Laser eye surgery systems and methods of treating vitreous and ocular floaters

Abstract

A laser eye surgery system used to treat vitreous bodies includes a laser source, a ranging subsystem, an integrated optical subsystem, and a patient interface assembly. The laser source produces a treatment beam that includes a plurality of laser pulses. The ranging subsystem produces a source beam used to locate one or more structures of an eye. In some embodiments, the ranging subsystem includes an optical coherence tomography (OCT) pickoff assembly that includes a first optical wedge and a second optical wedge separated from the first optical wedge. The OCT pickoff assembly is configured to divide an OCT source beam into a sample beam and a reference beam. The integrated optical subsystem is used to scan the treatment beam and the sample beam. In other embodiments, Purkinje imaging, Scheimpflug imaging, confocal or nonlinear optical microscopy, ultrasound, stereo imaging, fluorescence imaging, or other medical imaging technique may be used.

1 . A laser surgical system for making incisions in ocular tissues, the system comprising:
 a laser system comprising a scanning assembly, a laser operable to generate a laser beam configured to incise ocular tissue; and   a control system operably coupled to the laser system and configured to:
 operate the imaging device to locate a posterior of a lens in an eye; 
 operate the imaging device to locate a retina in the eye; 
 operate the imaging device to locate a vitreous body in a vitreous humor in the eye; 
 process the image data to determine a treatment scanning pattern for scanning a focal zone of the laser beam for performing one or more incisions in the vitreous humor; and 
 wherein positioning of the focal zone is guided by the control system based on the location of the vitreous body so as to perform the one or more incisions in the vitreous humor. 
   
     
     
         2 - 8 . (canceled) 
     
     
         9 . The system of  claim 1 , wherein the control system is configured to control the laser and the scanning assembly to cut the vitreous humor into the discrete portions by scanning the focal zone in one or more cutting planes. 
     
     
         10 . The system of  claim 9 , wherein the discrete portions are sized to be removable through a lumen of an ophthalmic aspiration probe. 
     
     
         11 . The system of  claim 10 , wherein the controller is further configure to scan the focal zone of the laser beam in the eye surface to form an incision minimally sized for insertion of the ophthalmic aspiration probe. 
     
     
         12 - 23 . (canceled) 
     
     
         24 . A method for incising ocular tissue, the method comprising:
 operating an imaging device to acquire image data of ocular tissue, the image data including a vitreous humor in an anterior chamber of an eye;   processing the image data via a control system so as to generate an vitreous humor scanning pattern for scanning a focal zone of a laser beam for cutting the vitreous humor, the imaging device being operatively coupled to the control system;   generating the laser beam; and   scanning the focal zone of the laser beam in the vitreous humor scanning pattern so as to cut the vitreous humor, wherein positioning of the focal zone is controlled by the control system based on the image data.   
     
     
         25 - 28 . (canceled) 
     
     
         29 . A system to modify a laser cataract surgery device, comprising:
 a numerical aperture device which is configured to attach to a laser cataract device and position the focal length of the laser to a depth between the posterior of a lens in the eye and at least three millimeters in front of a retina in the eye.   
     
     
         30 . (canceled) 
     
     
         31 . A laser surgical system for making incisions in ocular tissues, the system comprising:
 a laser system comprising a scanning assembly, a laser operable to generate a laser beam configured to incise ocular tissue;   an imaging device configured to acquire point by point image data from locations distributed throughout a volume of an anterior chamber of the eye of the patient and construct one or more images of patient eye tissues in the anterior chamber from the image data; and   a control system operably coupled to the laser system and configured to:   operate the imaging device to generate image data for vitreous humor in the anterior chamber of the eye;   process the image data to identify a location for each of one or more targets in the vitreous humor of the patient;   process the image data to determine a treatment scanning pattern for scanning a focal zone of the laser beam for performing one or more incisions in the vitreous humor; and   operate the laser and the scanning assembly to scan the focal zone of the laser beam in the treatment scanning pattern at each location of the one or more targets, wherein positioning of the focal zone is guided by the control system based on the location of the one or more targets so as to perform the one or more incision in the vitreous humor.   
     
     
         32 . A laser surgical system for making incisions in ocular tissues, the system comprising:
 a laser system comprising one or more optical elements configured to produce a transverse focal volume that is transverse to an optical axis, a scanning assembly, a laser operable to generate a laser beam configured to incise ocular tissue;   an imaging device configured to acquire image data from locations distributed throughout a volume of an anterior chamber of a patient eye and construct one or more images of eye tissues from the image data, and   a control system operably coupled to the laser system and configured to:
 operate the imaging device to generate image data for the patient's ocular tissue, including the vitreous humor in the anterior chamber; 
 process the image data to determine an incision scanning pattern for scanning the transverse focal zone of the laser beam for performing an incision in the vitreous humor, and operate the laser and the scanning assembly to scan the transverse focal zone of the laser beam to perform the incision, wherein positioning of the transverse focal zone is guided by the control system based on the image data so as to perform the incision in the vitreous humor. 
   
     
     
         33 . A method for incising ocular tissue, the method comprising:
 operating an imaging device to acquire image data of ocular tissue, the image data including lens posterior data and retina data of an eye;   processing the image data via a control system to locate a vitreous body in a vitreous humor in the eye, and based on the location of the vitreous body, to generate a vitreous humor incision scanning pattern for scanning a focal zone of a laser beam for performing a vitreous humor incision, wherein the vitreous humor incision surrounds a volume that completely contains the vitreous body without cutting through the volume, the imaging device being operatively coupled to the control system;   generating the laser beam;   scanning the focal zone of the laser beam in the vitreous humor incision scanning pattern so as to perform the vitreous humor incision, wherein positioning of the focal zone is controlled by the control system based on the vitreous humor incision scanning pattern; and   scanning the focal zone of the laser beam in the eye surface to form an incision minimally sized for insertion of an ophthalmic aspiration probe which is configured for removing of the vitreous body.   
     
     
         34 . The method of  claim 33 , further comprising inserting the ophthalmic aspiration probe into the vitreous humor to remove the vitreous body by aspiration. 
     
     
         35 . The method of  claim 33 , wherein the incision of the vitreous body is conducted using cutting planes that form at least one of a cube, cylinder, prism, and a pyramid in the vitreous humor.