WO2011103357A2 - Optical coherence tomographic system for ophthalmic surgery - Google Patents

Optical coherence tomographic system for ophthalmic surgery Download PDF

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Publication number
WO2011103357A2
WO2011103357A2 PCT/US2011/025332 US2011025332W WO2011103357A2 WO 2011103357 A2 WO2011103357 A2 WO 2011103357A2 US 2011025332 W US2011025332 W US 2011025332W WO 2011103357 A2 WO2011103357 A2 WO 2011103357A2
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WO
WIPO (PCT)
Prior art keywords
image
imaging
oct
eye
imaging system
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2011/025332
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English (en)
French (fr)
Other versions
WO2011103357A3 (en
Inventor
Ilya Goldshleger
Guy Holland
Ferenc Raksi
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Alcon Lensx Inc
Original Assignee
LenSx Lasers Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by LenSx Lasers Inc filed Critical LenSx Lasers Inc
Priority to CA2788219A priority Critical patent/CA2788219C/en
Priority to EP11745275.5A priority patent/EP2536326B1/en
Priority to BR112012019873A priority patent/BR112012019873A2/pt
Priority to JP2012554039A priority patent/JP5844748B2/ja
Priority to AU2011217975A priority patent/AU2011217975B2/en
Priority to CN201180009880.3A priority patent/CN102762143B/zh
Priority to KR1020127024412A priority patent/KR101791126B1/ko
Priority to MX2012009575A priority patent/MX2012009575A/es
Priority to ES11745275.5T priority patent/ES2545894T3/es
Publication of WO2011103357A2 publication Critical patent/WO2011103357A2/en
Publication of WO2011103357A3 publication Critical patent/WO2011103357A3/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/102—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for optical coherence tomography [OCT]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
    • G01B9/00—Measuring instruments characterised by the use of optical techniques
    • G01B9/02—Interferometers
    • G01B9/02041—Interferometers characterised by particular imaging or detection techniques
    • G01B9/02044—Imaging in the frequency domain, e.g. by using a spectrometer
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
    • G01B9/00—Measuring instruments characterised by the use of optical techniques
    • G01B9/02—Interferometers
    • G01B9/02055—Reduction or prevention of errors; Testing; Calibration
    • G01B9/02075—Reduction or prevention of errors; Testing; Calibration of particular errors
    • G01B9/02078—Caused by ambiguity
    • G—PHYSICS
    • G01—MEASURING; TESTING
    • G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
    • G01B9/00—Measuring instruments characterised by the use of optical techniques
    • G01B9/02—Interferometers
    • G01B9/0209—Low-coherence interferometers
    • G01B9/02091—Tomographic interferometers, e.g. based on optical coherence
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • A61B5/0062—Arrangements for scanning
    • A61B5/0066—Optical coherence imaging
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7253—Details of waveform analysis characterised by using transforms
    • A61B5/7257—Details of waveform analysis characterised by using transforms using Fourier transforms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00844—Feedback systems
    • A61F2009/00851—Optical coherence topography [OCT]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/0087—Lens
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00872—Cornea
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/009—Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses

Definitions

  • the SD-OCT imaging system includes an imaging light source that outputs an imaging light; one or more beam splitters that splits the imaging light into an imaging beam and a reference beam; and unifies a returned imaging light-portion and a returned reference light-portion into an interfering light; a reference device, that returns the reference light-portion, with a time difference proportional to a reference distance; and an interference analyzer, that receives the interfering light; and generates an SD-OCT image of the eye.
  • the SD-OCT imaging system controls an imaging range around the reference depth into a range of one of 0 mm - 15 mm and 5 mm - 15 mm. [0033] In some implementations the SD-OCT imaging system suppresses the non- selected images by at least one of preventing the display of generated non-selected images; generating the non-selected images without displaying the non-selected images; or performing a computational step to prevent the generation of the non-selected images.
  • Optical imaging techniques and systems described in this document provide high- fidelity optical imaging based on optical coherence tomographic imaging and can be used in, among other applications, optical imaging in ophthalmic surgery and imaging-guided surgery.
  • the described optical imaging techniques and systems can be implemented in ways that mitigate technical problems associated with the complex ambiguity in OCT.
  • step 120 the SD-OCT system can be used to create an image of the eye. If the SD-OCT is practiced without following the steps of method 100, it generates direct and mirror images of the imaged objects. As explained above, this proliferation of the images leads to an imaging ambiguity and thus undermines the utility of the OCT imaging system for ophthalmic or any other applications.
  • Assembling the eventually displayed image may include performing a transformation on one of the first and second image-portions to generate a biologically representative image of the first and second eye-structures in step 150, when at least one of the first and the second image-portions is a mirror image.
  • This transformation can be e.g. a mirroring of the mirror image relative to a suitably chosen mirror plane or line, thus creating a direct image. Such a transformation may not be necessary when the first and the second image-portions are direct images.
  • FIG. 3B illustrates a related method of imaging 100'.
  • the method 100' can include the steps of:
  • Laser surgery systems can be designed to include laser control and aiming tools to precisely target laser pulses to a particular target inside the tissue.
  • the required level of targeting precision is relatively low. This is in part because the laser energy used is relatively high and thus the affected tissue area is also relatively large, often covering an impacted area with a dimension in the hundreds of microns. The time between laser pulses in such systems tend to be long and manual controlled targeting is feasible and is commonly used.
  • the precise distance from the reference plate on the surface of the eye to the target tends to vary due to the presence of collapsible structures, such as the cornea itself, the anterior chamber, and the iris. Not only is their considerable variability in the distance between the applanated cornea and the lens between individual eyes, but there can also be variation within the same eye depending on the specific surgical and applanation technique used by the surgeon. In addition, there can be movement of the targeted lens tissue relative to the applanated surface during the firing of the thousands of laser pulses required for achieving the surgical effect, further complicating the accurate delivery of pulses. In addition, structure within the eye may move due to the buildup of photodisruptive byproducts, such as cavitation bubbles.
  • the applanation plate in the present systems is provided to facilitate and control precise, high speed positioning requirement for delivery of laser pulses into the tissue.
  • Such an applanation plate can be made of a transparent material such as a glass with a predefined contact surface to the tissue so that the contact surface of the applanation plate forms a well- defined optical interface with the tissue.
  • This well-defined interface can facilitate transmission and focusing of laser light into the tissue to control or reduce optical aberrations or variations (such as due to specific eye optical properties or changes that occur with surface drying) that are most critical at the air-tissue interface, which in the eye is at the anterior surface of the cornea.
  • a number of contact lenses have been designed for various applications and targets inside the eye and other tissues, including ones that are disposable or reusable.
  • the imaging system 2200 in FIG. 8 can be an OCT module positioned relative to the patient interface 2150 of the surgical system 2100 to have a known spatial relation with respect to the patient interface 2150 and the target issue 1001 fixed to the patient interface 2150.
  • This OCT module 2200 can be configured to have its own patient interface 2240 for interacting with the target tissue 1001.
  • the imaging system 2200 includes an imaging control module 2220 and an imaging sub-system 2230.
  • the sub-system 2230 includes a light source for generating imaging beam 2250 for imaging the target 1001 and an imaging beam delivery module to direct the optical probe beam or imaging beam 2250 to the target tissue 1001 and receive returned probe light 2260 of the optical imaging beam 2250 from the target tissue 1001 to capture OCT images of the target tissue 1001.
  • Both the optical imaging beam 2250 and the surgical beam 2160 can be simultaneously directed to the target tissue 1001 to allow for sequential or simultaneous imaging and surgical operation.
  • FIG. 16 shows another imaging-guided system that uses a single pulsed laser 9100 to produce the surgical light and the imaging light.
  • a nonlinear spectral broadening media 9400 is placed in the output optical path of the femtosecond pulsed laser to use an optical non-linear process such as white light generation or spectral broadening to broaden the spectral bandwidth of the pulses from a laser source of relatively longer pulses, several hundred femtoseconds normally used in surgery.
  • the media 9400 can be a fiber-optic material, for example.
  • the light intensity requirements of the two systems are different and a mechanism to adjust beam intensities can be implemented to meet such requirements in the two systems.

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  • Health & Medical Sciences (AREA)
  • Physics & Mathematics (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • General Physics & Mathematics (AREA)
  • Ophthalmology & Optometry (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Optics & Photonics (AREA)
  • Vascular Medicine (AREA)
  • Pathology (AREA)
  • Artificial Intelligence (AREA)
  • Mathematical Physics (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Physiology (AREA)
  • Psychiatry (AREA)
  • Signal Processing (AREA)
  • Eye Examination Apparatus (AREA)
  • Investigating Or Analysing Materials By Optical Means (AREA)
PCT/US2011/025332 2010-02-18 2011-02-17 Optical coherence tomographic system for ophthalmic surgery Ceased WO2011103357A2 (en)

Priority Applications (9)

Application Number Priority Date Filing Date Title
CA2788219A CA2788219C (en) 2010-02-18 2011-02-17 Optical coherence tomographic system for ophthalmic surgery
EP11745275.5A EP2536326B1 (en) 2010-02-18 2011-02-17 Optical coherence tomographic system for ophthalmic surgery
BR112012019873A BR112012019873A2 (pt) 2010-02-18 2011-02-17 métodos para formar imagem de um olho e para formar imagem de um objeto, e, sistemas de formação de imagem e de laser cirúrgico
JP2012554039A JP5844748B2 (ja) 2010-02-18 2011-02-17 眼を画像化する方法及び眼を画像化する画像化システム
AU2011217975A AU2011217975B2 (en) 2010-02-18 2011-02-17 Optical Coherence Tomographic system for ophthalmic surgery
CN201180009880.3A CN102762143B (zh) 2010-02-18 2011-02-17 用于眼科手术的光学相干断层摄影系统
KR1020127024412A KR101791126B1 (ko) 2010-02-18 2011-02-17 안과 수술을 위한 광간섭성 단층촬영 시스템
MX2012009575A MX2012009575A (es) 2010-02-18 2011-02-17 Sistema tomografico de coherencia optica para cirugia oftalmica.
ES11745275.5T ES2545894T3 (es) 2010-02-18 2011-02-17 Sistema de tomografía de coherencia óptica para cirugía oftálmica

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12/708,450 2010-02-18
US12/708,450 US8414564B2 (en) 2010-02-18 2010-02-18 Optical coherence tomographic system for ophthalmic surgery

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WO2011103357A2 true WO2011103357A2 (en) 2011-08-25
WO2011103357A3 WO2011103357A3 (en) 2011-11-10

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US (1) US8414564B2 (enExample)
EP (1) EP2536326B1 (enExample)
JP (1) JP5844748B2 (enExample)
KR (1) KR101791126B1 (enExample)
CN (1) CN102762143B (enExample)
AU (1) AU2011217975B2 (enExample)
BR (1) BR112012019873A2 (enExample)
CA (1) CA2788219C (enExample)
ES (1) ES2545894T3 (enExample)
MX (1) MX2012009575A (enExample)
TW (1) TWI583348B (enExample)
WO (1) WO2011103357A2 (enExample)

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AU2011217975A1 (en) 2012-08-23
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TW201138715A (en) 2011-11-16

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