Patent Publication Number: US-2021177658-A1

Title: System and method of determining incision depths in eyes

Description:
BACKGROUND 
     Field of the Disclosure 
     This disclosure relates to determining incision depths in eyes. 
     Description of the Related Art 
     In the past, optical topography measuring instruments were available. These instruments utilized “white light” interferometry. For example, these instruments are utilized to measure height variations (e.g., surface roughness) of a surface. Interference optical profiling can use wave properties of light to compare an optical path difference between a test surface and a reference surface. For example, a light beam can be split. Half of the beam of light can be reflected from a test material. The other half of the beam of light can be reflected from a reference mirror. Constructive and destructive interference can occur when the two halves of the light beam are combined where respective lengths of the two halves are different. For example, interference fringes (e.g., light and dark bands) can be created. A digital camera can receive the combination of the two halves. Constructive interference can be lighter areas, while destructive interference can be darker areas. For a known wavelength of light, height differences across a surface can be determined in fractions of a wavelength of the light. Based on the height differences, a surface measurement can be determined. For example, a three-dimensional surface map can be determined based on the height differences. 
     Furthermore, in the past, traditional optical techniques that utilize a one-photon absorption process have limited uses to near surfaces of biological material (e.g., less than one hundred micrometers (100 μm)) for high-resolution imaging. Going deeper into biological material, light scatters and blurs the imaging. 
     SUMMARY 
     The present disclosure provides a medical system that may produce a laser beam and may determine first multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam. In one example, the laser beam may include photons associated with multiple frequencies. In another example, the plane may be associated with a X-axis and a Y-axis. The medical system may further determine second multiple focal point distances associated with the respective multiple positions of the plane orthogonal to the laser beam. 
     To determine second multiple focal point distances associated with the respective multiple positions of the plane orthogonal to the laser beam, the medical system may further, via for each position of the multiple positions: adjust at least one mirror to target the laser beam to the position; determine multiple intensity values associated with respective multiple interim focal point distances, each interim focal point distance greater than each focal point distance of the first multiple focal point distances associated with the position of the multiple positions; determine a maximum intensity value of the multiple intensity values; determine an interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value; and determine a focal point distance of the multiple focal point distances as the interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value. The medical system may further determine a depth of at least one incision in the eye of the patient based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances. 
     To determine multiple intensity values associated with respective multiple interim focal point distances, each interim focal point distance greater than each focal point distance of the first multiple focal point distances associated with the position of the multiple positions, the medical system may further, for each interim focal point distance of the multiple interim focal point distances: adjust a beam expander to focus the laser beam to the interim focal point distance; receive, via the TPA detector, at least a portion of the laser beam reflected from an incision in an eye of a patient; and determine, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance. The medical system may further determine a topography of the at least one incision in the eye of the patient based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances. 
     To produce the laser beam, the medical system may pulse the laser beam. For example, the medical system may pulse the laser beam at femtosecond pulse durations. The medical system may include an analog to digital converter (ADC). For example, to determine, from the at least the portion of the laser beam, the intensity value of the multiple intensity values associated with the interim focal point distance, the medical system may further receive, by the ADC, an analog signal from the TPA detector; and convert, by the ADC, the analog signal from the TPA detector to the intensity value of the multiple intensity values associated with the interim focal point distance. In one example, the ADC may be configured to convert current into digital values. In another example, the ADC may be configured to convert voltage into digital values. 
     The present disclosure further includes a non-transient computer-readable memory device with instructions that, when executed by a processor of a medical system, cause the system to perform the above steps. The present disclosure further includes a medical system 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) produce the laser beam; ii) determine first multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam; iii) determine second multiple focal point distances associated with the respective multiple positions of the plane orthogonal to the laser beam via for each position of the multiple positions: a) adjust at least one mirror to target the laser beam to the position; b) determine multiple intensity values associated with respective multiple interim focal point distances, each interim focal point distance greater than each focal point distance of the first multiple focal point distances associated with the position of the multiple positions, via for each interim focal point distance of the multiple interim focal point distances: 1) adjust a beam expander to focus the laser beam to the interim focal point distance; 2) receive, via the TPA detector, at least a portion of the laser beam reflected from an incision in an eye of a patient; and 3) determine, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance; c) determine a maximum intensity value of the multiple intensity values; d) determine an interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value; and e) determine a focal point distance of the multiple focal point distances as the interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value; iv) determine a depth of at least one incision in the eye of the patient based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances; and v) determine a topography of the at least one incision in the eye of the patient based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances. 
     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 an optical system; 
         FIG. 1B  illustrates another example of an optical system; 
         FIG. 2A  illustrates a surface of a cornea of an eye; 
         FIG. 2B  illustrates incisions in an eye; 
         FIG. 3A  illustrates an example of a medical system; 
         FIG. 3B  illustrates an example of a biometry device; 
         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. 4D  illustrates another example of a medical system; 
         FIG. 5  illustrates an example of a computer system; 
         FIG. 6  illustrates an example of a method of operating an optical system; 
         FIG. 7A  illustrates an example of a method of determining a topography of an eye of a patient; 
         FIG. 7B  illustrates an example of method of determining multiple of focal point distances associated with respective multiple positions of a plane orthogonal to a laser beam; 
         FIG. 7C  illustrates an example of a method of determining multiple intensity values associated with respective multiple interim focal point distances; 
         FIG. 7D  illustrates an example of a method of determining a topography of a portion of a patient interface; 
         FIG. 7E  illustrates another example of method of determining multiple of focal point distances associated with respective multiple positions of a plane orthogonal to a laser beam; 
         FIG. 7F  illustrates another example of a method of determining multiple intensity values associated with respective multiple interim focal point distances; 
         FIG. 8A , illustrates an example of a method of determining at least one incision depth; 
         FIG. 8B  illustrates an example of method of determining multiple of focal point distances associated with respective multiple positions of a plane orthogonal to a laser beam; 
         FIG. 8C  illustrates an example of a method of determining multiple intensity values associated with respective multiple interim focal point distances; 
         FIG. 9A  illustrates an example of a plane and multiple positions of the plane; 
         FIG. 9B  illustrates an example of multiple positions of a plane that may be utilized with an eye of a patient; 
         FIGS. 9C-9G  illustrate examples of multiple focal point distances of a laser beam; 
         FIGS. 9H-9M  illustrate examples of interim focal point distances of a laser beam associated with respective multiple intensity values; 
         FIGS. 9N-9Q  illustrate examples of multiple focal point distances of a laser beam; 
         FIGS. 9R-9T  illustrate examples of interim focal point distances of a laser beam associated with respective multiple intensity values; 
         FIGS. 9U-9X  illustrate examples of multiple focal point distances of a laser beam; 
         FIG. 10A  illustrates an example of multiple positions of a plane utilized with a patient interface; 
         FIG. 10B  illustrates an example of multiple positions of a plane utilized with a surface of a patient interface; 
         FIGS. 10C-10G  illustrate examples of multiple focal point distances of a laser beam; 
         FIGS. 10H-10K  illustrate examples of interim focal point distances of a laser beam associated with respective multiple intensity values; and 
         FIGS. 10L and 10M  illustrate examples of a patient interface at an angle to plane. 
     
    
    
     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 ‘12A’ 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. 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. 
     An optical system may be utilized to determine a topography of at least a portion of a patient. For example, an optical system may be utilized to determine a topography of at least a portion of an eye of a patient. The topography of the at least the portion of the eye of the patient may reveal one or more deformations of the at least the portion of the eye of the patient. The topography of the at least the portion of the eye of the patient may reveal damage of the at least the portion of the eye of the patient. 
     The optical system may include one or more of a laser and a two-photon absorption (TPA) detector, among others. In one example, the laser may produce a laser beam that includes photons of multiple frequencies. In another example, the laser may produce a pulsed laser beam. The pulsed laser beam may include photons of multiple frequencies. 
     An optical system may be configured to vary focal point distances of a laser beam. A TPA detector may determine an intensity of a reflection of at least a portion the laser beam. In one example, the optical system may determine multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam. The optical system may determine a topography of an eye of a patient based at least on the multiple focal point distances associated with the respective multiple positions. In another example, the optical system may determine first multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam. The optical system may determine second multiple focal point distances associated with the respective multiple positions of the plane orthogonal to the laser beam. The optical system may determine a depth of at least one incision in the eye of the patient based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances. 
     The optical system may be utilized in correcting a cutting depth of an incision based at least on a depth of the incision in an eye of a patient. In one example, the optical system may be utilized to maintain a cutting depth (e.g., without one or more deviations from a prescribed cutting depth) while an incision in the eye of the patient is being performed. In a second example, the optical system may be utilized to maintain a cutting contour (e.g., without one or more deviations from a prescribed cutting depth) while an incision in the eye of the patient is being performed. In a third example, the optical system may be utilized in incising a flap in the eye of the patient with little deviation or no deviation from a prescribed cutting depth. In another example, the optical system may be utilized in incising a lenticule in the eye of the patient with little deviation or no deviation from a prescribed cutting depth. As one example, a WAVELIGHT® FS 200 laser system, available from Alcon Vision LLC, may perform an incision in the eye of the patient. As another example, surgical tooling equipment (e.g., a scalpel, a blade, etc.) may be utilized in performing an incision in the eye of the patient. 
     Turning now to  FIGS. 1A and 1B , an example of an optical system is illustrated. An optical system  110  may be utilized to determine a surface of an eye  116  of a patient. For example, optical system  110  may be utilized to determine a topography of eye  116 . Optical system  110  may be utilized to determine a depth of an incision in eye  116 . For example, optical system  110  may be utilized to determine a topography of an incision in eye  116 . 
     Optical system  110  may be utilized in a medical procedure. For example, a medical system may include optical system  110 . The medical procedure may include an ophthalmic procedure on at least a portion part of eye  116 . Although optical system  110  may be utilized in a medical system, optical system  110  may be utilized in any system. 
     Optical system  110  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, optical system  110  may include a laser  120 . Laser  120  may generate a laser beam. In one example, laser  120  may be a device that generates a beam of coherent monochromatic light by stimulated emission of photons from excited atoms or molecules. In another example, laser  120  may be a device that generates a laser beam that includes photons associated with multiple frequencies. A laser beam may have any suitable wavelength, e.g., a wavelength in the infrared (IR), in the visible range, or ultraviolet (UV) range, among others. Pulses of the laser beam may have a pulse duration in any suitable range, e.g., the microsecond, nanosecond, picosecond, femtosecond, or attosecond range, among others. The focus of the laser beam may be a focal point of the laser beam. As illustrated, optical system may include detector optics  122  and focusing optics  140 . As shown, detector optics  122  may include a polarizer  124 , a lens  128 , a two-photon absorption (TPA) detector  130 , and a waveplate  134 . Although lens  128  is shown as a single lens, lens  128  may be multiple lenses. 
     Polarizer  124  may be an optical filter that transmits light of a specific polarization direction while reflecting light of other polarization directions. Polarizer  124  may filter light of undefined or mixed polarization into light with a single linear polarization. In one example, polarizer  124  may transmit at least a portion of the laser beam received from laser  120  (which may have a first polarization) towards waveplate  134 . In another example, polarizer  124  may reflect at least portion of the laser beam received from waveplate  134  (which may have a second polarization) towards lens  128  and TPA detector  130 . The first polarization may be a linear polarization. The second polarization may be the linear polarization rotated by ninety degrees) (90°). Lens  128  may focus the beam from polarizer  124  to TPA detector  130 . For example, TPA detector  130  may be located at a focal plane of lens  128 . Lens  128  may be an achromatic lens. For example, lens  128  may be configured to limit effects of one or more chromatic aberrations and/or one or more spherical aberrations, among others. 
     Waveplate  134  may be an optical device that alters a polarization of light traveling through it. Waveplate  134  may be any suitable waveplate, e.g., a quarter-waveplate, which may convert linearly polarized light into circularly polarized light and vice versa, or a combination of a half-waveplate (which may rotate linearly polarized light by forty-five degrees (45°)) and a forty-five degree (45°) Faraday rotator (also known as an optical diode when used in combination with polarizer  124 ). Waveplate  134  may be a quarter-waveplate that may receive the laser beam with a first linear polarization from polarizer  124 . Waveplate  134  may convert the laser beam from the first linear polarization to a circular polarization. Waveplate  134  may direct the laser beam to focusing optics  140 . Waveplate  134  may receive at least a reflected portion of the laser beam from focusing optics  140 . Waveplate  134  may convert the at least the reflected portion of the laser beam from focusing optics  140  from a circular polarization to a second linear polarization rotated relative to a first linear polarization. Waveplate  134  may change the original linear polarization of the laser beam by ninety degrees (90°). 
     Waveplate  134  may include a combination of a half-waveplate and a Faraday rotator. Waveplate  134  may receive the laser beam with a first linear polarization from polarizer  124 . In this direction, the half-waveplate and the Faraday rotator may compensate for each other&#39;s rotational effect, which may result in a rotation of the laser beam by zero degrees (0°). Waveplate  134  may then direct the laser beam to focusing optics  140 . Waveplate  134  may also receive the at least the reflected portion of the laser beam reflected from focusing optics  140 . In this direction, the half-waveplate and the Faraday rotator may add rotational effects, which may result in a rotation of the laser beam by ninety degrees (90°), which may be a second linear polarization rotated relative to the first linear polarization. For example, the laser beam may pass through waveplate  134 , which may rotate the beam by zero degrees (0°), and may be reflected back through waveplate  134 , which may rotate the beam by ninety degrees (90°), resulting in a change from the original linear polarization of the laser beam by ninety degrees (90°). Waveplate  134  may be reconfigured such that the laser beam may pass through waveplate  134 , which may rotate the beam by ninety degrees (90°), and may be reflected back through waveplate  134 , which may rotate the beam by zero degrees (0°). 
     Although not specifically illustrated, optical system  110  may not include waveplate  134 . For example, polarizer  124  may be replaced with a partially reflecting mirror. Although not specifically illustrated, detector optics  122  may be positioned between beam expander  141  and scanner  144 . 
     As illustrated, focusing optics  140  may include a beam expander  141 , a scanner  144 , and an objective lens  148 . Objective lens  148  may include multiple lenses. In one example, objective lens  148  may be or include a compound lens. In another example, objective lens  148  may be or include a F-theta lens. As shown, beam expander  141  may include lenses  142 A and  142 B. Although beam expander  141  is shown with two lenses, beam expander  141  may include any number of lenses. 
     A direction of the laser beam, as the laser beam approaches surface  112 , may be parallel to a Z-axis. Surface  112  may be parallel to a X-axis and perpendicular to the Z-axis. Although a Y-axis is not specifically illustrated, the Y-axis may be perpendicular to the X-axis and the Z-axis. For example, the Y-axis may be perpendicular to a plane that includes the X-axis and the Z-axis. 
     Focusing optics  140  may direct and/or may focus the laser beam towards eye  116 . In one example, focusing optics  140  may direct and/or may focus the laser beam towards a surface  210  of eye  116 , as illustrated in  FIG. 2A . Surface  210  may be a surface of a cornea  220  of eye  116 . In another example, focusing optics  140  may direct and/or may focus the laser beam towards one or more incisions  230 A- 230 C, as shown in  FIG. 2B . Focusing optics  140  may direct a focal point of the laser beam parallel to or along the Z-axis towards eye  116 . Focusing optics  140  may receive at least a portion of the beam reflected by surface  210 . Focusing optics  140  may receive at least a portion of the beam reflected by an incision  230 . 
     An optical device, such as a lens  142 A and/or a mirror, may control a Z-position of a focal point of a laser beam. Another optical device, such as a lens  142 B (e.g., in combination with lens  142 A), may expand a diameter of a laser beam. In one example, beam expander  141  may be configured to control a focal point of a laser beam. In another example, optics may vary over time such that the Z-position of the focal point changes. 
     Scanner  144  may include one or more optical devices that may control a direction of a laser beam to control the XY-position of the focal point. To transversely deflect the laser beam, scanner  144  may include a pair of galvanometric actuated scanner mirrors that may tilt about mutually perpendicular axes. Scanner  144  may receive the laser beam from beam expander  141 . Scanner  144  may manipulate the laser beam to control the XY-position of the focal point. 
     Objective lens  148  may receive the laser beam from the scanner  144 . Objective lens  148  may direct the laser beam to eye  116 . 
     As illustrated in  FIG. 1B , a patient interface  114  may stabilize a position of a surface  112  relative to optical system  110 . In one example, surface  112  may be a surface of an applanation plane. Although surface  112  is illustrated, surface  112  may not be present. In another example, patient interface  114  may be made of one or more rigid materials (e.g., plastic, glass, metal, etc.). A patient interface  114  may shape an eye (e.g., flatten or otherwise deform) a surface of eye  116 . Patient interface may include an applanation plane. A “target-side” surface of patient interface  114  may be the surface of interface  114  designed to face (and may even be in contact with) eye  116 . A patient interface  114  may be a one-time-use product. For example, a patient interface  114  may be utilized with an eye of a patient and then discarded. Multiple patient interfaces  114  may be configured with a consistent length in a Z-direction. Multiple patient interfaces  114  may have different respective lengths. A calibration of a Z-position of a point with respect to a particular patient interface  114  may be performed. 
     As illustrated, optical system  110  may include a computer system  152 . Computer system  152  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 optical system  110  is illustrated as including computer system  152 , optical system  110  may not include computer system  152 . For example, computer system  152  may be external to optical system  110 . Computer system  152  may be communicatively coupled to optical system  110 . 
     Focusing optics  140  may direct a laser beam to eye  116 . For example, eye  116  may be located at an end of a patient interface  114 . Surface  210  of eye  116  may reflect at least a portion of the laser beam. Incision  230  may reflect at least a portion of the laser beam. Detector optics  122  may direct the at least the portion of the laser beam TPA detector  130 . For example, TPA detector  130  may transform an intensity of the at least the portion of the laser beam into digital data. The digital data may represent the intensity of the at least the portion of the laser beam. TPA detector  130  may provide the digital data to computer system  152 . 
     The at least the portion of the laser beam may cause two-photon absorption that may excite electrons, which may generate a signal in response to an intensity of incident radiation. The signal may indicate a proximity of a focal point of the laser beam to surface  210  or incision  230 . In one example, the farther away the focal point is from surface  210  or incision  230 , the lower an intensity of the beam at a portion TPA detector  130 . In a second example, the larger a diameter of the at least the portion of the laser beam, the lower an intensity of the beam at a portion TPA detector  130 . In a third example, the closer the focal point is to surface  210  or incision  230 , the higher an intensity of the beam at a portion TPA detector  130 . In a fourth example, the smaller a diameter of the at least the portion of the laser beam, the higher an intensity of the beam at a portion TPA detector  130 . In another example, when the focal point is at surface  210  or incision  230 , a diameter at TPA detector  130  may be at a minimum, and an intensity may be at a maximum. 
     As illustrated, computer system  152  may be communicatively coupled to TPA detector  130 . As shown, computer system  152  may be communicatively coupled to laser  120 . As illustrated, computer system  152  may be communicatively coupled to beam expander  141 . As shown, computer system  152  may be communicatively coupled to scanner  144 . In one example, computer system  152  may receive information from one or more of laser  120 , TPA detector  130 , beam expander  141 , and scanner  144 , among others. In another example, computer system  152  may provide information to one or more of laser  120 , TPA detector  130 , beam expander  141 , and scanner  144 , among others. Computer system  152  may provide control information to one or more of laser  120 , TPA detector  130 , beam expander  141 , and scanner  144 , among others. 
     Computer system  152  may determine a focal point of a laser beam in response to intensity measurements from TPA detector  130 . Computer system  152  may determine if an intensity is a maximum intensity. The maximum intensity may be the maximum of intensities may be measured at different positions of a focal point. The maximum intensity may be measured or calculated prior during a calibration session. If the intensity is the maximum intensity, computer system  152  may determine that the focal point is at surface  210  or incision  230 . If the intensity is not the maximum intensity, computer system  152  may adjust focusing optics  140  to direct a focal point to a different point of the Z-axis. Computer system  152  may generate, from one or more TPA detector signals, a graph that may represent intensities of the at least the portion of the laser beam. For example, the one or more TPA detector signals may be or include data. 
     An analog to digital converter (ADC) may transform signals from TPA detector  130  associated with the multiple intensities into digital data that represents multiple measurements of the multiple intensities. For example, computer system  152  may utilize the digital data that represents multiple measurements of the multiple intensities. Computer system  152  may include the ADC. The ADC may be external to computer system  152 . TPA detector  130  may include the ADC. For example, TPA detector  130  may provide digital data that represents multiple measurements of the multiple intensities. 
     Turning now to  FIG. 3A , an example of a medical system is illustrated. As shown, a medical system  310  may be utilized with a patient  320 . As illustrated, medical system  310  may include a computer system  312 . Computer system  312  may be communicatively coupled to displays  316 A and  316 B. Computer system  312  may be communicatively coupled to a biometry device  314 . In one example, biometry device  314  may include one or more cameras. In another example, biometry device  314  may include a three-dimensional scanner. Biometry device  314  may be utilized in biometry of an eye  116  of patient  320 . As shown, display  316 A may display an image  330 A associated with eye  116  of patient  320 . As illustrated, display  316 B may display an image  330 B associated with eye  116  of patient  320 . 
     Computer system  312  may determine eye recognition information. For example, the eye recognition information may include biometry information associated with eye  116  of patient  320 . The biometry information associated with eye  116  may include one or more of a pattern of blood vessels of a sclera of eye  116 , a structure of an iris of eye  116 , a position of a structure of an iris of eye  116 , a distance measurement of a cornea of eye  116  to a lens of eye  116 , a distance measurement of a lens of eye  116  to a retina of eye  116 , a corneal topography of eye  116 , a retinal pattern of eye  116 , and a wavefront measurement, among others. 
     As shown, display  316 B may display display areas  336 A- 336 D. In one example, a display area  336  may display a distance measurement of a cornea of eye  116  to a lens of eye  116 , a distance measurement of a lens of eye  116  to a retina of eye  116 , a position of a structure of an iris  334 , corneal topography information, or wavefront measurement information, among other biometry information associated with eye  116 . In another example, a display area  336  may display any information associated with patient  320 . 
     A person  350  may operate medical system  310 . For example, person  350  may be medical personnel. Person  350  may enter identification information associated with patient  320  into computer system  312 . The identification information associated with patient  320  may include one or more of a name of patient  320 , an address of patient  320 , a telephone number of patient  320 , a government issued identification number of patient  320 , a government issued identification string of patient  320 , and a date of birth of patient  320 , among others. 
     Person  350  may provide medical procedure information, associated with patient  320 , to computer system  312 . The medical procedure information may be associated with a medical procedure. The medical procedure information may be associated identification information associate with patient  320 . Computer system  312  may store the medical procedure information. For example, computer system  312  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. 3B , an example of a biometry device is illustrated. As shown, biometry device  314  may include image sensors  360 A- 360 C. For example, an image sensor  360  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  314  may include light projectors  362 A- 362 C. In one example, a light projector  362  may project visible light. In another example, a light projector  362  may project infrared light. A light projector  362  may project circles and/or dots onto an eye of a patient. An image sensor  360  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  314  may include depth sensors  364 A- 364 C. A depth sensor  364  may include a light projector  362 . A depth sensor  364  may include an optical sensor. As illustrated, biometry device  314  may include an optical low coherence reflectometer (OLCR) device  366 . As shown, biometry device  314  may include a wavefront device  368 . 
     Wavefront device  368  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  116 . A wavefront sensor may receive a first perturbed light wave, based at least on the first light wave, from eye  116 . In one example, wavefront device  368  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  368  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  368 . 
     Any two or more of an image sensor  360 , a light projector  362 , a depth sensor  364 , an OLCR device  366 , and a wavefront device  368  may be combined. One or more of image sensors  360 A- 360 C, one or more of light projectors  362 A- 362 C, one or more of depth sensors  364 A- 364 C, OLCR device  366 , and/or wavefront device  368 , among others, may produce data that may be utilized by a computer system. As illustrated, biometry device  314  may include an optical system  110 . 
     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 involving eye  116  of patient  320 . 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 graphical user interface (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 surgical 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, MID  450  may include an optical system  110 . 
     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  116  of patient  320 . System  400 B may include multiple systems. As shown, system  400 B may include a cutting system  415 A. For example, surgeon  410  may utilize system  415 A in cutting eye  116 . Eye  116  may include a flap in a cornea of an eye of patient  320 . As illustrated, system  400 B may include a shaping system  415 B. For example, surgeon  410  may utilize shaping system  415 B in performing ablation on an interior part of the cornea of eye  116 . 
     As shown, system  415 A may include a display  440 A. As illustrated, system  415 A may include a MID  450 A. As illustrated, MID  450 A may include eye pieces  452 AA and  452 AB. An eye piece  452 A may refer to an eye piece  452 AA or to an eye piece  452 BA. An eye piece  452 B may refer to an eye piece  452 AB or to an eye piece  452 BB. System  415 A may include one or more of image sensors  360 A- 360 C, one or more of light projectors  362 A- 362 C, one or more of depth sensors  364 A- 364 C, OLCR device  366 , wavefront device  368 , and/or an optical system  110 A, among others. As illustrated, system  415 B may include a display  440 B. As shown, system  415 B may include a MID  450 B. As illustrated, MID  450 B may include eye pieces  452 BA and  452 BB. System  415 B may include one or more of image sensors  360 A- 360 C, one or more of light projectors  362 A- 362 C, one or more of depth sensors  364 A- 364 C, OLCR device  366 , and/or wavefront device  368 , among others. As shown, system  415 B may include an optical system  110 B. 
     System  415 A may include a laser, such as a femtosecond laser, which may use short laser pulses to separate a series of small portions of corneal tissue to form a flap that may be lifted up to expose an interior part of the cornea. The flap may be planned and cut using one or both of cutting device displays  440 A and  450 A, along with control devices and a computer system  430 A. As shown, system  415 A may include computer system  430 A. For example, computer system  430 A may be communicatively coupled to one or more of image sensors  360 A- 360 C, one or more of light projectors  362 A- 362 C, one or more of depth sensors  364 A- 364 C, OLCR device  366 , wavefront device  368 , and/or optical system  110 A, among others, of system  415 A. As illustrated, system  415 B may include computer system  430 B. For example, computer system  430 B may be communicatively coupled to one or more of image sensors  360 A- 360 C, one or more of light projectors  362 A- 362 C, one or more of depth sensors  364 A- 364 C, OLCR device  366 , wavefront device  368 , and/or optical system  110 B among others, of system  415 B. 
     Systems  415 A and  415 B may be physically separated as shown in  FIG. 4B . Patient  320  may be moved between systems  415 A and  415 B. Alternatively, patient  320  may remain stationary and systems  415 A and  415 B may be moved to patient  320 . Systems  415 A and  415 B may be physically combined into a single unitary device, such that neither the device nor patient  320  is repositioned when switching between systems  415 A and  415 B. 
     System  400 B may include one or more control devices for controlling systems  415 A and  415 B. 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 displays  440 A,  450 A,  440 B, and  450 B, among others. For example, the at least one computer system may include one or more of computer systems  430 A and  430 B. One or more of computer systems  430 A and  430 B 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. One or more of computer systems  430 A and  430 B may be communicatively coupled to one or more of the control devices. 
     In one example, cutting device computer system  430 A: i) may be communicatively coupled to observational devices that observe the eye when patient  320  is positioned with system  415 A, ii) may provide graphical information regarding the planned flap location and the planned area of ablation to one or more of displays  440 A and  450 A, and iii) may be communicatively coupled to one or more control devices of system  415 A. In a second example, shaping device computer  430 B: i) may be communicatively coupled to observational devices that observe the eye when patient  320  is positioned with a shaping device, ii) may provide graphical information regarding the planned flap location and the planned area of ablation to one or more of displays  440 B and  450 B, and iii) may be communicatively coupled to one or more control devices of system  415 B. In another example, a computer system may include the properties and/or the attributes described above with respect to one or more of computer systems  430 A and  430 B, 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  320  and the treatment to be performed on patient  320  or actually performed on patient  320 . System  400  may allow a user to enter and view information regarding patient  320  and the treatment to be performed on patient  320 . Such data may include information about patient  320 , such as identifying information, a medical history of patient  320 , and/or information about eye  116  being treated, among others. Such data may include information about the treatment plans, such as the shape and location of a corneal cut and/or a shape and location of ablation, among others. 
     Turning now to  FIG. 4C , an example of a microscope integrated display and examples of surgical tooling equipment are illustrated. 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. 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 structures and/or one or more functionalities as those described with reference to biometry device  314 . In one example, MID  450  may include OLCR device  366 . In another example, MID  450  may include wavefront device  368 . MID  450  may include a biometry device  314 . MID  450  may include an optical system  110 . 
     Turning now to  FIG. 4D , another example of a medical system is illustrated. As shown, a medical system  400 C may include a suction cone  480 . For example, suction cone  480  may be or include an applanation cone. As illustrated, suction cone  480  may include an optical system  110 . As shown, a computer system  430  may be coupled to a control device  482  of suction cone  480 . For example, computer system  430  may control suction cone  480  via control device  482 . After a suction ring  484  is docked with an eye  116 , suction cone  480  may be docked with suction ring  484 . As illustrated, suction cone  480  may include a lens  486 . Although lens  486  is illustrated as flat or planar, lens  486  may include concave shape and/or may include convex shape. If lens  486  is planar, lens  486  may be referred to as an applanation plane. For example, the applanation plane may include surface  112 . 
     As illustrated, medical system  400 C may include a vacuum system  490 . As shown, vacuum system  490  may be communicatively coupled to computer system  430 . For example, computer system  430  may control vacuum system  490 . Vacuum system  490  may create one or more low pressures via one or more of lines  492  and  494 . For example, vacuum system  490  may create one or more low pressures via line  494  to adhere and/or seal a suction ring  484  to an eye  116  of a patient. As shown, medical system  400 C may include lines  492  and  494  and suction ring  484 . 
     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. In one example, the multiple processors may execute instructions of a single instruction set architecture (ISA). In another example, at least two of the multiple processors may execute instructions of different instruction set architectures (ISAs). As an example, at least one of the multiple processors may be or include a graphics processor unit (GPU). 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  may further include one or more microprocessors, microcontrollers, digital signal processors (DSPs), graphics processor units (GPUs), 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  152  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  312  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 . Although not specifically illustrated, any device and/or any system may be coupled to a processor of a computer system. For example, any device and/or any system may be communicatively coupled to a processor of a computer system. 
     Turning now to  FIG. 6 , an example of a method of operating an optical system is illustrated. At  610 , a laser beam may be generated. For example, laser  120  may generate a laser beam. Computer system  152  may provide control information, that indicates generating a laser beam, to laser  120 . For example, laser  120  may receive the control information from computer system  152  and generate the laser beam in accordance with the control information. 
     At  615 , the laser beam may be directed to a test surface. For example, focusing optics  140  may direct the laser beam to surface  112 . Focusing optics  140  may reflect a portion of the laser beam. A remainder of the laser beam may travel to surface  112 . At  620 , a reflected portion of the laser beam may be directed to TPA detector  130 . For example, detector optics  122  may direct the reflected portion of the laser beam to TPA detector  130 . The reflected portion of the laser beam may be reflected from surface  112 . 
     At  625 , an intensity of the reflected portion of the laser beam may be determined. For example, TPA detector  130  may determine an intensity of the reflected portion of the laser beam. TPA detector  130  may transform the intensity of the reflected portion of the laser beam into digital data that indicates the intensity of the reflected portion of the laser beam. TPA detector  130  may provide the digital data that indicates the intensity of the reflected portion of the laser beam to computer system  152 . Computer system  152  may receive the digital data that indicates the intensity of the reflected portion of the laser beam. 
     At  630 , it may be determined if the intensity of the reflected portion of the laser beam is a maximum intensity. For example, computer system  152  may determine, from the digital data that indicates the intensity of the reflected portion of the laser beam, if the intensity of the reflected portion of the laser beam is a maximum intensity. Determining if the intensity of the reflected portion of the laser beam is a maximum intensity may include comparing the intensity of the reflected portion of the laser beam with other one or more intensities of repetitive other reflected portions of the laser beam. For example, computer system  152  may store and/or access the other one or more intensities via memory medium. 
     If the signal is not at the maximum intensity, focusing optics  140  may be adjusted, at  635 . For example, computer system  152  may adjust focusing optics  140 . Computer system  152  may provide, to focusing optics  140 , control information that indicates at least one adjustment of focusing optics  140 . For example, computer system  152  may provide, to beam expander  141 , control information that indicates at least one adjustment of one or more of lenses  142 A and  142 B. Adjusting focusing optics  140  may direct a focal point of the laser beam to a different location with respect to the Z-axis. For example, adjusting focusing optics  140  may direct a focal point of the laser beam toward or away from surface  112 . The method may proceed to  610 . 
     If the signal is at the maximum, it may be determined that the focal point is at surface  112 , at  640 . For example, computer system  152  may determine that the focal point is at surface  112 . Interpolation may be utilized to refine a position of surface  112 . At  645 , results may be provided. For example, computer system  152  may provide results. Providing the results may include one or more of displaying the results via a display, printing the results via a printer, storing the results to a memory medium, and sending the result to a communication network, among others. 
     Turning now to  FIG. 7A , an example of a method of determining a topography of an eye of a patient is illustrated. At  702 , a laser beam may be produced. For example, laser  120  may produce a laser beam. Producing a laser beam may include pulsing the laser beam. Pulsing the laser beam may include pulsing the laser beam at femtosecond pulse durations. The laser beam may include photons associated with multiple frequencies. 
     At  704 , multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam may be determined. In one example, as illustrated in  FIG. 9A , multiple positions  910 A- 910 M of a plane  900 , orthogonal to a laser beam, may be associated with multiple focal point distances. Although only fourteen positions are illustrated in  FIG. 9A , any number of positions may be utilized. Furthermore, the positions may be at any locations. As shown, plane  900  may be associated with a X-axis and a Y-axis. In a second example, as illustrated in  FIG. 9B , multiple positions  910 A- 910 M of plane  900  may be utilized with eye  116 . Although only fourteen positions are illustrated in  FIG. 9B , any number of positions may be utilized. Furthermore, the positions may be at any locations. In another example, multiple focal point distances  920 A- 920 E of a laser beam  915 , illustrated in respective  FIGS. 9C-9G , associated with respective multiple positions  910 E- 910 I of plane  900  may be determined. The multiple focal point distances associated with respective multiple positions of the plane orthogonal to the laser beam may be determined via a method illustrated in  FIG. 7B . 
     At  706 , a topography of an eye of a patient may be determined based at least on the multiple focal point distances associated with the respective multiple positions. For example, a topography of eye  116  of patient  320  may be determined based at least on the multiple focal point distances associated with the respective multiple positions. 
     At  708 , the topography of the eye of the patient may be displayed. In one example, the topography of the eye of the patient may be displayed via a display. In another example, the topography of the eye of the patient may be displayed via a printer. The printer may print the topography of the eye of on a piece of paper. 
     Turning now to  FIG. 7B , an example of method of determining multiple of focal point distances associated with respective multiple positions of a plane orthogonal to a laser beam is illustrated. The method illustrated in  FIG. 7B  may be performed for each position of the multiple positions of the plane orthogonal to the laser beam. For example, the method illustrated in  FIG. 7B  may be performed for each position of positions  910 A- 910 M of plane  900 . 
     At  710 , at least one mirror may be adjusted to target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. For example, the at least one mirror may be adjusted to target the laser beam to position  910 E of positions  910 A- 910 M of plane  900 . Scanner  144  may include one or more mirrors. For example, scanner  144  may target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. Scanner  144  may adjust at least one mirror to target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. 
     At  712 , multiple intensity values associated with respective interim focal point distances may be determined. In one example, multiple intensity values associated with respective interim focal point distances  930 A- 930 D of laser beam  915 , respectively illustrated in  FIGS. 9H-9K , may be determined. Interim focal point distance  930 D of laser beam  915 , illustrated in  FIG. 9K , may be to a surface  210  of eye  116 . In another example, multiple intensity values associated with respective interim focal point distances  930 A- 930 C and  930 E of laser beam  915 , respectively illustrated in  FIGS. 9H-9J, 9L, and 9  M, may be determined. Interim focal point distance  930 F of laser beam  915 , illustrated in  FIG. 9M , may be to an incision  230  in eye  116 . The multiple intensity values associated with the respective interim focal point distances may be determined via a method illustrated in  FIG. 7C . 
     At  714 , a maximum intensity value of the multiple intensity values may be determined. In one example, computer system  152  may determine a maximum intensity value of the multiple intensity values. In another example, computer system  430  may determine a maximum intensity value of the multiple intensity values. If a maximum intensity value associated with interim focal point distance  930 D has been determined, another maximum intensity value of the multiple intensity values may be determined. For example, the other maximum intensity value of the multiple intensity values may be associated with interim focal point distance  930 F. 
     At  716 , an interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value may be determined. In one example, interim focal point distance  930 D of interim focal point distances  930 A- 930 D may be determined. In another example, interim focal point distance  930 F of interim focal point distances  930 A- 930 C,  930 E,  930 F and may be determined. If interim focal point distance  930 D has been determined, interim focal point distance  930 F may be determined. For example, optical system  110  may utilize additional interim focal point distances  930  that are greater than interim focal point distance  930 D in determining another maximum intensity value that is associated with interim focal point distance  930 F. 
     At  718 , a focal point distance of the multiple focal point distances may be determined as the interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value. In one example, a focal point distance of the multiple focal point distances may be determined as interim focal point distance  930 D, of interim focal point distances  930 A- 930 D, respectively associated with the maximum intensity value. In another example, a focal point distance of the multiple focal point distances may be determined as interim focal point distance  930 F, of interim focal point distances  930 A- 930 C,  930 E, and  930 F, respectively associated with the maximum intensity value. 
     Turning now to  FIG. 7C , an example of a method of determining multiple intensity values associated with respective multiple interim focal point distances is illustrated. The method illustrated in  FIG. 7C  may be performed for each interim focal point distance of the multiple interim focal point distances. For example, the method illustrated in  FIG. 7C  may be performed for each interim focal point distance of interim focal point distances  930 A- 930 F. 
     At  720 , a beam expander may be adjusted to focus the laser beam to the interim focal point distance. For example, beam expander  141  may be adjusted to focus the laser beam to interim focal point distance  930 . Adjusting beam expander  141  to focus the laser beam to interim focal point distance  930  may include adjusting one or more lenses of beam expander  141 . For example, one or more of lenses  142 A and  142 B may be adjusted to focus the laser beam to an interim focal point distance  930 . 
     At  722 , at least a portion of the laser beam reflected from a surface of an eye of a patient may be received via a TPA. For example, TPA detector  130  may receive at least a portion of the laser beam reflected from surface  210  of eye  116  of patient  320 . 
     At  724 , an intensity value, of the multiple intensity values, associated with the interim focal point distance may be determined from the at least the portion of the laser beam. For example, an intensity value associated with an interim focal point distance  930  may be determined. An intensity value associated with interim focal point distance  930 D may be a maximum intensity value. An intensity value associated with interim focal point distance  930 F may be a maximum intensity value. 
     Determining, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance may include an ADC receiving an analog signal from the TPA detector. Determining, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance may include the ADC converting the analog signal from the TPA detector to the intensity value of the multiple intensity values associated with the interim focal point distance. In one example, the ADC may convert current into digital values. In another example, the ADC may convert voltage into digital values. 
     At  726 , the intensity value, of the multiple intensity values, associated with the interim focal point distance may be stored via a memory medium. For example, the intensity value associated with the interim focal point distance and the interim focal point distance may be stored via the memory medium. The interim focal point distance may be accessed and/or may be retrieved from the memory medium via the intensity value associated with the interim focal point distance. For example, a focal point distance may be accessed and/or may be retrieved from the memory medium via a maximum intensity value. 
     Storing the intensity value associated with the interim focal point distance and the interim focal point distance via the memory medium may include storing the intensity value associated with the interim focal point distance and the interim focal point distance via a database. The interim focal point distance may be accessed and/or may be retrieved from the database via the intensity value associated with the interim focal point distance. For example, a focal point distance may be accessed and/or may be retrieved from the database via a maximum intensity value. The database may be stored locally, via a remote computer system, or via a remote data center. In one example, the database may include a relational database. In a second example, the database may include a graph database. In a third example, the database may include an associative array. In another example, the database may include a NoSQL database. 
     Turning now to  FIG. 7D , an example of a method of determining a topography of a portion of a patient interface is illustrated. At  730 , a laser beam may be produced. For example, laser  120  may produce a laser beam. Producing a laser beam may include pulsing the laser beam. Pulsing the laser beam may include pulsing the laser beam at femtosecond pulse durations. The laser beam may include photons associated with multiple frequencies. 
     At  732 , multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam may be determined. In one example, as illustrated in  FIG. 9A , multiple positions  910 A- 910 M of a plane  900 , orthogonal to a laser beam, may be associated with multiple focal point distances. Although only fourteen positions are illustrated in  FIG. 9A , any number of positions may be utilized. Furthermore, the positions may be at any locations. As shown, plane  900  may be associated with a X-axis and a Y-axis. In a second example, as illustrated in  FIG. 10A , multiple positions  910 A- 910 M of plane  900  may be utilized with patient interface  114 . Although only fourteen positions are illustrated in  FIG. 10A , any number of positions may be utilized. Furthermore, the positions may be at any locations. In another example, as illustrated in  FIG. 10B , multiple positions  910 A- 910 M of plane  900  may be utilized with a surface  1005  of patient interface  114 . Although only fourteen positions are illustrated in  FIG. 10B , any number of positions may be utilized. Furthermore, the positions may be at any locations. 
     At  734 , a topography of a surface of a patient interface may be determined based at least on the multiple focal point distances associated with the respective multiple positions. For example, a topography of a surface  1005  of patient interface  114  may be determined based at least on the multiple focal point distances associated with the respective multiple positions. Surface  1005  may be a surface  1012  as illustrated in  FIGS. 10E-10G . As an example, multiple focal point distances  1020 A- 1020 E (respectively illustrated in  FIGS. 10C-10G ) may be associated with respective multiple positions  910 E- 910 I. 
     At  736 , the topography of the surface of the patient interface may be stored. For example, the topography of the surface of the patient interface may be stored via a memory medium. Storing the topography of the surface of the patient interface via the memory medium may include storing the topography of the surface of the patient interface via a database. The topography of the surface of the patient interface may be accessed and/or may be retrieved from the database. The database may be stored locally, via a remote computer system, or via a remote data center. In one example, the database may include a relational database. In a second example, the database may include a graph database. In a third example, the database may include an associative array. In another example, the database may include a NoSQL database. 
     Turning now to  FIG. 7E , another example of method of determining multiple of focal point distances associated with respective multiple positions of a plane orthogonal to a laser beam is illustrated. The method illustrated in  FIG. 7E  may be performed for each position of the multiple positions of the plane orthogonal to the laser beam. For example, the method illustrated in  FIG. 7E  may be performed for each position of positions  910 A- 910 M of plane  900 . 
     At  738 , at least one mirror may be adjusted to target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. For example, the at least one mirror may be adjusted to target the laser beam to position  910 E of positions  910 A- 910 M of plane  900 . Scanner  144  may include one or more mirrors. For example, scanner  144  may target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. Scanner  144  may adjust at least one mirror to target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. 
     At  740 , multiple intensity values associated with respective interim focal point distances may be determined. For example, multiple intensity values associated with respective interim focal point distances  1030 A- 1030 D of a laser beam  1015 , respectively illustrated in  FIGS. 10H-10K , may be determined. Interim focal point distance  1030 D of laser beam  1015 , illustrated in  FIG. 10K , may be to a surface or end  1012  of a patient interface  114 . Although surface or end  1012  of patient interface  114  is illustrated as linear or “flat”, surface or end  1012  of patient interface  114  may be nonlinear. For example, surface or end  1012  of patient interface  114  may be concave or convex. As shown in  FIGS. 10A-10K , patient interface may have surfaces  1010  and  1012 . Surface  1010  may be an anterior surface or an anterior end of patient interface  114 . Surface  1012  may be a posterior surface or a posterior end of patient interface  114 . In one example, surface  1012  may be surface  1005 . In a second example, surface  1012  may be surface  112 . In another example, surface  1012  may be a surface of lens  486 . Surface  1012  may be a surface of lens  486  that contacts eye  116 . 
     At  742 , a maximum intensity value of the multiple intensity values may be determined. For example, computer system  152  may determine a maximum intensity value of the multiple intensity values. In another example, computer system  430  may determine a maximum intensity value of the multiple intensity values. 
     At  744 , an interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value may be determined. For example, interim focal point distance  1030 D of interim focal point distances  1030 A- 1030 D may be determined. 
     At  746 , a focal point distance of the multiple focal point distances may be determined as the interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value. In one example, a focal point distance of the multiple focal point distances may be determined as interim focal point distance  1030 D, of interim focal point distances  1030 A- 1030 D, respectively associated with the maximum intensity value. 
     Turning now to  FIG. 7F , another example of a method of determining multiple intensity values associated with respective multiple interim focal point distances is illustrated. The method illustrated in  FIG. 7F  may be performed for each interim focal point distance of the multiple interim focal point distances. For example, the method illustrated in  FIG. 7F  may be performed for each interim focal point distance of interim focal point distances  1030 A- 1030 D. 
     At  748 , a beam expander may be adjusted to focus the laser beam to the interim focal point distance. For example, beam expander  141  may be adjusted to focus the laser beam to interim focal point distance  1030 . Adjusting beam expander  141  to focus the laser beam to interim focal point distance  1030  may include adjusting one or more lenses of beam expander  141 . For example, one or more of lenses  142 A and  142 B may be adjusted to focus the laser beam to an interim focal point distance  1030 . 
     At  750 , at least a portion of the laser beam reflected from a surface of a patient interface may be received via a TPA. For example, TPA detector  130  may receive at least a portion of the laser beam reflected from surface  1012  of patient interface  114 . 
     At  752 , an intensity value, of the multiple intensity values, associated with the interim focal point distance may be determined from the at least the portion of the laser beam. For example, an intensity value associated with an interim focal point distance  1030  may be determined. An intensity value associated with interim focal point distance  1030 D may be a maximum intensity value. 
     Determining, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance may include an ADC receiving an analog signal from the TPA detector. Determining, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance may include the ADC converting the analog signal from the TPA detector to the intensity value of the multiple intensity values associated with the interim focal point distance. In one example, the ADC may convert current into digital values. In another example, the ADC may convert voltage into digital values. 
     At  754 , the intensity value, of the multiple intensity values, associated with the interim focal point distance may be stored via a memory medium. For example, the intensity value associated with the interim focal point distance and the interim focal point distance may be stored via the memory medium. The interim focal point distance may be accessed and/or may be retrieved from the memory medium via the intensity value associated with the interim focal point distance. For example, a focal point distance may be accessed and/or may be retrieved from the memory medium via a maximum intensity value. 
     Storing the intensity value associated with the interim focal point distance and the interim focal point distance via the memory medium may include storing the intensity value associated with the interim focal point distance and the interim focal point distance via a database. The interim focal point distance may be accessed and/or may be retrieved from the database via the intensity value associated with the interim focal point distance. For example, a focal point distance may be accessed and/or may be retrieved from the database via a maximum intensity value. The database may be stored locally, via a remote computer system, or via a remote data center. In one example, the database may include a relational database. In a second example, the database may include a graph database. In a third example, the database may include an associative array. In another example, the database may include a NoSQL database. 
     The multiple intensity values may be utilized to determine a topography. For example, the multiple intensity values may be utilized to determine a topography of a surface of a patient interface. The multiple intensity values may be utilized to determine a topography of surface  1012  of patient interface  114 . For example, a surface of patient interface  114  may include manufacturing inconsistencies and/or manufacturing flaws. When eye  116  is in contact with surface  1012  of patient interface  114 , the topography of surface  1012  may be utilized in determining and/or maintaining a depth of a cut or incision in eye  116 . For example, the topography of surface  1012  may be utilized as a topography of a surface of eye  116  in determining and/or maintaining a depth of a cut or incision in eye  116  when eye  116  is in contact with surface  1012 . 
     Turning now to  FIG. 8A , an example of a method of determining at least one incision depth is illustrated. At  810 , a laser beam may be produced. For example, laser  120  may produce a laser beam. Producing a laser beam may include pulsing the laser beam. Pulsing the laser beam may include pulsing the laser beam at femtosecond pulse durations. The laser beam may include photons associated with multiple frequencies. 
     At  815 , first multiple focal point distances associated with respective multiple positions of a plane orthogonal to the laser beam may be determined. In one example, as illustrated in  FIG. 9A , multiple positions  910 A- 910 M of plane  900 , orthogonal to a laser beam, may be associated with multiple focal point distances. Although only fourteen positions are illustrated in  FIG. 9A , any number of positions may be utilized. Further, the positions may be at any locations. As shown, plane  900  may be associated with a X-axis and a Y-axis. In a second example, as illustrated in  FIG. 9B , multiple positions  910 A- 910 M of plane  900  may be utilized with eye  116 . Although only fourteen positions are illustrated in  FIG. 9B , any number of positions may be utilized. Further, the positions may be at any locations. In another example, multiple focal point distances  940 A- 940 D of laser beam  915 , illustrated in respective  FIGS. 9N-9Q , associated with respective multiple positions  910 E- 910 H of plane  900  may be determined. The multiple focal point distances associated with respective multiple positions of the plane orthogonal to the laser beam may be determined via a method illustrated in  FIG. 8B . 
     At  820 , a depth of at least one incision in the eye of the patient may be determined based at least on differences between each of second multiple focal point distances and each respective one of the first multiple focal point distances. In one example, a depth of incision  230  in eye  116  of patient  320  may be determined based at least on differences between focal point distances  940 A- 940 D and respective focal point distances  920 A- 920 D. The second multiple focal point distances may be associated with a topography of a surface of eye  116 . In a second example, a depth of incision  230  in eye  116  of patient  320  may be determined based at least on differences between focal point distances  940 A- 940 D and respective focal point distances  1020 A- 1020 D. The second multiple focal point distances may be associated with a topography of a surface of patient interface  114 . In another example, a depth of incision  230  in eye  116  of patient  320  may be determined based at least on differences between focal point distances  942 A- 942 D, respectively illustrated in  FIGS. 9U-9X , and respective focal point distances  920 A- 920 D. 
     A topography of the at least one incision in the eye of the patient may be determined based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances. A flap thickness may be determined via the depth of the at least one incision in the eye of the patient. For example, a flap thickness profile may be determined based at least on one or more depths of at least one incision in the eye of the patient. A flap thickness may be determined based at least on differences between each of the second multiple focal point distances and each respective one of the first multiple focal point distances. 
     A cutting depth may be corrected based at least on a depth of an incision in the eye of the patient. In one example, a cutting depth may be maintained (e.g., with little deviations or no deviations from a prescribed cutting depth) while an incision in the eye of the patient is being performed. In a second example, a cutting contour may be maintained (e.g., with little deviations or no deviations from a prescribed cutting depth) while an incision in the eye of the patient is being performed. A little deviation from a prescribed cutting depth may be a margin of acceptable error for the prescribed cutting depth. In a third example, a flap may be incised in the eye of the patient with little deviation or no deviation from a prescribed cutting depth. In another example, a lenticule may be incised in the eye of the patient with little deviation or no deviation from a prescribed cutting depth. As an example, a WAVELIGHT® FS 200 laser system, available from Alcon Vision LLC, may perform an incision in the eye of the patient. 
     At  825 , the depth of the at least one incision in the eye of the patient may be displayed. In one example, the depth of the at least one incision may be displayed via a display. In another example, the depth of the at least one incision may be displayed via a printer. The printer may print the depth of the at least one incision on a piece of paper. The topography of the eye of the patient may be displayed with the depth of the at least one incision in the eye of the patient. The topography of the surface of the patient interface may be displayed with the depth of the at least one incision in the eye of the patient. The topography of the at least one incision in the eye of the patient may be displayed. The topography of the eye of the patient and the topography of the at least one incision in the eye of the patient may be displayed. 
     Turning now to  FIG. 8B , an example of method of determining multiple of focal point distances associated with respective multiple positions of a plane orthogonal to a laser beam is illustrated. The method illustrated in  FIG. 8B  may be performed for each position of the multiple positions of the plane orthogonal to the laser beam. In one example, the method illustrated in  FIG. 8B  may be performed for each position of positions  910 A- 910 M of plane  900 . In another example, the method illustrated in  FIG. 8B  may be performed for each position of some of positions  910 A- 910 M of plane  900 . 
     At  830 , at least one mirror may be adjusted to target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. The at least one mirror may be adjusted to target the laser beam to any position. As an example, the at least one mirror may be adjusted to target the laser beam to position  910 F. Scanner  144  may include one or more mirrors. For example, scanner  144  may target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. Scanner  144  may adjust at least one mirror to target the laser beam to the position of the multiple positions of the plane orthogonal to the laser beam. 
     At  835 , multiple intensity values associated with respective interim focal point distances may be determined. In one example, multiple intensity values associated with respective interim focal point distances  950 A- 950 C of laser beam  915 , illustrated in respective  FIGS. 9R-9T , may be determined. In another example, multiple intensity values associated with respective interim focal point distances  930 A- 930 C,  930 E, and  930 F of laser beam  915 , illustrated in respective  FIGS. 9H-9J, 9L and 9M , may be determined. The multiple intensity values associated with the respective interim focal point distances may be determined via a method illustrated in  FIG. 8C . 
     At  840 , a maximum intensity value of the multiple intensity values may be determined. In one example, computer system  152  may determine a maximum intensity value of the multiple intensity values. In another example, computer system  430  may determine a maximum intensity value of the multiple intensity values. If a maximum intensity value associated with interim focal point distance  930 D has been determined, another maximum intensity value of the multiple intensity values may be determined. For example, the other maximum intensity value of the multiple intensity values may be associated with interim focal point distance  930 F. As an example, a maximum intensity value, of the multiple intensity values, associated with interim focal point distance  930 F may be determined. 
     At  845 , an interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value may be determined. In one example, interim focal point distance  950 C of interim focal point distances  950 A- 950 C may be determined. In another example, interim focal point distance  930 F of interim focal point distances  930 A- 930 C,  930 E, and  930 F may be determined. 
     At  850 , a focal point distance of the multiple focal point distances may be determined as the interim focal point distance of the multiple interim focal point distances respectively associated with the maximum intensity value. In one example, a focal point distance of the multiple focal point distances may be determined as interim focal point distance  950 C, of interim focal point distances  950 A- 950 C, respectively associated with the maximum intensity value. In another example, a focal point distance of the multiple focal point distances may be determined as interim focal point distance  930 F, of interim focal point distances  930 A- 930 C,  930 E, and  930 F, respectively associated with the maximum intensity value. 
     Turning now to  FIG. 8C , an example of a method of determining multiple intensity values associated with respective multiple interim focal point distances is illustrated. The method illustrated in  FIG. 8C  may be performed for each interim focal point distance of the multiple interim focal point distances. For example, the method illustrated in  FIG. 8C  may be performed for each interim focal point distance of interim focal point distances  950 A- 950 C. 
     At  855 , a beam expander may be adjusted to focus the laser beam to the interim focal point distance. In one example, beam expander  141  may be adjusted to focus the laser beam to interim focal point distance  930 . In another example, beam expander  141  may be adjusted to focus the laser beam to interim focal point distance  950 . Adjusting beam expander  141  to focus the laser beam to an interim focal point distance may include adjusting one or more lenses of beam expander  141 . In one example, one or more of lenses  142 A and  142 B may be adjusted to focus the laser beam to interim focal point distance  930 . In another example, one or more of lenses  142 A and  142 B may be adjusted to focus the laser beam to interim focal point distance  950 . 
     At  860 , at least a portion of the laser beam reflected from an incision in an eye of a patient may be received via a TPA. For example, TPA detector  130  may receive at least a portion of the laser beam reflected from incision  230  in eye  116  of patient  320 . 
     At  865 , an intensity value, of the multiple intensity values, associated with the interim focal point distance may be determined from the at least the portion of the laser beam. In one example, an intensity value associated with interim focal point distance  930  may be determined. An intensity value associated with interim focal point distance  930 F may be a maximum intensity value. In another example, an intensity value associated with interim focal point distance  950  may be determined. An intensity value associated with interim focal point distance  950 C may be a maximum intensity value. 
     Determining, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance may include an ADC receiving an analog signal from the TPA detector. Determining, from the at least the portion of the laser beam, an intensity value of the multiple intensity values associated with the interim focal point distance may include the ADC converting the analog signal from the TPA detector to the intensity value of the multiple intensity values associated with the interim focal point distance. In one example, the ADC may convert current into digital values. In another example, the ADC may convert voltage into digital values. 
     At  870 , the intensity value, of the multiple intensity values, associated with the interim focal point distance may be stored via a memory medium. For example, the intensity value associated with the interim focal point distance and the interim focal point distance may be stored via the memory medium. The interim focal point distance may be accessed and/or may be retrieved from the memory medium via the intensity value associated with the interim focal point distance. For example, a focal point distance may be accessed and/or may be retrieved from the memory medium via a maximum intensity value. 
     Storing the intensity value associated with the interim focal point distance and the interim focal point distance via the memory medium may include storing the intensity value associated with the interim focal point distance and the interim focal point distance via a database. The interim focal point distance may be accessed and/or may be retrieved from the database via the intensity value associated with the interim focal point distance. For example, a focal point distance may be accessed and/or may be retrieved from the database via a maximum intensity value. The database may be stored locally, via a remote computer system, or via a remote data center, among others. In one example, the database may include a relational database. In a second example, the database may include a graph database. In a third example, the database may include an associative array. In another example, the database may include a NoSQL database. 
     Turning now to  FIGS. 10L and 10M , examples of a patient interface at an angle to plane are illustrated. As shown in  FIG. 10L , a line  1040 A may be parallel to plane  900  and a X-axis. Determining a topography of a surface of a patient interface may include determining an angle θ. As illustrated in  FIG. 10M , a line  1040 B may be parallel to plane  900  and a Y-axis. For example, line  1040 B may be orthogonal to line  1040 A. Lines  1040 A and  1040 B may be parallel to plane  900 . Determining a topography of a surface of a patient interface may include determining an angle φ. One or more of angles θ and φ may be utilized in determining and/or maintaining a depth of a cut or incision in eye  116 . For example, when eye  116  is in contact with surface  1012  of patient interface  114 , one or more of angles θ and φ may be utilized in determining and/or maintaining a depth of a cut or an incision in eye  116 . 
     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.