TWI749760B - Apparatus for treating ocular tissue - Google Patents

Abstract

The present invention relates to an apparatus for treating an ocular tissue. The apparatus for treating the ocular tissue includes a laser source, an optical system, an optical scanning movement device, a controller and a removing device. The controller is configured to control the laser source to generate a femtosecond laser beam, to control the optical system to orientate the femtosecond laser beam toward the optical scanning movement device, and to control the optical scanning movement device to define a target area in the ocular tissue using the femtosecond laser beam, wherein the target area contains a sharp-edge part and a to-be-removed part, in which the sharp-edge part has a minimum thickness being gradually reduced to zero and is ablated by the femtosecond laser beam while the target area is defined. The removing device is configured to remove the to-be-removed part of the target area from the ocular tissue in response to operation from a user.

Description

Equipment for processing eye tissue

The present invention relates to equipment for processing ocular tissues.

In order to achieve the purpose of correcting vision, there is a conventional method of using excimer laser to change the curvature of the cornea of the eye, which can be called Laser Vision Correction (LVC). Among the laser vision correction methods, the most common is the excimer laser in situ lamellar orthokeratology (LASIK), which accounts for approximately 85% of all laser vision correction methods.

In the early stage of LASIK surgery, doctors usually use a physical blade (also called a microkeratome) to cut out a corneal flap on the cornea, then open the corneal flap, and then use a laser to cut away the exposed corneal tissue to change the cornea. Of radians. In recent years, with regard to the method of cutting the corneal flap on the cornea, a method using femtosecond lasers has also been developed, which uses thousands of laser pulses to produce photo-splitting effects to form tiny dotted vacuoles. The tissue separates, and the corneal flap is formed. Since femtosecond lasers can provide higher safety, repeatability, predictability and flexibility than microkeratomes, this method of using femtosecond lasers has been more and more widely used in LASIK surgery To form a corneal flap. In addition, the use of femtosecond lasers can also reduce the occurrence of adverse complications such as iatrogenic keratoconus (steep cornea), corneal flap displacement (flat cornea) and irregular corneal flaps related to the microkeratome. Probability.

However, in LASIK surgery, due to the large incision of the corneal flap, it is difficult for the corneal flap to support the cornea to resist intraocular pressure after the operation, which greatly weakens the strength of the cornea after the operation.

In addition to LASIK surgery, another laser vision correction method using femtosecond lasers has been developed in recent years. It uses femtosecond lasers to produce corneal lenses in the corneal tissue, and then the femtosecond lasers produce corneal lenses. Minimally invasive incisions remove (take out) the corneal lens from the corneal tissue, thereby changing the curvature of the cornea. In this method, since there is no need to produce a corneal flap with a larger incision, the problem of corneal flap displacement after the operation can be avoided, and the strength of the cornea is less likely to be weakened.

Regarding the method of removing (removing) the corneal lens, it is known to use a femtosecond laser to cut out two cut planes in the complete corneal tissue to form the corneal lens. The two cut planes include an upper cut plane that follows the outer shape of the cornea ( Called Cap) and a lower surface with a curvature higher than the upper surface (called Curvature). Then, a femtosecond laser is used to cut the outer periphery of the corneal lens again to create a minimally invasive incision through the corneal surface, so that the corneal lens can be taken out of the corneal tissue through this minimally invasive incision. In this way, after the corneal lens is taken out, the outer curvature of the cornea changes, and the difference is the refractive power necessary to correct the refractive error (correction of vision) of the eye.

U.S. Patent No. 10682256 discloses the technique of taking out the corneal lens. In order to prevent the corneal lens from rupturing (especially the edge part of the corneal lens) during removal from the corneal tissue, the upper section of the corneal lens must be cut. A compensation thickness is set between the undercut surface to increase the intensity of the edge of the corneal lens. However, as shown in Figures 5A and 5B, the method of setting the compensation thickness DH between the upper and lower cut surfaces will increase the thickness of the corneal lens that is removed (taken out), making the total thickness of the remaining cornea after the operation It will become thinner, which is less conducive to the strength of the cornea against intraocular pressure.

The purpose of the present invention is to provide a device for treating eye tissue, which can advantageously overcome the aforementioned problems in the prior art, while maintaining the strength of the eye tissue and avoiding partial rupture of the removed (taken out) eye tissue Favorable technical effect.

The device for processing eye tissue provided by the present invention includes a laser light source configured to generate a femtosecond laser beam; an optical system configured to guide the femtosecond laser beam generated by the laser light source; and an optical scanning moving device, It is configured to apply the femtosecond laser beam from the optical system to the eye tissue through the condenser lens; the controller is connected with the laser light source, the optical system and the optical scanning mobile device, and is configured to control the laser light source to generate the femtosecond laser beam ; Control the optical system to guide the femtosecond laser beam to the optical scanning moving device; and control the optical scanning moving device to use the femtosecond laser beam to generate a target treatment area in the eye tissue, wherein the target treatment area includes a sharp edge part and a waiting The removed part, the sharp-edged portion can have a minimum thickness that is tapered to a value of zero, and the sharp-edged portion is ablated by the femtosecond laser beam during the generation of the target processing area; and the removal device, configuration To remove the to-be-removed part of the target treatment area from the eye tissue under the operation of the user.

With the equipment for processing eye tissue provided by the present invention, the controller has already controlled the optical scanning moving device to ablate the target by the femtosecond laser beam before the removal device removes the portion to be removed from the target treatment area. The sharp edge of the area leaves the target treatment area with only the part to be removed that needs to be removed from the eye tissue, and this part to be removed will not break during the process of being removed from the eye tissue, so , It can avoid the problem of rupture of the removed (taken out) part of the eye tissue.

In addition, with the equipment for processing eye tissue provided by the present invention, there is no need to control the optical scanning moving device to set an additional compensation thickness for the target treatment area to avoid the removal of the removal device during the removal of the eye tissue ( During the process of taking out) the part of the crack occurred, according to the treatment According to the actual needs of tissues, the controller of the device for processing eye tissues of the present invention can control the optical scanning moving device so that the generated target treatment area has a corresponding thickness, and the minimum value of the thickness may be zero. In other words, the device for processing eye tissues of the present invention can avoid an additional increase in thickness other than the thickness of the target treatment area required for processing (for example, correcting) eye tissues, thereby achieving the purpose of maintaining the strength of eye tissues to the greatest extent. .

1: Undercut

2: Upper cut noodles

4: remove the cut

8: cut surface

100: Equipment for processing eye tissue

101: Laser light source

102: optical system

103: Optical scanning mobile device

104: Condenser

105: Controller

DH: Compensation thickness

E: Eye tissue

O: Central axis

S101~S104: steps

T1, T2: target processing area

TE: Sharp edge part

TR: part to be removed

With reference to the following detailed description, especially when considered in conjunction with the accompanying drawings, a more complete understanding of the present invention and many of its accompanying advantages will become easier to understand. Among them: FIG. 1 is a processing eye according to an embodiment of the present invention. Fig. 2A is a schematic front view of the target treatment area generated in the ocular tissue by the method of processing ocular tissue according to an embodiment of the present invention; Fig. 2B is along the line II- of Fig. 2A Figure 3A is a schematic front view of another target treatment area generated in the ocular tissue by the method for processing ocular tissue according to an embodiment of the present invention; Figure 3B is along the line III of Figure 3A -III is a schematic cross-sectional view taken; FIG. 4 is a schematic diagram of an apparatus for processing ocular tissue according to an embodiment of the present invention; and FIGS. 5A and 5B are schematic cross-sectional views of producing a corneal lens in the cornea according to the prior art.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In the following description, constituent elements having substantially the same function and arrangement are denoted by the same reference numerals, and repeated descriptions are made only when necessary.

First, referring to FIG. 1, a method for processing eye tissue according to an embodiment of the present invention will be described. In the following description of the embodiments of the present invention, the cornea is taken as an example of ocular tissue for description. However, the applicable ocular tissues of the method for processing ocular tissue of the present invention are not limited to this. For example, the method for treating ocular tissues according to the present invention can also be applied to ocular tissues such as lens.

As shown in FIG. 1, the method for processing eye tissue according to an embodiment of the present invention includes steps S101 to S104. First, in step S101, a femtosecond laser beam is generated from a laser light source. Next, in step S102, the femtosecond laser beam is directed toward the eye tissue. Next, in step S103, the target treatment areas T1 and T2 are generated in the eye tissue E by the femtosecond laser beam (see FIGS. 2A to 3B). The target treatment areas T1 and T2 include sharp-edged parts TE and to-be-moved Except for the portion TR, the sharp-edged portion TE may have a minimum thickness that tapers to a value of zero. Regarding more details of the target processing regions T1 and T2, a detailed description will be made later with reference to FIGS. 2A to 3B. Finally, in step S104, the to-be-removed parts TR of the target treatment areas T1 and T2 are removed from the eye tissue E.

Hereinafter, examples of two target treatment areas T1 and T2 generated in the eye tissue E according to the method for processing eye tissue according to the embodiment of the present invention will be described with reference to FIGS. 2A to 3B.

2A and 2B show an example of a target treatment area T1 generated in the eye tissue E by the method for processing eye tissue according to an embodiment of the present invention.

2A and 2B, the target treatment area T1 generated in the ocular tissue E includes: firstly, a lower section is generated in the ocular tissue E by a femtosecond laser beam 1, and then ablation by the femtosecond laser beam The sharp edge portion TE of the target processing area T1 and finally produced in the eye tissue E by the femtosecond laser beam The upper section 2 connected to the lower section 1 is produced. After the target processing area T1 has undergone such processing, its sharp edge TE has been ablated by the femtosecond laser beam and bubbled, and only the portion TR to be removed is left.

In the example shown in FIGS. 2A and 2B, the upper section 2 and the lower section 1 generated by the femtosecond laser beam are connected to each other at the outer periphery of the lower section 1, and therefore, the sharp edge portion TE of the target processing area T1 includes The connection between the upper section 2 and the lower section 1 at the outer periphery of the lower section 1.

In addition, in order to remove the to-be-removed portion TR of the target treatment area T1 from the eye tissue E, the method for processing eye tissue according to an embodiment of the present invention further includes using a femtosecond laser beam in the eye tissue E A removal incision 4 is made. This removal incision 4 is located at the outer periphery of the upper section 2 and connected from the outer surface of the eye tissue E to the upper section 2, and therefore, the removal incision 4 is also in line with the target treatment area T1 connect. In this way, the to-be-removed portion TR of the target treatment area T1 can be removed from the ocular tissue E through the removal incision 4.

After removing the to-be-removed portion TR of the target treatment area T1 shown in FIGS. 2A and 2B from the eye tissue E, the outer curvature of the eye tissue E (that is, the cornea in this embodiment) will be changed ( For example, it becomes more gentle), thus achieving the purpose of changing the curvature of the cornea to correct vision. In other words, the target treatment area T1 shown in FIGS. 2A and 2B is an example of the target treatment area that needs to be removed from the cornea in order to correct myopia.

3A and 3B show an example of another target treatment area T2 generated in the eye tissue E by the method for processing eye tissue according to an embodiment of the present invention.

3A and 3B, the target treatment area T2 is generated in the eye tissue E in a similar manner to the target treatment area T1 shown in FIGS. 2A and 2B. The difference between the two is that in FIGS. 3A and In the example shown in 3B, first the inferior section 1 generated by the femtosecond laser beam has a shape similar to W, and therefore, the upper section 2 and the inferior section 1 generated by the femtosecond laser beam are in addition to the lower section cut In addition to the outer periphery of the surface 1, the portions close to the central axis O are connected to each other (refer to FIG. 3B), and therefore, the sharp-edged portion TE of the target processing area T2 includes the outer periphery of the lower cutting surface 1 of the upper cutting surface 2 and the lower cutting surface 1. The edge and the part close to the central axis O are connected to each other. Furthermore, the sharp-edged portion TE of the target processing area T2 also includes the turning points on both sides of the cut plane 1 under the W shape. These sharp-edged portions TE of the target processing area T2 are all ablated by the femtosecond laser beam to become bubbles.

In addition, in order to remove the to-be-removed portion TR of the target treatment area T2 from the eye tissue E, similar to the removal of the to-be-removed portion TR of the target treatment area T1 from the eye tissue E as described above, according to the present invention The method for treating ocular tissues of the embodiment further includes making a removal incision 4 in the ocular tissue E by a femtosecond laser beam. The removal incision 4 is located at the outer periphery of the upper section 2 and is removed from the eye The outer surface of the tissue E is connected to the upper cut surface 2, and therefore, the removal incision 4 is also connected to the target treatment area T2. In this way, the to-be-removed portion TR of the target treatment area T2 can be removed from the ocular tissue E through the removal incision 4.

However, in the example shown in FIGS. 3A and 3B, since the upper cut surface 2 and the lower cut surface 1 of the target processing area T2 are connected to each other in a portion close to the central axis O in addition to the outer periphery of the lower cut surface 1 (refer to FIG. 3B ), when viewed from the direction of the front schematic view of FIG. 3A, the target processing area T2 has a shape similar to a doughnut. In this case, if you want to remove the to-be-removed portion TR of the target treatment area T2 through the removal incision 4, it is necessary to additionally ablate the cut surface 8 in the ocular tissue E with a femtosecond laser beam ( 3A), this cut surface 8 connects the upper cut surface 2 of the target treatment area T2 and the lower cut surface 1 at the connection between the outer periphery of the lower cut surface 1 and the part close to the central axis O, and penetrates the target treatment area T2, In this way, the target treatment area T2 is separated by the cut surface 8 so that the portion TR to be removed of the target treatment area T2 can be easily removed from the removal cut 4.

In order to further facilitate the removal of the portion TR to be removed of the target treatment area T2 from the removal incision 4, it is preferable to position the removal incision 4 and the cut surface 8 relative to the central axis O of the target treatment area T2. On the opposite side, so that the to-be-removed portion TR of the target treatment area T2 can be uniformly removed from the removal cut 4.

After removing the to-be-removed portion TR of the target treatment area T2 shown in FIGS. 3A and 3B from the ocular tissue E, the outer curvature of the ocular tissue E (that is, the cornea in this embodiment) will be changed ( For example, it becomes more convex), thus achieving the purpose of changing the curvature of the cornea to correct vision. In other words, the target treatment area T2 shown in FIGS. 3A and 3B is an example of the target treatment area that needs to be removed from the cornea in order to correct hyperopia.

From the above description with reference to FIGS. 2A to 3B for the examples of the target treatment areas T1 and T2 generated in the ocular tissue E by the method for treating ocular tissue according to the embodiment of the present invention, it can be clearly understood that the Before removing the to-be-removed parts TR of the target processing areas T1 and T2, the sharp-edged parts TE of the target processing areas T1 and T2 have been ablated by the femtosecond laser beam, leaving only the target processing areas T1, T2 to-be-removed. The part TR is removed, and in the process of removing the target treatment areas T1 and T2 of the eye tissue E, the part TR to be removed is less likely to be broken. Therefore, the method for treating ocular tissue according to the present invention can indeed effectively avoid the part of the removed ocular tissue (for example, the cornea) (that is, the target treatment areas T1, T2) from rupturing during the removal process. The problem occurs.

In addition, because in the method of processing ocular tissues according to the present invention, the removed ocular tissues (for example, cornea) will not rupture during the removal process, compared with the previous The technology avoids the problem of rupture during the removal process by setting an additional compensation thickness for the target treatment area. The method of processing ocular tissues of the present invention does not need to set an additional compensation thickness for the target treatment area. Therefore, according to the treatment The actual needs of eye tissue, the method of processing eye tissue of the present invention can be The resulting target processing area has a corresponding thickness, and the minimum value of this thickness may be zero. In other words, the method for processing ocular tissues of the present invention can avoid additional increase in thickness (for example, the compensation thickness in the prior art) other than the thickness of the target treatment area necessary for processing (for example, correcting) ocular tissues, and thereby to the greatest extent To achieve the purpose of maintaining the strength of eye tissue.

On the other hand, since the method for processing ocular tissues according to the present invention can produce a target treatment area with a corresponding thickness without setting a compensation thickness, it can more accurately determine what is necessary for processing (for example, correcting) ocular tissues The range of the target processing area makes the processing range (for example, correctable visual acuity) more extensive. For example, for vision correction, if the maximum thickness of the removed target treatment area that the cornea can withstand is DA, since the prior art must additionally set a compensation thickness DH for the removed target treatment area, the range of vision that can be corrected is The maximum thickness is equivalent to the range of DA-DH (the maximum thickness of the target treatment area that the cornea can withstand removal minus the compensation thickness) range. In contrast, the method for treating ocular tissue according to the present invention does not require any The compensation thickness of, the range of vision that can be corrected is the maximum thickness equivalent to DA (the maximum thickness of the target treatment area that the cornea can withstand removal).

FIG. 4 shows a schematic diagram of an apparatus 100 for processing eye tissue according to an embodiment of the present invention.

The apparatus 100 for processing eye tissue according to an embodiment of the present invention includes a laser light source 101 configured to generate a femtosecond laser beam; an optical system 102 configured to guide the femtosecond laser beam generated by the laser light source 101; The optical scanning moving device 103 is configured to apply the femtosecond laser beam from the optical system 102 to the eye tissue E through the condenser lens 104; and the controller 105 is connected to the laser light source 101, the optical system 102 and the optical scanning moving device 103 , And is configured to control the laser light source 101, the optical system 102 and the optical scanning moving device 103 to generate target treatment areas T1, T2 in the eye tissue E (see Figures 2A to 3B). The apparatus 100 for treating eye tissue according to an embodiment of the present invention further includes a removing device (not shown in the figure), which is configured to remove the target treatment area T1, T2 from the eye tissue E under the operation of the user. The part of TR to be removed (see Figures 2A to 3B).

Specifically, the controller 105 is configured to control the laser light source 101 to generate a femtosecond laser beam, control the optical system 102 to guide the femtosecond laser beam to the optical scanning moving device 103, and control the optical scanning moving device 103 by femtosecond The laser beam passes through the condenser lens 104 to generate target processing areas T1, T2 in the eye tissue E. The target processing areas T1, T2 include sharp-edged portions TE and portions to be removed TR. The sharp-edged portions TE may be tapered to a value of zero The minimum thickness of φ, and the sharp edge portion TE is ablated by the femtosecond laser beam during the generation of the target processing regions T1 and T2.

For more details on how the controller 105 generates the target processing regions T1 and T2 in the eye tissue E, please refer to the description of FIGS. 2A to 3B in the foregoing, and will not be repeated here.

Similarly, in the device 100 for processing eye tissues according to the present invention, the controller 105 has first controlled The optical scanning moving device 103 uses the femtosecond laser beam to ablate the sharp edge portions TE of the target processing regions T1, T2, so that only the portion TR to be removed is left in the target processing regions T1, T2, and this portion TR to be removed In the process of removing the target treatment areas T1 and T2 of the eye tissue E, it is less likely to break. Therefore, the device for treating ocular tissue according to the present invention can indeed effectively avoid the part of the removed ocular tissue (for example, the cornea) (that is, the target treatment areas T1, T2) from rupturing during the removal process. The problem occurs.

In addition, since in the apparatus 100 for processing ocular tissues according to the present invention, the portion of the removed ocular tissue E (for example, the cornea) will not rupture during the process of being removed by the removal device. Compared with the prior art by setting an additional compensation thickness for the target treatment area to avoid the problem of rupture during the removal process, the device for processing ocular tissues of the present invention does not require treatment of the target treatment area. The additional compensation thickness is set in the field. Therefore, according to the actual needs of processing eye tissue, the controller of the device for processing eye tissue of the present invention can control the optical scanning moving device so that the generated target processing area has a corresponding thickness, and this The minimum thickness may be zero. In other words, the device for processing ocular tissues of the present invention can avoid an additional increase in thickness other than the thickness of the target treatment area necessary for processing (for example, correcting) ocular tissues (for example, the compensation thickness in the prior art), thereby maximizing To achieve the purpose of maintaining the strength of eye tissue.

On the other hand, likewise, since the device 100 for processing ocular tissues according to the present invention can generate a target treatment area with a corresponding thickness without setting a compensation thickness, it can more accurately determine the treatment (for example, correction) of the eye The range of the target treatment area necessary for the tissue makes the range (for example, correctable vision) more extensive. This advantage has been explained in detail in the previous article, so I won't repeat it here.

The drawings of the embodiments described herein are intended to provide an understanding of the present invention. In other words, the drawings are only representative and may not be drawn to scale. Some proportions in the drawing may be enlarged, while other proportions may be reduced. Accordingly, the drawings should be regarded as illustrative rather than restrictive.

Although various embodiments of the present invention have been described in the above embodiments with reference to the drawings, the above embodiments are only preferred embodiments of the present invention, and are not intended to limit the present invention to the above description and the drawings. Features and structure shown. It should be understood that, without departing from the scope of the present invention, various other omissions, substitutions, changes and modifications that can be envisaged by those skilled in the art are also included in the scope of the present invention.

100: Equipment for processing eye tissue

101: Laser light source

102: optical system

103: Optical scanning mobile device

104: Condenser

105: Controller

E: Eye tissue

Claims (9)

A device for processing eye tissue, comprising: a laser light source configured to generate a femtosecond laser beam; an optical system configured to guide the femtosecond laser beam generated by the laser light source; and an optical scanning moving device configured to To apply the femtosecond laser beam from the optical system to the eye tissue through a condenser lens; a controller is connected to the laser light source, the optical system and the optical scanning moving device, and is configured to control the laser light source to generate The femtosecond laser beam; controlling the optical system to guide the femtosecond laser beam to the optical scanning moving device; and controlling the optical scanning moving device to use the femtosecond laser beam to generate a target treatment area in the eye tissue , Wherein the target processing area includes a sharp-edged portion and a portion to be removed, the sharp-edged portion may have a minimum thickness that is tapered to a value of zero, and wherein the sharp-edged portion is borrowed during the generation of the target processing area Ablated by the femtosecond laser beam; and a removal device configured to remove the part to be removed of the target treatment area from the ocular tissue under the operation of the user. The device for processing ocular tissue according to claim 1, wherein, before the removing device removes the part to be removed of the target treatment area from the ocular tissue, the controller is further configured to control the optical The scanning mobile device uses the femtosecond laser beam to make a removal incision in the ocular tissue from the outer surface of the ocular tissue to the target treatment area, and wherein the removal device is configured to be in the user's Under operation, the part to be removed of the target treatment area is removed from the ocular tissue through the removal incision. The device for processing eye tissue according to claim 1, wherein the controller controlling the optical scanning moving device to generate the target treatment area in the eye tissue with the femtosecond laser beam includes: in the eye tissue A lower cut surface is generated in the middle; the sharp-edged portion of the target treatment area is ablated; and an upper cut surface connected to the lower cut surface is generated in the ocular tissue. The device for processing eye tissue according to claim 3, wherein the upper cut surface and the lower cut surface are connected to each other at the outer periphery of the lower cut surface; and wherein the sharp edge portion of the target treatment area includes the upper cut surface and The undercut surface is where the outer peripheral edges of the undercut surface are connected to each other. The device for processing eye tissue according to claim 4, wherein, before the removing device removes the portion to be removed of the target treatment area from the eye tissue, the controller is further configured to control the optical The scanning mobile device uses the femtosecond laser beam to make a removal incision in the ocular tissue from the outer surface of the ocular tissue to the target treatment area, and wherein the removal device is configured to be in the user's Under operation, the part to be removed of the target treatment area is removed from the ocular tissue through the removal incision. The device for processing eye tissue according to claim 3, wherein the upper cut surface and the lower cut surface are connected to each other at the outer periphery of the lower cut surface and a portion close to the central axis; wherein, the sharp-edged portion of the target treatment area It includes the interconnection between the upper cut surface and the lower cut surface at the outer periphery of the lower cut surface and the part close to the central axis; and wherein the controller controls the optical scanning moving device to use the femtosecond mine The beam generating the target treatment area in the eye tissue also includes ablating a cut surface that connects the upper cut surface and the lower cut surface. The connection point between the outer peripheral edge of the undercut surface and the part close to the central axis passes through the target treatment area. The device for processing eye tissue according to claim 6, wherein, before the removing device removes the portion to be removed of the target treatment area from the eye tissue, the controller is further configured to control the optical The scanning mobile device uses the femtosecond laser beam to make a removal incision in the ocular tissue from the outer surface of the ocular tissue to the target treatment area, and wherein the removal device is configured to be in the user's Under operation, the part to be removed of the target treatment area is removed from the ocular tissue through the removal incision. The device for treating ocular tissue according to claim 7, wherein the cut surface is located on the opposite side of the removal incision with respect to the central axis of the target treatment area. The device for processing ocular tissue according to claim 1, wherein the ocular tissue is a cornea or a lens.

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