Patent Publication Number: US-2023157870-A1

Title: Controlling a laser delivery head of an ophthalmic laser system

Description:
TECHNICAL FIELD 
     The present disclosure relates generally to ophthalmic laser surgical systems, and more particularly to controlling a laser delivery head of an ophthalmic laser surgical system. 
     BACKGROUND 
     In ophthalmic laser surgery, a surgeon may direct a laser beam into the eye to treat the eye. For example, a laser beam may be directed into the vitreous to treat eye floaters. Eye floaters are clumps of collagen proteins that form in the vitreous. These clumps can disturb vision with moving shadows and distortions. The laser beam may be used to disintegrate the floaters to improve vision. 
     BRIEF SUMMARY 
     In certain embodiments, an ophthalmic laser system that performs a laser procedure on an eye includes a laser device, an ophthalmic microscope, a y-direction motor, a user interface device, and a controller. The laser device includes a laser delivery head that directs a laser beam towards a target within the eye. The laser beam defines a z-axis, which defines an xy-plane. The x-axis of the xy-plane is aligned in a horizontal direction, and the y-axis of the xy-plane is aligned in a vertical direction. The ophthalmic microscope receives light from within the eye to provide an image of the eye. The y-direction motor moves the laser delivery head and the ophthalmic microscope in a y-direction defined by the y-axis. The user interface device receives instructions from a user. The controller receives an instruction from the user interface device to move the laser delivery head and the ophthalmic microscope in the y-direction, and instructs the y-direction motor to move the laser delivery head and the ophthalmic microscope in the y-direction in response to the instruction. 
     Embodiments may include none, one, some, or all of the following features: 
     * The ophthalmic laser system includes a lift support that supports the laser delivery head and the ophthalmic microscope. The y-direction motor moves the laser delivery head and the ophthalmic microscope in the y-direction by moving the lift support in the y-direction. 
     * The y-direction motor comprises a motor-driven servo system with a rotary actuator. 
     * The y-direction motor comprises a motor-driven servo system with a stepper motor. 
     * The y-direction motor comprises a scissor jack lift with arms that raise and lower the lift support. 
     * The y-direction motor comprises a rotating vertical adjustment system with one or more shafts that rotate to raise and lower the lift support. 
     * The y-direction motor comprises a screw-based vertical adjustment system with a screw that rotates to raise and lower the lift support. 
     * The y-direction motor comprises a wheel that rotates to raise and lower the lift support. 
     * The user interface device comprises a joystick. The joystick can be rotated, and the controller receives an instruction from the user interface device by detecting rotation of the joystick. Or, the joystick can be raised and lowered, and the controller receives the instruction from the user interface device by detecting raising or lowering of the joystick. 
     In certain embodiments, a method for moving a laser delivery head of an ophthalmic laser system includes receiving, by a user interface device, instructions for the ophthalmic laser system from a user. The ophthalmic laser system includes the laser delivery head and an ophthalmic microscope. The laser delivery directs a laser beam towards a target within an eye. The laser beam defines a z-axis, which defines an xy-plane with an x-axis aligned in a horizontal direction and a y-axis aligned in a vertical direction. The ophthalmic microscope receives light from within the eye to provide an image of the eye. The method also includes: receiving, by a controller from the user interface device, an instruction to move the laser delivery head and the ophthalmic microscope in a y-direction defined by the y-axis; instructing, by the controller, a y-direction motor to move the laser delivery head and the ophthalmic microscope in the y-direction in response to the instruction; and moving, by the y-direction motor, the laser delivery head and the ophthalmic microscope in the y-direction. 
     Embodiments may include none, one, some, or all of the following features: 
     * Moving, by the y-direction motor, the laser delivery head and the ophthalmic microscope in the y-direction further includes moving a lift support in the y-direction, where the lift support supports the laser delivery head and the ophthalmic microscope. 
     * Receiving, by the controller from the user interface device, the instruction to move the laser delivery head and the ophthalmic microscope further includes detecting rotation of the user interface device, the user interface device comprising a joystick. 
     * Receiving, by the controller from the user interface device, the instruction to move the laser delivery head and the ophthalmic microscope further includes detecting raising or lowering of the user interface device, the user interface device comprising a joystick. 
     * The method further includes receiving, by the controller from the user interface device, an instruction to move the laser delivery head and the ophthalmic microscope in an x-direction defined by the x-axis, and instructing, by the controller, an xz-direction motor to move the laser delivery head and the ophthalmic microscope in the x-direction in response to the instruction. 
     * The method further includes receiving, by the controller from the user interface device, an instruction to move the laser delivery head and the ophthalmic microscope in a z-direction defined by the z-axis, and instructing, by the controller, a xz-direction motor to move the laser delivery head and the ophthalmic microscope in the z-direction in response to the instruction. 
     In certain embodiments, an ophthalmic laser system that performs a laser procedure on an eye includes a laser device, an ophthalmic microscope, a lift support, a y-direction motor, an xz-direction motor, a user interface device, and a controller. The laser device includes a laser delivery head that directs a laser beam towards a target within the eye. The laser beam defines a z-axis, which defines an xy-plane. The x-axis of the xy-plane is aligned in a horizontal direction, and the y-axis of the xy-plane is aligned in a vertical direction. The ophthalmic microscope receives light from within the eye to provide an image of the eye. The lift support supports the laser delivery head and the ophthalmic microscope. The y-direction motor moves the laser delivery head and the ophthalmic microscope in a y-direction defined by the y-axis by moving the lift support in the y-direction. The y-direction motor comprises a motor-driven servo system with a rotary actuator or a stepper motor. The y-direction motor comprises at least one of the following: a scissor jack lift with arms that raise and lower the lift support; a rotating vertical adjustment system with one or more shafts that rotate to raise and lower the lift support; a screw-based vertical adjustment system with a screw that rotates to raise and lower the lift support; or a wheel that rotates to raise and lower the lift support. The xz-direction motor moves the laser delivery head and the ophthalmic microscope in an x-direction defined by the x-axis and in an z-direction defined by the z-axis. The user interface device comprises a joystick and receives instructions from a user. The controller receives an instruction from the user interface device to move the laser delivery head and the ophthalmic microscope in the y-direction, and instructs the y-direction motor to move the laser delivery head and the ophthalmic microscope in the y-direction in response to the instruction. The controller receives an instruction from the user interface device to move the laser delivery head and the ophthalmic microscope in the x-direction, and instructs the xz-direction motor to move the laser delivery head and the ophthalmic microscope in the x-direction in response to the instruction. The controller receives an instruction from the user interface device to move the laser delivery head and the ophthalmic microscope in the z-direction, and instructs the xz-direction motor to move the laser delivery head and the ophthalmic microscope in the z-direction in response to the instruction. The joystick can be rotated, and the controller receives an instruction from the user interface device by detecting rotation of the joystick. Or, the joystick can be raised and lowered, and the controller receives the instruction from the user interface device by detecting raising or lowering of the joystick. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    illustrates an example of an ophthalmic laser system that an operator may use to perform laser vitreolysis on a patient eye to remove vitreous floaters, according to certain embodiments; 
         FIGS.  2 A and  2 B  illustrate an example of a mechanism that the y-direction motor of  FIG.  1    may use to move the laser delivery head and ophthalmic microscope in the y-direction, according to certain embodiments; 
         FIGS.  3 A to  3 C  illustrate additional examples of mechanisms that the y-direction motor of  FIG.  1    may use to move the laser delivery head and ophthalmic microscope in the y-direction, according to certain embodiments; 
         FIG.  4    is an example of how a positioning device, such as a joystick, may be used to move the laser delivery head and ophthalmic microscope of  FIG.  1   , according to certain embodiments; and 
         FIG.  5    illustrates an example of a method for moving a laser delivery head that may be used by the ophthalmic laser system of  FIG.  1   , according to certain embodiments. 
     
    
    
     DESCRIPTION OF EXAMPLE EMBODIMENTS 
     Referring now to the description and drawings, example embodiments of the disclosed apparatuses, systems, and methods are shown in detail. The description and drawings are not intended to be exhaustive or otherwise limit the claims to the specific embodiments shown in the drawings and disclosed in the description. Although the drawings represent possible embodiments, the drawings are not necessarily to scale and certain features may be simplified, exaggerated, removed, or partially sectioned to better illustrate the embodiments. 
     Slit lamps with built in lasers are typically used for posterior capsulotomy, iridotome, selective laser trabecoplasty, and retinal photocoagulation. These procedures often require much more horizontal adjustment of the laser beam than vertical adjustment. However, newer procedures require more vertical movement. Accordingly, embodiments of the system include a motor that vertically adjusts the laser delivery head. 
       FIG.  1    illustrates an example of an ophthalmic laser system  10  that an operator (with an operator eye  12 ) may use to perform laser vitreolysis on a patient eye  14  to remove vitreous floaters, according to certain embodiments. Vitreous floaters are microscopic collagen fibers within the vitreous that tend to clump together. These clumps scatter light and cast shadows on the retina, which appear as visual disturbances in the vision of the patient. Ophthalmic laser system  10  allows the operator to see floaters in relation to the retina and lens of the eye, and then direct a laser beam to break up the floaters. 
     In the example, ophthalmic laser system  10  comprises oculars  20 , a laser delivery head  22 , a slit illumination source  26 , a positioning device (such as a joystick  28 ), a base  30 , a lift support  35 , a xz-direction motor  31 , a y-direction motor  33 , and a console  32 , coupled as shown. Laser delivery head  22  includes a laser fiber  34 , a zoom system  36 , a collimator  38 , a mirror  40 , and an objective lens  42 , coupled as shown. Slit illumination source  26  includes a light source  43 , condenser lens  44 , a variable aperture  45 , a variable slit plate  46 , a projection lens  47 , and a mirror  48 . Console  32  includes a computer (such as a controller  50 ), a laser  52 , and a user interface  54 , coupled as shown. 
     As an overview, ophthalmic laser system  10  includes a laser device  16  (e.g., laser  52 , laser fiber  34 , and laser delivery head  22 ) and an ophthalmic microscope  18  such as a slit lamp (e.g., oculars  20 , mirror  40 , objective lens  42 , mirror  48 , and slit illumination source  26 ). Operator eye  12  utilizes the optical path from oculars  20  through mirror  40 , objective lens  42 , and mirror  48  to view patient eye  14 . A laser beam follows the laser path from laser  52  through laser delivery head  22  and mirror  48  to treat patient eye  14 . 
     According to the overview, laser device  16  comprises a laser delivery head  22  that directs a laser beam towards a target within patient eye  14 . The laser beam defines a z-axis when aligned with an axis (e.g., optical or visual) of the eye. The z-axis in turn defines an xy-plane, where an x-axis of the xy-plane is aligned in a horizontal direction, and a y-axis of the xy-plane is aligned in a vertical direction. Ophthalmic microscope  18  receives light from within the eye to provide an image of the eye. Y-direction motor  33  moves laser delivery head  22  and ophthalmic microscope  18  in a y-direction defined by the y-axis. A user interface device (such as joystick  28 ) receives instructions from a user. Controller  50  receives an instruction from the user interface device to move the laser device and the ophthalmic microscope in the y-direction, and instructs the y-direction motor to move the laser device and the ophthalmic microscope in the y-direction in response to the instruction. 
     In more detail, in certain embodiments, oculars  20  allow operator eye  12  to view patient eye  14 . Laser delivery head  22  delivers a laser beam of laser pulses from laser  52  of console  32  to patient eye  14 . Laser fiber  34  of delivery head  22  transports the laser beam from laser  52  to the end of fiber  34 . Zoom system  36  includes optical elements that change the spot size of the laser beam that exits fiber  34 . An optical element can act on (e.g., transmit, reflect, refract, diffract, collimate, condition, shape, focus, modulate, and/or otherwise act on) light such as a laser beam. Collimator  38  collimates the laser beam, and mirror  40  directs the beam through objective lens  42 , which focuses the beam. Zoom system  36  and collimator  38  are configured to direct a parallel laser beam to mirror  40 , in order to focus the laser beam onto the image plane of ophthalmic microscope  18 . Mirror  40  may be a dichroic mirror that is reflective for the laser beam wavelength and transmissive for visible light. 
     Slit illumination source  26  of laser system  10  provides light that illuminates the surgical site of patient eye  14 . Slit illumination source  26  includes light source  43 , which emits light such as a high-intensity illumination light. Condenser lens  44  directs the light towards variable aperture  45  and variable slit plate  46 . Variable aperture  45  defines the height of the light in the y-direction, and variable slit plate  43  defines the width of the light in the x-direction to form the light into a slit shape. Projection lens  47  directions the light towards prism mirror  48 , which directs the slit of light into patient eye  14 . 
     Base  30  and lift support  35  support laser delivery head  22  and ophthalmic microscope  18  comprising the slit lamp. Y-direction motor  33  moves laser delivery head  22  and ophthalmic microscope  18  in the y-direction, and xz-direction motor  31  moves laser delivery head  22  and ophthalmic microscope  18  in the x- and z-directions. The motors may move laser delivery head  22  and ophthalmic microscope  18  by moving base  30  and/or lift support  35 , which in turn moves delivery head  22  and microscope  18 . For example, y-direction motor  33  may move lift support  35 , and xz-direction motor  31  may move base  30  to move laser delivery head  22  and ophthalmic microscope  18 . 
     Y-direction motor  33  may comprise any suitable actuator that moves laser delivery head  22  and ophthalmic microscope  18 . In certain embodiments, Y-direction motor  33  may comprise a motor-driven servo system, which may be based on, e.g., a rotary actuator or stepper motor. Joystick  28  is a user interface device (such as a positioning device) that receives instructions from a user such as the operator. The user instructions may include, e.g., instructions to move laser delivery head  22  and ophthalmic microscope  18  in the x-, y-, and/or z-directions. 
     Console  32  includes components that support the operation of system  10 . Controller  50  of console  32  is a computer that controls of the operation of components of system  10 , e.g., joystick  28 , base  30 , lift support  35 , laser delivery head  22 , slit illumination source  26 , laser  52 , and/or user interface  54 . For example, in response to instructions from joystick  28  in the x-, y-, and/or z-directions, controller  50  moves the laser delivery head  22  in the x-, y-, and/or z-directions, according to the instructions. User interface  54  communicates information between a user (e.g., the operator) and system  10 . 
     Laser  52  supplies the laser beam that has a cone-shaped energy profile that focuses energy onto a point. Any suitable laser  30  may be used, e.g., a femtosecond or nanosecond laser (e.g., Q-switched) with any suitable crystal (e.g., Nd:YAG, Erbium:YAG, Ti:Sapphire, or ruby). The laser beam may have any suitable wavelength, e.g., in a range from 500 nm to 1100 nm. 
       FIGS.  2 A and  2 B  illustrate an example of a mechanism that y-direction motor  33  of  FIG.  1    may use to move laser delivery head  22  and ophthalmic microscope  18  in the y-direction, according to certain embodiments. In the example, y-direction motor  33  includes a motor  72  coupled to a wheel  60 , such as a cogwheel, which is coupled to a platform, such as lift support  35 . An example of motor  72  may be a motor-driven servo system, which may be based on, e.g., a rotary actuator or stepper motor. Motor  72  moves (e.g., rotates) wheel  60  to move lift support  35  upwards or downwards, which in turn moves delivery head  22  and microscope  18  upwards or downwards. 
     The user may manipulate joystick  28  in any suitable manner to provide the instructions move lift support  35 . In the illustrated example, joystick  28  is configured to be rotated  70  in one direction to move delivery head  22  and microscope  18  upwards, and in the other direction to move them downwards. Controller  50  detects rotation of joystick  28  to receive an upward or downward instruction from joystick  28 , and then instructs y-direction motor  33  to move lift support  35  upwards or downwards. 
       FIGS.  3 A to  3 C  illustrate additional examples of mechanisms that y-direction motor  33  of  FIG.  1    may use to move laser delivery head  22  and ophthalmic microscope  18  in the y-direction, according to certain embodiments. In the examples, y-direction motor  33  includes a motor  72 . An example of motor  72  may be a motor-driven servo system, which may be based on, e.g., a rotary actuator or stepper motor. 
       FIG.  3 A  shows an example of motor  72  and a scissor jack lift  74  that may be used to adjust lift support  35  in the y-direction in certain embodiments. A scissor jack lift  74  is a jack lift that includes arms that can raise or lower a platform, such as lift support  35 . As an example of operation, motor  72  turns a crank of scissor jack lift  74 , which cause the arms to move lift support  35  in the y-direction. 
       FIG.  3 B  shows an example of motor  72  coupled to a rotating vertical adjustment system  76  that may be used to move lift support  35 in the y-direction in certain embodiments. A rotating vertical adjustment system  76  includes one or more shafts  80  that can be rotated to raise or lower a bearing  82  to raise or lower a platform, such as lift support  35 . In the example, rotating vertical adjustment system  76  includes fringes  78  ( 78   a - d ), shafts  80  ( 80   a - b ), a bearing  82 , a contact piece  84 , and a crank  86  coupled as shown. As an example of operation, motor  72  turns crank  86 , which rotates shafts  80  to move bearing  82  and contact piece  84  in the y-direction. In turn, contact piece  84  moves lift support  35  in the y-direction. 
       FIG.  3 C  shows an example of motor  72  coupled to a screw-based vertical adjustment system  89  that may be used to move lift support  35  in the y-direction in certain embodiments. A screw-based vertical adjustment system  89  includes a screw  94  that can be rotated to raise or lower a platform, such as lift support  35 . In the example, screw-based vertical adjustment system  89  includes a crank  90 , a vertical mount  92  (with a screw  94  and rails  96 ), and a carriage  98  coupled as shown. Carriage  98  has an internal surface that defines a threaded hole  100  that receives screw  94 . As an example of operation, motor  72  turns crank  90 , which rotates screw  94 . As screw  94  turns within threaded hole  100  of carriage  98 , carriage  98  moves in the y-direction to adjust lift support  35  in the y-direction. 
       FIG.  4    is an example of how a positioning device, such as joystick  28 , may be used to move laser delivery head  22  and ophthalmic microscope  18  of system  10  of  FIG.  1   , according to certain embodiments. The user may manipulate joystick  28  in any suitable manner to provide the instructions move delivery head  22  and microscope  18 . In the illustrated example, joystick  28  is configured to be rotated  70  in one direction to move delivery head  22  and microscope  18  upwards, and in the other direction to move them downwards. Controller  50  detects rotation of joystick  28  to receive the instruction from joystick  28 . Joystick  28  is configured to be moved in the x-direction to move delivery head  22  and microscope  18  in the x-direction, and in the z-direction to move them in the z-direction. Controller  50  detects movement of joystick  28  in the x- or z-direction to receive the instruction from joystick  28 . 
     In other examples, joystick  28  may be configured to be raised to move delivery head  22  and microscope  18  upwards, and lowered to move them downwards. In response, controller  50  detects raising and lowering of joystick  28  to receive the instruction from joystick  28 . 
       FIG.  5    illustrates an example of a method for moving a laser delivery head that may be used by ophthalmic laser system  10  of  FIG.  1   , according to certain embodiments. The method starts at step  110 , where a positioning device, such as joystick  28 , receives instructions from a user (e.g., the operator) of ophthalmic laser system  10 . 
     At step  112 , controller  50  receives from the positioning device an instruction to move laser delivery head  22  and ophthalmic microscope  18  in the y-direction. Controller  50  may receive the instructions by detecting rotation of the joystick or detecting raising or lowering of the joystick. Controller  50  may also receive instructions to move the laser delivery head and ophthalmic microscope in the x-direction and/or z-direction. 
     Controller  50  instructs y-direction motor  33  to move laser delivery head  22  and ophthalmic microscope  18  in the y-direction at step  114  in response to the instruction. Controller  50  may also instruct xz-direction motor  31  to move laser delivery head  22  and ophthalmic microscope  18  in the x-direction and/or z-direction if controller  50  received instructions to move in the x-direction and/or z-direction. 
     Y-direction motor  33  moves laser delivery head  22  and ophthalmic microscope  18  in the y-direction at step  116  in response to the instruction. Y-direction motor  33  may move lift support  35  in the y-direction to move laser delivery head  22  and ophthalmic microscope  18 . If xz-motor  31  received instructions to move in the x-direction and/or z-direction, xz-direction motor  31  may move laser delivery head  22  and ophthalmic microscope  18  in the x-direction and/or z-direction. 
     A component (such as the control computer) of the systems and apparatuses disclosed herein may include an interface, logic, and/or memory, any of which may include computer hardware and/or software. An interface can receive input to the component and/or send output from the component, and is typically used to exchange information between, e.g., software, hardware, peripheral devices, users, and combinations of these. A user interface is a type of interface device that a user can utilize to communicate with (e.g., send input to and/or receive output from) a computer. Examples of user interface devices include a display, Graphical User Interface (GUI), touchscreen, joystick, keyboard, mouse, gesture sensor, microphone, and speakers. 
     Logic can perform operations of the component. Logic may include one or more electronic devices that process data, e.g., execute instructions to generate output from input. Examples of such an electronic device include a computer, processor, microprocessor (e.g., a Central Processing Unit (CPU)), and computer chip. Logic may include computer software that encodes instructions capable of being executed by an electronic device to perform operations. Examples of computer software include a computer program, application, and operating system. 
     A memory can store information and may comprise tangible, computer-readable, and/or computer-executable storage medium. 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 Digital Video or Versatile Disk (DVD)), database, network storage (e.g., a server), and/or other computer-readable media. Particular embodiments may be directed to memory encoded with computer software. 
     Although this disclosure has been described in terms of certain embodiments, modifications (such as changes, substitutions, additions, omissions, and/or other modifications) 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, or the operations of the systems and apparatuses may be performed by more, fewer, or other components, as apparent to those skilled in the art. 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, as apparent to those skilled in the art. 
     To aid the Patent Office and readers in interpreting the claims, Applicants note that they do not intend any of the claims or claim elements to invoke 35 U.S.C. § 112(f), unless the words “means for” or “step for” are explicitly used in the particular claim. Use of any other term (e.g., “mechanism,” “module,” “device,” “unit,” “component,” “element,” “member,” “apparatus,” “machine,” “system,” “processor,” or “controller”) within a claim is understood by the applicants to refer to structures known to those skilled in the relevant art and is not intended to invoke 35 U.S.C. § 112(f).