Invented by Michael A. Campos, Javier G. Gonzalez, Teresa G. Miller-Gadda, AMO Development LLC
The AMO Development LLC invention works as follows
A laser-eye surgery system with a patient interface that relies on suction in order to keep the interface attached to the eye. The interface between the eye and laser system may consist of a liquid filled interface. Liquid is used to transmit the laser. During a procedure, various inputs are monitored in order to detect leaks. These inputs can include the video feed of an eye that is looking for air bubbles, force sensors on a patient interface which detect movement and vacuum sensors which directly sense the level of suction. The method can include combining the three monitoring activities and a Bayesian algorithms that calculates the probability of an impending vacuum loss event.
Background for Vacuum loss detection during laser eye surgery
The crystalline lens of the eye or its capsule, the lens capsule, is opacified. The cataract blocks the passage of light. The degree of opacity in a cataract can range from a slight haze to complete darkness. The power of the eye lens can increase early in the age-related cataract development, leading to nearsightedness (myopia). The lens can become progressively yellower and opaquer as the wavelengths of blue light are scattered and absorbed within the crystalline lens. The formation of cataracts usually progresses slowly, resulting in progressive loss of vision. Untreated cataracts can lead to blindness.
The most common treatment for cataracts is to replace the opaque crystalline lenses with artificial intraocular lenses (IOL). An estimated 15 million cataract operations are performed each year worldwide. In the past, cataract surgery was performed with a technique known as phacoemulsification. This involves using an ultrasonic tip and associated irrigation ports to sculpt the relatively soft nucleus of a lens in order to make it easier to remove through an anterior lens capsule opening. An anterior capsulotomy, in which a round hole is made in the anterior lens capsule with a surgical instrument, can provide access to the nucleus. Manual continuous curvilinear capsuleorhexis can be used to access the lens nucleus. “After removing the lens nucleus a foldable synthetic intraocular (IOL) may be inserted in the remaining lens capsule.
The phacoemulsification procedure to remove the cataract is one of the most challenging and crucial steps of the entire cataract extraction process. It is important to create a circular, smooth opening that allows for phacoemulsification and insertion of an intraocular implant. Some surgeons, because of the importance of this step choose a surgical laser over other tools such as microkeratomes or forceps. The laser can focus on very small amounts of eye tissues, improving the accuracy and reliability.
There are several commercial laser-assisted systems available for cataract removal and correction of astigmatism. Abbott Medical Optics’ CATALYS Precision Laser System is indicated for anterior capsuleotomy, astigmatism correction, phacofragmentation and creation of multi-plane and single-plane arc incisions/cuts on the cornea. The CATALYS System is a liquid-filled two-piece interface that docks to the patient’s eyes and provides a clear path for real-time imaging, OCT, and laser treatments. U.S. Pat. discloses aspects of the CATALYS system. Nos. 8,394,084, 8,500,724, 8,425,497, U.S. Patent Publication 2014/0163534, U.S. patent application Ser. No. No. 14/256 307, filed Apr. 18, 2014 (published as U.S. Patent Publication No. Published as U.S. Patent Publication No. The U.S. Patent Publication No. 2015/0018674 was published on January 15, 2015. No. No. 14/255.430, filed Apr. Published as U.S. Patent Publication No. The contents of the above publications are all incorporated by reference herein as if they were fully stated. The LenSx Laser by Alcon Laboratories, Inc., LENSAR Laser Systems from LENSAR, Inc., as well as the VICTUS Femtosecond Laser Platform of TECHNOLAS Perfection Vision GmbH, a Bausch+Lomb Company, are other systems for laser cataract surgery.
The docking interfaces that connect the eye to the laser system are a drawback of current systems. Docking interfaces are usually held in place by suction. Sometimes, separate pieces of interfaces can be held together. A negative event can occur if the vacuum level in these couplings decreases during a laser procedure. A loss of vacuum can introduce air, which has a diffractive index different from the liquid, into interfaces that are filled with liquid. This could affect the laser’s optics. Even though a sudden, significant pressure difference is a sign of deterioration, pressure fluctuations can still lead to failure. It is also not desirable to stop the laser during surgery if it isn’t necessary. In some cases, water that is displaced by the patient interface can be aspirated into the vacuum system. This reduces the system’s ability to detect a vacuum event. There is therefore a need for sophisticated detection systems to detect such loss of vacuum.
Improved Laser Eye Surgery Systems, and Related Methods, are Provided.” Laser eye surgery systems form precise incisions using a laser in the cornea, lens capsule and/or crystalline lens nucleus. A laser eye surgery system is preferred to include a subsystem for producing a laser treatment beam that incises tissue inside the eye. A scanning subsystem for optical coherence Tomography (OCT), which measures the spatial arrangement of external and inner structures of the eyes in order to form incisions. The laser eye system also includes an alignment system, shared optics that can scan the treatment beam and an alignment system relative to the laser surgery system. The alignment subsystem may include a video system that provides images of the eyes during docking the eye with the laser eye surgery device. In a preferred embodiment a liquid is used as an interface between the patient interface lens, and the eye. “The liquid interface is used to avoid imparting unwanted forces to the eye of the patient.
A laser-eye surgery system with a patient interface that relies on suction in order to keep the interface attached to the eye. The interface between the eye and laser system may consist of a liquid filled interface. Liquid is used to transmit the laser. During a procedure, various inputs are monitored in order to detect leaks. These inputs can include the video feed of an eye that is looking for air bubbles, force sensors on a patient interface which detect movement and vacuum sensors which directly sense the level of suction. The method can include combining the three monitoring activities and a Bayesian algorithms that calculates the probability of an impending vacuum loss event.
INCORPORATION BY RESEARCH
All publications, patents and patent applications mentioned herein are herein incorporated as if each publication, patent, and/or patent application were specifically and individually indicated that they would be incorporated by refer.
The disclosure includes methods and systems for laser eye surgery. Lasers are used to create precise incisions on the cornea, lens capsule and/or crystalline lens nucleus. A laser eye surgery device includes, in a preferred embodiment: a laser cutting system to generate a laser treatment beam that can incise the tissue in the eye; a range measuring system to determine the location of internal and external structures in the eye where incisions are possible; an alignment system and shared optics to scan a treatment beam, the beam of the ranging system, or an alignment beam in relation to the laser surgery system. The alignment subsystem may include a video system that provides images of the retina during docking the retina to the laser surgery system, and images of it after docking is completed. In one embodiment, the liquid interface between a patient’s interface lens and eye is preferred. “The liquid interface is used to avoid imparting unwanted forces to the eye of the patient.
Laser System Config
FIG. The system 2 includes a diagnostic and interventional unit 4, a patient chair 6, a dual function footswitch 8, and crystalline lens nucleus 10. The system 2 includes an interventional and diagnostic unit 4, a chair for the patient 6, a dual-function footswitch 8 and a laser switch 10.
The diagnostic and interventional module 4 contains many of the primary subsystems that make up the system 2. Externally visible subsystems, for example, include a touch screen control panel 12, a vacuum connection assembly 16, a docking keypad 18, and a radio frequency identification reader 20 (RFID), external connections 22 (e.g. network, video outputs, footswitch USB ports, door interlocks, and AC power), emergency laser stop button 24, key switch 28, USB data ports 30, and laser emission indicator 24.
The patient chair 6 consists of a base 32 and a patient support mattress 34. It also includes a headrest, a joystick control for the patient chair 38, which is located on the headrest. The positioning control is attached between the base 32, the patient support bed (34), and the headrest 36. The patient chair 6 can be positioned and adjusted in three axes, (x,y,z), using the joystick control for the chair. The headrest 36, along with a restraint system (not shown) that engages the forehead of the patient, stabilizes the patient’s neck during the procedure. The headrest 36 has an adjustable neck support that reduces head movement and provides comfort to the patient. The headrest 36 can be adjusted vertically to allow for patient comfort, and to accommodate variations in head size.
The patient chair 6 has manual adjustments that allow for tilt articulation. This includes the legs, torso and head. The patient chair 6 has three positions: a load position for the patient, a capture position for the suction rings, and a treat position for patients. In the patient-load position, the chair is rotated away from the diagnostic and treatment unit 4, with the patient’s chair in an upright position. The patient’s footrest is in a lower position. In the suction-ring capture position, rotate the chair out of the diagnostic and interventions unit 4, with the patient’s chair in a reclined position. The patient’s footrest is raised. In the patient treatment position, the chair rotates under the diagnostic unit 4. The patient chair is in a reclined position with the footrest raised.
The patient chair 6 has a “chair enable” feature to protect against unintended chair motion. The feature protects against accidental chair movement. Two ways are available to enable the patient chair joystick. The patient chair joystick has a “chair enable” button on the top of it. The button is located at the top of joystick. By pressing the “chair enable” button, you can control the position of patient chair 6 using the joystick 38. button. “Alternatively, the left foot switch of the dual-function footswitch 8, can be continuously pressed to enable the positional control of patient chair 6 via joystick 38.
In a preferred embodiment the patient control joystick is a proportional device. By moving the joystick in a small increment, the chair can move slowly. You can make the chair move faster by moving the joystick in a large quantity. The maximum speed of the chair can be achieved by holding the joystick to its maximum travel. As the patient approaches the patient interaction assembly 14, the chair speed available can be reduced.
The emergency stop button 26 is pressed to disable the patient’s chair 6, release the vacuum that couples the system 2 to the patient, and stop all laser output. The stop button is located next to the key switch on the front panel of the system.
The key switch 28 is used to activate the system 2. The system can be disabled by removing the key from the standby position. The key is activated when in the ready position.
The dual-function footswitch 8, also known as the dual footswitch, is a dual footswitch that consists of a left foot switch 40 along with a right foot 42. The left foot switch is the “chair enable” switch. footswitch. The right footswitch is a “vacuum ON” switch. Footswitch enabling vacuum to secure the liquid optics interface to the patient?s eye. The shrouded laser footswitch 10, is a footswitch which activates the treatment when pressed while the system has been enabled.
In a preferred implementation, the system 2 has external communication connections. The system 2 may include a RJ45 network connector (for example) to connect the system 2 with a network. The network connection may be used for network printing of reports on treatments, remote access in order to view performance logs and remote access in order to perform diagnostics. The system 2 may include a video port (e.g. HDMI) which can be used to output videos of treatments performed by system 2. The video output can be shown on an external monitor, for example to family members or for training. The output video may also be recorded, for instance, to archive. The system 2 may include one or multiple data output ports, such as USB, to enable, for instance, exporting treatment reports to data storage devices. The treatment reports can be accessed later for any purpose, such as printing from an external PC if the user does not have access to network-based printing.
