Ophthalmic surgical microscope with adaptive optics for optical wavefront compensation

An ophthalmic surgical microscope can include a first light source configured to project a first light beam at an observer's eye. The microscope can include a first wavefront sensor. The first wavefront sensor can be configured to determine aberrations in the first reflection wavefront of a reflection of the first light beam. The microscope can include adaptive optical element(s). The adaptive optical element(s) can be controlled to modify the phase of incident light. The microscope can include a computing device in communication with the first wavefront sensor and the adaptive optical element(s). The computing device can be configured to generate the control signal to compensate for the aberrations and to provide the control signal to the adaptive optical element(s). A second light source and second wavefront sensor can be provided to compensate for aberrations of a subject's eye.

BACKGROUND

Technical Field

Embodiments disclosed herein are related to ophthalmic surgical microscopes. More specifically, embodiments described herein relate to an ophthalmic surgical microscope including adaptive optical element(s) and wavefront sensor(s) to dynamically compensate for optical aberrations.

Related Art

Doctors can use surgical microscopes during ophthalmic surgical procedures to see fine details of a patient's eye. A successful procedure can depend on the doctor's ability to view the patient's eye clearly using the microscope. This can be challenging, however, because of artifacts of the doctor's eye and/or the patient's eye. For example, the doctor and/or the patient can have static vision problems. These can include refractive errors, astigmatism, other low order aberrations, and/or high order aberrations. Further, dynamic errors can arise during a surgical procedure. These include the presence of tear film in the doctor's eye, saline solution in the patient's eye, among others. The artifacts of the doctor's eye and/or the patient's eye interfere with the doctor's vision of the surgical field and can hinder the efficacy of a surgical procedure.

Some conventional methods can partially compensate for a doctor's and/or a patient's vision problems when using current surgical microscope models. The doctor can have refractive surgery to correct some vision problems, such as long term refractive errors. The doctor can wear spectacles to compensate for refractive errors and astigmatism. Wearing spectacles during the surgical procedure, however, can be uncomfortable for a doctor. Turning oculars of the microscope can be used to compensate for spherical refractive errors of the doctor and the patient. However, no microscope currently compensates for high order aberrations of the doctor's eye. And no microscope currently compensates for astigmatism and high order aberrations of the patient's eye. Further, no microscope compensates for dynamic errors that arise during the surgical procedure.

SUMMARY

The presented solution fills an unmet medical need with a unique solution to provide the combination of adaptive optical element(s) and wavefront sensor(s) in an ophthalmic surgical microscope to actively remove optical aberrations caused by vision problems of a doctor and/or a patient, as well as dynamic errors arising during a surgical procedure. As a result, the doctor's vision of the patient's eyes and the doctor's ability resolve fine details during a surgical procedure can be drastically improved.

Consistent with some embodiments, an ophthalmic surgical microscope disposed in an optical path between an observer and a subject includes: a first light source configured to project a first light beam at an eye of the observer, a reflection of the first light beam from the eye of the observer including a first reflection wavefront; a first wavefront sensor disposed in an optical path of a reflection of the first light beam from the eye of the observer, the first wavefront sensor being configured to determine aberrations in a first reflection wavefront of the reflection of the first light beam; an adaptive optical element disposed in the optical path between the observer and the subject, the adaptive optical element being configured to modify the phase of incident light to compensate for the aberrations in the first reflection wavefront in response to a control signal; and a computing device in communication with the first wavefront sensor and the adaptive optical element, the computing device being configured to generate the control signal to compensate for the aberrations in the first reflection wavefront and to provide the control signal to the adaptive optical element.

Consistent with some embodiments, a method of compensating for optical aberrations in an ophthalmic surgical microscope disposed in an optical path between an observer and a subject includes: projecting a first light beam at an eye of an observer; determining aberrations in a first reflection wavefront of a reflection of the first light beam from the eye of the observer; projecting a second light beam at an eye of the subject; determining aberrations in a second reflection wavefront of a reflection of the second light beam from the eye of the subject; and controlling an adaptive optical element disposed in the optical path between the observer and the subject to modify a phase of light in the optical path to compensate for the aberrations in the first and second reflection wavefronts.

In the drawings, elements having the same designation have the same or similar functions.

DETAILED DESCRIPTION

In the following description specific details are set forth describing certain embodiments. It will be apparent, however, to one skilled in the art that the disclosed embodiments may be practiced without some or all of these specific details. The specific embodiments presented are meant to be illustrative, but not limiting. One skilled in the art may realize other material that, although not specifically described herein, is within the scope and spirit of this disclosure.

The present disclosure describes an ophthalmic surgical microscope with adaptive optical element(s) and wavefront sensor(s). The adaptive optical element and the wavefront sensor can be implemented in optical paths associated with the doctor and/or the patient. For example, a laser can be projected on the doctor's retina. A wavefront of light reflected from the retina can be detected by the wavefront sensor. The wavefront sensor can determine if the wavefront is curved (e.g., it includes phase aberrations) or flat (e.g., it does not include phase aberrations). The reflective or transmissive adaptive optical element can be controlled to modify the phase of light in the optical path between the doctor and the patient to compensate for any detected aberrations. A similar configuration can be implemented to correct optical aberrations associated with the patient.

The devices, systems, and methods of the present disclosure provide numerous advantages, including: (1) improving efficacy of surgical procedures by compensating for wavefront deformations resulting from a doctor's vision problems, including astigmatism and high order aberrations; (2) improving efficacy of surgical procedures by compensating for wavefront deformations resulting from a patient's vision problems, including astigmatism and high order aberrations; (3) increasing flexibility for surgical microscopes by providing dynamic wavefront compensation for optical aberrations arising during surgical procedures; and (4) increasing usability for surgical microscopes by maximizing surgical field sight for all doctors, regardless of varying degrees of problematic vision.

FIG. 1provides a flow diagram of a method100of compensating for optical aberrations in an ophthalmic surgical microscope disposed in an optical path between an observer and a subject. The method100can be further understood with reference toFIGS. 2and3, which illustrate ophthalmic surgical microscopes according to embodiments of the present disclosure.FIG. 2illustrates a microscope206including reflective adaptive optical elements (e.g., reflective elements218and232), andFIG. 3illustrates the microscope206including a transmissive adaptive optical element (e.g., transmissive element234).

Referring toFIG. 1, the method100can include, at step110, projecting a first light beam at the eye of an observer. The method100further includes, at step120, determining aberrations in a first reflection wavefront associated with the first light beam. Steps110and120can be associated with identifying optical aberrations of the observer.

As shown inFIGS. 2 and 3, an observer202can use an ophthalmic surgical microscope206to view the eye of a subject204. The observer202can be a healthcare professional, such as a doctor or surgeon performing a diagnostic, surgical, and/or other medical procedure. The subject204can be a patient undergoing the medical procedure.

The microscope206can include a light source208. The light source208can be, for example, a laser light source, super-luminescent diode(s), or other suitable light source(s). At step110(FIG. 1), the light source208can project a first light beam along an optical path210at the eye of the observer202. The light source208can be configured to continuously or intermittently project the first light beam at the eye of the observer202. The light source208can be in communication with the computing device238. The computing device238can be configured to generate a control signal for and provide the control signal to the light source208. The control signal can be based on a first wavefront compensation frequency that describes a frequency at which the microscope206compensates for optical aberrations associated with the observer202. The control signal can be an electrical signal. The first wavefront compensation frequency can be adjustable (e.g., before and/or during the surgical procedure) based on the clinical objectives for wavefront compensation. For example, the first light beam can be projected at the eye of the observer202relatively infrequently, such as once a day, once during a surgical procedure, once every ten minutes, or other periods greater than, less than, and/or between those listed, to compensate for static vision problems. Projecting the light at a lower frequency can be associated with a lesser risk to the health of the observer202caused continuous or higher frequency irradiation of the retina. For example, the first light beam can be projected at a relatively higher frequency, such as once every thirty seconds, once a minute, or other periods greater than, less than, and/or between those listed, to compensate both for static vision problems and for dynamic errors arising during the surgical procedure (e.g., tear film in the eye of the observer202). Projecting the light at a higher frequency can be associated with maximizing vision of the surgical field for the observer202during the surgical procedure.

A reflection of the first light beam off of the eye of the observer202includes a reflection wavefront212. The reflection wavefront212can be received at a wavefront sensor214. The wavefront sensor214can be disposed in the optical path210of the reflection wavefront212. One or more optical paths (e.g., optical paths210,240, and242) can include beam splitters220. At step120(FIG. 1), the wavefront sensor214can determine phase aberrations in the reflection wavefront212(e.g., is the reflection wavefront212flat or curved). The aberrations detected by the wavefront sensor214can arise from multiple sources. For example, the aberrations detected by the reflection wavefront212can be associated with the eye of the observer202, including spherical refractive errors, cylindrical refractive errors, astigmatism, other low order aberrations, and/or high order aberrations. The aberrations can also result from dynamic sources, such as tear film in the eye of the observer202that naturally arises during the surgical procedure. Further, the aberrations can be associated with the structure of optical elements of the microscope206, such as one or more lenses222. The wavefront sensor214can be any suitable device for detecting optical aberrations, including a Shack-Hartmann wavefront sensor, a Talbot-Moire wavefront sensor, a Tscherning aberrometer, a laser ray tracing aberrometer, or other aberrometry device(s). The wavefront sensor214can be in communication with the computing device238. For example, the deformations in the reflection wavefront212detected by the wavefront sensor214can be received at the computing device238.

Referring again toFIG. 1, in some embodiments, the method100can include determining aberrations in the reflection wavefront212resulting from the optical elements in the optical path between the observer and the subject. For example, as shown inFIGS. 2 and 3, the lenses222can be disposed in the optical path240between the observer202and the subject204. The lenses222can be part of the eyepiece236and/or the body of the microscope206. The microscope206can include an optics correction device216for determining and compensating for optical aberrations associated with the structure of the lenses222. For example, the optics correction device216can identify and compensate for optical aberrations from the optical elements. In embodiments of the microscope206that include the optics correction device216, the aberrations determined by the wavefront sensor214can include those arising from vision problems and/or dynamic errors of the observer202because the optics correction device216mathematically compensates for the aberrations arising from the optical elements of the microscope206. Microscope optics errors can be identified during production (e.g., calibration) of the microscope206. For example, in some embodiments, the reflection wavefront from an ideal source (e.g., known not have any optical aberrations) can be detected and stored. Any aberrations in the ideal reflection wavefront can be the result of microscope optics errors. The ideal reflection wavefront can be compared to the reflection wavefront212from the observer202. Recall that the reflection wavefront212can include aberrations from the observer202and the optical elements. The difference between the ideal reflection wavefront and the reflection wavefront212can be associated solely with optical aberrations of the observer202and not the optical elements of the microscope206.

Referring again toFIG. 1, the method100can include, at step130, projecting a second light beam at the eye of a subject. The method100further includes, at step140, determining aberrations in a second reflection wavefront associated with the second light beam. Steps130and140can be associated with identifying optical aberrations of the subject. Steps130and140can be similar to steps110and120described above.

As shown inFIGS. 2 and 3, the microscope206can include similar components in the optical path associated with the subject204as those in the optical path associated with the observer202described above. For example, the microscope206can include a light source224. At step130(FIG. 1), the light source224can be configured to project a second light beam at an eye of the subject204. The light source224can be configured to continuously or intermittently project the second light beam at the eye of the subject204. The light source224can be in communication with the computing device238. The computing device238can be configured to generate a control signal for and provide the control signal to the light source224. The control signal can be based on a second wavefront compensation frequency. For example, second light beam can be projected at a relatively higher frequency, such that wavefront compensation is performed continuously or quasi-continuously. For example, the second light beam can be projected once approximately every 0.5 seconds, every 1 second, every 2 seconds, every 5 seconds, every 10 seconds, every 30 seconds, every 1 minute, every 2 minutes, and other periods greater than, less than, and/or between those listed, to compensate both for static vision problems and for dynamic errors arising during the surgical procedure (e.g., saline solution in the eye of the subject204). A reflection of the second light beam off of the eye of the subject204includes a reflection wavefront226. The reflection wavefront226can be received at a wavefront sensor228. The wavefront sensor228can be disposed in the optical path242of the reflection wavefront226. At step140(FIG. 1), the wavefront sensor228can determine phase aberrations in the reflection wavefront226(e.g., is the reflection wavefront226flat or curved). The wavefront sensor228can be in communication with the computing device238. Referring again toFIG. 1, in some embodiments, the method100can include determining aberrations in the second reflection wavefront resulting from the optical elements in the optical path between the observer and the subject. For example, as shown inFIGS. 2 and 3, the microscope206can include an optics correction device230for determining and compensating for optical aberrations associated with the structure of the lenses222.

Referring again toFIG. 1, the method100can include, at step150, controlling an adaptive optical element disposed in the optical path between the observer and the subject to modify a phase of light in the optical path to compensate for the aberrations in the first and second reflection wavefronts. The adaptive optical element can be in communication with the computing device238(FIGS. 2 and 3). The computing device238can include any suitable processor or processing circuit for generating a control signal for the adaptive optical element to compensate for wavefront deformations in the reflection wavefronts212and/or226. The control signal for the adaptive optical element can be generated based on the wavefront deformations detected by the wavefront sensors214and/or228, and received at the computing device238. The computing device238can provide the control signal to the adaptive optical element. As a result, the adaptive optical element compensates for optical aberrations by modifying the phase of incident light (e.g., modifying a curved wavefront such that it becomes flat). The adaptive optical element is configured to compensate for optical aberrations resulting from spherical refractive errors, cylindrical refractive errors, astigmatism, other low order aberrations, high order aberrations, dynamic errors, and/or microscope optics errors.

Referring now toFIG. 2, the adaptive optical element can include a reflective element218and/or a reflective element232. For example, the reflective elements218and232can include deformable mirrors or other suitable reflective component(s). The reflective elements218and232can be disposed in the optical path240between the observer202and the subject204. The reflective element218can be configured to compensate for wavefront deformations associated with the observer202, and the reflective element232can be configured to compensate for wavefront deformations associated with the subject204. The reflective elements218and232can be deformable in response to the control signal from the computing device238to modify the phase of incident light to compensate for the aberrations in the reflection wavefronts212and226.

Referring now toFIG. 3, the adaptive optical element can include a transmissive element234. For example, the transmissive element234can include a translucent (liquid crystal display or LCD) microdisplay, liquid lens, or other suitable transmissive component(s). For example, the transmissive element234can include a spatial light modulator available from HOLOEYE Photonics AG of Berlin-Adlershof, Germany. The transmissive element234can be disposed in the optical path240between the observer202and the subject204. In some embodiments, the microscope206includes one transmissive element234to compensate for wavefront deformations associated with both the observer202and the subject204. In some embodiments, the microscope206includes two or more transmissive elements234. A parameter of the transmissive element234can be adjustable in response to the control/electrical signal from the computing device238to modify the phase of incident light to compensate for the aberrations in the reflection wavefronts212and226. The parameter of the transmissive element can be adjustable, in response to the control/electrical signal, to modify the phase of incident light with a given spatial resolution. Thus, in some embodiments, controlling the adaptive optical/transmissive element in the method100can include providing the control/electrical signal to modify the phase of incident light with a given spatial resolution. For example, the parameter can be an electric field associated with the transmissive element234. In an embodiment in which the transmissive element234includes an LCD, providing an electrical signal to modify the electric field can cause the orientation of the liquid crystals to shift, resulting in a change in the refractive index of the LCD. Because of the change in the refractive index, the phase of incident light can be modulated as the light passes through the LCD.

In some embodiments, the method100including compensating for wavefront deformations associated with both the eye of the observer202and the eye of the subject204. In such embodiments, the microscope206includes wavefront compensation components for both the observer202and the subject204(e.g., the light sources208and224, the wavefront sensors214and228, the reflective elements218and232, etc.). In some embodiments, the method100can include selectively performing the projecting, determining, and controlling steps to compensate for aberrations in one of the reflection wavefronts212and226. For example, the microscope206can include only wavefront compensation components for one of the observer202and the subject204(e.g., one of the light sources208and224, one of the wavefront sensors214and228, one of the reflective elements218and232, etc.). For example, the projecting, determining, and controlling steps can be performed to compensate for aberrations in the reflection wavefronts212and226at different times or with different frequencies. For example, the microscope206can include wavefront compensation components for both the observer202and the subject204, but each set of components can be electronically switched on and off (or otherwise activated and deactivated) at different times or with different frequencies. For example, the observer202, such as a surgeon, can choose to compensate for his or her own wavefront errors (e.g., aberrations in the reflection wavefront212) once a day or once per surgical procedure. At the same time, the surgeon can choose to compensate for the wavefront errors of the subject204(e.g., aberrations in the reflection wavefront226) continuously or quasi-continuously during the surgical procedure (e.g., every 0.5 seconds, every 1 second, every 2 seconds, every 5 seconds, every 10 seconds, every 30 seconds, every 1 minute, every 2 minutes, etc.). The surgeon can also choose to perform wavefront compensation for his or her own wavefront errors in a continuous or quasi-continuous manner during the surgical procedure. In an embodiment of the microscope206includes reflective adaptive optics, the reflective elements218and232become flat when phase compensation in the respective optical path is electronically switched off or otherwise deactivated.

The microscope106can be a monocular or binocular microscope. Thus, whileFIGS. 2 and 3include one eyepiece236, it is understood that the microscope106can include one eyepiece for each eye of one or more observers202(e.g., two eyepieces each for a surgeon and an assistant). The teaching of the present disclosure can be implemented such that wavefront compensation is performed for one or more eyepieces. The microscope106can be a compound or stereo microscope. The teaching of the present disclosure can be implemented in one or more optical paths of the microscope106. For example, one set of the wavefront compensation components (e.g., the light sources208and224, the wavefront sensors214and228, the adaptive optical element, etc.) can be implemented in the single optical path between the observer202and the subject204in a compound microscope. For example, one set of wavefront compensation components can be implemented in each of the two optical paths between the observer202and the subject204in a stereo microscope. In some embodiments, wavefront compensation can be separately performed for each eye of the observer202. In some embodiments, the separate wavefront compensation for each optical path is combined (e.g., by the computing device238) before being provided to eyes of the observer202. In some embodiments, wavefront compensation can be separately performed for each of multiple observers202(e.g., for one eye of each observer, separately for each eye of each observer, etc.).

The devices, systems, and methods described herein are not limited to surgical microscopes. Teachings of the present disclosure can be implemented in slit lamps and/or diagnostic devices such as fundus cameras. For example, fundus cameras include complex optics to compensate for optical aberrations. Implementing the teachings of the present disclosure in a fundus camera can reduce the complexity of fundus camera optics while compensating for optical aberrations.

Embodiments as described herein can provide devices, systems, and methods that provide an ophthalmic surgical microscope with adaptive optical element(s) and wavefront sensor(s) to compensate for wavefront deformations associated with spherical and/or cylindrical refractive errors, astigmatism, low order aberrations, high order aberrations, and/or dynamic errors. The examples provided above are exemplary only and are not intended to be limiting. One skilled in the art may readily devise other systems consistent with the disclosed embodiments which are intended to be within the scope of this disclosure. As such, the application is limited only by the following claims.