EP4157173A1 - Système à laser uv pour la correction de l'amétropie et interface de contact - Google Patents

Système à laser uv pour la correction de l'amétropie et interface de contact

Info

Publication number
EP4157173A1
EP4157173A1 EP21729231.7A EP21729231A EP4157173A1 EP 4157173 A1 EP4157173 A1 EP 4157173A1 EP 21729231 A EP21729231 A EP 21729231A EP 4157173 A1 EP4157173 A1 EP 4157173A1
Authority
EP
European Patent Office
Prior art keywords
contact interface
eye
uvl
lvc
patient
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP21729231.7A
Other languages
German (de)
English (en)
Inventor
Hartmut Vogelsang
Dan Z. Reinstein
Wolfgang Kern
Christian Deutsch
Claus Goder
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Carl Zeiss Meditec AG
Original Assignee
Carl Zeiss Meditec AG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Carl Zeiss Meditec AG filed Critical Carl Zeiss Meditec AG
Publication of EP4157173A1 publication Critical patent/EP4157173A1/fr
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
    • A61F9/009—Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses
    • 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
    • A61F2009/00878—Planning
    • 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
    • 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
    • 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
    • A61F9/0084—Laser features or special beam parameters therefor

Definitions

  • the present invention relates to ultra violet laser (UVL) based laser vision correction (LVC) systems, i.e. systems for ametropia correction by means of laser radiation, the corresponding treatment laser emitting in the ultraviolet range, such as excimer lasers or solid-state lasers with wavelengths between approx. 193 nm and 213nm. These systems are typically pulsed systems, i.e. systems that do not emit continuous waves.
  • UVL-LVC systems are used to process the cornea of a patient's eye starting from its surface by means of photoablation, or to process a volume starting from the exposed area under a folded-away surface of the cornea of the patient's eye.
  • the invention also relates to corresponding methods for UVL-LVC systems and a contact interface for such UVL-LVC systems.
  • UVL-LVC systems such as the MEL systems from Carl Zeiss Meditec AG, the Amaris systems from Schwind eye-tech Solutions GmbH or the Micron systems from Excelsius Medical GmbH, have long been successfully used systems for ametropia correction. Nevertheless, they have a number of inadequacies or disadvantages, for which solutions are to be shown here.
  • a rigid laser beam guidance system is provided in today's UVL-LVC systems. Although this facilitates safe laser beam guidance, it makes it necessary to move the patient on a patient bed by means of this patient bed below a fixed system aperture in x, y, z coordinates until the patient's eye intended for treatment is correctly positioned relative to the optical axis of the system.
  • An exception is the system described in US 2013/0226157 A1, in which the laser arm, which is rigid per se, is positioned as a whole over the patient, but in such a way that it is still necessary to position the patient over the patient bed.
  • the latter often requires the patient to lie down for safety reasons are electrically and / or mechanically connected to the basic laser unit, which in turn enforces system approval and requires a large space.
  • eye trackers do not work for all eyes due to problematic eye color and / or a lack of contrast. Failure rates of the eye tracker in the percentage range occur in practice. The only option left for eye surgeons is to decide between aborting the operation or switching off the eye tracker, which then goes hand in hand with the risk of inaccurate correction.
  • a flap is typically only 100 ⁇ m thick and after the LASIK incision is only attached to the cornea by a very narrow "hinge", the hinge. Maintaining the hydration of the flap is very important for pathological reasons, but also to maintain the shape of the flap, since dehydrated flaps shrink within seconds.
  • a shrunk flap no longer “fits” well into the stromal bed (which of course is also due to the change in shape of the stroma surface due to the ablation), which in turn can lead to post-operative complications (eg “epithelial ingrowth”). If possible, flaps should not be folded, pulled or otherwise stressed.
  • Pulse ablation shape corresponds to the fluence distribution of the irradiated ablation laser pulse on a plane perpendicular to the direction of incidence
  • the pulse ablation shape is deformed by the geometry of the radiation on the cornea to the "Pulse ablation footprint on cornea” and thus changes Fluence distribution compared to the irradiated "Pulse ablation shape”.
  • Fresnel losses can be calculated with the help of the Fresnel equations with knowledge of the refractive indices of air and cornea (or stroma) and the angle of incidence.
  • the polarization of the light must also be taken into account.
  • Decentering will usually lead to a shift in the physiological visual axis.
  • the eye is "rotated” by the eye muscles so that the light continues to fall into the point of sharpest vision, which basically compensates for the prismatic offset ("tip / tilt”).
  • This can lead to problems with binocular vision (stereopsis), for example, which are known from examinations on badly centered spectacle lenses.
  • Aberrations couple with decentering. Due to the coupling of the sphere and cylinder to higher-order aberrations (coma, spherical aberration, higher-order astigmatism), including those that occur in natural (aspherical) eyes, decentering in real eyes, but also with purely spherical-cylindrical corrections, is critical . E.g. when decentered, coma couples to astigmatism and defocus or spherical aberration couples to coma, astigmatism and defocus. A few examples are to be given here which initially only show the effects for the primary aberrations (up to the 4th order).
  • transition zones have not yet been mentioned.
  • decentering also means that transition zones can extend into the optically active zone, especially in the case of hyperopia corrections. This then leads to disturbances ("night vision complaints post surgery", here is not meant night myopia) in mesopic to scotopic light conditions and thus to patient dissatisfaction.
  • Pupil centering (centering to the CSC, “Corneal Sighting Center”) can be achieved well and safely in refractive surgery using eye tracking systems (“eye trackers”) as integrated pupil recognition.
  • eye trackers eye tracking systems
  • this type of centering is not the preferred choice, as it is now undisputed in the professional world that centering to the ophthalmic pole (visual axis, coaxially sighted corneal light reflex, "CSCLR", condition, see below) would be correct.
  • CSCLR coaxially sighted corneal light reflex
  • Hyperopic eyes are typically characterized by a non-negligible angle between the pupillary axis and the visual axis ("angle kappa"). Corneal Sighting Center and Ophthalmie Pole are no longer close enough to one another, which leads to a difference between "angle lambda” and "angle kappa”. In addition, the pupil and the pupil center are not a fixed mark. Both fluctuates with the lighting conditions.
  • the user moves the treatment center manually based only on the visual comparison to a topography measurement. Or he enters displacement coordinates into the system, which are usually given in relation to the center of the pupil (CSC) and which are taken from a topography measurement, for example.
  • CSC center of the pupil
  • the problem is that the pupil diameter during the topography measurement does not match the pupil diameter under the laser due to the differences in illumination.
  • the frequently occurring displacement of the pupil center with the pupil size then results in not optimal centering, since the corneal vertex is not correctly determined.
  • UVL-LVC systems do not offer a method of tomographic alignment of the anterior chamber and tomographic centering. This can become important, e.g. in the case of corneal irregularities (e.g. caused by trauma or brief swelling of the corneal surface due to bubbles after femtosecond laser flap generation), which lead to the corneal vertex and / or the Purkinje reflex not being found correctly or otherwise In other words, a position is identified as a vertex which does not correspond to the normal physiological vertex position. The pure “surface information” of the cornea is then not, or not sufficiently, suitable for determining the optimal centering.
  • corneal irregularities e.g. caused by trauma or brief swelling of the corneal surface due to bubbles after femtosecond laser flap generation
  • the pure “surface information” of the cornea is then not, or not sufficiently, suitable for determining the optimal centering.
  • the object of the present invention is therefore to describe devices and a method which address the above-mentioned problems of currently used UVL-LVC systems.
  • the object of the invention is to propose a coupling and fixation between the patient's eye and the UVL-LVC system by means of a contact interface in order to prevent eye movements when using UVL-LVC systems, even with fast UVL-LVC systems.
  • This contact interface is intended to solve the above-described specific problems of a UVL-LVC system, which arise from the application to ablate a cornea of a patient's eye and in UVL-LVC systems according to the prior art that are actually sold in large numbers Use of a contact interface.
  • UV-LVC system UV laser based system for ametropia correction
  • contact interface contact interface
  • a UV laser based system according to the invention for ametropia correction comprises, in addition to a base unit, an application arm with an application part at its distal end with a laser exit aperture through which a treatment laser beam exits the UVL-LVC system in order to Edit the cornea of a patient's eye.
  • This is done by means of a contact interface with which the patient's eye is coupled and usually fixed to the UVL-LVC system, and in particular to the laser exit aperture for the treatment laser beam in the application part at the distal end of the application arm.
  • a contact interface adapter is arranged on the applied part, the axis of which runs coaxially to the optical axis of the applied part at its laser exit aperture.
  • the contact interface adapter is set up to accommodate a contact interface.
  • the UVL-LVC system also includes a UV laser source, which preferably emits pulsed laser radiation in the UV range.
  • a UV laser source which preferably emits pulsed laser radiation in the UV range.
  • This can be, for example, an excimer laser or a solid-state laser with wavelengths between approx. 193 nm and 213 nm.
  • the UVL-LVC system comprises a scanning system for at least lateral scanning of the laser radiation in the x and y directions and preferably also for scanning in the z direction, as well as imaging optics for focusing (at least with regard to its lateral extent) the preferably pulsed Laser radiation on the cornea of a patient's eye. This leads to a process of photoablation of the cornea.
  • focusing the laser radiation means that the laser radiation is severely limited in terms of its lateral extent by appropriate optics, so that a cross-section through this laser radiation at a location where the patient's eye would be located is very small, yes even coincides with a point.
  • this “focus” can, however, extend over a wide area.
  • the UVL-LVC system includes a control unit for controlling all units of this system, in particular the UV laser source, the scanning system and moving parts of the imaging optics, and also for controlling moving parts of the application arm and the positioning of the contact interface.
  • the control unit can be designed as a central control unit, or it can be composed of several sub-units that are connected to one another.
  • a special planning unit for planning operations can also be part of the control unit.
  • the contact interface adapter is set up to accommodate a contact interface in such a way that the contact interface can be rotated and fixed in any way relative to the contact interface adapter.
  • the contact interface adapter is floatingly mounted in the application part of the application arm, which is preferably an articulated arm.
  • the contact interface adapter is floatingly mounted in the application part of the application arm, which is preferably an articulated arm.
  • UVL-LVC system according to the invention with an application arm are to be described here.
  • the application arm is preferably designed in such a way that tilting with respect to the horizontal orientation of the handpiece is not possible. To do this, it works according to the SCARA (Selective Compliance Assembly Robot Arm) principle.
  • SCARA Selective Compliance Assembly Robot Arm
  • the system has a rigid structure with regard to possible tilting. The alignment of the eye is crucial here. This results from the centering of the patient's eye under the contact interface until the moment of suction.
  • the application arm of the UVL-LVC system is therefore preferably an articulated arm, which, however, can essentially only be moved in the x-y direction, but with full freedom with regard to its lateral movement.
  • a preferred UVL-LVC system has a pressure sensor and / or a displacement transducer between the contact interface adapter and the application part.
  • the UVL-LVC system comprises imaging optics that have microscope optics for focusing the preferably pulsed laser radiation on the cornea of a patient's eye, the optical opening of which is designed so that an acceptance angle for through the UVL-LVC system detectable back reflections XMax of greater than 15 °, preferably greater than 25 ° and particularly preferably greater than or equal to 37 ° can be achieved.
  • the optical opening of the UVL-LVC system according to the invention is greater than 50mm, preferably even greater than or equal to 60mm and a working distance of the UVL-LVC system is less than 50mm, preferably even less than or equal to 40mm.
  • a preferred embodiment of the UVL-LVC system also has a transparent protective element, in particular a protective glass, behind the laser exit aperture of the application part of the application arm.
  • a contact interface according to the invention for positioning and fixing a patient's eye to a UVL-LVC system has a conical wall and a suction ring for sucking into a patient's eye by means of negative pressure, but does not include an optical element, in particular no lens element.
  • Contact interfaces such as those used for working with lasers that separate tissue by means of photodisruption (e.g. femtosecond lasers) and have a contact glass for this purpose, which is placed on a wide surface of the cornea of the patient's eye in the region that is to be processed, would be a hindrance here:
  • the UVL-LVC laser processing should finally use photoablation on a surface of the cornea or on an area, which, after folding away a flap, forms a (upper) surface to be processed as described above.
  • the contact interface is therefore designed in such a way that this surface to be processed remains free and accessible.
  • the suction to the patient's eye therefore only takes place via a suction ring, that is to say via a continuous or segment-like interrupted circumferential "channel".
  • the conical wall of a particularly preferred contact interface according to the invention also has an access opening which enables access to the patient's eye while it is being fixed to a UVL-LVC system.
  • This means that manual manipulation for example, preparing and folding away a flap forwards and folding back a flap after the treatment) is possible in a simple manner while the patient's eye is fixed, i.e. without it, both before a treatment with the UVL-LVC system and after such a treatment that the patient's eye must be separated from the UVL-LVC system.
  • the contact interface according to the invention has an access opening, but also a cover element for the reversible closability of the access opening. If manual manipulation of the patient's eye is to take place, the cover element is in such a position that the access opening is released for this. However, if the treatment is to take place with the UVL-LVC system, then the cover element is in a position in which it covers the access opening. In this way, particularly homogeneous process conditions can be achieved because the access opening then does not represent a possible disruption of the gas flows.
  • the cover element is rotatably arranged on an outside of the conical wall, preferably by means of a clip mechanism, in such a way that the access opening is in a first state by rotating the cover element is at least largely covered or is largely open in a second state.
  • a particularly preferred embodiment of the contact interface according to the invention has a flap holder at its end facing the patient's eye. This allows a controlled application of the above-mentioned flap, which is to be folded to the side for treatment, so that it no longer has to be put down in a disordered manner: Disordered putting down or "folding away to the side” harbors the risk of tearing and, when folded back, leads to the Troubleshoot problems with coverage of the treated area.
  • the contact interface according to the invention also has a contact interface adapter partition, which preferably runs at a constant distance from the conical wall of the contact interface and is set up to be fixed on a contact interface adapter of the UVL-LVC system.
  • a contact interface adapter partition protects the contact interface adapter, which is fixed (preferably floating) at an exit aperture of the application part of an application arm in the UVL-LVC system, from the deposition of waste products produced during the treatment.
  • the contact interface adapter partition - as part of the contact interface, but only optionally firmly connected to the conical wall of this contact interface - is then disposed of after each treatment, so it is a so-called “disposable”, ie a part intended for single use.
  • this contact interface adapter partition is glued to the conical wall of the contact interface on its upper side facing away from the patient's eye via edge elements.
  • this contact interface adapter partition is glued to the conical wall of the contact interface on its upper side facing away from the patient's eye via edge elements.
  • Such a contact interface system preferably has a connection for connection to a pump for generating the negative pressure in the suction ring for fixing to the patient's eye, which is arranged on the contact interface, and also a connection for suctioning air or another gas from its interior, which is preferred is arranged on the contact interface.
  • the contact interface system according to the invention has a connection for connection to a pump for generating the negative pressure for fixing the contact interface on the contact interface adapter, which is preferably arranged on the contact interface adapter, or a mechanical turning and fixing system for turning and Has fixing the contact interface on the contact interface adapter. This ensures simple connections between the contact interface and the contact interface adapter for the purpose of fixing the contact interface on the contact interface adapter.
  • the contact interface system according to the invention has a connection for the supply of air or another gas, which is preferably arranged on the contact interface adapter, this supply preferably is set up to ensure cleaning, sterilization, cooling and / or hydrogenation of the air or the other gas.
  • the contact interface system has a contact interface with a first conical wall and with a first upper and a first lower diameter, and a contact interface adapter with a second conical wall with a second upper and a second lower diameter, which are smaller than the first diameter, in such a way that the two walls run essentially parallel to one another.
  • a supply or suction of the air or the other gas is set up centrally through the second conical wall of the contact interface adapter and a suction or supply of the air or the other gas is set up between the first and second conical wall, preferably in such a way that a cycloid flow course occurs when the contact interface is fixed to the UVL-LVC system and the patient's eye.
  • the air or the other gas is supplied centrally, then it is supplied from above into the cone formed by the contact interface adapter, which protects the laser exit aperture and in particular the optics from deposits of process waste, as they are caused by the direction of the Gas flow moved away from the optics and sucked off between the first and second conical walls. If the gas flow is selected in the other direction, there is a certain risk of process waste being deposited, which must then be counteracted by other means (see below). However, in this case it is easier to regulate the humidity of the patient's eye accordingly.
  • the intention is to create a kind of mini-cylon inside the contact interface adapter, through which the process waste can be effectively removed.
  • a contact interface system according to the invention is preferred, in particular a contact interface system, in the interior of which a mini-cyclone is to be produced, the supply of which with air or another gas is a Has pressurization of greater than 10 mbar, but preferably greater than 20 mbar.
  • An alternative embodiment of the contact interface system according to the invention contains two opposing chamber dividing walls that run essentially over the entire height of the contact interface between the conical wall and the contact interface adapter partition or the contact interface adapter, which contain the space between the conical wall and the contact interface. Divide the adapter partition or the contact interface adapter into two chambers, the first chamber having a connection for the supply of air or another gas and the second chamber having a connection for the suction of air or another gas, and preferably the contact interface adapter Intermediate wall or the contact interface adapter has perforations at least over part of its surface.
  • Such a system enables air or gas flows that move essentially (at least centrally over the cornea of the patient's eye to be processed) parallel to the surface of the patient's eye, the first chamber having an inlet function and the second chamber having an outlet function.
  • Corresponding perforations (depending on the embodiment) in the contact interface adapter partition wall or in the contact interface adapter allow the air or gas flows to be further parallelized or homogenized.
  • perforations on the contact interface adapter partition or the contact interface adapter are particularly preferably adapted in number and diameter so that the air or gas flow in the contact interface system can be modeled, in particular has stronger and weaker airflow areas.
  • the contact interface system according to the invention also has a transparent protective element for the device optics, in particular a protective glass, which is arranged in the contact interface adapter so that the laser radiation emitted by the UVL-LVC system can pass through without any obstacles.
  • a transparent protective element offers additional protection against deposits of process waste on the optics of the UVL-LVC system, in particular on its last optical element.
  • a UVL-LVC system according to the invention as described above is set up in particular to receive a contact interface according to the invention that is also described above and / or it has a contact interface system as described above.
  • FIG. 2 shows an example of a basic structure of a UVL-LVC system according to the invention with an application arm;
  • FIG. 3 shows an enlarged section of the UVL-LVC system according to the invention: application part at the distal end of the application arm with contact interface;
  • FIG. 4 shows a first exemplary embodiment of the contact interface system according to the invention;
  • FIG. 5 shows a contact interface adapter integrated on the laser exit aperture of the applied part of the UVL-LVC system
  • FIG. 6 shows a second exemplary embodiment of the contact interface system according to the invention with connections for the supply or extraction of air or gases;
  • FIG. 7 shows a third exemplary embodiment of the contact interface system according to the invention comprising a contact interface adapter and contact interface with connections for hose lines and an associated function; 8 shows a fourth exemplary embodiment of the contact interface system according to the invention comprising a contact interface adapter and a contact interface with a contact interface adapter partition;
  • FIG. 9 shows an exemplary embodiment of the contact interface according to the invention with a contact interface adapter partition and a cover element
  • FIG. 10 shows individual parts of the exemplary embodiment of the contact interface according to the invention with a contact interface adapter partition and a cover element;
  • FIG. 11 a and 11 b a fifth embodiment of a contact interface system according to the invention with a cover element in the open and in the closed state on a patient's eye;
  • FIG. 12 shows the illustration of gas dynamics with a cycloidal flow profile in a sixth exemplary embodiment of a contact interface system according to the invention
  • 13a and 13b show the representation of gas dynamics with a cycloid flow profile in a seventh embodiment of a contact interface system according to the invention.
  • FIG. 14a and 14b show the representation of an alternative gas dynamics with a flow course parallel to the cornea of the patient's eye in an eighth embodiment of a contact interface system according to the invention
  • FIG. 1 shows a schematic representation of the geometry on the eye 110 when the patient is fixed in a “wrong” direction.
  • the patient's eye 110 does not look at the center of a fixation cloud 120.
  • an ablation profile 150 is not correctly applied along the necessary treatment axis, for example along a visual axis 130 (also called “visual axis”).
  • the visual axis 130 is defined by the ophthalmic pole OP and fixation of the patient.
  • the ablation profile 150 is therefore not applied normal to the visual axis 130.
  • the relationships are shown greatly exaggerated in FIG.
  • FIG. 1 also shows a fovea 140 of the eye, an eye lens 145, a scanner 160 (rotatable; represented by a curved arrow) of the UVL-LVC system for the lateral deflection of laser radiation 170, an axis of symmetry 180 of the eye 110 and an optical axis 190 of the UVL-LVC system is shown.
  • an ablation profile 150 is not applied in the correct plane (that is, not on the surface normal, that is, perpendicular to the visual axis 130). This can happen when the patient fixes in a largely fixed, but “wrong” direction, for example permanently looking in a fixed direction that does not correspond to the center of the “fixation cloud” 120. This can occur if the patient can no longer see the fixation target clearly during the operation, depending on the refraction deficit and the duration of the treatment. The wrong fixation results in a prismatic correction error (tip / tilt).
  • FIG. 2 shows an example of a basic structure of a UVL-LVC system 50 according to the invention with an application arm 55, which here is an articulated arm with three swivel joints DG1, DG2, DG3 in a Scara arrangement for the x, y movement.
  • the flea adjustment (z) of the articulated (laser) arm is done by adjusting the entire laser system (spindle, scissor table, ...) and is not shown here.
  • the application part 60 with laser exit aperture 65 is located at the distal end of the articulated arm.
  • the laser head for the ablation laser used here, power supplies, etc. are housed in the mobile laser base unit.
  • the treatment laser beam is guided to the patient's eye 110 via deflecting balls, among others in the swivel joints DG1 to DG3 (by means of suitable optics).
  • the placement of the contact interface 10 attached to the application part 60 (application part) onto the patient's eye 110 should also be supported, for example, by a horizontal stripe projection (for example, by scanning a suitable laser).
  • the application part 60 with the contact interface 10 can be aligned with the patient's eye 110 - e.g. the eyelid angles - under control of the projected strip by rotating the application part 60 itself (swivel joint DG3), in order to avoid a static cyclic rotation of the patient's eye 110 to the system 50. This is an advantage compared to all prior art UVL-LVC systems 50.
  • a cycotation correction and the avoidance of the risk of turning the patient's head during the treatment takes place in the UVL-LVC system 50 according to the invention by coupling and fixing the patient's eye 110 on the contact interface 10.
  • Registration data from diagnostic devices that enable automatic cyclic rotation correction are preferably used.
  • a reference image obtained after contact interface adaptation is used, which is compared with the registration data of the diagnosis in order to calculate a transformation of the pulse coordinates to compensate for the cyclic rotation, similar to other systems for UV laser-based ametropia correction.
  • FIG. 3 shows an enlarged section of the UVL-LVC system 50 according to the invention with an application part 60 at the distal end of the application arm 55 with contact interface 10 with operating units for flea setting (z), lighting, control elements for the contact interface 10 (for suctioning the ablation products suction of the patient's eye, etc.).
  • the controls are not shown in full.
  • a display 62 for simple representation and operation is an optional component.
  • the contact interface 10 itself is adapted by the user (surgeon) via a corresponding interface.
  • the contact interface 10 is of decisive importance for the use of the UVL-LVC system 50 according to the invention. This solves a number of problems and improves the prior art UVL-LVC systems.
  • FIG. 4 shows a first exemplary embodiment of the contact interface system 1 according to the invention.
  • the contact interface 10 is constructed in a conical shape; it has a conical wall 11. It is adapted and fixed by the user directly under the optical exit, the so-called laser exit aperture 65, of the application part 60 via a contact interface adapter 40.
  • the actual contact interface 10 is preferably used as a sterile consumable part ("disposable"), preferably made of a biocompatible plastic (part shown in blue) utilized. This is attached by the user to the contact interface adapter 40 of the application part 60 of the UVL-LVC system 50 according to the invention before the treatment.
  • the contact interface 10 is equipped with a suction ring 12 so that the patient's eye 110 is fixed in the event of negative pressure.
  • a LASIK flap can be placed on a dedicated flap. Shelf 15 can be placed.
  • the contact interface 10 remains rotatable to determine the flap-flinge position.
  • the suction ring 12 enables the contact interface 10 to be firmly connected to the patient's eye 110 and a possible LASIK flap can be positioned on the flap holder 15.
  • the flap manipulation takes place via an access opening 14 in the contact interface 10, which enables access for instruments.
  • the height of the contact interface 10 is preferably in the range from approximately 20 to 40 mm (corresponds to the distance between the eyes of the patient's eye 110 and the contact interface adapter 40). It results from the overall optical concept of the UVL-LVC system 50 according to the invention with a small working distance from the patient's eye 110.
  • the induction of prismatic errors by the eye tracker should also be mentioned (see FIG. 1).
  • the ablation profiles are not applied in the correct plane, i.e. not on the surface normal, i.e. perpendicular to the visual axis. This can happen if the patient fixes his eye 110 preferably in a largely fixed, but “wrong” direction, for example permanently looking in a fixed direction that does not correspond to the center of the “fixation cloud” 120 (during the operation the patient can Depending on the refraction deficit and the duration of the treatment, the fixation target can no longer be seen clearly).
  • the contact interface 10 according to the invention in interaction with the UVL-LVC system 50 according to the invention either eliminates the above-described problems caused by the ambient conditions or at least mitigates the consequences, since a direct air flow to the eye and thus dehydration is avoided, debris (i.e. process waste products) can be removed effectively and in a controlled manner and hydrogenated, temperature-controlled and purified air can be supplied.
  • the conical contact interface 10 (disposable)
  • the surgical site is also largely shielded from the environmental conditions in the operating area (e.g. from directed air currents caused by air conditioning units in the operating theaters).
  • the contact interface 10 can also be designed as an eyelid lock and / or include an integrated tear film suction to support constant hydration.
  • the flap shelf 15 offers an integrated solution to a general user problem: In the absence of a solution integrated into today's UVL-LVC systems 50, users sometimes cut their own flap shelves from sterile foam spatulas (or similar material), which then be moistened and serve as a safe and sterile storage for the delicate flap. However, these can slip or have to be held in some other way. This is where the flap holder 15 is used, which is fixedly arranged at the end of the contact interface facing the patient's eye 110, preferably under the access opening 14. Such a flap tray 15 closes the described gap in the course of a LASIK Treatment effective and safe.
  • the contact interface 10 preferably consists of two components: A contact interface adapter 40 fixedly (floating) mounted on the laser exit aperture 65 of the application part 60 and a preferably conical actual contact interface 10 (“disposable”, consumable, new for every patient).
  • the contact interface 10 is preferably made of suitable biocompatible material, since it comes into direct contact with the patient's eye 110.
  • a correspondingly transparent plastic is preferably used.
  • the contact interface adapter 40 can be made of one or more materials such as metal, plastic or Teflon.
  • This access opening 14 is designed in such a way that the flap can be loosened and folded over (“lifting”) with instruments. This makes it possible to carry out the flap manipulation steps even after the contact interface 10 has been placed and sucked onto the patient's eye 110. Nevertheless, due to the largely closed cone of the patient interface 10, the area above the operating site is effectively shielded from the surroundings of the operating environment (and thus, for example, preferential currents in the operating area are prevented by air conditioning). In one embodiment of the contact interface 10, the access opening 14 can be closed reversibly, see below.
  • FIG. 5 shows a contact interface adapter 40 integrated in the laser exit aperture 65 of the application part 60 of the UVL-LVC system 50.
  • the contact interface adapter 50 is similarly conical in structure to the contact interface 10.
  • the contact interface adapter 40 is attached centered to the defined optical axis 190 of the laser exit aperture 65 of the application part 60.
  • An important feature of this arrangement is that the contact interface adapter 40 is “floating” mounted on the application part 60. This is necessary so that the contact interface 10 is not rigid when it is placed on the patient's eye 110, but rather yields to the contact pressure and can move “upwards” in the positive z-direction.
  • the evasive movement is preferably measured by displacement transducers and a pressure sensor is also preferably implemented (safety concept).
  • the signals from the displacement transducer and pressure sensor are fed to the control system of the UVL-LVC system 50 according to the invention, that is to say processed in the control unit of the ULV-LVC system 50 according to the invention. If certain limit values are exceeded, a further lowering of the application arm 55, here the articulated arm, of the UVL-LVC system 50 according to the invention, i.e. a height adjustment in the z-direction, is interrupted or the system is moved slightly upwards. In the case of a sucked-in patient's eye 110, the negative pressure for the suction ring 12 is automatically eliminated, so that the contact interface 10 detaches itself from the patient's eye 110.
  • FIG. 6 shows a second exemplary embodiment of the contact interface system 1 according to the invention with connections 25 for the supply or extraction of air or gases.
  • the connections 25 of the contact interface system 1, that is to say of the contact interface adapter 40 and the contact interface 20, are described in more detail.
  • the tubes (not shown) belonging to these connections 25 are made of suitable material and preferably run within the application part 60 and from there into the application arm 55, i.e. the articulated arm, and finally into the base unit 52 of the UVL-LVC system 50 according to the invention , which is also designed to be mobile, that is, the UVL-LVC system 50 can be displaced in a simple manner - here by means of wheels or rollers.
  • the contact interface 10 it is the hose connections 25 “A2” and “A3”.
  • the hoses to be connected to it are preferably made of flexible and suitable material, which should be biocompatible. These tubes run away from the contact interface 10, specifically outside the application part 60 in the patient area.
  • the tubes, together with the contact interface 10 itself, are preferably part of a “disposable kit” for the user and are supplied fully configured in a blister per patient's eye 110.
  • the opposite side of the hose ends are provided with appropriate adapters and are preferably provided for connection to the base unit 52 of the UVL-LVC system 50 according to the invention (not shown).
  • the functional features connected to the hose connections (and hoses) are explained in more detail with reference to FIGS. 6 and 7.
  • A1 Suction of the contact interface 10 to the contact interface adapter 40
  • A2 Suction for negative pressure of the suction ring 12 for fixation on the patient's eye 110
  • A3 Suction in the compartment between the contact interface adapter 40 and the contact interface 10 ("space")
  • connection 25 labeled “Z1” in FIG. 6 is therefore designed for the supply of air.
  • This air is preferably cleaned, sterilized, cooled and / or hydrogenated.
  • the air is appropriately prepared via the associated hose (see above) and supplied under pressure from the base unit 52 of the UVL-LVC system 50 according to the invention.
  • This air flows under pressure into the "inflow channel", see Fig. 7.
  • the inflow is designed in terms of gas dynamics, for example, in such a way that there is a cycloid vortex field (“mini cyclone”, see FIGS. 12 and 13b) in the center of which the pupil of the patient's eye 110 to be treated is located. This is intended to ensure that the debris, i.e.
  • FIG. 7 shows a third exemplary embodiment of the contact interface system 1 according to the invention comprising contact interface adapter 40 and contact interface 10 with connections 25 for hose lines and an associated function, namely:
  • A1 suction of the contact interface 10 to the contact interface adapter 40 by generating negative pressure in the rotationally symmetrical area U 1, which holds the contact interface 10;
  • A2 suction for the negative pressure of the suction ring 12 and thus generation of the negative pressure U2 for the fixation of the patient's eye 110;
  • a suitable pump in the base unit 52 of the UVL-LVC system 50 according to the invention generates negative pressure at connection 25 “A1” via the associated hose. Air suction takes place via the connection 25 “A1”, which is conveyed to the negative pressure “U1” when the contact interface 10 is placed (or pushed) onto the contact interface adapter 40. This mediation is created by a self-centering form fit between the contact interface 10 and the contact interface adapter 40, which is designed accordingly.
  • the negative pressure is imparted rotationally symmetrically over the entire rounding of the contact interface 10.
  • a special feature is that the contact interface 10 can be rotated with respect to the contact interface adapter 40, and thus the application part 60, during and after the suction. As a result, the user can align the position of the flap holder 15 according to the requirements of the flap generated in advance (“hinge position”), for example.
  • connection 25 “A2” there is a negative pressure which is generated via the associated hose (see above) by a suitable pump in the base unit 52 of the UVL-LVC system 50 according to the invention.
  • this pump can be the same that generates the negative pressure at "A1".
  • the negative pressure “U2” is conveyed via the connection 25 “A2” and leads to the suction of the suction ring 12 on the patient's eye 110.
  • the negative pressure at connection 25 “A2” is controlled in one variant by the user, in another variant it is controlled by the user auto-centering is also controlled automatically by the control unit of the UVL-LVC system 50 according to the invention when the suction ring 12 is on the patient's eye 110 lies.
  • a preferred embodiment of the suction ring 12 is designed to implement suction on the transparent cornea 111 and / or in the transition region between the cornea 111 and the sclera (limbus). In one embodiment, an additional, supporting suction is provided on the sclera. In a further embodiment, the suction ring 12 comprises support facets opposite the patient's eye 110, that is to say it contains a series of individual “suction holes” instead of a continuous “suction channel” connected to one another.
  • the flap holder 15 already mentioned above. This is intended for the safe and sterile storage of the LASIK flap. After being released by the user, the flap is folded over in a known manner and safely deposited on the flap tray 15.
  • the flap shelf 15 is preferably equipped with a soft and sterile foam layer that can be moistened by the user.
  • the contact interface 10 is not in one embodiment through the Held under pressure on the contact interface adapter 40, but pushed onto the contact interface adapter 40 and mechanically fixed on the contact interface adapter 40 in the desired position (for example by means of a ball catch).
  • FIG. 8 shows a fourth exemplary embodiment of the contact interface system 1 according to the invention comprising contact interface adapter 40 and contact interface 10 with a contact interface adapter partition wall 30.
  • a vacuum is used here for suctioning off the debris in an intermediate space (compartment) between the conical wall 11 of the contact interface 10 and the contact interface adapter Partition 30 is generated.
  • This contact interface adapter partition 30, which is placed directly on the conical wall 41 of the contact interface adapter 40, is part of the contact interface 10 that has been used once, so it is replaced by a new one for each treatment of a patient's eye 110 and then disposed of. In this way it is prevented that process waste products can settle on the conical wall 41 of the contact interface adapter 40 during suction - the latter is not exchanged after each treatment of a patient's eye 110 and would otherwise have to be cleaned if necessary.
  • a cover element 20 is shown for closing the access opening 14 in the conical wall 11 of the contact interface 10 during a treatment of the patient's eye 110 with the UVL-LVC system 50, which of course also in a similar form on a contact interface system 1 as in FIG 7 can be used - this cover element 20 is not dependent on the presence of a contact interface adapter partition wall 30.
  • FIG. 9 shows an embodiment of the contact interface 10 according to the invention with a contact interface adapter partition 30 and a cover element 20.
  • FIG. 10 the individual parts of the embodiment of the contact interface 10 according to the invention are then shown with a contact interface adapter partition 30 and a cover element 20 shown.
  • the contact interface 10 is planned here as a three-part disposable product, with two parts - the contact interface and the contact interface adapter partition 40 - being glued together (blue parts) over the edge element 13 of the conical wall 11 of the contact interface 10 and the edge element 41 of the contact interface -Adapter partition wall 40, and a part - the cover element 20 - is attached via a clip mechanism (gray part).
  • This cover element 20 serves to close the access opening 14 in the conical wall 11 of the contact interface 10 during the treatment of a patient's eye 110 with the UVL-LVC system 50.
  • the conical wall 11 of the contact interface 10 and the contact interface adapter partition 40 thus form a double-walled concept of a contact interface 10 to protect the contact interface adapter 40 from the deposition of process waste products during suction.
  • a protective glass is optionally also provided in this context, which is located at the docking point to the contact interface 10.
  • This (expensive) protective glass is part of the application part 60 (located on the laser exit aperture 65) and is regularly cleaned or, if necessary, replaced by the service.
  • FIG. 11a and 11b show a fifth embodiment of a contact interface system 1 according to the invention with a cover element 20 in the open and closed state on a patient's eye 110 (the parts and functions not described here correspond to those of the previous examples).
  • the cover element 20 which has been brought into a second position by rotation on the outside of the conical wall 11 of the contact interface 10, releases an access opening 14 in the conical wall 11 of the contact interface 10 and the cornea 111 of the patient's eye 110 to be treated can be manipulated by the surgeon without the contact interface 10 having to be detached from the patient's eye 110.
  • a flap can be opened in the corneal surface and placed on the flap tray 15.
  • the cover element 20 which has been brought into a first position by rotation on the outside of the conical wall 11 of the contact interface 10, covers the access opening 14 in the conical wall 11 of the contact interface 10.
  • the cornea 111 of the patient's eye 110 can thus be processed in a homogeneous manner by means of the UVL-LVC system 50.
  • FIG. 12 the illustration of gas dynamics with a cycloid flow profile (“mini-cyclone”) in a sixth exemplary embodiment of a contact interface system 1 according to the invention is sketched.
  • a special feature of the gas dynamics is the tactile pocket that the “eye of the cyclone” is located above the pupil area of the patient's eye 110, so that in this area of the cornea 111 of the patient's eye 110 there is little air flow that could dry it out. This air is effectively removed via the negative pressure “U3” (see FIG. 7) in the “compartment” between the contact interface 10 and the contact interface adapter 40.
  • the arrangement is three-dimensional and thus the compartment extends over the entire space between contact interface adapter 40 and contact interface 10 (or, if a contact interface system 1 is used, as shown in FIGS. 8 to 10, between contact interface adapter partition 30 and contact interface 10 ).
  • connection 25 “A3”, which leads to the negative pressure “U3”, is used to remove the air contaminated with debris.
  • the extracted air is guided via the hoses (see above) to the base unit 52 of the UVL-LVC system 50 according to the invention and filtered there in a suitable manner to avoid biohazard in the environment.
  • the direction of the air flow can also be configured in the opposite direction.
  • I. E. the inlet of the air flow is arranged close to the patient's eye 110, the suction at the end of the contact element 10 facing the objective.
  • This embodiment is advantageous in three essential aspects: First, an intended hydration and cooling effect of the cornea 111 of the patient's eye 110 is made more direct by the controlled supply air achieved because the tissue to be checked is close to the inlet.
  • the kinetic energy of the plume particles is used to transport the overburden of the ablation (i.e. the process waste products) in the direction of the flow, the particles do not have to be slowed down before they are transported in the direction of the outlet.
  • these ablation products are no longer transported in the direction of the cornea 111 of the patient's eye 110, where they could be deposited again.
  • 13a and 13b show gas dynamics with a cycloidal flow profile in a seventh exemplary embodiment of a contact interface system 1 according to the invention comprising contact interface adapter 40 and contact interface 10 with a contact interface adapter partition wall 30.
  • Corresponding arrows show the essential feeds and discharges of air or gas, as well as their courses within the contact interface system 1, as well as the associated pressure conditions.
  • S1 denotes the supply of purified, cooled and hydrated air or gas through a connection 25 on the contact interface adapter 40 into the interior of the contact interface system 1
  • Contact interface system 1 generates a “mini cyclone” S3, which moves from above towards the cornea 111 of the patient's eye 110.
  • a slight lower pressure and thus a slight vacuum S4 is created by the suction of warm and polluted air or gas (debris) S5 is generated.
  • Such a flow course creates the important balance between air or gas supply and suction and prevents a loss of air or gas through the access opening 14 in the conical wall 11 of the contact interface 10, which occurs during the processing of the patient's eye 110 by the UVL LVC system 50 in this exemplary embodiment is almost completely closed by a cover element 20, effectively guaranteed, and at the same time the process waste products (debris) are effectively transported away.
  • FIG. 14a and 14b show an alternative gas dynamics with a flow path parallel to the cornea 111 of the patient's eye 110 in an eighth embodiment of a contact interface system 1 according to the invention, FIG. 14a showing this in a side view (SA) and FIG. 14b in a view from above (AO) shows.
  • SA side view
  • AO view from above
  • a double-walled funnel for implementing a horizontal laminar flow is formed between the conical wall 11 of the contact interface 10 and the contact interface adapter partition wall 30 or the contact interface adapter 40.
  • two chamber partition walls 35 which preferably run over the entire height of the contact interface 10 and are arranged on opposite sides of the double-walled funnel.
  • two chambers 37 are formed, one of which is used to flow in and the other to suck in air or another gas through corresponding connections 25 on the chambers 37.
  • a funnel through which there is a laminar flow perpendicular to the optical axis 190 is formed.
  • the air is brought into the double-walled funnel via a supply line 25.
  • This double-walled funnel has on its inside, i.e. preferably in the contact interface adapter partition, if one is used (with a correspondingly adapted, usually much shorter contact interface adapter) or in the contact interface adapter 40 preferably at least over part of these surfaces perforations 36 at suitable intervals.
  • the Chamber partition walls 35 separate the funnel into two symmetrical halves - that is, in two chambers 37.
  • An overpressure is built up in the first chamber 37, through which the air or gas flows in, and a negative pressure is generated in the second, opposite chamber 37.
  • the advantage of such a design is a laminar air flow that effectively transports the material away without generating zones with particle accumulation in eddies.
  • the removal takes place essentially perpendicular to the direction of propagation of the plume and the direction of propagation of the ablation laser, so that dirt is transported away quickly and efficiently from the ablation zone.
  • the area of the instrument access i.e. the access opening 14 in the conical wall 11 of the contact interface 10, should in this embodiment be in the area of one of the chamber dividing walls 35, i.e. between the inlet and outlet, since here the flow field flows approximately tangentially to the funnel wall and the cover of the instrument access hardly any turbulence.
  • the number and the diameter of the perforations 36 are adapted in order to realize a stronger air flow in certain areas. These areas are preferably adapted to the expansion of the plume, so that accumulations of process waste products are efficiently avoided, or alternatively or additionally to control the tissue temperatures and hydration in the area of the corneal surface of the patient's eye 110 by means of the supply air.
  • the flow velocity perpendicular to the plume spread should be greater than 2.5 m / s, preferably 5 m / s and particularly preferably greater than 10 m / s.
  • the volume flow should be in the range 2.5 to 101 / s (corresponds to 10 m / s). In the design as a laminar, horizontal flow-through funnel, this means one Pressurization of 10 to 20 mbar in the supply line, in designs in which a "mini-cyclone" is to be generated, the pressure should be even higher, as more friction is generated in these embodiments.
  • pipes or feed lines with a diameter of approx> 20mm may be used to transport the air.
  • a description of a device based on method features applies analogously to the corresponding method with regard to these features, while method features correspondingly represent functional features of the device described.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Optics & Photonics (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • Laser Surgery Devices (AREA)
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Abstract

L'invention concerne des systèmes de correction de la vue au laser (50) basés sur un laser ultraviolet, c'est-à-dire des systèmes de correction de l'amétropie au moyen d'un rayonnement laser. L'invention concerne en outre une interface de contact (10), ainsi qu'un système d'interface de contact (1) pour un tel système de correction de la vue (50) à laser UV. L'invention vise à empêcher des mouvements oculaires lors de l'utilisation de systèmes de correction de la vue (50) à laser UV par l'intermédiaire d'un couplage et d'une fixation entre l'œil du patient (110) et le système de correction de la vue (50) à laser UV au moyen d'une interface de contact (10). Cet objectif est atteint grâce à un système de correction de la vue (50) à laser UV comprenant une unité de base (52) et un bras d'application (55) qui présente sur la partie d'application (60) du bras d'application un adaptateur d'interface de contact (40) sur lequel peut être fixée une interface de contact (10) permettant de fixer l'œil du patient (110) au système de correction de la vue à laser UV. L'objectif est atteint également grâce à une interface de contact (10) présentant une paroi conique (11) et une bague d'aspiration (12), mais sans élément de lentille, et présentant de préférence une ouverture d'accès (14) et grâce à un système d'interface de contact (1) correspondant composé d'un adaptateur d'interface de contact (40) et d'une interface de contact (10).
EP21729231.7A 2020-05-24 2021-05-21 Système à laser uv pour la correction de l'amétropie et interface de contact Pending EP4157173A1 (fr)

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DE102020206422 2020-05-24
DE102020208679.6A DE102020208679A1 (de) 2020-05-24 2020-07-10 UV-Laser basiertes System zur Fehlsichtigkeitskorrektur und Kontaktinterface
PCT/EP2021/063607 WO2021239601A1 (fr) 2020-05-24 2021-05-21 Système à laser uv pour la correction de l'amétropie et interface de contact

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DE102022114573B4 (de) 2022-06-09 2024-05-02 Schwind Eye-Tech-Solutions Gmbh Behandlungsvorrichtung und Verfahren zum Steuern einer Fixiervorrichtung zum Fixieren eines menschlichen oder tierischen Auges
CN117281684B (zh) * 2023-11-24 2024-03-29 超目科技(北京)有限公司 眼球吸附装置和眼球吸附系统

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IL103290A (en) * 1992-09-25 1996-06-18 Ben Nun Joshua Ophthalmologic examination and/or treatment apparatus
US6090100A (en) 1992-10-01 2000-07-18 Chiron Technolas Gmbh Ophthalmologische Systeme Excimer laser system for correction of vision with reduced thermal effects
JPH06154264A (ja) 1992-11-20 1994-06-03 Akio Okamoto 眼球角膜手術装置
DE102005040338B4 (de) 2005-08-25 2019-08-29 Carl Zeiss Meditec Ag Kontaktglas für die Augenchirurgie
PT2451415T (pt) * 2009-07-10 2018-05-22 Wavelight Gmbh Dispositivo para cortar uma parte de tecido de um olho por meio de radiação laser
US20130226157A1 (en) 2012-02-24 2013-08-29 Cheng-Hao Huang Laser beam ophthalmological surgery method and apparatus
US9592156B2 (en) 2012-02-24 2017-03-14 Excelsius Medical Co. Ltd. Laser beam ophthalmological surgery method and apparatus
US20170056243A1 (en) * 2012-11-02 2017-03-02 Optimedica Corporation Free floating patient interface for laser surgery system
CN105338932B (zh) * 2013-03-13 2017-07-04 光学医疗公司 用于激光手术系统的自由浮动式患者接口

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DE102020208679A1 (de) 2021-11-25
WO2021239601A1 (fr) 2021-12-02

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