MXPA06009378A - Methods and systems for differentiating left and right eye images - Google Patents

Abstract

Methods and systems for determining whether an image is of a left eye or a right eye may be used to enhance laser eye surgery systems and techniques. Methods generally involve locating an iris center and/or pupil center on an image of the eye, locating a corneal vertex and/or at least one reflection on the image, and determining whether the image is of a left eye or a right eye, based on the location of the corneal vertex and/or reflection(s) relative to the iris center and/or pupil center. Systems include a laser emitting a beam of an ablative light energy and a computer processor having a computer program for determining whether the image is of a left eye or a right eye, based on a location of the corneal vertex and/or reflection(s) relative to the iris center and/or pupil center.

Description

,, FR, GB, GR, HU, IE, IS, IT, LT, LU, MC, NL, PL, PT, RO, anee Notes on Codes and? Bbreviations "appearing at thebegm- SE, SI, SK, TR) , O? PI (BF ', BJ, CF, CG, C ?, CM, GA, GN, no ofeach regular issue of the CTGazette, GQ, GW, ML, MR, NE, SN, TD, TG). Published: - without intemational search repon and lo be republished upon receipl oflhat report METHODS AND SYSTEMS FOR DIFFERENTIATING IMAGES OF THE LEFT AND RIGHT EYE CROSS REFERENCE TO RELATED REQUESTS This application claims priority to the U.S. Patent Application Serial No. 10/784481 (Attorney's File No. 18158-025100US), filed February 19, 2004. The present application relates to the U.S. Patent Applications. Nos. Of Series 10/300714 (File of Attorney No. 18158-021510US), filed on November 19, 2002, and 10/460060 (File of Attorney No. 18138-020410US), filed on June 11, 2003. The full descriptions of all the aforementioned applications are incorporated herein by reference.

BACKGROUND OF THE INVENTION The present invention relates, generally, to laser eye surgery methods and systems More specifically, the present invention relates to methods and systems for differentiating between the right eye and right eye images.

Known laser procedures of the eye, particularly employ an ultraviolet or infrared laser to remove the microscopic layer of the stromal tissue from the cornea of the eye, and alter the refractive characteristics of the eye. The laser removes a selected configuration of the corneal tissue, often to correct the refractive errors of the eye. Ultraviolet laser ablation results in photo-decomposition of the corneal tissue, but generally does not cause significant thermal damage to the adjacent and underlying tissues of the eye. The irradiated molecules are broken into photogenic fragments, directly breaking the intermolecular bonds. Laser ablation procedures can remove the objective stroma of the cornea, and change the contour of this cornea for various purposes, such as correcting myopia, hyperopia, astigmatism and the like. Control over the distribution of ablation energy through the cornea can be provided by a variety of systems and methods, which include the use of masks that can be excised from discrete pulses of laser light energy, with the configuration and total amount of tissue removed being determined by the configuration, size, location and / or number of a pattern of laser energy pulses that strike the cornea. A variety of algorithms can be used to calculate the pattern of the laser pulses used to reconfigure the cornea, and thus correct a refractive error of the eye. Known systems make use of a variety of laser and / or laser energy forms to effect correction, which include infrared lasers, ultraviolet lasers, femtosecond lasers, solid state lasers of multiplied wavelength, and the like. Alternative techniques of vision correction make use of radial incisions in the cornea, infraocular lenses, removable structures of corneal support, thermal configuration and the like. Corneal correction known treatment methods have been successful in correcting standard vision errors, such as myopia, hyperopia, astigmatism and the like. Generally, an ablation pattern, based on wavefront measurements, may be able to correct minor aberrations to provide, reliably and repeatedly, visual acuity greater than 20/20. Methods and systems for providing wavefront measurement continue to benefit from improvements and advances, such as those described in U.S. Patent Application Serial No. 10/300714 and 10/460060 (previously incorporated by reference. ). Of course, wavefront measurement systems alone can not eliminate all potential errors from a laser eye surgery procedure. Errors may occur, for example in transferring the information from the measurement system to the ablation system or in the operation of this ablation system, a possible error can be made in that the image of the measurement of the wavefront of the left eye can be confused with the Wave front of the right eye. This can occur due to bad labeling of the images, misinterpreting the images by the operator of the ablation system, and the like. In the worst case scenario, data from the frontal wave measurement for the eyes, left and right, can be accident inverted, so that the treatment of the left eye is performed in the right eye and vice versa. Therefore, it would be convenient to provide methods and systems to differentiate between the images of the left and right eye. Ide, such methods and systems will differentiate right and left eye images, acquired using wavefront imaging technology and reducing the likelihood of human error in the laser eye surgery procedure.

BRIEF SUMMARY OF THE INVENTION In one aspect of the present invention, a method for determining whether an image of an eye is of a left eye or a right eye involves locating an iris center in the image, locating a corneal apex in the image and determine if the image is from an izigier eye or a right eye, based on the location of the corneal vertex in relation to the center of the iris. Some modalities also include locating a center of the pupil of the eye in the image, before locating the center of the iris. In some modalities, the location of the corneal vertex involves locating at least one reflection in the image, this reflection being caused by illuminating the eye, while the image is adhered. In some modalities, the determination whether the image is of a left eye or a right eye may imply that at least one reflection is displaced, relative to the center of the iris, towards the nose of the patient from where the image is adhered. In such embodiments, the determination step may further include measuring a displacement of at least one reflection towards the nose, relative to the center of the iris and determining whether the image is of the left eye or the right eye, based on the measured displacement. Alternatively, the determination step may include: measuring a displacement of at least one reflection toward the nose, relative to the center of the iris; compare the measured displacement with the predetermined threshold displacement; and determine whether the image is from the left eye or from the right eye only if the measured displacement is equal to or greater than the predetermined threshold. Optionally, the method may also include illuminating the eye and obtaining the image of the eye before the location stages. In some embodiments, the eye is illuminated with at least one source of infrared light. For example, the pupil of the eye can be illuminated with at least two diodes that emit infrared light, arranged near an aperture, through which the image is acquired. In some embodiments, the image of the eye is obtained using a device that forms images of the wavefront. Again in some such embodiments, an image of the pupil of the eye can be obtained, and the illumination of the eye can optionally involve illuminating the pupil using at least one infrared light source, disposed wax of an aperture, through which the image of the eye adheres. In some embodiments, the method may also involve performing the laser eye surgery procedure customary in the eye, based on the determination of whether the image is of a left eye or a right eye. In another aspect of the present invention, a method for determining whether the eye image is of the left or right eye involves locating the center of the pupil of the image, locating a corneal apex in the image and determining whether the image is of one eye izguierdo or of a right eye, based on the location of the corneal vertex in relation to the center of the pupil. Again, in some embodiments the location of the corneal apex involves locating at least one reflection in the image, with this at least one reflection being caused by the illumination of the eye, while the image is adhered. Any of the features described above can be suitably applied to various embodiments of this aspect of the invention. In yet another aspect of the invention, a method for determining whether an image of an eye is of a left eye or a right eye, comprises locating the center of the iris in the image, locating at least one reflection in the image, and determining whether the image is of an izigierdo eye or of a right eye, based on the location of at least one reflection in relation to the center of the iris. As with the modalities discussed above, the reflections are caused by illuminating the eye while the image is adhered, again, this method can include any of the characteristics described above. In another aspect of the invention, a method for performing laser eye surgery comprises: acquiring a measurement of the wavefront of an eye, obtaining an image of the eye during the measurement of the wavefront; generate a treatment for the eye, based on the measurement of the wavefront; determine if the image is from an izigierdo eye or a right eye, based on the image; and verify that a correct eye has been selected, in which an eye laser surgery procedure is performed, the stage of determining whether the image of the eye is of the left eye or the right eye, involves: locating the center of the iris in the picture; locate the corneal vertex in the image; and compare the location of the corneal apex at the location of the center of the iris. As mentioned before, in some embodiments, the pupil of the eye can first be located before locating at least one reflection in the image, in which at least one reflection is caused by the illumination of the eye, as long as the image is adhered to. In some modalities, the determination whether the image is of a left eye or a right eye may imply that at least one reflection is displaced, relative to the center of the iris, towards the nose of the patient, from which the image is adhered. The determination step may optionally include a displacement of at least one reflection toward the nose, relative to the iris center and determine whether the image is of the left eye or the right eye, based on the measured displacement. Alternatively, the determination step may involve: measuring a displacement of at least one direction towards the nose, relative to the center of the iris; compare the measured displacement with the displacement of the predetermined threshold and determine whether the image is of the left eye or the right eye, if the measured displacement is equal to or greater than this predetermined threshold. Various embodiments involve lighting the eye with one or more lighting devices, such as infrared lights, as described above. In some modalities, the pupil is illuminated with two infrared lights that form the reflections in the image, as justly described. In another aspect of the invention, a laser eye surgery system includes a laser that emits a beam of ablation light energy and a computer processor, configured to receive an image of an eye and at least one measurement of the wave front and an ablation pattern for an eye, The computer processor has a computer program to determine whether the image is from an eye or a right eye, based on the location of the corneal vertex in the image relative to its center. iris in the image. The computer processor is configured to verify that a correct eye has been selected, in which a laser eye surgery procedure is to be performed, based on the determination and measurement of the wavefront and / or the ablation pattern. . In some embodiments, the image of the eye comprises an image of the pupil, taken during the measurement of the wavefront. Optionally, the computer processor can also be configured to locate the center of the iris and the corneal vertex in the image. For example, the computer processor can determine the location of the corneal apex based on a location of at least one reflection in the image, with this at least one reflection being caused by illuminating the eye, while the image is adhered. In some modalities, the computer processor determines whether the image is of the left eye or the right eye, assuming that the reflection is located closer than the center of the iris to the nose of a patient, from which the image is obtained. In some embodiments, the computer processor is further configured to measure a distance between the center of the iris and at least one reflection. Optionally, the computer processor can be further configured to compare the measured distance to a predetermined threshold distance and decide whether a determination of the left eye / right eye can be made, based on the comparison. In some embodiments, the system also includes at least one image adduction device, to get this image. For example, the image adduction device may comprise a wavefront imaging device by imaging the pupil of the eye. In some embodiments, this wavefront image forming device includes at least one infrared light source, disposed wax of an aperture, through which the image of the pupil is adhered. In another aspect of the present invention, a laser eye surgery system includes: a laser that emits an energy beam of ablation light; a light source, which directs light towards a corneal tissue of the eye; a microscope that captures an image of the illuminated corneal tissue and a computer processor, configured to direct a customary pattern of ablation light energy towards the eye, the processor has an identification module of the left / right eye of the light energy of the eye. ablation to the eye. This processor has an identification module of the left / right eye that generates either a left eye signal or a right eye signal, in response to the image of the corneal tissue. In some embodiments, the module generates an indeterminate eye signal, when the image of the corneal tissue provides insufficient information to generate a signal from the left eye or a signal from the right eye. For example, insufficient information may comprise an amount of displacement of a location of the corneal apex of the eye relative to the center of the iris of the eye, the amount of displacement being less than the predetermined threshold amount. In some embodiments, the processor verifies that the correct eye has been selected in which the laser eye surgery procedure is to be performed, based on the left eye signal or the right eye on at least one wavefront measurement and an ablation pattern for the eye. Other aspects and embodiments of the invention will be described in more detail below, with reference to the accompanying drawing figures.

BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 schematically illustrates a simplified system of laser eye surgery, according to one embodiment of the present invention; Figure 2 is a perspective / spaghetti view of a laser surgery system, according to an embodiment of the present invention; Figure 3 is a diagram of a wavefront measuring device, according to an embodiment of the present invention; Figure 3A is a diagram of a wavefront sensor system, according to an embodiment of the present invention; and Figure 4 illustrates schematically a method for distinguishing between the images of the right eye and the images of the left eye, according to an embodiment of the present invention.

DETAILED DESCRIPTION OF THE INVENTION The present invention is particularly useful in increasing the safety and accuracy of laser surgical procedures of the eye, such as photorefractive keratectomy (PRK), phototherapeutic gelerectomy (PTK), laser in situ geraterate (LASIK), and Similar. Security and accuracy are enhanced by distinguishing the images of the right eye from the images of the left eye, to help ensure that the eye treatment plan corresponds to the appropriate eye. While and the system and methods of the present invention were described primarily in the context of improving laser eye surgery methods and systems, various embodiments may also be adapted for use in alternative methods and systems of eye treatment, such as Femtosecond lasers and laser treatment, infrared laser and laser treatments, radial gueratotomy (RK), scleral bands, follow-up of diagnostic procedures and the like. Referring to Figure 1, one embodiment of a system for performing laser eye surgery includes a laser system, coupled to a wavefront measuring device 10, which measures the aberrations and other optical characteristics of a complete tissue system. optical. The data of such a wavefront measuring device can be used to generate an optical surface of an array of optical gradients. The optical surface does not need to coincide exactly on the actual surface of the tissue, since the gradients show the effects of aberrations that are actually located through the ocular tissue system. However, the corrections imposed on the surface of the optical tissue, in order to correct the aberrations derived from the gradients, must correct the system of the optical tissue, according to the use of agui, the terms such as "an optical tissue surface" may comprise a theoretical surface of the tissue (derived, for example, from data from the wavefront sensor, a real surface of tissue and / or a tissue surface formed for treatment purposes (for example, by incision of the corneal tissues, for allow a fin of the corneal epithelium, Bo man membrane and stroma to be displaced to expose the underlying stroma during the LASI procedure.) Referring now to Figures 1 and 2, one embodiment of the eye laser surgery system 15 includes a laser 12, which produces a laser beam 14. This laser beam is optically coupled to the laser delivery optical device 16, which directs the laser beam 14 to an eye E of a patient An optical delivery device supports the structure (not shown acutely for clarity) extending from a frame 17 which supports the laser 12. A microscope 20 is mounted on the supporting structure of the optical delivery device, the microscope often being used to form an image on the cornea of the eye E. The laser 12 generally comprises an excimer laser, which includes pulses that produce argon laser -fluor, laser light that has a wavelength of about 193 nm. This laser 12 will preferably be designed to provide a stabilized fluence of feedback in the E-eye of a patient, delivered by means of the optical delivery device 16. The present invention may also be useful with alternative sources of ultraviolet or infrared radiation, particularly aguella adapted for the controlled removal of corneal tissue, without causing significant damage to the adjacent and / or underlying tissues of the eye. Such sources include, but are not limited to, solid-state lasers and other devices that can generate ultraviolet wavelength energy, between about 185 and 315 nm and / or those that use frequency multiplying techniques. Thus, even if an excimer laser is the illustrative source of an ablation beam, other lasers can be used in the present invention. This laser 12 and the optical delivery device 16 will generally direct the laser beam 14 to the eye E under the direction of a computer processor 22. This processor 22 will generally selectively adjust the lasers 14 to expose portions of the cornea to the pulses of lateral energy, to perform the predetermined sculpting of the cornea and alter the refractive characteristics of the eye. In many embodiments, both the laser 14 and the optical laser delivery system 16 will be under the computer control of the processor 22, to effect the desired laser sculpting process, in order to deliver the customary ablation profile, with this processor ideally altering the ablation process in response to the inputs of the optical feedback system, or can manually enter the processor by a system operator, using an input device, in response to visual inspection of the analysis images by the system optical feedback. The processor 22 will often continue and / or complete a sculpting process in response to feedback, and may optionally also modify the planned sculpting based, at least in part, on the feedback. The laser beam 14 can be adjusted to produce the desired sculpting, using a variety of alternative mechanisms, This laser beam 14 can be selectively constrained using one or more variable apertures. An exemplary variable aperture system, having a variable iris and a slit of variable width is described in U.S. Patent No. 5,713,892, the complete disclosure of which is incorporated herein by reference. The laser beam can also be adjusted by varying the size and displacement of the laser area of an eye axis, as described in U.S. Patent No. 5,683,379, and also disclosed in U.S. UU., Also pending, Nos. Of Series 08 / 968,380, filed on November 12, 1997; and 09 / 274,999, filed on March 22, 1999, whose full descriptions are incorporated herein by reference. Still other alternatives are possible, which include scanning the laser beam on the surface of the eye and controlling the number of pulses and / or dwell time at each location, as described, for example, in US Pat. , Nos. 4,665,913 (whose full description is incorporated herein by reference), and as demonstrated by other scanning laser systems, such as the LSX laser by LserSight, LadarVision by Alcon / Autonomous, and the 217C by Tec nolas; using masks in the optical path of the laser beam 14, which is excised to vary the profile of the incident beam in the cornea, as described in U.S. Patent Application Serial No. 08/468/898, filed on June 6, 1996 (whose full description is incorporated herein by reference); hybrid profile-scan systems, in which the beam of variable size (typically controlled by a slit of variable width and / or variable diameter of the iris diaphragm) is scanned through the cornea or the like. Computer programs and control methodology for these pattern adjustment techniques. Laser are widely described in the patent literature. Additional components and subsystems and may be included with the laser system 15. For example, spatial and / or temporal integrators may be included to control the distribution of energy within the laser beam, as described in U.S. Pat. , No. 5,646,791, whose description is incorporated herein by reference. An ablation effluent / filter evacuator and other auxiliary components of the laser surgery system, which are not necessary to understand the invention, do not need to be described in detail to understand the present invention. As mentioned before, the laser system 15 will generally include a computer system or a programmable processor 22. This processor 22 may comprise (or interface with) a conventional personal computer system, which includes standard user interface devices, such as like a keyboard, an exhibition monitor and the like. The processor will typically include an input device such as a magnetic or optical disk drive, a compact disk drive (CD), an Internet connection, or the like. Such input devices are often used to download a computer code that can be executed from a computer network or a tangible storage medium 29, which incorporates the programming steps or instructions for any of the methods of the present invention. The tangible storage medium 29 includes, but is not limited to, a CD-R, a CF-RW, DVD, a diskette, an optical disc, a data tape, a non-volatile memory or the like, and the processor 22 it includes the memory boards and other standard components of the modem computer systems, to store and execute this code. The wavefront measurement device 10 typically includes a wavefront measurement assembly 11, and an array 13 which forms images. This wavefront measurement assembly 11 can be used to measure and obtain the wavefront elevation surface of at least one of the patient's eyes, and the image-forming assembly 13 can obtain fixed or mobile images of the eye of the patient, during the measurement of the wavefront. In exemplary embodiments, the set 13 which forms images is a CCD camera which can obtain a fixed image of the patient's eye. The images obtained by the image-forming assembly 13 can then be used to record the wavefront measurement and / or a customary ablation pattern (based on the wavefront measurement) with the patient's eye during the surgical procedure. To be. Various modalities and characteristics of the assembly 13 which forms images are described in more detail below. The measurement set 11 of the wave front and the set 13 which forms images, can be coupled to, or be integral with, a computer system 17, which can generate and store the wavefront measurements and images of the patient's eye. Next, the patient's wavefront data can be stored in a computer-readable medium, such as a CD-R, CD-RW, DVD-R, diskette, optical disk, or hard drive. other means that can be read by computer. Optionally, in some embodiments, the computer system of the wavefront measuring device can generate and save an ablation profile based on the wavefront data. The wavefront data and / or the customary ablation profile can be loaded into a laser surgery system 15 through the reading of the medium that can be read by computer, or through the delivery in a memory of a system Surveillance 14 over a local area or wide area network (LAN or WAN). The laser surgery system 15 of the eye may include a computer control system 22, which is in communication with a set 20 which forms images and a laser assembly 112. The computer system 22 may have software (program) stored in the memory and hardware (eguipment) which can be used to control the delivery of the ablation energy to the patient's eye, the track of the position (translations in the x directions, yy and twist rotations) of the patient's eye relative to an optical axis of the laser beam 14 and the like. In exemplary embodiments, among other functions, the computer system 22 can be programmed to calculate a customary ablation profile based on the wavefront data, register the images taken with the wavefront measurement set 11, with the Images taken by the set 20 form these images, and measure the torsion displacement between the patient's eye in the two images. Additionally, the computer system 22 can be programmed to measure in real time the movement (x (t), y (t), z (t (and the rotation orientation of the patient's eye, relative to the optical axis of the laser beam , so as to allow the computer system to modify the delivery of the customary ablation profile based on the real-time position of the patient's eye Such characteristics are more fully described in U.S. Patent Application No. Series 10/300714, which was previously incorporated by reference. Referring now to Figure 3, one embodiment of a wavefront measuring device 10 of the present invention is illustrated schematically, the embodiment illustrated is merely an example of a measurement device 10 of the wavefront and any of a number of other conventional or patented wavefront measuring devices can be used with the various embodiments of the present invention Generally, the wavefront measuring device 10 includes an image forming assembly 13 which can form the image of the patient's eye E, during the measurement of the wavefront. The image forming assembly 13 includes a source 32 of images which projects an image of this source through the optical tissues 34 of the eye E, to form an image 44 on a surface of the retina R. The image of the retina R is transmits by the optical system of the eye (specifically, the optical tissues 34) and the image is formed on a sensor 36 of the wavefront by the optics 38 of the system. In some embodiments, the set 13 which forms the image also includes a camera 19 of the pupil, which can be used to acquire one or more images of the pupil of the eye B. The images of the pupil are images of the iris of the eye And, typically adgiridas with the infrared illumination (IR). Such images can be used, for example, to determine the size of the pupil of the eye R, to compare the locations of the iris and the pupil and to record these locations of the iris and the pupil for treatment and / or the like. In some modalities, one or more (preferably two) infrared (IR) light emitting diodes (IR) 33 are disposed on opposite sides of an aperture, through which the source 32 projects its source image. IR LEDs generally provide IR illumination to acquire images of the pupil. IR illumination produces distinct reflections on the surface of the cornea of the eye R, which are visible in each image of the acquired pupil. The camera 13 of the pupil may be in communication with a system 17 of the computer, to deliver the images of the patient's eye E to a memory in the computer 17. In various embodiments, the computer system 17 may determine a location of the patient's eye. The pupil of the eye in the image of the pupil and use that location to determine a location of the center of the iris of the eye. Techniques for determining a center location of the iris is more fully described in Patent Application Serial No. 10/300714, previously incorporated herein by reference. The computer 17 can also determine the locations of one or more reflections (Perkinje images) in a pupil image, caused by the ID illumination, and uses the reflection locations to determine a location of the corneal apex of the E eye. for determining a location of the corneal apex are described more fully in U.S. Patent Application Serial No. 10/460060, which was previously incorporated by reference. Next, the computer can compare the location of the corneal vertex, the location of one or more reflections, or both, with the location of the center of the iris.

It has been found that the location of the reflections and / or the corneal apex are typically displaced nasally relative to the center of the iris in one eye. In other words, the computer system 17 may assume that a reflection and / or a corneal apex in the image of the pupil is closer to the patient's nose than the center of the iris, comparing the location of the reflection and / or Corneal vertex to the location of the iris, the computer system 17 can determine whether an image of the given pupil is from the left eye or the right eye. The location of the optical axis of the eye E can also be verified with reference to the data provided from the camera 19 of the pupil. In the exemplary embodiment, the pupil chamber 19 produces images of the pupil 50 and / or the iris to thereby enable the subsequent determination of the position and torsional orientation of the pupil and / or iris for the recording of the sensor of the pupil. wavefront relative to optical tissues, as described more fully in U.S. Patent Application Serial No. 10/300714, previously incorporated by reference. The wavefront sensor 36 may also communicate signals to the computer 17 for the determination of a corneal ablation treatment program. The computer 17 may be the same computer used for the direct operation of the laser surgery system 15, or at least some or all of the computer components of the wavefront measuring device 10 and the laser surgery system may be separate. The data from the wavefront sensor 36 can be transmitted to the computer of the laser system 22 (Figure 1) via a tangible means 29, via an input / output door, via a network connection, such as the Intranet, the Internet, or similar. The wavefront sensor 36 generally comprises an array 38 of lenses and forms images on the surface of the array 38 of lenses, this array of lenses separates the transmitted image into an array of beams 42, and (in combination with other optical components) of the system) the images of the bundles stick them apart on the surface of the sensor 40. This sensor 40 typically comprises a coupled charge device (CCD) and detects the characteristics of these individual stick beams, which can be used to determine the characteristics of an associated region of optical tissues 34. In particular, where the images 44 comprise a point or area of light glue, a location of the area is transmitted as images by the sticky beam, it can directly indicate a local gradient of the associated region of the tissue optical. The eye E generally defines an anterior orientation ANT and a posterior orientation POS. The image source 32 generally projects an image in a posterior orientation, through the optical tissues 34 on the retina R. The optical tissues 34 again transmit an image 44 from the retina anteriorly towards the sensor 36 of the wavefront. This image 44 actually formed on the retina R can be distorted by any imperfection in the optical system of the eye, when the image source is originally transmitted by the optical tissues 34. In some embodiments, the optics of the projection of the image source (not shown) can be configured or adapted to reduce any distortion of the image 44. In some embodiments, the optics of the image source can decrease the optical errors of minor order, compensating for spherical and / or cylindrical errors of the optical tissues. 34. Optical errors of higher order of the optical fabrics can also be compensated through the use of an adaptive optical element, such as a deformable mirror. The use of an image source 32, selected to define a point or sticky area in image 44, on the retina R, can facilitate the analysis of the data provided by the frontal wave sensor 36. Image distortion 44 may be limited by transmitting an image of the source through a central region 48 of the optical tissues 34, which is smaller than the pupil 50, since the portion of the pupil may be less prone to optical errors than the portion peripheral. Regardless of the particular structure of the image source, it will generally be beneficial to have the image 44 formed exactly on the retina R.

While the method of the present invention will generally be described with reference to the detection of an image 44 on the retina, it should be understood that a series of data readings from the wavefront sensor can be taken. For example, a time series of wavefront data readings can help provide a more accurate general determination of ocular tissue aberrations. Since the ocular tissues can vary in configuration over a short period of time, a plurality of temporarily separated wavefront sensor measurements can avoid relying on a simple snapshot of the optical characteristics as the basis for the refractive correction procedure. . Still other alternatives may also be available, which include taking data from the eye wavefront sensor, with the eye in different configurations, positions and / or orientations. For example, a patient will often help to maintain the alignment of the eye with the wavefront device 10, by focusing on the fixed objective, as described in U.S. Patent No. 6,004,313, the complete description of which is incorporated I pointed as a reference. By varying a focal position of the fixation target, as described in that reference, the optical characteristics of the eye can be determined, while the eye accommodates or adapts for the image of a field of vision at a variable distance. Other alternatives include turning the eye by the alternate provision and / or motion setting objectives, within the wavefront device 10. An alternative embodiment of a wavefront sensing system is illustrated in Figure 3A. The main components of the system of Figure 3A are similar to those of Figure 3. Additionally, Figure 3A includes an adaptive optical element 52 in the form of a deformable mirror. The image of the source is reflected from the deformable mirror 52 during transmission to the retina TR and this deformable mirror 52 is also used along the optical path to form the image transmitted between the retina R and the image sensor 40. This deformable mirror 52 can be deformed in a controllable manner to limit the distortion of the image formed in the retina and can increase the accuracy of the wavefront data. The structure and use of the system of Figure 3A are described more fully in U.S. Patent No. 6,095,651, the full disclosure of which is incorporated herein by reference. The components of a modality of a wavefront system for measuring the eye and ablations comprise elements of a VISX WaveScan®, available from VISX Incorporated, of Santa Clara, California. A preferred embodiment includes a WaveScan (Wave scanner) with a deformable mirror, as described above. An alternative embodiment of a wavefront measuring device is described in U.S. Pat. No. 6,271,915, whose full description is incorporated herein by reference. A map of the treatment program can be calculated from the elevation map of the wavefront as well as to remove the regular and irregular errors (spherical and cylindrical) of the optic tissues. By combining the treatment program with the laser ablation pulse characteristics of a particular laser system, a table of ablation pulse locations, sizes, configurations and / or numbers can be developed. An exemplary method and system for preparing such an ablation table is described in co-pending US Patent Application No. 09 / 805,737, filed March 13, 2001, and entitled "Generating Explorations of Locations of Zones. for Laser Eye Surgery ", whose full description is incorporated as a reference. The ablation table can, optionally, be optimized by the individual classification of pulses to avoid localized heating, minimize irregular ablations if the treatment program is interrupted, and similar. Based on the measurements of the eye wavefront, a corneal ablation pattern can be calculated by the computer processor 17 or 22 (or by another separate processor) for ablation of the eye with the laser ablation system 15 to correct the optical errors of the eye. Such calculations will often be based on both the measured optical properties of the eye and on the characteristics of the corneal tissue targeted for ablation (such as the ablation rate and the refractive index).

The results of the calculation will often comprise an ablation pattern in the form of an ablation table, which lists ablation locations, pulse numbers, ablation sizes and / or ablation configurations to effect the desired refractive correction. An exemplary method for generating ablation patterns is described in U.S. Patent Application. , also pending, Serial No. 09/805/737, whose full description was previously incorporated as reference. When the refractive error is going to be corrected by modalities of alternative treatments. Alternative treatment plans can be prepared, such as a corneal implant or similar. Now referring to Figure 4 an exemplary method for determining whether an image is of the left eye or a right eye, as described above, suitably includes a first step of acquiring an image of the eye 60. This image, for example, can be an image of the pupil A center of the pupil can then be located on said image 62 of the pupil. This location stage, just as many or all of the subsequent stages can be achieved in some embodiments via a center 64 of the iris and a corneal apex 66 in the image of the pupil. In some embodiments, the location of the corneal apex 55 may involve first locating one or more reflections on the image of the pupil, caused by the infrared illumination used to acquire the image. Once the locations of the corneal vertex and the iris have been determined, the displacement of the vertex relative to the iris can be determined 68. The image processing software or other suitable software then determines whether the displacement of the vertex relative to the iris is greater than or equal to a threshold amount of displacement 70. If not, then no determination is made whether the image is of the left eye or the right eye 72. If the vertex displacement is or exceeds the threshold, then it becomes one. determination of whether the image is of the left eye or the right eye 74. As described above, - this determination is made based on the fact that the vertex is almost always displaced nasally in relation to the center of the iris. When a determination is made whether an image is of the left eye or the right eye, such a determination can be used as a safety check in the laser eye surgery procedure. For example, the determination of whether the image is of the left or right eye can be checked against a treatment plan for an eye in which the procedure is to be performed. If the treatment plan corresponds to the eye that is represented in the image, then the procedure may proceed as planned. If the treatment plan and the image do not correspond - for example, if the image is of a right eye and the treatment plan is for an unforeseen eye, - then the laser energy system may be fired to provide a warning or alarm the eguivocado eye is going to operate. In other modalities, a non-correspondence may cause the laser surgery system to be temporarily interrupted. Any suitable technique to provide a security check can be incorporated in several modalities. In other modalities, several changes can be made to the method just described, while still achieving similar results. For example, instead of locating the center of the iris, some modalities can skip that stage and compare the location of the corneal apex to the location of the center of the pupil. In other modalities, the step of locating the corneal vertex can be omitted, the displacement of one or more reflections in the image of the pupil relative to the center of the iris and / or the center of the pupil, can be used to make the determination left / right. In some modalities this left or right determination can be made without first comparing the vertex to a threshold amount, and in still other modalities, the order of the steps can be altered. For example, it can be advantageous in some modalities to determine the location of the corneal apex before the location of the center of the iris. Thus, the method, described above is only one embodiment and is provided primarily for exemplary purposes. While the foregoing provides a complete and accurate description of specific embodiments of the invention, a number of changes and adaptations of the present invention can be made easily. Therefore, the scope of the invention is limited only by the following claims.

Claims (59)

1. CLAIMS 1. A method to determine if an image of an eye is from the left eye or the right eye, this method includes: locating the center of the iris in the image; locate the corneal vertex in the image, and determine if the image is from the left eye or the right eye, based on the location of the corneal apex relative to the center of the iris.
2. 2. A method, according to claim 1, which further comprises locating the center of the pupil of the eye on the image, before locating the center of the iris.
3. 3. A method according to claim 1, wherein the location of the corneal apex comprises locating at least one reflection on the image, in which at least one reflection is caused by illuminating the eye while adhering the image.
4. 4. A method according to claim 3, in which the determination of whether the image is of the left eye or the right eye comprises assuming that at least one reflection is displaced relative to the center of the iris towards the nose of a patient, from which Adguire the image.
5. 5. A method according to claim 4, wherein the determination further comprises: measuring the displacement of at least one reflection toward the nose, relative to the center of the iris; and determine if the image is from the left eye or the right eye, based on the measured displacement.
6. 6. A method according to claim 4, wherein the determination further comprises: measuring the displacement of at least one reflection toward the nose, relative to the center of the iris; and comparing the measured displacement of this at least one reflection with a predetermined threshold displacement; and determining whether the image is of the left eye or the right eye, only if the measured displacement is equal to or greater than said predetermined threshold.
7. 7. A method according to claim 4, which further comprises determining the predetermined threshold in response to a sub-population group of the patient having said eye.
8. 8. A method, according to claim 1, further comprising, prior to the location steps, illuminating the eye; and get the image of the eye.
9. 9. A method according to claim 8, the illumination of the eye comprises illuminating with at least one source of infrared light.
10. 10. A method according to claim 9, wherein the illumination of the eye comprises illuminating the pupil of the eye with at least two light-emitting diodes, arranged near an aperture, through which the image is adhered.
11. 11. A method according to claim 8, wherein obtaining the image comprises forming an image of the eye using a wavefront imaging device.
12. 12. A method according to claim 11, wherein obtaining the image comprises obtaining an image of a pupil of the eye.
13. 13. A method according to claim 12, wherein the illumination of the eye comprises illuminating the pupil, using an infrared light source, arranged near an aperture, through which the image of the eye is adhered.
14. 14. A method according to claim 1, further comprising verifying that the corrected eye has been selected in which the eye laser surgery procedure is performed, based on the determination of whether the image is of the left eye or the right eye.
15. 15. A method according to claim 1, further comprising providing a warning to the user of a laser eye surgery system, before this system is used to perform the laser eye surgery procedure, on an incorrect eye, where the warning is based on the determination of whether the image is of the left eye or the right eye.
16. 16. A method according to claim 1, further comprising performing the laser eye surgery procedure customary in this eye, based on the determination of whether the image is of the left eye or the right eye.
17. 17. A method to determine, say, an image of an eye is from the left eye or the right eye, this method includes: locating the center of the pupil on the image; locate the corneal vertex on the image; and to determine if the image is of the left eye or the right eye, based on the location of the corneal vertex in relation to the center of the pupil.
18. 18. A method according to claim 17, wherein the location of the corneal apex comprises locating at least one reflection on the image, where at least one reflection is caused by illuminating the eye, while the image is adhered.
19. 19. A method, according to claim 18, in which the determination of whether the image is of the left eye or the right eye, comprises assuming that this at least one reflection is displaced relative to the center of the pupil, towards the nose of a patient, from which the image is adhered.
20. 20. A method according to claim 19, wherein the determination further comprises: measure the displacement of this at least one reflection towards the nose, in relation to the center of the pupil: and determine if the image is from the left eye or the right eye, based on the measured displacement.
21. 21. A method according to claim 19, wherein the determination further comprises: measuring a displacement of at least one reflection toward the nose, relative to the center of the pupil; compare the measured displacement with a predetermined threshold displacement; and determine whether the image is of the left eye or the right eye only if the measured displacement is equal to or greater than the predetermined threshold.
22. 22. A method according to claim 21, further comprising determining the predetermined threshold in response to a sub-population group of the patient having said eye.
23. 23. A method according to claim 17, which further comprises, before the locating steps, illuminating the eye; Y get the image of the eye.
24. 24. A method according to claim 23, wherein the illumination of the eye comprises illuminating with at least one source of infrared light.
25. 25. A method according to claim 24, wherein the illumination of the eye comprises illuminating the pupil of the eye with at least two infrared light emitting diodes, arranged close to an aperture through which the image is adhered.
26. 26. A method according to claim 23, wherein the obtaining of the image comprises forming the image of the eye using the image device of the wavefront.
27. 27. A method according to claim 36, wherein obtaining the image comprises obtaining an image of the pupil of the eye.
28. 28. A method according to claim 27, wherein the illumination of the eye comprises illuminating the pupil using at least one source of infrared light, arranged near the aperture through which the image of the eye is adhered.
29. 29. A method, according to claim 17, further comprising verifying that a correct eye has been selected on which a procedure of laser eye surgery is performed, based on the determination of whether the image is of the left eye or the right eye.
30. 30. A method according to claim 17, further comprising providing a warning to the user of a laser eye surgery system, before using the system to perform this laser eye surgery procedure on an incorrect eye, where the warning is based on the determination of whether the image is from the left eye or the right eye
31. 31. A method according to claim 17, further comprising performing the laser surgery procedure of the eye on said eye, based on the determination of whether the image is of the left eye or the right eye.
32. 32. A method to determine if an image of an eye is from the left eye or the right eye, this method includes: locating the center of the iris on the image; locate at least one reflection in the image, in which at least one reflection is caused by illuminating the eye while the image is adhered; and determine if the image is of the left eye or the right eye, based on the location of at least one reflection in relation to the center of the iris.
33. 33. A method to perform a laser eye surgery, this method comprises: acquiring a measurement of the wavefront of an eye; obtain an image of the eye, during the measurement of the left eye or the right eye of the left eye or the right eye in front of waves; determine if the image is of the left eye or the right eye, based on the displacement directed nasally of a corneal vertex on the image, with relation to the center of the iris on the image; and verify that the corrected eye has been selected in which the laser eye surgery procedure is performed, based on the determination of whether the image is of the left eye or the right eye.
34. 34. A method according to claim 33, in which the determination of whether the image is of the left eye or the right eye comprises: locating the center of the iris on the image; locate the corneal vertex on the image; and compare the location of the corneal apex to the location of the center of the iris.
35. 35. A method according to claim 34, wherein the location of the corneal apex comprises locating at least one reflection on the image, where at least one reflection is caused by the illumination of the eye, while the image is adhered.
36. 36. A method, according to claim 35, in which the determination whether the image is of the left eye or the right eye comprises assuming that at least one reflection has been displaced, in relation to the center of the iris, toward the nose of the patient, from which the image is adhered.
37. 37. A method according to claim 36, wherein the determination further comprises: measuring a displacement of at least one reflection toward the nose, with respect to the center of the iris, and determining whether the image is of the left eye or the right eye, based on the measured displacement.
38. 38. A method according to claim 36, wherein the determination further comprises: measuring a displacement of at least one reflection, towards the nose, relative to the center of the iris; compare the measured displacement with a predetermined threshold displacement; and determine whether the image is of the left eye or the right eye only if the measured displacement is equal to or greater than the predetermined threshold.
39. 39. A method according to claim 34, which further comprises locating a center of the pupil of the eye on the image, before locating the center of the iris.
40. 40. A method according to claim 33, which further comprises illuminating the eye before obtaining the image of the eye.
41. 41. A method according to claim 40, wherein the illumination of the eye comprises illuminating with at least one source of infrared light.
42. 42. A method according to claim 41, wherein the illumination of the eye comprises illuminating the pupil of the eye with at least two infrared light emitting diodes, arranged wax of the aperture through which the image is adhered.
43. 43. A method according to claim 33, wherein obtaining the image comprises forming the image of the eye using a wavefront imaging device.
44. 44. A method according to claim 43, wherein obtaining the image comprises obtaining an image of the pupil of the eye.
45. 45. A method according to claim 44, wherein the illumination of the eye comprises illuminating the pupil using at least one source of infrared light, disposed close to the aperture, through which the image of the eye is adhered.
46. 46. A laser eye surgery system, this system includes: a laser that emits a beam of ablative light energy; Y a computer processor, configured to receive an image of an eye and at least one of a wavefront measurement and an ablation pattern, this computer processor has a computer program, to determine whether the image is of the eye iz ' guierdo or the right eye, based on the location of the corneal vertex in the image, relative to the iris center on the image; in which the computer processor is configured to verify that the correct eye has been selected, in which the laser eye surgery procedure will be performed, based on the determination and measurement of the wavefront and / or the pattern of ablation.
47. 47. A system according to claim 46, wherein the image of the eye comprises an image of the pupil taken during the measurement of the wavefront.
48. 48. A system according to claim 46, in which the computer processor is further configured to locate the center of the iris and the corneal apex on the image of the eye.
49. 49. A system, according to claim 48, in which the computer processor determines the location of the corneal apex, based on the location of at least one reflection on the image, where at least one reflection is used by the illumination of the eye while Adguire the image.
50. 50. A system, according to claim 49, in which the computer's processor determines whether the image is of the left eye or the right eye, assuming that this at least one reflection is located closer than the center of the iris to the nose of a patient. , from which the image is obtained.
51. 51. A system, according to claim 50, in which the computer processor is further configured to measure a distance between the center of the iris and at least one reflection.
52. 52. A system according to claim 51, wherein the computer processor is further configured to compare the measured distance to a predetermined threshold distance and decides whether a determination of the left eye / right eye can be made, based on said comparison.
53. 53. A system, according to claim 46, which further comprises at least one image adducing device, to obtain this image.
54. 54. A system according to claim 53, wherein the image adduction device comprises an image device of the wave front, to form the image of the pupil of the eye.
55. 55. A system according to claim 53, wherein the wavefront imaging device includes at least one infrared light source, disposed close to an aperture, through which the image is adhered.
56. 56. A laser eye surgery system, this system includes: a laser that emits a beam of ablative light energy; a light source, which directs light towards the corneal tissue of the eye; a microscope that captures the image of illuminated corneal tissue; and a computer processor, configured to direct a customary pattern of energy from the ablation light to the eye, this processor has an identification module of the left / right eye, which generates a signal from the left eye or a signal from the right eye, in response to the image of the corneal tissue.
57. 57. A system according to claim 56, wherein the module generates an indeterminate eye signal when the image of the corneal tissue provides insufficient information to generate a left eye signal or a right eye signal.
58. 58. A system, according to claim 57, in which this insufficient information comprises an amount of displacement of the location of the corneal vertex of the eye relative to the iris center of the eye, the amount of displacement being less than the predetermined threshold amount.
59. 59. A system according to claim 56, wherein the processor verifies that the correct eye has been selected, in which the procedure of laser surgery of the eye will be performed, based on the signal of the left eye or the right eye and at least one of the wavefront measurement and an ablation pattern for the eye.