Refractive treatment of an eye by printing material onto a target

In certain embodiments, a system for performing refractive treatment of an eye comprises a laser, a printer, and a computer. The laser emits a laser beam to prepare the eye for the refractive treatment. The printer prints material onto a print area of a target. The printer comprises a printer head and a printer controller. The printer head directs the material onto the print area, and the printer controller moves the printer head to direct the material onto a specific location of the print area. The computer comprises a memory and processors. The memory stores instructions for a pattern for the target. The pattern is designed to provide the refractive treatment for the eye. The processors instruct the printer controller to move the printer head to print the material onto the print area according to the pattern.

TECHNICAL FIELD

The present disclosure relates generally to refractive treatment of an eye, and more specifically to refractive treatment of an eye by printing material onto a target.

BACKGROUND

Refractive treatment of an eye refers to surgery performed to change the refractive properties of the eye to reduce refractive error in order to improve vision. Refractive error occurs when the shape of the eye does not bend light correctly, resulting in a blurred image. The main types of refractive errors are myopia (nearsightedness), hyperopia (farsightedness), presbyopia (loss of near vision with age), and astigmatism. Typical refractive treatments include laser in-situ keratomileusis (LASIK), photorefractive keratectomy (PRK), radial keratotomy (RK), astigmatic keratotomy (AK), automated lamellar keratoplasty (ALK), laser thermal keratoplasty (LTK), conductive keratoplasty (CK), and intracorneal ring (Intacs).

BRIEF SUMMARY

In certain embodiments, a system for performing refractive treatment of an eye comprises a laser, a printer, and a computer. The laser emits a laser beam to prepare the eye for the refractive treatment. The printer prints material onto a print area of a target. The printer comprises a printer head and a printer controller. The printer head directs the material onto the print area, and the printer controller moves the printer head to direct the material onto a specific location of the print area. The computer comprises a memory and processors. The memory stores instructions for a pattern for the target. The pattern is designed to provide the refractive treatment for the eye. The processors instruct the printer controller to move the printer head to print the material onto the print area according to the pattern.

In certain embodiments, a method for performing refractive treatment of an eye comprises emitting, from a laser, a laser beam to prepare the eye for the refractive treatment. A computer communicates with a printer configured to print material onto a print area of a target, where the printer comprises a printer head that directs the material onto the print area and a printer controller that moves the printer head to direct the material onto a specific location of the print area. The computer accesses instructions for a pattern for the target, where the pattern is designed to provide the refractive treatment for the eye. The computer instructs the printer controller to move the printer head to print material onto the print area according to the pattern.

DESCRIPTION OF EXAMPLE EMBODIMENTS

Referring now to the description and drawings, example embodiments of the disclosed apparatuses, systems, and methods are shown in detail. As apparent to a person of ordinary skill in the field, the disclosed embodiments are exemplary and not exhaustive of all possible embodiments.

FIG. 1illustrates an example of a system10for refractive treatment of an eye12a. System10includes a printer14that prints material (e.g., biological or biocompatible material) onto a print area of a target12according to a pattern16designed to provide refractive treatment for eye12a. In some cases, target12may be eye12a, and printer14prints the material directly onto eye12ato perform the refractive treatment. In other cases, target12may be an implant substrate12b. When implant substrate12bis printed with the material, it yields an implant to be implanted into eye12afor the refractive treatment.

In the illustrated embodiment, system10comprises a computer20, printer14, a laser22, an eye-tracker24, a fixation beam system26, a mechanical fixation27, a camera28, a curing illuminator30, and a dispenser32. Computer20includes one or more processors40one or more memories42that stores pattern16. Printer14includes a printer head44and a printer controller46.

As an overview, in certain embodiments, computer20controls the components of system10. Laser22prepares eye12afor refractive treatment by, e.g., exposing an area of the cornea of eye12ato be printed or making an incision within the cornea to receive an implant. Memory42stores pattern16designed to provide refractive treatment for eye12a. Printer14prints material onto target12according to pattern16. Fixation beam system26and/or mechanical fixation27stabilizes target12to reduce movement of target12. Eye-tracker24tracks movement of target12and sends information describing the movement to computer20, which in response can instruct printer14to compensate for the movement. Curing illuminator30illuminates the printed material with a light that promotes curing of the material. Dispenser32dispenses an adhesive that promotes adhesion of the material to target12and/or a cross-linking solution that promotes cross-linking within the cornea. Camera28generates images of the treatment to assist with monitoring the treatment.

System10provides refractive treatment for eye12a. Refractive treatment involves a procedure that changes the refractive properties of eye12ato improve vision. Pattern16indicates where material should be printed on a print area of target12in order to yield a result (e.g., a resulting corneal shape) that improves vision. For example, pattern16may indicate where material should be printed on a print area of eye12asuch that, after eye12arecovers from the procedure, the printed material yields a shape for eye12athat improves the vision of eye12a. As another example, pattern16may indicate where material should be printed on a print area of an implant substrate12bto yield an implant such that, after eye12arecovers from the implantation procedure, the implant improves the vision of eye12a. Examples of pattern16are illustrated inFIGS. 3 to 6.

In some embodiments, target12is an eye12a, such as an eye of a human or other animal. In other embodiments, target12is an implant substrate12bfor an ocular implant. An ocular implant is an artificial aid surgically implanted into eye12ato improve vision. Implant substrate12bis a substrate onto which material may be printed to form an implant. Implant substrate12bmay comprise any suitable transparent biocompatible material, e.g., hyaluronan (also called hyaluronic acid) or collagen. Implant substrate12bmay have any suitable size or shape. For example implant substrate12bmay be circular or annular with a diameter in the range of 0.5 to 12 millimeters (mm), or in a sub-range such as 0.5 to 5 mm, 5 mm to 8 mm, and/or 8 to 12 mm. The print area of target12may be the area onto which material is printed.

To aid in description, this description uses a coordinate system commonly used in ophthalmological surgery. In this coordinate system, a laser beam operating on the eye defines the z-axis, and the xy-plane is the plane normal to the z-axis. Generally, the xy-plane coincides with the plane defined by the pupil, apex, or vertex of the eye.

Fixation beam system26and/or mechanical fixation27stabilizes target12to reduce movement of target12. Fixation beam system26provides a fixation beam onto which the patient fixes their gaze to avoid moving eye12a. Mechanical fixation27is affixed to eye12ato reduce or prevent movement of eye12a. Examples of mechanical fixation27include patient interfaces such as corneal suction rings.

Laser22prepares eye12afor refractive treatment. Laser22may be any suitable laser surgical device that generates and emits a laser beam that interacts with (e.g., photodisrupt or photoablate) the cornea of eye12a. A laser surgical device typically comprises laser source (e.g., femto or excimer) that generates a laser beam, and scanning components (e.g., optics) that direct the focus of the laser beam to specific points of the target. Laser22prepares eye12afor treatment by interacting with the cornea in any suitable manner. For example, laser22may expose the print area of the cornea of eye12aby creating a flap in the cornea or removing all or part of an epithelium of eye12a(e.g. phototherapeutic keratectomy (PTK)). As another example, laser22may make an incision (e.g., a pocket) within the cornea to receive an implant. As another example, laser22may perform subsequent steps of the treatment. For instance, laser22may shape the cornea or printed material to yield prescribed refractive properties or perform other actions to complete the treatment. In certain embodiments, laser22may incorporate different laser sources that generate different laser beams, e.g., laser22may have sources that generate a beam that photodisrupts the corneal or printed material and a beam that ablates the corneal or printed material.

Printer14prints material onto the print area of target12, and may comprise any suitable printer configured to deposit material onto a print area according to digital instructions. For example, printer14may be a 3D, or additive manufacturing, printer that deposits successive layers of material to yield the material configured in a specific shape and size. Printer14includes printer head44and printer controller46. Printer head44directs material onto the print area and may be any suitable printer extruder that deposits material onto a surface. Printer controller46moves the printer head in the x, y, z directions to direct the material onto a specific location of the print area, and may receive instructions from computer20to move the printer head44according to pattern16.

The material comprises any suitable transparent or semitransparent material that is biological and/or biocompatible. Examples of such material include cultivated collagen material, human or animal cell material, biocompatible plastic, or hyaluronan. In certain cases, a material over which the epithelium can grow may be used. Such material may provide optimal nutrition of corneal cells and extra-cellular material, optical transparency over lifetime, and supportive surface properties for epithelium growth.

Eye-tracker24tracks movement of target12to aid in accurately printing the material on target12. Eye-tracker24may track eye12a, as a target eye12ais more likely to move and need tracking than a target implant substrate12b. However, eye-tracker24may be used to track any type of target12. An eye-tracker detects translational and/or angular (or rotational) movement of eye12a. In certain embodiments, image processing is used to locate the central point of eye12a, e.g., the pupil, determine translational movement. Image processing is used to locate features of eye12a(e.g., blood vessels, iris features, or any other appropriate feature) to determine angular movement.

When eye-tracker24detects movement of target12, eye-tracker24notifies computer20, which adjusts the instruction to printer controller46to compensate for the movement of target12. For example, if target12is translates and/or rotates a certain amount, printer controller46compensates for the movement by translating and/or rotating pattern16that certain amount. In other embodiments, an interface may fix or hold target12in a desired location and position such that eye-tracker24may not be required. For example, a patient interface may hold eye12ain place using, e.g., suction.

Curing illuminator30illuminates the print area with a light that cures the material. The light may cure the material by promoting cross-linking of the material and optionally the cornea of the eye. Examples of curing light include ultraviolet light or light (such as LED light) between 400 to 500 nm.

Dispenser32deposits a liquid onto target12during the procedure. For example, dispenser32directs onto eye12aa corneal cross-linking solution that promotes cross-linking of the cornea of eye12a. Examples of a corneal cross-linking solution include a riboflavin solution or other suitable solution. As another example, dispenser32directs onto the print area an adhesive that promotes adhesion of the material onto the print area. An adhesive may include fibrin.

Camera28generates an image of the print area to monitor the printing of the material. Camera28may comprise any suitable system that can generate an image of an object. Examples of camera28include an OCT system (such as a time domain or frequency domain OCT system) that generates OCT scans that can be used to create the image of the print area.

FIG. 2illustrates an example of a method for refractive treatment of an eye12aby printing material on a target12, which may be performed by system10ofFIG. 1. The method starts at step110, where laser22prepares eye12afor refractive treatment. Depending on the procedure, laser22may: create a flap in the cornea of eye12ato prepare for a LASIK procedure; create a pocket in the cornea designed to receive a corneal implant; or remove the epithelium of eye12ato prepare for a PRK procedure.

Print area of target12is prepared at step112. Target12may be eye12aitself or an implant substrate12bfor an implant to be implanted into eye12a. The print area may be prepared in any suitable manner. For example, dispenser32may direct an adhesive onto the print area that promotes adhesion of the material onto the print area. Camera28generates an image (such as a OCT scan image) of the print area at step114to monitor the printing of the material.

At step116, printer14prints material onto the print area according to pattern16designed to provide refractive treatment for eye12a. The material may be transparent material that is biological and/or biocompatible. Note, if target12is implant substrate12b, step116may be performed prior to the procedure, such that step116occurs before step110.

Eye-tracker24tracks movement of target12at step117. Movement may be detected at step118. If movement is detected, computer20receives information describing a movement of target12and instructs printer14to compensate for the movement. The method then moves to step122. If no movement is detected, method moves directly to step122. In embodiments that use a patient interface to fix target12into position, the method typically does not perform steps117,118, and122.

Curing illuminator illuminates the print area at step122with a light that cures the material. Step124depends on the procedure and whether target12is eye12aor implant substrate12b. If target12is implant substrate12b, the method moves to step126, where the implant is inserted into eye12a. The method then moves to step128. If target12is eye12a, the method moves directly to step128.

At step128, dispenser32directs a corneal cross-linking solution onto eye12athat promotes cross-linking of the cornea. The procedure is completed at step130, which depends on the procedure. For example, in a LASIK procedure, completing the procedure may involve closing the flap. The method then ends. After the method ends, the healing processes begin. For example, if the method removes the epithelium, it re-grows over the printed implant.

FIGS. 3 to 6illustrate implants and deposited material that may be created using patterns16that guide the creation of the 3D shapes. A pattern16may be stored as a 3D printable file, such as the STL file format native to the stereolithography CAD software created by 3D Systems.

FIG. 3illustrates an example of an implant54created by system10for correction of hyperopia. In the example, eye12ahas a cornea50and an epithelium52. Implant54may have a shape similar to that of a contact lens, and is inserted into a pocket56of cornea50.

FIG. 4illustrates an example of material60deposited by system10for correction of hyperopia. In the example, part of epithelium52is removed. System10deposits material60onto the exposed stroma of cornea50in a shape that corrects hyperopia. Deposited material60may have the shape of a thin layer disposed on the stroma. Epithelium52grows over material60.

FIG. 5illustrates an example of material60deposited by system10for correction of astigmatism and/or improvement of biomechanical stability (e.g., keratoconus). In the example, part of epithelium52is removed. System10deposits material60onto the exposed stroma of cornea50in a shape that corrects astigmatism and/or improves biomechanical stability. Deposited material60may have the shape of a dome disposed on the stroma. Epithelium52grows over material60.

FIG. 6illustrates an example of material60deposited by system10for correction of myopia. In the example, part of epithelium52is removed. System10deposits material60onto the exposed stroma of cornea50in a shape that corrects myopia. Deposited material60may have the shape of an annular ring disposed on the stroma. Epithelium52grows over material60.

A component (e.g., a computer) of the systems and apparatuses disclosed herein may include an interface, logic, and/or memory, any of which may include hardware and/or software. An interface can receive input to the component, provide output from the component, and/or process the input and/or output. Logic can perform the operations of the component, e.g., execute instructions to generate output from input. Logic may be a processor, such as one or more computers or one or more microprocessors. Logic may be computer-executable instructions encoded in memory that can be executed by a computer, such as a computer program or software. A memory can store information and may comprise one or more tangible, non-transitory, computer-readable, computer-executable storage media. Examples of memory include computer memory (e.g., Random Access Memory (RAM) or Read Only Memory (ROM)), mass storage media (e.g., a hard disk), removable storage media (e.g., a Compact Disk (CD) or a Digital Video Disk (DVD)), and network storage (e.g., a server or database).

Although this disclosure has been described in terms of certain embodiments, modifications (such as substitutions, additions, alterations, or omissions) of the embodiments will be apparent to those skilled in the art. Accordingly, modifications may be made to the embodiments without departing from the scope of the invention. For example, modifications may be made to the systems and apparatuses disclosed herein. The components of the systems and apparatuses may be integrated or separated, and the operations of the systems and apparatuses may be performed by more, fewer, or other components. As another example, modifications may be made to the methods disclosed herein. The methods may include more, fewer, or other steps, and the steps may be performed in any suitable order.