JP2015213777A - 術後の眼の光学的性能を改善するための方法および装置 - Google Patents
術後の眼の光学的性能を改善するための方法および装置 Download PDFInfo
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Abstract
Description
本出願は、Ronald M.Kurtzによる米国仮出願番号第60/985,192号、発明の名称、「Methods and Apparatus for Improved Port-Operative Ocular Optical Performance」の優先権を主張し、この文献は、引用によって、その全体が本願に援用される。
本発明は、レーザ眼科手術に関する。
視軸:固視点(point of fixation)から中心窩(Fovea)と呼ばれる網膜の中心上の画像を通過する線
照準線:対象点(object point)から瞳孔の入射孔の中心を通過する線
瞳孔軸:角膜の中心および瞳孔の入射孔の中心を垂直に通る線
これらの軸は、理論上の軸、幾何学的な軸、機能的な軸、解剖学的な軸またはこれらの何らかの組合せとして表現することができる。
Claims (28)
- 眼の光学的機能を改善するための方法であって、
眼の光学的特徴を判定することによって、手術のために前記眼を準備するステップと、
レーザマーキングパルスを適用して、前記判定された光学的特徴に対応して、前記眼の領域内にレーザマークを作成するステップと、
前記作成されたレーザマークに関連して選択された手術領域において手術処置を実行するステップと、
を有する方法。 - 前記眼の光学的特徴を、光軸、視軸、照準線、瞳孔軸および中間軸から選択するステップを有し、
前記眼を準備するステップは、前記眼の選択された軸に沿って眼を整列させるステップを含む、
請求項1記載の方法。 - 前記光学的特徴は、眼の向きを含む、請求項1記載の方法。
- 前記眼を準備するステップは、
インクベースのマーカ、角膜の機械的な窪み、取付可能なマーカおよびレーザパルスのうちの少なくとも1つを用いて、眼の外部の領域に、前記判定された眼の光学的特徴を参照する準備マークを作成するステップを含む、
請求項1記載の方法。 - 前記レーザマーキングパルスを適用するステップは、
前記判定された光学的特徴に対応して、前記眼の角膜または水晶体の標的にレーザパルスを適用するステップを含む、
請求項1記載の方法。 - 前記レーザパルスを適用するステップは、
点状または円状の標的にレーザパルスを適用して、選択された軸を示すステップと、
眼の中心から移動された領域にレーザパルスを適用して、眼の向きをマーキングするステップと、
のうちの少なくとも1つを含む請求項5記載の方法。 - 前記レーザマーキングパルスを適用するステップは、患者が第1の患者姿勢にあるとき、前記レーザパルスを適用するステップを含み、
前記手術処置を実行するステップは、前記患者が第2の患者姿勢にあるとき、前記手術処置を実行するステップを含む、
請求項1記載の方法。 - 前記第1の患者姿勢は、前記患者の眼が実質的に中立または通常の位置になる直立姿勢であり、
前記第2の患者姿勢は、前記眼が中立または通常の位置から逸れる背臥位である、
請求項7記載の方法。 - 前記レーザパルスを適用するステップは、
レーザパルスを適用して、角膜、水晶体、水晶体嚢胞、および角膜輪部の少なくとも1つに切込みおよび穿孔の1つを形成するステップを含む、
請求項1記載の方法。 - 前記レーザパルスを適用するステップは、
前記判定された光学的特徴に対応して整列されている、前記眼の2つの別個の標的に前記レーザパルスを適用するステップを含む、
請求項1記載の方法。 - 前記レーザパルスを適用するステップは、
角膜の標的および水晶体の標的を含む2つの別個の標的に前記レーザパルスを適用するステップを含み、前記角膜の標的および前記水晶体の標的は、前記眼の選択された軸および前記眼の選択された向きのうちの1つに対応して整列されている、
請求項10記載の方法。 - 前記手術処置を実行するステップは、
手術用レーザを用いて、前記水晶体嚢胞に切込みを作成するステップと、
前記水晶体嚢胞から元の水晶体の一部を除去するステップと、
前記水晶体嚢胞に眼内レンズを挿入するステップと、
前記眼の軸、前記眼の中心および前記眼の向きのうち少なくとも1つをマーキングするために作成されたレーザマークに基づいて、前記水晶体嚢胞内で前記眼内レンズを整列させるステップと、
を含む請求項1記載の方法。 - 前記手術処置を実行するステップは、
前記眼内に角膜内レンズを配置するステップと、
前記眼の軸、前記眼の中心および前記眼の向きの少なくとも1つをマーキングするために作成されたレーザマークに基づいて、前記眼内で前記角膜内レンズを整列させるステップと、
を含む請求項1記載の方法。 - 前記手術処置を実行するステップは、
眼内レンズまたは角膜内レンズの補足的マークをレーザマークと整列させることによって、前記眼内レンズまたは前記角膜内レンズを整列させるステップを含む、
請求項1記載の方法。 - 眼の光学的機能を改善するための方法であって、
前記眼の選択された軸に沿って前記眼を整列させるステップと、
前記眼の選択された軸に対して、前記眼の少なくとも1つの部分の画像上に形成されたマークを参照として使用するステップ、および前記眼の選択された軸に対して、前記眼の少なくとも1つの部分の画像を参照として選択するステップのうち少なくとも1つを実行するステップと、
レーザパルスのビームを制御して、前記眼の選択された軸に対して、前記眼の上の標的にレーザパルスを方向付け、術後の前記眼の光学的整列を調整するステップと、
を有する方法。 - 眼科手術のためのレーザシステムであって、
レーザパルスのビームを生成するパルスレーザと、
眼の選択された軸に沿って眼を整列させるメカニズムと、
前記眼の上または中に作成された参照マークの位置、および前記眼の選択された軸に対して選択された前記眼の少なくとも1つの部分の参照画像のうち少なくとも1つを監視するイメージングモジュールと、
前記イメージングモジュールと通信して、前記眼の選択された軸に対して、前記眼の中の少なくとも1つの標的にレーザパルスを方向付ける制御モジュールと、
を備えるレーザシステム。 - 前記眼を整列させるメカニズムは、前記選択された軸に対して、前記眼の位置を固定するように構成されている、
請求項16記載のレーザシステム。 - 前記イメージングモジュールは、前記参照マークの位置および解剖学的な参照情報の位置を監視するように構成されている、
請求項16記載のレーザシステム。 - 前記参照マークは、前記眼が圧平されていない状態のときに配置され、
前記解剖学的な参照情報は、前記眼が圧平された状態のときに判定される、
請求項18記載のレーザシステム。 - 眼における複数の光学的に影響がある施術を整列させる方法であって、
前記光学的に影響がある施術の少なくとも1つを整列させる軸を選択するステップと、
前記眼の外側の領域に、前記選択された軸の位置を表す物理的なマークを作成するステップと、
前記物理的なマークを特定し、前記特定された物理的なマークを眼の画像上に表示するステップと、
前記眼の画像上の前記特定された物理的なマークの位置を用いて、前記眼の前記マークまたは前記選択された軸に対して、前記レーザパルスを前記眼の少なくとも1つの標的に方向付けるステップと、
を有する方法。 - レーザパルスによって作成されたレーザマークを用いて、後の整列を誘導するステップをさらに有する、
請求項20記載の方法。 - 角膜の切込みと切除を整列させるステップを有する、請求項21記載の方法。
- 前記レーザマークを用いて、眼内または角膜内の移植の整列または配置を誘導するステップを有する、
請求項21記載の方法。 - 眼科手術の方法であって、
レーザパルスを適用することによって、眼の上または中にマークを作成するステップと、
前記マークを特定するステップと、
前記眼に移植する光学的要素の選択および確認のうち少なくとも1つを実行するステップと、
を有する方法。 - 前記特定されたマークに関する情報を用いて、前記眼に移植される眼内レンズの位置の予測を補助するステップをさらに有する、
請求項24記載の方法。 - 眼科手術のためのレーザシステムであって、
レーザパルスのビームを生成するパルスレーザと、
前記レーザパルスによって、前記眼の少なくとも1つの標的に作成された参照マークの位置を監視するイメージングモジュールと、
を備えるレーザシステム。 - 前記参照マークの位置に少なくとも部分的に基づいて、推奨される眼内レンズのパワーを算出するコンピュータシステムを備える、
請求項26記載のレーザシステム。 - 前記パルスレーザ、前記イメージングモジュールおよび前記コンピュータシステムのうち少なくとも1つは、前記参照マークとともに、眼内レンズまたは角膜内レンズの上のマークを用いて、前記眼内レンズまたは角膜内レンズの位置、光学的パワーまたはサイズの選択の1つを改善するように構成されている、
請求項27記載のレーザシステム。
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EP2211802A2 (en) | 2010-08-04 |
JP2011502585A (ja) | 2011-01-27 |
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JP6046774B2 (ja) | 2016-12-21 |
WO2009059251A2 (en) | 2009-05-07 |
US20090137988A1 (en) | 2009-05-28 |
EP2211802B1 (en) | 2012-06-27 |
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WO2009059251A3 (en) | 2009-08-27 |
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