimum measured light intensities are too large, it is likely that the light-absorbing agent has not been correctly applied.

10 FIG. 10 is a flowchart for explaining another embodiment of a method of performing capsulorhexis. FIG.

In one step 201 a light-absorbing agent is applied to a capsular bag. In one step 203 For example, an eye surgery system is placed in a first mode of operation, light returned from the eye, and adjusted depending on the eye surgery system. Thereafter, the eye surgery system is placed in a second mode of operation in which high intensity laser light is directed along an elongate line on the capsular bag. In one step 205 The laser light is directed to a next location along the line to modify the tissue there. In one step 207 For example, light returning from the eye is detected and analyzed. Depending on the intensity of in the step 207 detected light is in one step 209 the intensity of the laser light directed onto the capsular bag is modified and / or the speed at which it advances to the next location or the duration during which the laser beam is held at the current location is changed. In one step 211 a decision is made as to whether all locations along the line have been exposed. If this is the case, the procedure in the step 213 completed. If not, the process goes to step 205 continued, in which the laser light is directed to a next location along the line.

This method can be used in particular with any of the 1 to 4 described eye surgery systems are executed.

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• US 8409182 B2 [0036]

Claims (20)

Eye surgery system for the treatment of an eye ( 3 ), wherein the eye surgery system comprises: an optic ( 7 ), at least one laser light source ( 31 . 59 ), a measuring module ( 57 ) with at least one light detector ( 69 ) and a controller ( 21 ); wherein the optics is configured to laser light generated by the laser light source in a focal plane ( 33 ) of the optics in several places ( 47 ) to focus; the optic being further configured to be separated from the locations ( 47 ) to lead outgoing light to the measuring module and to focus on the measuring module; and where the controller ( 21 ) is configured to position the focal plane ( 33 ) in the eye as a function of a detection signal output by the at least one light detector ( 70 ). An eye surgery system according to claim 1, wherein the optic is a variable optic comprising a first actuator ( 54 ) to the distance of the focal plane ( 33 ), in which the laser light is focused to change from the optics, and wherein the controller ( 21 ) is configured to connect the first actuator ( 54 ) in dependence on that of the at least one light detector ( 69 ) control the issued detection signal. An eye surgery system according to claim 1 or 2, further comprising a tripod ( 11 ), which the optics relative to the eye ( 5 ), the tripod has a second actuator ( 17 ), which is configured to change a distance between the optics and the eye, and wherein the controller ( 21 ) is configured to connect the second actuator ( 17 ) in dependence on that of the at least one light detector ( 69 ) control the issued detection signal. Eye surgery system according to one of claims 1 to 3, wherein in a beam path between the focal plane ( 33 ) and the at least one light detector ( 69 ) a beam-limiting detection aperture ( 67 ) is arranged so that the light detector ( 69 ) can only detect light which is the detection aperture ( 67 ), and wherein the optic is configured to receive light from locations ( 47 ) in the focal plane ( 33 ), at the detection aperture ( 67 ) focused. The eye surgery system of claim 4, wherein the optic is configured to sense the locations ( 47 ) in the focal plane ( 33 ) to the detection aperture ( 67 ). An eye surgery system according to claim 4 or 5, wherein the detection signal represents an intensity of the light striking the light detector, and wherein the controller is configured to adjust the position of the focal plane (FIG. 33 ) in the eye in response to the detection signal so that the intensity of the light incident on the light detector is maximum. Eye surgery system according to one of claims 1 to 6, wherein the measuring module comprises a first light detector ( 69a ₁ ) and a second light detector ( 69a ₂ ); wherein in a beam path between the focal plane ( 33 ) and the first light detector ( 69a ₁ ) a beam-limiting first detection aperture ( 67a ₁ ), so that the first light detector ( 69a ₁ ) can only detect light which is the first detection aperture ( 67a ₁ ) has penetrated; wherein in a beam path between the focal plane ( 33 ) and the second light detector ( 69a ₂ ) a beam-limiting second detection aperture ( 67a ₂ ), so that the second light detector ( 69a ₂ ) can only detect light which is the second detection aperture ( 67a ₂ ) has enforced; and wherein the first detection aperture ( 67a ₁ ) and the second detection aperture ( 67a ₂ ) along the beam paths with different distances from the focal plane ( 33 ) are arranged. The ophthalmic surgery system of claim 7, wherein a detection signal of the first light detector represents an intensity of the light impinging thereon and a detection signal of the second light detector represents an intensity of light impinging thereon, and wherein the controller is configured to determine the position of the surface in the eye to set that the incident on the first light detector light intensity and the incident on the second light detector light intensity have a predetermined ratio and in particular are the same. Eye surgery system according to one of claims 1 to 8, wherein the measuring module ( 57b ) has a plurality of light detectors, which along the beam path at different distances from the focal plane ( 33 ) are arranged. Eye surgery system according to claim 9, wherein in the beam path an astigmatic optical element ( 65b ) is arranged. An eye surgery system according to claim 9 or 10, wherein the plurality of light detectors are arranged in a row. An eye surgery system according to any one of claims 1 to 11, further comprising a beam-limiting illumination aperture ( 36 ), which in a beam path between the laser light source ( 31 ) and the focal plane ( 33 ) is arranged so that only laser light can reach the focal plane which the illumination aperture ( 36 ). The eye surgery system of claim 12, wherein the optic is configured to illuminate the illumination aperture (10). 36 ) on the focal plane ( 33 ). An eye surgery system according to claim 12 or 13, wherein the optic comprises at least one deflection element ( 41 ) which is configured to store the location ( 47 ), at which the laser light illuminates the focal plane ( 33 ), within the focal plane ( 33 ) and the controller ( 21 ) is configured to change the location ( 47 ) along a line ( 48 ) so that the laser light is sequentially focused at the locations lying on the elongated line. An eye surgery system according to any one of claims 12 to 14, wherein the optic is configured to receive the laser light illuminating the illumination aperture ( 36d ), at the same time in several places, which on an elongated, in particular circular, line ( 48 ), in the focal plane ( 33d ) to focus. An eye surgery system according to claim 15, wherein the optic is an optical element ( 75d ), which is configured to generate a hollow beam, wherein the optical element comprises in particular an axicon and / or a hologram and / or a field of controllable micromirrors. An eye surgery system according to any one of claims 1 to 16, wherein the eye surgery system has a first mode of operation and a second mode of operation, wherein in the first mode of operation the laser light is focused at the locations with a low intensity and the position of the focal plane in the eye is adjusted, and wherein in the second mode of operation the laser light is focused at a high intensity at the locations in the focal plane to modify a tissue of the eye. The ophthalmic surgery system of claim 17, wherein the controller is configured to adjust, in the second mode of operation, an intensity of the laser light focused at the locations and / or a speed of displacement of the location along the line in response to the detection signal. A method for preparing a capsulorhexis, the method comprising: Using the ophthalmic surgery system according to one of claims 1 to 18, by adjusting the position of the focal plane so that it is located near or intersecting the capsular bag. A method of performing capsulorhexis, the method comprising: Applying a light-absorbing agent to a capsular bag of an eye; Use of the ophthalmic surgery system of any one of claims 1 to 18, by: the position of the focal plane is adjusted to be near or to cut the capsular bag, and the tissue of the capsular bag is modified with the laser light.

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