JP6538759B2 - Adjustment of laser energy according to optical density - Google Patents

Description

  The present invention relates generally to surgical systems, and more particularly to adjusting laser energy according to optical density.

  The cornea is the normal outer membrane of the eye without haze. The haze of the cornea results in the loss of transparency of the whole or part of the cornea. This clouding can be caused by any of several conditions such as chemical burns, surgery, trauma, poor nutrition, or illness. This clouding reduces the amount of light that enters the eye, which can impair vision.

  In one embodiment, the apparatus of the present invention comprises a laser device and a control computer. The laser device directs a laser beam having laser energy through the outer portion of the eye toward the target portion of the eye. The control computer receives the optical density measurement of the outer portion, determines the laser energy according to the optical density measurement, and the laser directs a laser beam having laser energy to direct the target portion of the eye through the outer portion of the eye Give to the device.

  In one embodiment, the method of the present invention comprises receiving optical density measurements of the outer portion of the eye with a control computer. The laser energy of the laser beam is determined by the control computer according to the optical density measurement. The laser device is provided by the control computer with an instruction to direct a laser beam having laser energy through the outer portion of the eye toward the target portion of the eye.

  In one embodiment, the apparatus of the present invention comprises a laser device and a control computer. The laser device directs a laser beam having laser energy to a target portion of the eye. The control computer instructs the laser device to direct the trial shot in the direction of the trial part, determines the action of the applied shot of the trial part, determines the laser energy according to the action, and determines the laser energy with the laser energy in the eye An instruction is given to the laser device to aim at the target portion.

  In one embodiment, the method of the present invention provides instructions to the laser to direct multiple trial shots in the direction of the trial part, determining the effect of multiple execution shots on the trial part, and In response, determining the laser energy and providing an instruction to the laser device to direct the laser beam with the laser energy towards the target portion of the eye.

  Exemplary embodiments of the invention will be described in detail hereinafter by way of example with reference to the accompanying drawings.

FIG. 7 illustrates an example of a system that can adjust laser energy according to optical density values in an embodiment. FIG. 1 illustrates an example of a system capable of adjusting laser energy according to trial shots in an embodiment. It is a figure which shows the operation example of the imaging system in one embodiment. It is a figure which shows the operation example of the imaging system in one embodiment. It is a figure which shows the operation example of the imaging system in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to a patient's cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to the donor cornea in one embodiment. FIG. 7 illustrates an example of directing a trial shot to the donor cornea in one embodiment. FIG. 1 illustrates an example of a laser device and a control computer configured to photocut a biological tissue according to an embodiment. FIG. 7 illustrates an example of a method of adjusting laser energy according to optical density measurements in an embodiment. FIG. 7 illustrates an example of a method of adjusting laser energy according to a trial shot in an embodiment.

  Hereinafter, embodiments of the disclosed apparatus, system, and method will be described in detail with reference to the description of the specification and the drawings. The description and drawings are to be considered as exhaustive, or as the claims are shown in the drawings and not intended to be limited or restricted to the specific embodiments disclosed in the specification. Although the drawings represent possible embodiments, the drawings are not necessarily to scale and certain features may be exaggerated, deleted, or partially to better illustrate the embodiments. It may be drawn as a sectional view.

  FIG. 1A illustrates an example of a system 10 capable of adjusting laser energy according to optical density values in one embodiment. In one embodiment, system 10 receives an optical density measurement of the outer portion of eye 22, determines the laser energy of the laser beam according to the optical density measurement, and transmits the laser beam with the laser energy to the outer portion of eye 22. The laser device can be instructed to point through the to the target portion of the eye 22.

  In the example, system 10 includes imaging system 12, laser device 15, and computer system 20. Computer system 20 includes one or more interfaces (IFs) 24, logic 26, and one or more memories 28. Logic 26 includes control computer 30 and computer code such as, for example, densitometer module 36, laser energy module 38, and laser control program 34. The memory 28 stores data structures such as computer code, image data 40, and a table 42.

  The eye 22 may be an eye of a suitable living organism, such as a human. The eye 22 is composed of different parts. In one embodiment, the laser beam may be directed towards the target portion to photocut the tissue of the target portion. The laser beam may pass through the outer portion of the eye 22 to reach the target portion. The outer portion is typically the front portion with respect to the target portion. One portion may refer to any suitable portion of the eye 22. In one embodiment, one portion may refer to one layer of the cornea. Multiple layers of the cornea from anterior to posterior include the epithelium, Bowman's layer, corneal stroma, Descemet's membrane, and endothelium. For example, the outer portion may be the outer layer of the cornea, and the target portion may be the inner layer of the cornea. In one embodiment, one portion may be a portion of the eye. Portions of the eye from anterior to posterior include the cornea, the aqueous humor, the lens, the vitreous humor, and the retina. For example, the outer portion may be the cornea and the aqueous humor and the target portion may be the lens.

  The imaging system 12 may acquire an image of the eye 22 and then an optical density measurement of the eye 22 may be calculated. In one embodiment, imaging system 12 may use slit scanning to direct light linearly and / or rotationally. For example, imaging system 12 may be a shineproof imaging system, such as a shineproof slit camera. In one embodiment, imaging system 12 may use a Shine Proof approach coupled to a Placid approach that produces an image from concentric rings reflected from eye 22. In one embodiment, imaging system 12 may be an optical coherence tomography (OCT) system using a low coherence interferometer to acquire an image of eye 22.

  The image data 40 records an image of the eyeball 22. The image data 40 may have one or more numerical values for each pixel of the image. Each pixel corresponds to the position of the eye, and the numerical value indicates the optical density at that position. An example of the image will be described in more detail with reference to FIG.

  The densitometer module 36 determines the optical density measurement of the outer portion from the image data 40. The optical density measurement may include one or more optical density values for one or more positions of the outer portion of the eye. Each optical density value indicates the optical density at a particular location of the outer portion of the eye.

  Optical density measurements may be determined from image data 40 in any suitable manner. In one embodiment, the pixel value at a pixel may be used to determine the optical density value for the location corresponding to that pixel. The calibration table allows pixel values to be mapped to optical density values indicated by the pixel values. For example, a calibration table can map pixel intensity values (0 to 255) to standardized optical density values (ODU) indicated by the intensity values.

  The laser energy module 38 determines laser pulse energy in accordance with the optical density measurement. In one embodiment, laser energy module 38 determines laser energy by accessing data structures (such as table 42) that map optical density values to corresponding laser energy adjustments. The laser energy adjustment value corresponding to the optical density value may be an adjustment made to the laser energy to compensate for the optical density indicated by the optical density value. For example, the adjustment value of X joules (J) corresponding to the Y optical density value (ODU) is that the laser energy should be increased by X (J) to compensate for the optical density of Y (ODU) It shows. X and Y can take appropriate values. In one embodiment, higher optical density requires a larger increase in laser energy, and lower optical density requires a smaller increase in laser energy or does not require an increase. The mapping may be determined from experimental data. The laser energy module 38 may identify the appropriate adjustment value and then use the adjustment value to adjust the laser energy.

  The laser energy module 38 can use any suitable method to determine the initial energy (which can be adjusted later). In one embodiment, the laser energy module 38 determines the initial laser energy according to the depth of the cornea. For example, a table mapping corneal depth and laser energy may be used to determine the initial laser energy. The initial laser energy can then be adjusted according to the laser energy adjustment value to compensate for the optical density.

  In one embodiment, the laser energy module 38 determines laser energy according to a laser energy equation. In that embodiment, the laser energy equation is a mathematical function with one or more variables, eg, optical density values, and other variables such as, for example, corneal depth and / or patient parameters, It is also good. For example, the optical density value and the corneal depth for one location may be entered into a function to calculate the laser energy value for that location.

  The laser energy module 38 sends the calculated laser energy to the laser control program 34. The laser control program 34 instructs the controllable components of the laser device 15 to direct a laser beam with laser energy through the outer portion to the target portion of the eye 22. In one embodiment, the laser device 15 can generate pulsed laser radiation (such as a laser beam) having laser energy and ultrashort pulses (such as pico, femto, or attosecond pulses). The laser device 15 can direct a pulsed laser beam through the outer portion of the eye 22 to the target portion of the eye 22 to photocut the biological tissue of the target portion.

  FIG. 1B depicts an example of a system 10 capable of adjusting laser energy according to trial shots (radiation) in an embodiment. In one embodiment, the system 10 instructs the laser to direct the trial shot towards the trial portion, determines the effect of the applied shot on the trial portion, determines the laser energy accordingly, and has the laser energy. An instruction can be provided to the laser device to direct the laser beam towards the target portion of the eye 22.

  In the example shown, system 10 includes a microscope 13 in place of (or in addition to) imaging system 12 and a trial shot module 35 in place of (or in addition to) densitometer module 36. The microscope 13 may be any suitable microscope capable of viewing the eye 22 and may be used to determine the effect of a trial shot on the cornea of the eye 22.

  The trial shot module 35 can provide an instruction to the laser to direct the trial shot towards the trial portion. The trial shot may be a laser pulse directed in the direction of the trial portion to determine the laser energy. The trial portion may be an unimportant portion of body tissue, such as the patient's cornea, or body tissue removed from the donor cornea (and may be discarded). The trial shot may be related to parameters such as the laser energy of the shot, the depth of the cornea of the shot (which may be measured in the z direction as described below), or the size and shape of the shot. Good. The parameters can be appropriate values. For example, the shot may be round or square. The trial shot module 35 can direct trial shots in an appropriate pattern of appropriate size and shape. An example of how a trial shot is directed is shown below.

  2A through 2C depict an example of the operation of an imaging system in accordance with one embodiment. FIG. 2A depicts an example of the end of the plane 50 of the eye that can be imaged by the imaging system. FIG. 2B depicts an example of a particular surface 52 and an image 54 generated from that surface 52. Image 54 shows cloudiness 56 of the cornea. FIG. 2C represents an example of an image that can be generated by the imaging system. The imaging system may generate images 62 (ab) of the faces 60 (ab) of the eye. For example, image 62a is of surface 60a and image 62b is of surface 60b. Image 62 shows cloudiness 64 of the cornea.

  Figures 3A-4D illustrate an example of directing a trial shot to a patient's cornea according to one embodiment. In that example, the patient's cornea 150 contains unimportant body tissue 152, such as the part of the disease that may be removed and replaced with the donor's cornea. The unimportant tissue 152 serves as a trial part for trial shot 154.

  Figures 3A through 3D depict an example of directing a pattern of trial shots 154a to the patient's cornea in accordance with one embodiment. In the example, each trial shot 154a of the pattern has a different laser energy. For example, the first trial shot has a first laser energy and the second trial shot has a second laser energy different from the first laser energy. In that example, the trial shots 154a of the pattern may each be directed to the same corneal depth. That is, trial shots 154a may be placed on the same surface of the cornea.

  4A-4D depict another example of directing a pattern of trial shots 154b to the patient's cornea in accordance with an embodiment. In the example, each trial shot 154b of the pattern has a different corneal depth such that the pattern intersects at an angle (greater than zero) with the corneal surface at a position of constant corneal depth . For example, the first trial shot has a first corneal depth and the second trial shot has a second corneal depth different from the first corneal depth. In that example, the trial shots 154b of the pattern may each have the same laser energy. In another example, the energy level of the second trial shot may be different than the energy level of the first trial shot to measure the endothelium at the same level as the required energy.

  5A and 5B depict an example of directing trial shots to the donor cornea according to one embodiment. In that example, the donor cornea 160 contains non-essential biological tissue 162, such as the excess that is removed from the portion of the donor cornea 160 that is to be implanted into the patient. The unimportant body tissue 162 serves as a trial portion for trial shot 164.

  FIG. 5A depicts an example of directing a trial shot to the donor cornea in a manner similar to that of FIGS. 3A-3D. In the example, each trial shot 164a of the pattern has different laser energy and may each be directed to the same corneal depth.

  FIG. 5B depicts an example of directing trial shots to the donor cornea in a manner similar to that of FIGS. 4A-4D. In the example, each trial shot 164b of the pattern has a different corneal depth such that the pattern intersects at an angle (greater than zero) with respect to the corneal surface of a constant corneal depth. Each trial shot 164b may have the same laser energy. In another example, the energy level of the second trial shot may be different than the energy level of the first trial shot to measure the endothelium at the same level as the required energy.

  FIG. 6 illustrates an example of a laser device 15 and a control computer 30 configured to photocut living tissue in accordance with an embodiment. In that embodiment, the laser device 15 can generate the calculated laser energy and pulsed laser radiation of ultrashort pulses (such as pico, femto or attosecond pulses). The laser device 15 can direct a pulsed laser beam through the outer portion of the eye to the target portion of the eye to photocut the biological tissue of the target portion. The control computer 30 receives the optical density measurement of the outer part, determines the laser energy according to the optical density measurement, and one or more controllables to direct the laser beam with laser energy through the outer part to the target part Instructions can be given to the component parts.

  In one embodiment, the elements in the cornea (such as the corneal flap or the corneal cap) may be formed by a laser beam, the elements of the cornea being removed to allow application of excimer laser power correction. It may be done. Elements of the cornea may or may not be replaced after power correction. In one embodiment, the laser beam may form a lenticular which is removed to provide refractive power correction.

  In the illustrated example, computer system 20 includes control computer 30 and memory 28. The memory 28 stores the control program 34. The laser device 15 includes a laser light source 112, a scanner 116, one or more optical elements 117, and / or a focusing objective lens 118 coupled as shown. The laser device 15 is connected to a patient adapter 120. The patient adapter 120 includes a contact piece 124 (with a contact surface 126 located outwardly from the sample) and a sleeve 128 connected as shown.

  The laser light source 112 generates an ultrashort pulse laser beam 114. As used herein, an ultrashort pulse of light is a pulse of light less than nanoseconds that is on the order of picoseconds, femtoseconds, or attoseconds in duration. At the in-focus position of the laser beam 114, laser-induced optical breakdown (LIOB) may be generated in a living tissue such as the cornea. The laser beam 114 may be precisely focused to provide an accurate incision in the cell layer of the epithelium, which allows to reduce or avoid unnecessary destruction of other tissues.

  Examples of laser light sources 112 include femtosecond, picosecond, and attosecond lasers. The laser beam 114 is, for example, in a suitable vacuum in the range of 300 to 1500 (nm), which is a wavelength in the range of 300 to 650, 650 to 1050, 1050 to 1250, or 1100 to 1500 nanometers (nm). Have a wavelength of The laser beam 114 may have a relatively small focal volume, eg, 5 micrometers (μm) or less in diameter. In one embodiment, the laser light source 112 and / or the transmission line may be vacuum or near vacuum.

  The scanner 116, the optical element 117 and the focusing objective 118 are in the light path. The scanner 116 controls the focal position of the laser beam 114 in the lateral and longitudinal directions. The "lateral direction" is the direction perpendicular to the propagation direction of the laser beam 114, and the "longitudinal direction" is the propagation direction of the beam. The transverse plane may be referred to as the xy plane, and the longitudinal direction may be referred to as the z direction. In one embodiment, the mating surface 126 of the patient interface 120 is in the xy plane.

  The scanner 116 may direct the laser beam 114 laterally in any suitable manner. For example, the scanner 116 may include a scanner mirror driven by the principle of a set of galvanometers that can be tilted about mutually orthogonal axes. As another example, the scanner 116 may include an electro-optic crystal capable of moving the laser beam 114 electro-optically. The scanner 116 may direct the laser beam 114 longitudinally in any suitable manner. For example, the scanner 116 may include a longitudinally adjustable lens, a lens with variable refractive power, or a mirror that is deformable to allow control of the z-position of the focal point of the beam. The components that control the focus of the scanner 116 may, for example, be arranged in a suitable manner along the light path, in the same or different module units.

  One (or more) optical element 117 directs the laser beam 114 in the direction of the focusing objective 118. Optical element 117 may be any suitable optical element capable of reflecting and / or refracting / diffracting laser beam 114. For example, the optical element 117 may be a fixed deflection mirror. The focusing objective 118 focuses the laser beam 114 on the patient adapter 120 and may be releasably coupled to the patient adapter 120. The focusing objective 118 may be a suitable optical element such as an fθ objective.

  The patient adapter 120 is placed in contact with the cornea of the eye 22. In the example, patient adapter 120 includes a sleeve 128 coupled to contact piece 124. The sleeve 128 is connected to the focusing objective lens 118. The contact piece 124 may be transparent to the laser beam and have a contact surface 126 disposed in contact with the cornea to flatten a portion of the cornea. In one embodiment, the contact surface 126 is planar and forms a planar region on the cornea. The contact surface 126 may be in the xy plane, as a result of which the planar area is also in the xy plane. In other embodiments, the cornea need not include a planar region.

  The control computer 30 controls controllable components, for example the laser light source 112 and the scanner 116, according to the control program 34. The control program 34 comprises computer code which instructs the controllable components of the laser device 15 to focus the pulsed laser beam having the laser energy calculated according to the optical density of the outer part of the eye 22 It is.

  In some operational examples, the scanner 116 may direct the laser beam 114 to form an appropriately shaped incision. Examples of incision types include bed incisions and side incisions. Bed incisions are two-dimensional incisions that typically lie in the x-y plane. The scanner 116 may focus the laser beam 114 at a constant z value below the contact surface 126 and form a bed incision by moving the focus in a pattern in the xy plane. A side incision is an incision that extends from under the corneal surface (such as from a bed incision) to the surface. The scanner 116 may form a side incision by changing the z-value of the focus of the laser beam 114 and optionally changing the x and / or y values.

  FIG. 7 depicts an example of a method for adjusting laser energy according to optical density measurements in one embodiment. The method may be performed by computer system 20. The method begins at step 210 where computer system 20 receives an optical density measurement of an outer portion of eye 22. In one embodiment, the outer portion may be the outer layer of the cornea. In one embodiment, the optical density measurement includes one or more optical density values for one or more positions of the outer portion, each optical density value representing an optical density at one position. May be

  Laser adjustment values are determined in accordance with the optical density measurements at step 212. In one embodiment, laser energy module 38 determines the laser adjustment value. In that embodiment, the laser energy module 38 may access data structures (such as table 42) that combine several optical density values into several laser adjustment values. The laser energy module 38 may specify a laser adjustment value for that location that is tied to the optical density value for one location.

  Laser energy is determined at step 214 according to the laser adjustment value. In one embodiment, laser energy module 38 may determine laser energy. In that embodiment, the laser energy module may determine the initial laser energy at one location and then adjust the initial laser energy according to the laser adjustment value for that location.

  The laser device 15 is instructed at step 216 to direct a laser beam having laser energy through the outer portion to the target portion. For example, the laser energy module 38 may send an instruction to the laser device 15 to direct the laser beam to one location with the adjusted laser energy determined for that location.

  FIG. 8 depicts an example of a method of adjusting laser energy according to a trial shot in one embodiment. The method may be performed by computer system 20. The method begins at step 310 with the computer system 20 instructing the laser to direct a trial shot towards the trial portion. In one embodiment, the trial portion may be a non-essential biological tissue of a donor or patient.

  The action of the trial shot is determined at step 312. In one embodiment, the microscope 13 may be used to identify one trial shot that has one purpose. A purposeful action is one of one or more actions that satisfy one or more (such as the best effect) requirements. For example, one effect that may serve the purpose of a trial shot may be to make a cut in the biological tissue without damaging it.

  Laser energy is determined at step 314 according to the above action. In one embodiment, laser energy module 38 may determine laser energy. In that embodiment, the laser energy module 38 may identify trial shots having an intended effect and determine the laser energy to be the laser energy of the identified trial shot. In one embodiment, the laser energy module 38 may be capable of interpolating and / or extrapolating laser energy from the measured action. For example, if one laser shot with low laser energy does not cut, but the next shot with higher laser energy causes excessive damage, the laser energy module between that high energy and low energy May be used.

  The laser device 15 is instructed at step 316 to direct a laser beam having the laser energy to the target portion. For example, the laser energy module 38 sends an instruction to the laser device 15 to direct the laser beam with its laser energy in the direction of the target portion.

  The components of the systems and devices disclosed herein may include interfaces, logic, memory, and / or other suitable elements, any of which may include hardware and / or software. . The interface may receive input, send output, process the input and / or output, and / or perform other suitable operations. Logic may perform operations of the component, such as executing instructions to generate output from input. The logic may be encoded in memory and may perform actions when executed by a computer. The logic may be one or more processors, such as a computer, one or more microprocessors, one or more application software, and / or other logic. A memory is capable of storing information, and is one or more tangible, computer readable and / or computer executable storage media. Examples of memory include computer memory (eg random access memory (RAM) or read only memory (ROM)), mass storage medium (eg hard disk), removable storage medium (eg compact disc (CD), etc. Alternatively, digital video disc (DVD), database, and / or network storage (eg, server), and / or other computer readable media are included.

  In particular embodiments, the operations of the embodiments may be performed by one or more computer readable media encoded with a computer program, software, computer executable instructions, and / or a computer. It may be realized by instructions that can be In particular embodiments, the operations may be stored, embodied, and / or one or more computer programs encoded and / or stored and / or encoded computer programs. The present invention may be realized by computer readable media.

  While this disclosure has been described in terms of certain embodiments, changes in the embodiments (such as changes, substitutions, additions, omissions, and / or other changes) will be apparent to those skilled in the art. Therefore, those modifications may be made to the embodiments without departing from the scope of the present invention. For example, modifications may be made to the systems and devices disclosed herein. The system and device components may be integrated or separated, and the system and device operations may be performed by more, less, or other components. In another example, modifications may be made to the methods disclosed herein. The method may include more, fewer, or other steps, and the steps may be performed in any suitable order.

  Other modifications can be made without departing from the scope of the present invention. For example, although the present description has illustrated embodiments for particularly practical applications, other applications will be apparent to those skilled in the art. In addition, future developments may occur to the technology discussed herein, and the disclosed system, apparatus, and method will be used with such future developments.

  The scope of the present invention should not be determined solely in relation to the description. In accordance with the laws of the patent, the description sets forth and illustrates the principles and modes of operation of the invention using exemplary embodiments. While the description is adapted to enable one of ordinary skill in the art to use the system, apparatus, and method with various modifications in various embodiments, it should be used to limit the scope of the present invention. Absent.

  The scope of the invention should be determined with reference to the claims and the broad scope of equivalents to which the claims are entitled. The terms of all the claims should be given the broadest reasonable interpretation and ordinary meaning understood by a person skilled in the art, if this is not explicitly stated otherwise. For example, the use of singular articles such as “a”, “the” and the like is for re-quoting one or more of the indicated elements if the claim does not describe the obvious limitation to the contrary Should be read as As another example, "each" means each part in a collection, or each part in a collection that constitutes a collection, where a collection is zero or more than one It may contain an element. In short, the present invention can be modified, and the scope of the invention should be determined not only by the description thereof but by the broad scope of the claims and the equivalents.

Claims (10)

A laser device configured to direct a laser beam having laser energy through an outer portion of the eye toward a target portion in the eye;
Receiving the optical density measurements of the outer portion of the eye, the optical density measurements, a corresponding laser energy adjustment value, laser energy adjustment value corresponding to the optical density value was indicated by the optical density value Adjustments made to laser energy to compensate for optical density, with higher optical density requiring a larger increase in laser energy, and smaller optical density requiring a smaller increase in laser energy, to a laser energy adjustment value Determining the laser energy by accessing a data structure to be mapped, and directing a laser beam having the laser energy adjusted by the laser energy adjustment value through the outer portion of the eye toward the target portion of the eye Will be given to the laser device Apparatus characterized in that and a control computer configured.   The apparatus of claim 1, wherein the control computer is configured to receive the optical density measurement from an imaging system.   The apparatus according to claim 1, wherein the laser device is configured to direct a laser beam having the laser energy through an outer portion of the eye toward a target portion of the eye.   4. The device of claim 3, wherein the outer portion comprises an outer layer of the cornea and the target portion comprises an inner layer of the cornea.   The device of claim 1, wherein the target portion comprises a lens. In the operating method of the laser device
The control computer is
Receiving an optical density measurement of the outer portion of the eye;
The optical density measurement value is the corresponding laser energy adjustment value , and the laser energy adjustment value corresponding to the optical density value is an adjustment made to the laser energy to compensate for the optical density indicated by the optical density value. The higher the optical density is, the larger the laser energy needs to be, and the lower the optical density is, the smaller the laser energy is. Determine the laser energy by accessing the data structure that maps to the laser energy adjustment value The process to
Providing an instruction to the laser device to direct a laser beam having the laser energy adjusted by the laser energy adjustment value through the outer portion of the eye toward a target portion of the eye. How to operate the laser device.   7. The method of claim 6, wherein receiving the optical density measurement of the eye comprises receiving the optical density measurement from an imaging system.   The step of giving an instruction to the laser device to direct the laser beam having the laser energy to the target portion directs the laser device to direct the laser beam having the laser energy to the target portion through the outer portion of the eyeball. The method of claim 6, comprising the step of providing.   9. The method of claim 8, wherein the outer portion comprises the outer layer of the cornea and the target portion comprises the inner layer of the cornea.   7. The method of claim 6, wherein the target portion comprises a lens.

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