Patent Publication Number: US-2021177651-A1

Title: System and method of corneal cross-linking

Description:
BACKGROUND 
     Field of the Disclosure 
     This disclosure relates to corneal cross-linking. 
     Description of the Related Art 
     In the past, corneal cross-linking (CXL) was used as a treatment for keratoconus. With this condition, a cornea of an eye of a patient thins and becomes weaker over time. Sometimes another condition can cause a similar weakening of the cornea. The weakened cornea can bulge into a cone shape or some irregular shape. The cone shape can distort vision of the eye. If the cornea continues to weaken and/or becomes too thin, a corneal transplant may be performed on the eye. With CXL, a doctor can use riboflavin and ultraviolet (UV) light to make tissue of the cornea stronger. The source of the UV light has been an UV lamp, and the UV lamp can produce the UV light for an amount of time. CXL can add bonds between collagen fibers of the cornea. The bonds between the collagen fibers can aid in stabilizing the cornea. When the tissue of the cornea become stronger, the cornea may have additional one or more bulges and/or may reduce one or more risks of a rupture in the cornea. CXL can mitigate or stop progressive keratoconus from becoming worse. 
     SUMMARY 
     The present disclosure provides a system that may receive data associated with multiple locations associated with a cornea of an eye of a patient and may adjust at least one lens, based at least on diameter information of the data associated with at least one of the multiple locations, to set a diameter of a laser beam. The system may include a laser that generates the laser beam. The laser beam may be an ultraviolet (UV) laser beam. A first portion of the cornea may be associated with the multiple locations. A second portion of the cornea, different from the first portion, may not be associated with the multiple locations. The system, for each location of the multiple locations, may further determine if the eye has changed from a first position to a second position, different from the first position; if the eye has not changed from a first position to a second position, may further adjust, based at least on the location, at least one mirror; if the eye has changed from the first position to the second position, may further adjust, based at least on the location and based at least on the second position, the at least one mirror; may further produce the laser beam; and may further direct the laser beam to the location for a period of time associated with the location. 
     To determine if the eye has changed from the first position of the eye to the second position of the eye, the system may further determine if an iris structure of the eye has changed from a first position of the iris structure to a second position of the iris structure. To produce the laser, the system may pulse the laser beam at a pulse duration. For example, the pulse duration may be a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration, among others. A first period of time associated with a first location of the multiple locations may be different from a second period of time associated with a second location of the multiple locations, different from the first location. The system may further adjust the at least one lens, based at least on second diameter information of the data associated with at least another one of the multiple locations, to set a second diameter of the laser beam. The system may further, if the eye has changed from the first position of the eye to the second position of the eye, translate at least two of the multiple locations based at least on the first position of the eye and the second position of the eye. Before the laser beam is produced, the system may further produce another laser beam to cut at least one of a flap and a pocket in the cornea. 
     The present disclosure further includes a non-transient computer-readable memory device with instructions that, when executed by a processor of a system, cause the system to perform the above steps. The present disclosure further includes a system and/or a non-transient computer-readable memory device as described above with one or more of the following features, which may be used in combination with one another unless clearly mutually exclusive: i) receive data associated with multiple locations associated with a cornea of an eye of a patient; ii) adjust at least one lens, based at least on diameter information of the data associated with at least one of the multiple locations, to set a diameter of a laser beam; iii) determine if the eye has changed from a first position of the eye to a second position of the eye, different from the first position of the eye; iv) if the eye has not changed from the first position of the eye to the second position of the eye, adjust, based at least on the location, at least one mirror; v) if the eye has changed from the first position of the eye to the second position of the eye, adjust, based at least on the location and based at least on the second position of the eye, the at least one mirror; vi) produce the laser beam; vii) direct the laser beam to the location for a period of time associated with the location; viii) determine if an iris structure of the eye has changed from a first position of the iris structure to a second position of the iris structure; ix) pulse the laser beam at a pulse duration; x) adjust the at least one lens, based at least on second diameter information of the data associated with at least another one of the multiple locations, to set a second diameter of the laser beam; xi) if the eye has changed from the first position of the eye to the second position of the eye, translate at least two of the multiple locations based at least on the first position of the eye and the second position of the eye; and xii) before the laser beam is produced, produce another laser beam to cut at least one of a flap and a pocket in the cornea. 
     Any of the above systems may be able to perform any of the above methods and any of the above non-transient computer-readable memory devices may be able to cause a system to perform any of the above methods. Any of the above methods may be implemented on any of the above systems or using any of the above non-transient computer-readable memory devices. 
     It is to be understood that both the foregoing general description and the following detailed description are examples and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the present disclosure. In that regard, additional aspects, features, and advantages of the present disclosure will be apparent to one skilled in the art from the following detailed description. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       For a more complete understanding of the present disclosure and its features and advantages, reference is now made to the following description, taken in conjunction with the accompanying drawings, which are not drawn to scale, and in which: 
         FIG. 1A  illustrates an example of a medical system; 
         FIG. 1B  illustrates an example of a biometry device; 
         FIG. 2  illustrates an example of a laser system; 
         FIG. 3  illustrates an example of layers of a cornea of an eye; 
         FIG. 4A  illustrates a second example of a medical system; 
         FIG. 4B  illustrates a third example of a medical system; 
         FIG. 4C  illustrates an example of a microscope integrated display and examples of surgical tooling equipment; 
         FIG. 5  illustrates an example of a computer system; 
         FIGS. 6A-6D  illustrate examples of an eye; 
         FIGS. 6E-6H  illustrate examples of an eye and a coordinate system; 
         FIG. 7A  illustrates an example of a method of operating a medical system; 
         FIG. 7B  illustrates another example of a method of operating a medical system; 
         FIG. 8  illustrates an example of data associated with multiple locations associated with a cornea of an eye of a patient; 
         FIG. 9A  illustrates an example of a plane and multiple locations; 
         FIG. 9B  illustrates an example of a plane associated with an eye; 
         FIG. 9C  illustrates an example of a location associated with a plane; 
         FIG. 9D  illustrates an example of multiple locations associated with a plane; 
         FIG. 9E  illustrates a second example of multiple locations associated with a plane; 
         FIG. 9F  illustrates another example of multiple locations associated with a plane; 
         FIG. 9G  illustrates an example of multiple locations associated with a plane and a cornea; and 
         FIG. 9H  illustrates an example of a portion of a cornea associated multiple locations. 
     
    
    
     DETAILED DESCRIPTION 
     In the following description, details are set forth by way of example to facilitate discussion of the disclosed subject matter. It should be apparent to a person of ordinary skill in the field, however, that the disclosed embodiments are examples and not exhaustive of all possible embodiments. 
     As used herein, a reference numeral refers to a class or type of entity, and any letter following such reference numeral refers to a specific instance of a particular entity of that class or type. Thus, for example, a hypothetical entity referenced by ‘ 12 A’ may refer to a particular instance of a particular class/type, and the reference ‘12’ may refer to a collection of instances belonging to that particular class/type or any one instance of that class/type in general. 
     Medical systems may be utilized in performing medical procedures with patients. In one example, a first medical system may be utilized, at a first time, in identifying one or more portions of a patient before a medical procedure. In a second example, a second medical system may be utilized, at a second time, in performing the medical procedure. In another example, the second medical system may utilize, at the second time, one or more identifications respectively associated with the one or more portions of the patient. The second time may be a later time than the first time. In one example, the first medical system may be utilized at an office of a doctor. In a second example, the second medical system may be utilized at a surgical facility. In another example, the second medical system may be utilized at the office of the doctor. 
     Medical systems may include optics. For example, a medical system may include one or more optical systems that may include optics. An optical system may include one or more optical devices. For example, an optical device may be or may include a device that controls light (e.g., reflects light, refracts light, filters light, transmits light, polarizes light, etc.). An optical device may be made of any material that controls the light as designed. For example, the material may include one or more of glass, crystal, metal, and semiconductor, among others. Examples of optical devices may include one or more of lenses, mirrors, prisms, optical filters, waveguides, waveplates, beam expanders, beam collimators, beam splitters, gratings, and polarizers, among others. 
     A medical procedure may include corneal cross-linking (CXL). CXL may be utilized in treating a condition and/or an issue of a cornea of an eye. The condition and/or the issue may cause the cornea to become weakened and/or thinned over time. For example, the condition and/or the issue may be keratoconus. CXL may be achieved via utilization of an ultraviolet (UV) laser. A laser may be or include a device that generates a beam of coherent monochromatic light by stimulated emission of photons from excited atoms and/or molecules. The UV laser may be pulsed. For example, pulses of a laser beam may have a pulse duration in any suitable range, e.g., the microsecond, nanosecond, picosecond, femtosecond, or attosecond range, among others. An UV laser beam may be directed to one or more locations associated with the cornea. For example, directing the UV laser beam to the one or more locations associated with the cornea may include adjusting at least one mirror to direct the UV laser beam to the one or more locations associated with the cornea. One or more locations associated with the cornea may be utilized in treating the cornea. A diameter of the UV laser beam may be adjustable. For example, a beam expander may be utilized to adjust a diameter of the UV laser beam. 
     Each of at least two of multiple locations associated with the cornea may be associated with an intensity profile. In one example, a first location associated with the cornea may be associated with a first intensity profile. The first intensity profile may be associated with a first optical intensity of a laser beam. In another example, a second location, different from the first location, associated with the cornea may be associated with a second intensity profile, different from the first intensity profile. The second intensity profile may be associated with a second optical intensity of the laser beam, different from the first optical intensity of the laser beam. An optical intensity of a laser beam may be an optical power per unit area. For example, the optical power per unit area may be watts per centimeters squared (W/cm 2 ). The optical intensity of the laser beam may be a product of photon energy and photon flux. 
     Different intensity profiles may be utilized to compensate for intensity losses in certain areas (e.g., at a border of an area). For example, an intensity profile associated with a border of an area may be associated with an optical intensity that is greater than an optical intensity that is with a location that is closer to a center of the area. Different intensity profiles may be utilized to provide increased optical intensities in one or more areas. For example, the increased optical intensities in the one or more areas may enhance one or more CXL effects. Different intensity profiles may be utilized to achieve different effects. For example, the different effects may include one or more refractive change in the cornea. The one or more refractive change in the cornea may be achieved without additional beam shaping apertures and/or without additional optics. 
     Each of at least two of multiple locations associated with the cornea may be associated with a laser beam diameter. In one example, a first location associated with the cornea may be associated with a first laser beam diameter. In another example, a second location associated with the cornea may be associated with a second laser beam diameter, different from the first laser beam diameter. For example, a beam expander may be utilized to set and/or to configure a laser beam diameter. An angle of a laser beam expansion may be determined based at least on one or more laser beams parameters. For example, an area of irradiation (e.g., a laser beam diameter) may be determined based at least on a distance between a laser output aperture and an eye of a patient. 
     Multiple locations associated with the cornea may be associated with a shape and/or a pattern. For example, the multiple locations associated with the cornea may be similar to elements of a shape and/or a pattern. An element of the shape and/or the pattern may be associated with a diameter of a laser beam. An element of the shape and/or the pattern may be associated with a location of a laser beam on the cornea. An element of the shape and/or the pattern may be associated with an amount of photonic irradiation. Two or more elements of the shape and/or the pattern may at least partially overlap. Two or more elements of the shape and/or the pattern may not overlap. 
     Before and/or during a medical procedure, an eye may change positions and/or may rotate. In one example, if the eye changes positions and/or rotates, a medical system may compensate for position changes and/or for rotation. The medical system may compensate for the position changes and/or for the rotation to direct a laser beam to multiple locations associated with the cornea. In another example, the medical system may alert one or more medical personnel, may cease the medical procedure, and/or may prevent the medical procedure from starting. The medical system may utilize one or more iris structures in determining if the eye changes positions and/or rotates. 
     A first medical system may determine structures of an iris of an eye of a patient. For example, determining the structures of the iris of the eye of the patient may include identifying the structures of the iris of the eye of the patient. A second medical system may utilize the structures of the iris of the eye of the patient to determine if the eye changes positions and/or rotates. The second medical system may utilize a pupil of the eye of the patient to determine if the eye changes positions. 
     The second medical system may include an UV laser that may be utilized in one or more CXL medical procedures. The second medical system may include a laser (e.g., an UV laser, a visible spectrum laser, an infrared laser, etc.) that may cut a pocket in the eye. The position of an incision for the pocket may be associated with a location on the eye. As an example, the second medical system and the first medical system may be combined into a single medical system. As another example, the second medical system and the first medical system may be different medical systems. 
     A CXL medical procedure may be performed after another medical procedure. For example, as a preventative medical procedure, the CXL medical procedure may be performed after a corneal procedure. A laser device may be utilized to perform the corneal procedure and to perform the CXL medical procedure, as an example. The corneal procedure and the CXL medical procedure may be different medical procedures. Utilizing the laser device for the corneal procedure and the CXL medical procedure may reduce an amount of time for the corneal procedure and the CXL medical procedure. Utilizing the laser device for the corneal procedure and the CXL medical procedure may reduce a number of pieces of medical equipment for the corneal procedure and the CXL medical procedure. 
     Turning now to  FIG. 1A , an example of a medical system is illustrated. As shown, a medical system  110  may be utilized with a patient  120 . As illustrated, medical system  110  may include a computer system  112 . Computer system  112  may be communicatively coupled to displays  116 A and  116 B. Computer system  112  may be communicatively coupled to a biometry device  114 . In one example, biometry device  114  may include one or more cameras. In another example, biometry device  114  may include a three-dimensional scanner. Biometry device  114  may be utilized in biometry of an eye  122  of patient  120 . As shown, display  116 A may display an image  130 A associated with eye  122  of patient  120 . As illustrated, display  116 B may display an image  130 B associated with eye  122  of patient  120 . 
     A user interface may be associated with one or more of computer system  112 , display  116 A, and display  116 B, among others. In one example, a user interface may include one or more of a keyboard, a mouse, a joystick, a touchscreen, an eye tracking device, a speech recognition device, a gesture control module, dials, and/or buttons, among other input devices. In another example, a user interface may include a graphical user interface (GUI). A user (e.g., medical personnel) may enter desired instructions and/or parameters via the user interface. 
     Computer system  112  may determine eye recognition information. For example, the eye recognition information may include biometry information associated with eye  122  of patient  120 . The biometry information associated with eye  122  may include one or more of a pattern of blood vessels of a sclera of eye  122 , a structure of an iris of eye  122 , a position of a structure of an iris of eye  122 , a distance measurement of a cornea of eye  122  to a lens of eye  122 , a distance measurement of a lens of eye  122  to a retina of eye  122 , a corneal topography of eye  122 , a retinal pattern of eye  122 , and a wavefront measurement, among others. 
     As shown, display  116 B may display structures  134 A- 134 C of an iris of eye  122 . As illustrated, display  116 B may display display areas  136 A- 136 D. In one example, a display area  136  may display a distance measurement of a cornea of eye  122  to a lens of eye  122 , a distance measurement of a lens of eye  122  to a retina of eye  122 , a position of an iris structure  134 , corneal topography information, or wavefront measurement information, among other biometry information associated with eye  122 . In another example, a display area  136  may display any information associated with patient  120 . 
     A person  150  may operate medical system  110 . For example, person  150  may be medical personnel.  112 . Person  150  may enter identification information associated with patient  120  into computer system  112 . The identification information associated with patient  120  may include one or more of a name of patient  120 , an address of patient  120 , a telephone number of patient  120 , a government issued identification number of patient  120 , a government issued identification string of patient  120 , and a date of birth of patient  120 , among others. 
     Person  150  may provide medical procedure information, associated with patient  120 , to computer system  112 . The medical procedure information may be associated with a medical procedure. The medical procedure information may be associated identification information associate with patient  120 . Computer system  112  may store the medical procedure information. For example, computer system  112  may store the medical procedure information for later utilization. The medical procedure information may be associated with a surgery. For example, the medical procedure information may be retrieved before the surgery. The medical procedure information may be utilized during a medical procedure. For example, the medical procedure may include a surgery. 
     Turning now to  FIG. 1B , an example of a biometry device is illustrated. As shown, biometry device  114  may include image sensors  160 A- 160 C. For example, an image sensor  160  may include a camera. A camera may include a one or more digital image sensors. In one example, a digital image sensor may include a charge-coupled device (CCD). In another example, a digital image sensor may include a complementary metal-oxide-semiconductor (CMOS). The camera may transform light into digital data. The camera may utilize a Bayer filter mosaic. For example, the camera may utilize a Bayer filter mosaic in combination with an optical anti-aliasing filter. A combination of the Bayer filter mosaic in combination with the optical anti-aliasing filter may reduce aliasing due to reduced sampling of different primary-color images. The camera may utilize a demosaicing process. For example, the demosaicing process may be utilized to interpolate color information to create a full array of red, green, and blue (RGB) image data. 
     As illustrated, biometry device  114  may include light projectors  162 A- 162 C. In one example, a light projector  162  may project visible light. In another example, a light projector  162  may project infrared light. A light projector  162  may project circles and/or dots onto an eye of a patient. An image sensor  160  may receive reflections of the circles and/or the dots that were projected onto the eye of the patient. A computer system may determine one or more locations and/or one or more templates associated with the eye of the patient based at least on the reflections of the circles and/or the dots that were projected onto the eye of the patient. As shown, biometry device  114  may include depth sensors  164 A- 164 C. A depth sensor  164  may include a light projector  162 . A depth sensor  164  may include an optical sensor. As illustrated, biometry device  114  may include an optical low coherence reflectometer (OLCR) device  166 . As shown, biometry device  114  may include a wavefront device  168 . 
     Wavefront device  168  may include one or more of a light source and a wavefront sensor, among others. A light source may provide a first light wave to eye  122 . A wavefront sensor may receive a first perturbed light wave, based at least on the first light wave, from eye  122 . In one example, wavefront device  168  may determine first optical corrections based at least on the first perturbed light. In another example, a computer system may determine first optical corrections based at least on the first perturbed light. Wavefront device  168  may provide data, based at least on the first perturbed light wave, to a computer system. For example, the computer system may determine first optical corrections based at least on the data from wavefront device  168 . 
     Any two or more of an image sensor  160 , a light projector  162 , a depth sensor  164 , an OLCR device  166 , and a wavefront device  168  may be combined. One or more of image sensors  160 A- 160 C, one or more of light projectors  162 A- 162 C, one or more of depth sensors  164 A- 164 C, OLCR device  166 , and/or wavefront device  168 , among others, may produce data that may be utilized by a computer system. 
     Turning now to  FIG. 2 , an example of a laser system is illustrated. A laser system  210  may be utilized to irradiate one or more portions of eye  122 . For example, laser system  210  may be utilized to irradiate one or more portions of eye  122  with UV light from a UV laser device. Laser system  210  may be utilized in a medical procedure. For example, a medical system may include laser system  210 . The medical procedure may include an ophthalmic procedure on at least a portion part of eye  122 . Although optical system  210  may be utilized in a medical system, laser system  210  may be utilized in any system. 
     Laser system  210  may include multiple optical devices. For example, an optical device may be or may include a device that controls light (e.g., reflects light, refracts light, filters light, transmits light, polarizes light, etc.). An optical device may be made of any material that controls the light as designed. For example, the material may include one or more of glass, crystal, metal, and semiconductor, among others. Examples of optical devices may include one or more of lenses, mirrors, prisms, optical filters, waveguides, waveplates, beam expanders, beam collimators, beam splitters, gratings, and polarizers, among others. 
     As shown, laser system  210  may include a laser  220  (e.g., a laser device). Laser  220  may generate a laser beam  221 . In one example, laser  220  may be a device that generates a beam of coherent monochromatic light by stimulated emission of photons from excited atoms and/or molecules. In another example, laser  220  may be a device that generates a laser beam that includes photons associated with multiple frequencies. Laser beam  221  may have any suitable wavelength, e.g., a wavelength in an infrared (IR) range, in a visible range, or in an UV range. Pulses of laser beam  221  may have a pulse duration in any suitable range, e.g., the microsecond, nanosecond, picosecond, femtosecond, or attosecond range, among others. Laser beam  221  may deliver consecutive pulses, having a pulse duration, for a period of time. The focus of laser beam  221  may be a focal point of laser beam  221 . Laser beam  221  may represent one or more laser beams. For example, laser  220  may be configured to produce one or more laser beams  221 . 
     As illustrated, laser system may include focusing optics  240 . As shown, focusing optics  240  may include a beam expander  241 , a scanner  244 , and an objective lens  248 . Objective lens  248  may include multiple lenses. In one example, objective lens  248  may be or include a compound lens. In another example, objective lens  248  may be or include a F-theta lens. As illustrated, beam expander  241  may include lenses  242 A and  242 B. Although beam expander  241  is shown with two lenses, beam expander  241  may include any number of lenses. 
     Focusing optics  240  may direct and/or may focus laser beam  221  towards eye  122 . Focusing optics  240  may direct and/or may focus laser beam  221  towards a cornea  310 , illustrated in  FIG. 3 , of eye  122 . Focusing optics  240  may direct a focal point of laser beam  221  parallel to or along a Z-axis towards eye  122 . 
     An optical device, such as a lens  242 A and/or a mirror, may control a Z-position of a focal point of laser beam  221 . Another optical device, such as a lens  242 B (e.g., in combination with lens  242 A), may expand a diameter of laser beam  221 . For example, beam expander  241  may be configured to control a focal point of laser beam  221 . 
     Scanner  244  may include one or more optical devices that may control a direction of laser beam  221  to control a XY-position of the focal point. For example, to transversely deflect laser beam  221 , scanner  244  may include a pair of galvanometric actuated mirrors that may tilt about mutually perpendicular axes. Scanner  244  may receive laser beam  221  from beam expander  241 . Scanner  244  may manipulate laser beam  221  to control the XY-position of the focal point of laser  221 . Objective lens  248  may receive laser beam  221  from the scanner  244 . Objective lens  248  may direct laser beam  221  to eye  122 . 
     As illustrated, laser system  210  may include a computer system  250 . Computer system  250  may execute instructions in implementing at least a portion of one or more systems, one or more flow charts, one or more processes, and/or one or more methods described herein. Although laser system  210  is illustrated as including computer system  250 , laser system  210  may not include computer system  250 . For example, computer system  250  may be external to laser system  210 . Computer system  250  may be communicatively coupled to laser system  210 . 
     As shown, computer system  250  may be communicatively coupled to laser  220 . As illustrated, computer system  250  may be communicatively coupled to beam expander  241 . As shown, computer system  250  may be communicatively coupled to scanner  244 . In one example, computer system  250  may receive information from one or more of laser  220 , beam expander  241 , and scanner  244 , among others. In another example, computer system  250  may provide information to one or more of laser  220 , beam expander  241 , and scanner  244 , among others. Computer system  250  may provide control information to one or more of laser  220 , beam expander  241 , and scanner  244 , among others. 
     A medical system may include laser system  210 . Laser system  210  may be utilized in one or more medical procedures. As one example, laser system  210  may be utilized with a Dresden protocol. As a second example, laser system  210  may be utilized with a derivation of a Dresden protocol (e.g., higher/lower energy settings, different irradiation times, on/off “pulsed” irradiation, different riboflavin application strategies, etc.). As a third example, laser system  210  may be utilized with created pockets (e.g. corneal pockets, interface after refractive lenticule extraction, LASIK (laser-assisted in situ keratomileusis) flaps, etc.) to apply riboflavin. As another example, laser system  210  may be utilized in a CXL medical procedure. 
     Turning now to  FIG. 3 , an example of layers of a cornea of an eye is illustrated. As shown, a cornea  310  may include layers  320 - 360 . In one example, layer  320  may be an epithelium. In a second example, layer  330  may be a Bowman&#39;s membrane. In a third example, layer  340  may be a stroma. In a fourth example, layer  350  may be a Descemet&#39;s membrane. In another example, layer  360  may be an endothelim. 
     Turning now to  FIG. 4A , a second example of a medical system is illustrated. As shown, a surgeon  410  may utilize surgical tooling equipment  420 . In one example, surgeon  410  may utilize surgical tooling equipment  420  in a surgery and/or a medical procedure involving eye  122  of patient  120 . A medical system  400 A may include an ophthalmic surgical tool tracking system. As illustrated, medical system  400 A may include a computer system  430 , a display  440 , and a microscope integrated display (MID)  450 . 
     Computer system  430  may receive image frames captured by one or more image sensors. For example, computer system  430  may perform various image processing on the one or more image frames. Computer system  430  may perform image analysis on the one or more image frames to identify and/or extract one or more images of surgical tooling equipment  420  from the one or more image frames. Computer system  430  may generate a GUI, which may overlay the one or more image frames. For example, the GUI may include one or more indicators and/or one or more icons, among others. The one or more indicators may include medical data, such as one or more positions and/or one or more orientations. The one or more indicators may include one or more warnings. The GUI may be displayed by display  440  and/or MID  450  to surgeon  410  and/or other medical personnel. 
     Computer system  430 , display  440 , and MID  450  may be implemented in separate housings communicatively coupled to one another or within a common console or housing. A user interface may be associated with one or more of computer system  430 , display  440 , and MID  450 , among others. For example, a user interface may include one or more of a keyboard, a mouse, a joystick, a touchscreen, an eye tracking device, a speech recognition device, a gesture control module, dials, and/or buttons, among other input devices. A user (e.g., surgeon  410  and/or other medical personnel) may enter desired instructions and/or parameters via the user interface. For example, the user interface may be utilized in controlling one or more of computer system  430 , display  440 , and MID  450 , among others. As illustrated, medical system  400 A may include a laser system  210 . For example, surgeon  410  may utilize laser system  210  in performing a CXL procedure on eye  122 . As an example, MID  450  may include a laser system  210 . 
     Turning now to  FIG. 4B , a third example of a medical system is illustrated. As shown, a surgeon  410  may utilize a system  400 B. For example, surgeon  410  may utilize system  400 B in a surgery involving eye  122  of patient  120 . System  400 B may include multiple systems. System  400 B may include a cutting system. For example, surgeon  410  may utilize system  400 B in cutting eye  122 . Surgeon  410  may utilize system  400 B in cutting a flap in cornea  310  of eye  122  of patient  120  or in cutting a pocket in cornea  310  of eye  122  of patient  120 . In one example, system  400 B may cut a flap in cornea  310  of eye  122  with a blade. In a second example, system  400 B may cut a pocket in cornea  310  of eye  122  with a blade. In a third example, system  400 B may cut a flap in cornea  310  of eye  122  with a laser beam produced by a laser device and/or a laser system. In a fourth example, system  400 B may cut a flap in cornea  310  of eye  122  with a laser beam produced by a laser device and/or a laser system. In another example, system  400 B may cut any femto-cut in cornea  310  of eye  122  with a laser beam produced by a laser device and/or a laser system. A fluid may be applied to one or more interior portions of cornea  310  of eye  122  via the flap or via the pocket. For example, the fluid may include riboflavin. Surgeon  410  may utilize system  400 B in removing a layer from cornea  310  of eye  122 . For example, surgeon  410  may utilize system  400 B in removing layer  320  from cornea  310  of eye  122 . As an example, removing layer  320  may include scraping layer  320  from cornea  310 . After layer  320  of cornea  310  of eye  122  is removed, a fluid may be applied to one or more interior portions of the cornea of eye  122 . For example, the fluid may include riboflavin. 
     As illustrated, system  400 B may include a laser system  210 . For example, surgeon  410  may utilize laser system  210  in performing a CXL procedure on eye  122 . As shown, system  400 B may include a display  440 . As illustrated, system  400 B may include a MID  450 . System  400 B may include one or more of image sensors  160 A- 160 C, one or more of light projectors  162 A- 162 C, one or more of depth sensors  164 A- 164 C, an OLCR device  166 , and/or a wavefront device  168 , among others. 
     System  400 B may include a laser, such as a femtosecond laser, which may use short laser pulses to ablate or cut a series of small portions of corneal tissue to form a flap that may be lifted up to expose an interior part of cornea  310  of eye  122 . The flap may be planned and cut using one or both of display  440  and MID  450 , along with control devices and a computer system  430 . Fluid may be dispensed under the flap. For example, the fluid may be dispensed to the interior part of cornea  310  of eye  122 . The fluid may include riboflavin. 
     System  400 B may include a laser, such as a femtosecond laser, which may use short laser pulses to ablate or cut a series of small portions of corneal tissue to form a pocket that may expose an interior part of cornea  310  of eye  122 . The pocket may be planned and cut using one or both of display  440  and MID  450 , along with control devices and a computer system  430 . Fluid may be dispensed under in the pocket. For example, the fluid may be dispensed to the interior part of cornea  310  of eye  122 . The fluid may include riboflavin. 
     As shown, system  400 B may include computer system  430 . For example, computer system  430  may be communicatively coupled to one or more of image sensors  160 A- 160 C, one or more of light projectors  162 A- 162 C, one or more of depth sensors  164 A- 164 C, an OLCR device  166 , a wavefront device  168 , display  440 , MID  450 , a laser, and/or laser system  210 , among others, of system  400 B. 
     System  400 B may include one or more control devices. For example, the one or more control devices may include one or more of an interactive display, such as a touchscreen display, a keyboard, a mouse, a touchpad, buttons, a joystick, a foot pedal, a heads-up display, and virtual-reality glasses, or other devices able to interact with a user, such as medical personnel. 
     System  400 B may include at least one computer system configured to generate an image presented on at least one of display  440  and MID  450 , among others. For example, the at least one computer system may include computer system  430 . Computer systems  430  may be communicatively coupled to observational devices, such as a microscope, a camera, an optical coherence tomography (OCT) device or display, or another device able to measure the position of the eye undergoing surgery. Computer systems  430  may be communicatively coupled to one or more of the control devices. 
     In one example, computer system  430 : i) may be communicatively coupled to observational devices that observe eye  122  when patient  120  is positioned with system  400 B, ii) may provide graphical information regarding the planned flap location and the planned area of ablation to one or more of display  440  and MID  450 , and iii) may be communicatively coupled to one or more control devices of system  400 B. In a second example, computer system  430 : i) may be communicatively coupled to observational devices that observe eye  122  when patient  120  is positioned with system  400 B, ii) may provide graphical information regarding the planned pocket location and the planned area of ablation to one or more of display  440  and MID  450 , and iii) may be communicatively coupled to one or more control devices of system  400 B. In another example, a computer system may include the properties and/or the attributes described above with respect to computer system  430 , among others. 
     A computer system of a system  400  may be communicatively coupled to another part of system  400  in a wired fashion or in a wireless fashion. One of more of computer systems of system  400  may be communicatively coupled to a database, stored locally, on a remote computer system or a remote data center, or both, that store patient data, treatments plans, and/or other information associated with medical treatments and/or system  400 . In one example, the database may include a relational database. In a second example, the database may include a graph database. In another example, the database may include a “Not Only SQL” (NoSQL) database. 
     System  400  may enter information regarding patient  120  and the treatment to be performed on patient  120  or actually performed on patient  120 . System  400  may allow a user to enter and view information regarding patient  120  and the treatment to be performed on patient  120 . Such data may include information about patient  120 , such as identifying information, a medical history of patient  120 , and/or information about eye  122  being treated, among others. Such data may include information about the treatment plans, such as the shape and location of a corneal cut, a shape and location of ablation, and/or multiple locations associated with a CXL procedure, among others. 
     Turning now to  FIG. 4C , an example of a microscope integrated display and examples of surgical tooling equipment are illustrated. Medical personnel may utilize surgical tooling equipment  420 . As shown, surgical tooling equipment  420 A may be or include a scalpel. As illustrated, surgical tooling equipment  420 B may be or include a Q-tip. As shown, surgical tooling equipment  420 C may be or include tweezers. As illustrated, surgical tooling equipment  420 D may be or include an eyedropper. For example, an eyedropper may be utilized to dispense a fluid to eye  122 . The fluid may include riboflavin. Other surgical tooling equipment that is not specifically illustrated may be utilized with one or more systems, one or more processes, and/or one or more methods described herein. 
     As an example, surgical tooling equipment  420  may be marked with one or more patterns. The one or more patterns may be utilized in identifying surgical tooling equipment  420 . The one or more patterns may include one or more of a hash pattern, a stripe pattern, and a fractal pattern, among others. As another example, surgical tooling equipment  420  may be marked with a dye and/or a paint. The dye and/or the paint may reflect one or more of visible light, infrared light, and ultraviolet light, among others. In one example, an illuminator  478  may provide ultraviolet light, and image sensor  472  may receive the ultraviolet light reflected from surgical tooling equipment  420 . Computer system  430  may receive image data, based at least on the ultraviolet light reflected from surgical tooling equipment  420 , from image sensor  472  and may utilize the image data, based at least on the ultraviolet light reflected from surgical tooling equipment  420 , to identify surgical tooling equipment  420  from other image data provided by image sensor  472 . In another example, an illuminator  478  may provide infrared light, and image sensor  472  may receive the infrared light reflected from surgical tooling equipment  420 . Computer system  430  may receive image data, based at least on the infrared light reflected from surgical tooling equipment  420 , from image sensor  472  and may utilize the image data, based at least on the infrared light reflected from surgical tooling equipment  420 , to identify surgical tooling equipment  420  from other image data provided by image sensor  472 . 
     As illustrated, MID  450  may include eye pieces  452 A and  452 B. As shown, MID  450  may include displays  462 A and  462 B. Surgeon  410  may look into eye pieces  452 A and  452 B. In one example, display  462 A may display one or more images via eye piece  452 A. A left eye of surgeon  410  may utilize eye piece  452 A. In another example, display  462 B may display one or more images via eye piece  452 B. A right eye of surgeon  410  may utilize eye piece  452 B. Although MID  450  is shown with multiple displays, MID  450  may include a single display  462 . For example, the single display  462  may display one or more images via one or more of eye pieces  452 A and  452 B. MID  450  may be implemented with one or more displays  462 . 
     As shown, MID  450  may include image sensors  472 A and  472 B. In one example, image sensors  472 A and  472 B may acquire images. In a second example, image sensors  472 A and  472 B may include cameras. In another example, an image sensor  472  may acquire images via one or more of visible light, infrared light, and ultraviolet light, among others. One or more image sensors  472 A and  472 B may provide data of images to computer system  430 . Although MID  450  is shown with multiple image sensors, MID  450  may include a single image sensor  472 . MID  450  may be implemented with one or more image sensors  472 . 
     As illustrated, MID  450  may include distance sensors  474 A and  474 . For example, a distance sensor  474  may determine a distance to surgical tooling equipment  420 . Distance sensor  474  may determine a distance associated with a Z-axis. Although MID  450  is shown with multiple image sensors, MID  450  may include a single distance sensor  474 . In one example, MID  450  may be implemented with one or more distance sensors  474 . In another example, MID  450  may be implemented with no distance sensor. 
     As shown, MID  450  may include lenses  476 A and  476 B. Although MID  450  is shown with multiple lenses  476 A and  476 B, MID  450  may include a single lens  476 . MID  450  may be implemented with one or more lenses  476 . As illustrated, MID  450  may include illuminators  478 A and  478 B. For example, an illuminator  478  may provide and/or produce one or more of visible light, infrared light, and ultraviolet light, among others. Although MID  450  is shown with multiple illuminators, MID  450  may include a single illuminator  478 . MID  450  may be implemented with one or more illuminators  478 . MID  450  may include one or more devices, one or more structures, and/or one or more functionalities as those described with reference to biometry device  114 . In one example, MID  450  may include OLCR device  166 . In another example, MID  450  may include wavefront device  168 . MID  450  may include a biometry device  114 . As shown, MID  450  may include biometry device  114 . 
     Turning now to  FIG. 5 , an example of a computer system is illustrated. As shown, a computer system  500  may include a processor  510 , a volatile memory medium  520 , a non-volatile memory medium  530 , and an input/output (I/O) device  540 . As illustrated, volatile memory medium  520 , non-volatile memory medium  530 , and I/O device  540  may be communicatively coupled to processor  510 . 
     The term “memory medium” may mean a “memory”, a “storage device”, a “memory device”, a “computer-readable medium”, and/or a “tangible computer readable storage medium”. For example, a memory medium may include, without limitation, storage media such as a direct access storage device, including a hard disk drive, a sequential access storage device, such as a tape disk drive, compact disk (CD), random access memory (RAM), read-only memory (ROM), CD-ROM, digital versatile disc (DVD), electrically erasable programmable read-only memory (EEPROM), flash memory, non-transitory media, and/or one or more combinations of the foregoing. As shown, non-volatile memory medium  530  may include processor instructions  532 . Processor instructions  532  may be executed by processor  510 . In one example, one or more portions of processor instructions  532  may be executed via non-volatile memory medium  530 . In another example, one or more portions of processor instructions  532  may be executed via volatile memory medium  520 . One or more portions of processor instructions  532  may be transferred to volatile memory medium  520 . 
     Processor  510  may execute processor instructions  532  in implementing at least a portion of one or more systems, one or more flow charts, one or more processes, and/or one or more methods described herein. For example, processor instructions  532  may be configured, coded, and/or encoded with instructions in accordance with at least a portion of one or more systems, one or more flowcharts, one or more methods, and/or one or more processes described herein. Although processor  510  is illustrated as a single processor, processor  510  may be or include multiple processors. A processor may include one or more processor cores. One or more of a storage medium and a memory medium may be a software product, a program product, and/or an article of manufacture. For example, the software product, the program product, and/or the article of manufacture may be configured, coded, and/or encoded with instructions, executable by a processor, in accordance with at least a portion of one or more systems, one or more flowcharts, one or more methods, and/or one or more processes described herein. 
     Processor  510  may include any suitable system, device, or apparatus operable to interpret and execute program instructions, process data, or both stored in a memory medium and/or received via a network. Processor  510  further may include one or more microprocessors, microcontrollers, digital signal processors (DSPs), application specific integrated circuits (ASICs), or other circuitry configured to interpret and execute program instructions, process data, or both. 
     I/O device  540  may include any instrumentality or instrumentalities, which allow, permit, and/or enable a user to interact with computer system  500  and its associated components by facilitating input from a user and output to a user. Facilitating input from a user may allow the user to manipulate and/or control computer system  500 , and facilitating output to a user may allow computer system  500  to indicate effects of the user&#39;s manipulation and/or control. For example, I/O device  540  may allow a user to input data, instructions, or both into computer system  500 , and otherwise manipulate and/or control computer system  500  and its associated components. I/O devices may include user interface devices, such as a keyboard, a mouse, a touch screen, a joystick, a handheld lens, a tool tracking device, a coordinate input device, or any other I/O device suitable to be used with a system. 
     I/O device  540  may include one or more busses, one or more serial devices, and/or one or more network interfaces, among others, that may facilitate and/or permit processor  510  to implement at least a portions of one or more systems, processes, and/or methods described herein. In one example, I/O device  540  may include a storage interface that may facilitate and/or permit processor  510  to communicate with an external storage. The storage interface may include one or more of a universal serial bus (USB) interface, a SATA (Serial ATA) interface, a PATA (Parallel ATA) interface, and a small computer system interface (SCSI), among others. In a second example, I/O device  540  may include a network interface that may facilitate and/or permit processor  510  to communicate with a network. I/O device  540  may include one or more of a wireless network interface and a wired network interface. In a third example, I/O device  540  may include one or more of a peripheral component interconnect (PCI) interface, a PCI Express (PCIe) interface, a serial peripheral interconnect (SPI) interface, and an inter-integrated circuit (I 2 C) interface, among others. In a fourth example, I/O device  540  may include circuitry that may permit processor  510  to communicate data with one or more sensors. In a fifth example, I/O device  540  may facilitate and/or permit processor  510  to communicate data with one or more of a display  550  and a MID  560 , among others. In another example, I/O device  540  may facilitate and/or permit processor  510  to communicate data with an imaging device  570 . As illustrated, I/O device  540  may be coupled to a network  580 . For example, I/O device  540  may include a network interface. 
     Network  580  may include a wired network, a wireless network, an optical network, or a combination of the foregoing, among others. Network  580  may include and/or be coupled to various types of communications networks. For example, network  580  may include and/or be coupled to a local area network (LAN), a wide area network (WAN), an Internet, a public switched telephone network (PSTN), a cellular telephone network, a satellite telephone network, or a combination of the foregoing, among others. A WAN may include a private WAN, a corporate WAN, a public WAN, or a combination of the foregoing, among others. 
     A computer system described herein may include one or more structures and/or one or more functionalities as those described with reference to computer system  500 . In one example, computer system  250  may include one or more structures and/or one or more functionalities as those described with reference to computer system  500 . In a second example, computer system  112  may include one or more structures and/or one or more functionalities as those described with reference to computer system  500 . In a third example, computer system  430  may include one or more structures and/or one or more functionalities as those described with reference to computer system  500 . In another example, a computer system of MID  450  may include one or more structures and/or one or more functionalities as those described with reference to computer system  500 . 
     Turning now to  FIGS. 6A-6D , examples of an eye are illustrated. As shown in  FIG. 6A , eye  122  may be oriented upwards. In one example, eye  122  may be oriented upwards without being angled. In another example, eye  122  may be oriented upwards without being rotated. One or more of iris structures  134 A- 134 C may be utilized in determining that eye  122  is oriented upwards. For example, computer system  430  may determine respective positions of the one or more of iris structures  134 A- 134 C. Computer system  430  may determine that eye  122  is oriented upwards based at least on the respective positions of the one or more of iris structures  134 A- 134 C. 
     As illustrated in  FIG. 6B , eye  122  may be rotated. One or more of iris structures  134 A- 134 C may be utilized in determining that eye  122  is rotated. For example, computer system  430  may determine respective positions of the one or more of iris structures  134 A- 134 C. Computer system  430  may determine that eye  122  is rotated by an angle based at least on the respective positions of the one or more of iris structures  134 A- 134 C. 
     As shown in  FIG. 6C , eye  122  may be angled. As illustrated, eye  122  may be angled to the left. One or more of iris structures  134 A- 134 C may be utilized in determining that eye  122  is angled. For example, computer system  430  may determine respective positions of the one or more of iris structures  134 A- 134 C. Computer system  430  may determine that eye  122  is angled by an angle based at least on the respective positions of the one or more of iris structures  134 A- 134 C. 
     As illustrated in  FIG. 6D , eye  122  may be angled. As shown, eye  122  may be angled down. One or more of iris structures  134 A- 134 C may be utilized in determining that eye  122  is angled. For example, computer system  430  may determine respective positions of the one or more of iris structures  134 A- 134 C. Computer system  430  may determine that eye  122  is angled by an angle based at least on the respective positions of the one or more of iris structures  134 A- 134 C. 
     Turning now to  FIGS. 6E-6H , examples of an eye and a coordinate system are illustrated. As shown in  FIG. 6E , eye  122  may be at an angle θ x  from a Z-axis with respect to a X-axis. Angle θ x  may be positive or negative. As illustrated in  FIG. 6F , eye  122  may be at an angle θ y  from the Z-axis with respect to a Y-axis. Angle θ y  may be positive or negative. As shown in  FIG. 6G , eye  122  may be rotated by an angle ϕ. For example, eye  122  may be rotated by angle ϕ about the Z-axis. Angle ϕ may be positive or negative. As illustrated in  FIG. 6H , eye  122  may be rotated by angle ϕ about an arbitrary axis  610 . For example, axis  610  may be a vector in a three-dimensional Cartesian coordinate system. Angle ϕ may be positive or negative. In one example, axis  610  may be based at least on angle θ x . In a second example, axis  610  may be based at least on angle θ y . In another example, axis  610  may be based at least on angle θ x  and based at least on angle θ y . Although  FIGS. 6E-6H  utilize a Cartesian coordinate system, any coordinate system may be utilized. Computer system  430  may determine one or more of angle θ x , angle θ y , angle ϕ, and axis  610  based at least on respective positions of one or more of iris structures  134 A- 134 C. 
     Turning now to  FIG. 7A , an example of a method of operating a medical system is illustrated. At  710 , data associated with multiple locations associated with a cornea of an eye of a patient may be received. For example, computer system  430  may receive data  810  (illustrated in  FIG. 8 ) associated with multiple locations  910  associated with cornea  310  of eye  122  of patient  120 . Data  810  may include one or more of data  815 A- 815 M, among others. In one example, data  815 A- 815 M may be respectively associated with multiple locations  910 A- 910 M. In a second example, data  815 A may be associated with location  910 , illustrated in  FIG. 9C . In another example, data  815 A may be associated with location  910 , illustrated in  FIG. 9C , and data  815 B and  815 C may be respectively associated with locations  910 A and  910 B, any of illustrated in  FIGS. 9D-9F . The data associated with the multiple locations, associated with the cornea of the eye of the patient, may include locations  910  of any of  FIGS. 9C-9F . For example, multiple data  815  may be utilized in any order. Data associated with locations  910 A- 910 G, illustrated in any of  FIGS. 9D-9F , may be utilized before data associated with location  910 , illustrated in  FIG. 9C . Data associated with location  910 , illustrated in  FIG. 9C , may be utilized before data associated with locations  910 A- 910 G, illustrated in any of  FIGS. 9D-9F . For example, one or more locations of a FIG. of  FIGS. 9C-9F  may be irritated with a laser beam before another FIG. of  FIGS. 9C-9F  may be irritated with a laser beam. Data  810  may include information that may described, characterize, and/or indicate this performance. 
     As illustrated in  FIG. 9A , a plane  905  may be associated with multiple locations  910 A- 910 M. Plane  905  may be orthogonal to laser  221  after laser  221  is transmitted from objective lens  248 . Plane  905  may be associated with eye  122  as illustrated in  FIG. 9B . Multiple locations  910 A- 910 M may be associated with cornea  310  of eye  122  of patient  120 . Although only fourteen locations are illustrated in  FIG. 9A , any number of locations may be utilized. 
     Furthermore, locations  910  may be arranged at any locations. In one example, a single location  910  is illustrated in  FIG. 9C . In a second example, multiple locations  910  may be associated with plane  905  as illustrated in  FIG. 9D . In a third example, multiple locations  910  may be associated with plane  905  as illustrated in  FIG. 9E . In another example, multiple locations  910  may be associated with plane  905  as illustrated in  FIG. 9F . As illustrated in  FIG. 9G , multiple locations  910  may be associated with cornea  310  of eye  122 . As shown in  FIG. 9F , a first portion  920 A of cornea  310  is associated with locations  910 . As illustrated in  FIG. 9F , a second portion  920 B of cornea  310 , different from first portion  920 A, is not associated with locations  910 . For example, one or more portions of cornea  310  may be treated while one or more other one or more portions of cornea  310  may not be treated. 
     As illustrated in  FIG. 8 , data  810  may include data  815 A- 815 M. For example, data  815 A- 815 M may be respectively associated with locations  910 A- 910 M. Data  815  may include coordinate information  820 . For example, coordinate information  820  may include XY coordinates. The XY coordinates may be associated with a X-axis and a Y-axis. Data  815  may include diameter information  825 . For example, diameter information  825  may include a diameter measurement of a laser beam associated with location  910 . Data  815  may include period of time information  830 . For example, period of time information  830  may include a period of time to apply a laser beam at location  910 . Data  815  may include pulse duration information  835 . For example, pulse duration information  835  may include a pulse duration. As an example, a pulse duration may include a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration, among others. For example, laser  220  may be configured with a pulse duration based at least on pulse duration information  835 . 
     At  715 , at least one lens may be adjusted based at least on diameter information of the data associated with at least one of the multiple locations, to set a diameter of a laser beam. For example, at least one of lenses  242 A and  242 B may be adjusted based at least on diameter information of the data associated with at least one of the multiple locations, to set a diameter of laser beam  221 . A computer system may provide control information to beam expander  241  to adjust at least one of lenses  242 A and  242 B to set a diameter of laser beam  221 . In one example, computer system  250  may provide control information to beam expander  241  to adjust at least one of lenses  242 A and  242 B to set a diameter of laser beam  221 . In a second example, computer system  430  may provide control information to beam expander  241  to adjust at least one of lenses  242 A and  242 B to set a diameter of laser beam  221 . In a third example, computer system  430  may provide control information to computer system  250 . Computer system  250  may provide the control information to beam expander  241  to adjust at least one of lenses  242 A and  242 B to set a diameter of laser beam  221 . In another example, computer system  430  may be or include computer system  250 . The control information may be based at least on the diameter information of the data associated with the at least one of the multiple locations. 
     Method elements  720 - 740  may be performed for each of the multiple locations associated with the cornea of the eye of the patient. For example, Method elements  720 - 740  may be performed for each of multiple locations  910 . 
     At  720 , it may be determined if the eye has changed from a first position of the eye to a second position of the eye, different from the first position of the eye. For example, computer system  430  may determine if eye  122  has changed from a first position of the eye to a second position of the eye, different from the first position of the eye. As one example, eye  122  may change from a first position of eye  122 , illustrated in  FIG. 6A , to a second position of eye  122 , illustrated in  FIG. 6B . Eye  122  may have changed from the first position of eye  122 , illustrated in  FIG. 6A , to the second position of eye  122 , illustrated in  FIG. 6B , via one or more rotations. As a second example, eye  122  may change from a first position of eye  122 , illustrated in  FIG. 6A , to a second position of eye  122 , illustrated in  FIG. 6C . As a third example, eye  122  may change from a first position of eye  122 , illustrated in  FIG. 6A , to a second position of eye  122 , illustrated in  FIG. 6D . As another example, eye  122  may change from a first position of eye  122 , illustrated in  FIG. 6C , to a second position of eye  122 , illustrated in  FIG. 6D . Determining if the eye has changed from the first position of the eye to the second position of the eye, different from the first position of the eye, may include determining if a pupil of the eye has changed from a first position of the pupil to a second position of the pupil. Determining if the eye has changed from the first position of the eye to the second position of the eye, different from the first position of the eye, may include determining if a center of a pupil of the eye has changed from a first position of the center of the pupil to a second position of the center of the pupil. 
     Determining if the eye has changed from the first position of the eye to the second position of the eye, different from the first position of the eye, may include determining if at least one iris structure has changed from a first position of the at least one iris structure to a second position of the at least one iris structure. In one example, iris structure  134 A may be at a first position of iris structure  134 A, illustrated in  FIG. 6A , and iris structure  134 A may be at a second position of iris structure  134 A, illustrated in  FIG. 6B . In a second example, iris structure  134 A may be at a first position of iris structure  134 A, illustrated in  FIG. 6A , and iris structure  134 A may be at a second position of iris structure  134 A, illustrated in  FIG. 6C . In a third example, iris structure  134 A may be at a first position of iris structure  134 A, illustrated in  FIG. 6A , and iris structure  134 A may be at a second position of iris structure  134 A, illustrated in  FIG. 6D . In another example, iris structure  134 A may be at a first position of iris structure  134 A, illustrated in  FIG. 6C , and iris structure  134 A may be at a second position of iris structure  134 A, illustrated in  FIG. 6D . In these examples, one or more of iris structures  134 B and  134 C may be utilized in place of or in addition to iris structure  134 A in a fashion as iris structure  134 A has been described. As one example, one or more of iris structures  134 A- 134 C may be determined via medical system  110 . As another example, one or more of iris structures  134 A- 134 C may be determined via medical system  400 . 
     If the eye has not changed from a first position of the eye to a second position of the eye, at least one mirror may be adjusted based at least on the location, at  725 . For example, if eye  122  has not changed from a first position of eye  122  to a second position of eye  122 , at least one mirror of scanner  244  may be adjusted based at least on location  910 . For example, scanner  244  may include one or more mirrors that may be adjusted based at least on location  910 . 
     If the eye has changed from the first position of the eye to the second position of the eye, the at least one mirror may be adjusted based at least on the location and based at least on the second position of the eye, at  730 . For example, if eye  122  has changed from the first position of eye  122  to the second position of eye  122  at least one mirror of scanner  244  may be adjusted based at least on location  910  and based at least on the second position of eye  122 . As an example, scanner  244  may include one or more mirrors that may be adjusted based at least on location  910  and based at least on the second position of eye  122 . 
     If eye  122  has changed from the first position of the eye to the second position of the eye, location  910  may be translated based at least on the second position of the eye. 
     Adjusting the at least one mirror based at least on the location and based at least on the second position of the eye may include adjusting the at least one mirror based at least on the location and based at least on a translation of the location. The translation may be based at least on the second position of the eye. In one example, translating based at least on the second position may include translating based at least on a second position of a center of a pupil of eye  122 . In a second example, translating based at least on the second position of the eye may include translating based at least on a second position of an iris structure. The second position of the iris structure may be a second position of iris structure  134 A, a second position of iris structure  134 B, or a second position of iris structure  134 C, among others. In another example, translating based at least on the second position of the eye may include translating based at least on second positions of respective multiple iris structures. The second positions of the respective multiple iris structures may include two or more of a second position of iris structure  134 A, a second position of iris structure  134 B, and a second position of iris structure  134 C, among others. 
     A computer system may compute one or more translations of one or more locations  910 . For example, the computer system may compute a translation of a location  910  based at least on one or more of angle θ x , angle θ y , angle ϕ, and axis  610 , among others. A computer system may determine one or more of angle θ x , angle θ y , angle ϕ, and axis  610  based at least on respective positions of one or more of iris structures  134 A- 134 C. In one example, the computer system may determine one or more of angle θ x , angle θ y , angle ϕ, and axis  610  based at least on a first position of iris structure  134 A and a second position of iris structure  134 A. In a second example, the computer system may determine one or more of angle θ x , angle θ y , angle ϕ, and axis  610  based at least on a first position of iris structure  134 B and a second position of iris structure  134 B. In another example, the computer system may determine one or more of angle θ x , angle θ y , angle ϕ, and axis  610  based at least on a first position of iris structure  134 C and a second position of iris structure  134 C. 
     At  735 , the laser beam may be produced. For example, laser  220  may produce laser beam  221 . Laser beam  221  may be an UV laser beam. For example, laser  220  may be or include a device that generates a beam of coherent monochromatic light, in an UV spectrum, by stimulated emission of photons from excited atoms and/or molecules. Producing the laser beam may include pulsing the laser beam at a pulse duration. For example, the pulse duration may be a microsecond duration, a nanosecond duration, a picosecond duration, a femtosecond duration, or an attosecond duration, among others. The pulse duration may be configured and/or set based at least on pulse duration information  835  associated with location  910 . In one example, the pulse duration may be configured and/or set based at least on pulse duration information  835 A associated with location  910 A. In another example, the pulse duration may be configured and/or set based at least on pulse duration information  835 B associated with location  910 B. A first pulse duration, associated with a first location, may be different from a second pulse duration, associated with a second location. The pulse duration associated with location  910 A may be different from the pulse duration associated with location  910 B. The pulse duration associated with location  910 A may be equal to the pulse duration associated with location  910 B. 
     Before the laser beam is produced, at least one of a flap and a pocket may be cut in the cornea of the eye. In one example, a blade may cut the cornea of the eye. In another example, another laser may cut the cornea of the eye. Before the laser beam is produced, riboflavin may be applied to an interior portion of the cornea. For example, riboflavin may be applied to an interior portion of the cornea via the flap that was cut or via the pocket that was cut. Before the laser beam is produced, a layer of the cornea may be removed to expose an interior portion of the cornea. Layer  320 , as illustrated in  FIG. 3 , may be removed. Riboflavin may applied to the cornea after the layer of the cornea is removed and before the laser beam is produced. 
     At  740 , the laser beam may be directed to the location for a period of time associated with the location. For example, laser beam  221  may be directed to location  910  for a period of time associated with location  910 . Focusing optics  240  may direct laser beam  221  to location  910  for a period of time associated with location  910 . A first period of time associated with a first location may be different from a second period of time associated with a second location. For example, a period of time associated with location  910 A may be different from a period of time associated with location  910 B. The period of time associated with location  910 A may be indicated by period of time information  830 A. The period of time associated with location  910 B may be indicated by period of time information  830 B. A period of time associated with a first location may be equal a second period of time associated with a second location. For example, a period of time associated with location  910 A may be equal to a period of time associated with location  910 B. 
     Directing the laser beam to the location for the period of time associated with the location may add bonds between collagen fibers in the cornea. For example, directing laser beam  221  to location  910  for the period of time associated with location  910  may add bonds between collagen fibers in cornea  310  associated with location  910 . 
     The bonds between the collagen fibers may aid in stabilizing cornea  310 . For example, the bonds between the collagen fibers associated with each location of locations  910  may aid in stabilizing cornea  310 . Locations  910  may be determined based at least on a topography of cornea  310 . Locations  910  may be determined based at least on a thicknesses at respective multiple positions associated with cornea  310 . Locations  910  may be determined based at least on refractive information associated with one or more of cornea  310  and eye  122 , among others. For example, one or more of methods  7 A and  7 B, among others, may be utilized in correcting an astigmatism in cornea  310 . Locations  910  may be determined based at least on a medical plan that may mitigate or may stop an issue and/or a disease that may weaken and/or thin cornea  310 . For example, locations  910  may be determined based at least on a medical plan that may mitigate or may stop progressive keratoconus from becoming worse. 
     Turning now to  FIG. 7B , another example of a method of operating a medical system is illustrated. Method elements  710  and  720 - 740  may be performed as described with reference to  FIG. 7A . In the method associated with  FIG. 7B , method elements  715 - 740  may be performed for each of the multiple locations associated with the cornea of the eye of the patient. For example, method elements  715 - 740  may be performed for each of multiple locations  910 . At  715 , at least one lens may be adjusted, based at least on diameter information of the data associated with the location, to set a diameter of a laser beam. 
     At least a first diameter associated with a first location may be different from a second diameter associated with a second location. In one example, a diameter associated with location  910 A may be different from a diameter associated with location  910 B. Diameter information  825 A may indicate the diameter associated with location  910 A. Diameter information  825 B may indicate the diameter associated with location  910 B. In a second example, a diameter associated with location  910 A may be different from a diameter associated with location  910 C. Diameter information  825 A may indicate the diameter associated with location  910 A. Diameter information  825 C may indicate the diameter associated with location  910 C. In another example, a diameter associated with location  910 A may be equal to a diameter associated with location  910 D. Diameter information  825 A may indicate the diameter associated with location  910 A. Diameter information  825 D may indicate the diameter associated with location  910 D. 
     One or more of the method and/or process elements and/or one or more portions of a method and/or processor elements may be performed in varying orders, may be repeated, or may be omitted. Furthermore, additional, supplementary, and/or duplicated method and/or process elements may be implemented, instantiated, and/or performed as desired. Moreover, one or more of system elements may be omitted and/or additional system elements may be added as desired. 
     A memory medium may be and/or may include an article of manufacture. For example, the article of manufacture may include and/or may be a software product and/or a program product. The memory medium may be coded and/or encoded with processor-executable instructions in accordance with one or more flowcharts, systems, methods, and/or processes described herein to produce the article of manufacture. 
     The above disclosed subject matter is to be considered illustrative, and not restrictive, and the appended claims are intended to cover all such modifications, enhancements, and other implementations which fall within the true spirit and scope of the present disclosure. Thus, to the maximum extent allowed by law, the scope of the present disclosure is to be determined by the broadest permissible interpretation of the following claims and their equivalents, and shall not be restricted or limited by the foregoing detailed description.