Patent Description:
In many ophthalmic procedures a surgeon is required to use a variety of instruments in the patient's eye. For example, during a vitreoretinal surgery, a surgeon oftentimes manipulates a first handpiece for directing an illumination light beam onto the retinal surface in order to view patient anatomy and also manipulates an additional laser probe handpiece for delivering a laser treatment beam for treating the patient anatomy. However, there is a need for a multiple-input-coupled illuminated multi-spot laser probe. Reference is made to the documents <CIT> <CIT>and <CIT>, which have been cited as exemplary of the background state of the art.

The disclosed embodiments of the present technology relates to multiple-input-coupled illuminated multi-spot laser probes, adaptors and other systems for multiplexing an illumination light and multi-spot laser light, and methods for multiplexing an illumination light and multi-spot laser light for and delivering the multiplexed light onto patient anatomy.

Some embodiments of the present technology involve a surgical laser system, an illumination light source, a surgical probe assembly, and a laser system port adaptor for creating a multi-spot pattern of laser light beams, multiplexing the multi-spot pattern of laser light beams with an illumination light beam, and delivering the multiplexed light beam to a surgical probe for simultaneously transmitting illumination light and a multi-spot pattern of laser light beams. The laser system port adaptor can include a first port arm for coupling with a laser source, a second port arm for coupling with an illumination system, a third port arm for coupling with a fiber optic cable of a laser probe, and a multiplexing intersection region. In some cases, the second port arm and the third port arm are substantially collinear across the intersection region, and the first port arm is substantially orthogonal to the second port arm and the third port arm at the multiplexing intersection region.

The intersection region of the laser system port adaptor can contain a diffractive optical element (DOE) configured to receive a collimated laser light beam from the optical element and to create a multi-spot laser pattern of laser light beams. In some cases, the DOE creates the multi-spot laser pattern of laser light beams as a 2X2 array pattern.

The intersection region can also contain a beamsplitter configured to reflect a plurality of narrow bands of the electromagnetic spectrum of light that correspond to the wavelengths of laser light emitted by the surgical laser system. The beamsplitter can further receive both the multi-spot pattern of laser light beams and an illumination beam from the illumination system. The beamsplitter can reflect the multi-spot laser pattern of laser light beams towards the third port arm and transmit portions of the illumination beam not contained within the at least two narrow bands of the electromagnetic spectrum towards the third port arm. In some cases, the second port arm includes a collimating lens for collimating the illumination light at the beamsplitter. Also, in some cases the intensity of the laser beams and the intensity of the illumination beam can be adjusted to produce a clear multiplexed multi-spot laser pattern of laser light beams and illumination beam.

The first port arm can include a ferrule having a diameter configured to securely couple within a female port of the laser source and can include an opening for allowing a focused laser spot from the laser source to enter the first port arm. The first port arm can also include an optical element for collimating a laser light beam. In some cases, the first port arm and the optical element have lengths configured to place the optical element substantially adjacent to the point of the focused laser spot from the laser source. Also, the first port arm can include external threading which, when tightened with a nut, couples the first port arm with the female port of the laser source and keeps the optical element substantially adjacent to the point of the focused laser spot from the laser source.

The third port arm can include a condensing lens substantially adjacent to the beamsplitter in the multiplexing intersection region. The condensing lens can be selected to focus the multi-spot laser pattern of laser light beams and the illumination beam onto an interface of the terminal end of a multi-core optical fiber cable of the surgical probe assembly.

The multi-core optical fiber cable can include a first outer core surrounded by an outer-core cladding and a plurality of inner cores contained within the outer core, each inner core in the plurality of inner cores surrounded by an inner-core cladding. In some cases, the plurality of inner cores contained within the outer core form a 2X2 array that matches a 2X2 multi-spot pattern of laser light beams from the DOE.

The materials for the various cores and the various claddings can be selected such that the focused illumination beam is propagated down an entire length of a first outer core of the multi-core optical fiber cable and such that each of the laser light beams in the multi-spot laser pattern of laser light beams is propagated down an entire length of one of a plurality of inner cores contained within the outer core.

In some cases, a refractive index of the outer core is greater than a refractive index of the outer-core cladding, a refractive index of each of the inner cores in the plurality of inner cores is greater than a refractive index of the inner-core cladding, and a refractive index of each or the inner cores in the plurality of inner cores is larger than the refractive index of the outer-core cladding. Further, the condensing lens can be selected to focus each of the laser beams in the multiplexed multi-spot pattern of laser light beams onto an interface with a respective inner core in the plurality of inner cores, wherein a spot size of each of the focused laser beams, an angular spread of each of the focused laser beams, a refractive index of the inner core, and a refractive index of the inner-core cladding causes the laser light beams to spatially fill and propagate through the plurality of inner cores for the length of the multi-core optical fiber cable.

Likewise, the condensing lens can be selected to focus the illumination beam as a light cone with a spot size to fall incident on at least a portion of the first outer core, at least a portion of the plurality of inner cores, and at least a portion of the inner-core claddings. The light cone of the illumination beam can include a narrow half-angle portion of the light cone and a wide half-angle portion of the light cone. In these cases, the refractive index for the various cores and claddings of the multi-core optical fiber cable and an angle of the narrow half-angle and wide half-angle portions of the light cone causes the illumination beam to spatially fill and propagate the length of the outer core of the multi-core optical fiber cable. Also, the narrow half-angle portion of the illumination beam can be confined within the outer core region, and the wide angle portion of the illumination beam is free to propagate within the outer core region, the inner cladding regions, and the inner core regions.

In some cases, the surgical probe assembly includes a ferrule for coupling with a laser system port adaptor or other multiplexing system. The surgical probe assembly can also include the multi-core fiber cable and a handpiece with a probe tip coupled with the distal end of the multi-core optical fiber cable. The probe tip can have a lens located substantially at a distal end of the probe tip and the multi-core optical fiber cable can terminate in an interface with the lens. The lens can be selected to translate the geometry of the multiplexed multi-spot laser pattern of laser light beams and illumination beam from the distal end of the multi-core optical fiber cable onto a target surface.

Some embodiments of the present technology involve methods of multiplexing a multi-spot pattern of laser light beams with an illumination light beam. The methods can involve directing a laser light beam to an optical element for collimating the laser light beam and directing the collimated laser light beam to a diffractive optical element (DOE) to create a multi-spot laser pattern of laser light beams. Likewise, the methods can involve directing the multi-spot pattern of laser light beams and an illumination light beam to a beamsplitter. Next, the method involves the beamsplitter reflecting the multi-spot pattern of laser light beams towards a condensing lens and transmitting the illumination light beam to the condensing lens, thereby multiplexing the multi-spot pattern of laser light beams and a transmitted illumination beam. The methods can also involve the condensing lens focusing the multiplexed multi-spot pattern of laser light beams and transmitted illumination beam onto an interface with a multi-core optical fiber cable. Also, the methods can involve directing the multiplexed multi-spot pattern of laser light beams and transmitted illumination beam through the multi-core optical fiber cable and onto a lens in a probe tip. Next, the lens translates a geometry of the multiplexed multi-spot laser pattern of laser light beams and illumination beam from the distal end of the multi-core optical fiber cable onto a target surface.

Some embodiments of the present technology involve methods of creating an image of a multiplexed beam of multi-spot pattern of laser light beams and illumination light. The methods can involve selecting, for a multi-core optical fiber cable, a material with a first refractive index for an outer core, a material with a second refractive index for an outer-core cladding, a material with a third refractive index for a plurality of inner cores contained in the outer core, and a material with a fourth refractive index for an inner-core cladding for each of the plurality of inner cores. The methods can also include determining a numerical aperture of laser light beams from a laser source and a numerical aperture of an illumination light beam from an illumination light source, and selecting a condensing lens to focus the multiplexed multi-spot pattern of laser light beams and illumination beam onto an interface plane of the multi-core optical fiber cable. Next, the methods can include multiplexing a multi-spot pattern of laser light beams with the illumination light beam and focusing the multiplexed multi-spot pattern of laser light beams and illumination beam onto an interface plane of the multi-core optical fiber cable such that the illumination beam propagates down the outer core and the laser beams propagate down the multiple inner cores. The methods can also involve directing the multiplexed beam of multi-spot pattern of laser light beams and illumination light through a lens in the surgical handpiece.

Some embodiments of the present technology involve an integrated illumination and multi-spot laser multiplexing system. The integrated system can include a laser source that emits a collimated laser light beam and a diffractive optical element (DOE) configured to receive the collimated laser light beam and to create a multi-spot laser pattern. The integrated system also includes an illumination system that emits substantially white light and a collimating lens that collimates the substantially white light received from the illumination system. The integrated system further includes a fiber optic cable port that couples a multi-core optical cable fiber to the system and a beamsplitter that reflects the multi-spot laser pattern towards a condensing lens and that transmits the collimated illumination beam towards the condensing lens, thereby multiplexing the multi-spot laser light beams and the illumination light beam. The condensing lens can further focus the multiplexed multi-spot pattern of laser light beams and illumination beam onto an interface with the fiber optic cable port, through a multi-core optical fiber cable, and onto a lens in the tip of a surgical handpiece that translates a geometry of the multiplexed multi-spot laser pattern of laser light beams and illumination beam onto a target surface.

Some embodiments of the present technology involve an integrated illumination and multi-spot laser multiplexing system. The system can include a laser source that emits a collimated laser light beam, a diffractive optical element (DOE) to create a multi-spot laser pattern of laser light, an illumination system that emits substantially white light, and a collimating lens that collimates the substantially white light received from the illumination system. The system further includes a beamsplitter that reflects the collimated laser light beam and that transmits the collimated illumination beam towards a condensing lens. The DOE creates a multi-spot laser pattern of laser light beams and the beamsplitter multiplexes the pattern of laser light beams and the illumination light beam. The system further includes a fiber optic cable port that couples the multiplexed light with a multi-core optical cable fiber.

For a more complete understanding of the present technology, its features, and its advantages, reference is made to the following description, taken in conjunction with the accompanying drawings, in which:.

In a wide variety of medical procedures, laser light is used to assist the procedure and treat patient anatomy. For example, a vitreoretinal surgery oftentimes involves using a laser treatment beam for photocoagulation of retinal tissue. Vitreoretinal procedures commonly involve a laser probe that is capable of alternately emitting an aiming laser beam to select target spots on retinal tissue and emitting a treatment laser beam to perform the photocoagulation at the targeted spots. Frequently, the laser probe utilizes light in a red band of the electromagnetic spectrum for the aiming beam and light in a green band of the electromagnetic spectrum for the treatment beam. Also, during a panretinal laser photocoagulation procedure, a surgeon selects thousands of spots on retinal tissue to apply the treatment laser beam to, resulting in a very long and tedious procedure. Therefore, a laser probe capable of producing a multi-spot pattern of laser light is desirable.

Vitreoretinal procedures also benefit from illumination light being directed into the eye and onto retinal tissue. Vitreoretinal surgeons oftentimes use a laser probe handpiece for delivering the laser aiming and treatment beams and also use an additional handpiece for directing an illumination light beam onto the retinal surface in order to view patient anatomy.

The field of vitreoretinal surgery, as well as other medical laser procedures, would benefit from multiplexing an illumination light and multi-spot laser light. Accordingly, the technology described herein involves multiple-input-coupled illuminated multi-spot laser probes, adaptors and other systems for multiplexing an illumination light and multi-spot laser light, and methods for multiplexing an illumination light and multi-spot laser light and delivering the multiplexed light onto patient anatomy.

<FIG> illustrates a system <NUM> for creating a multi-spot pattern of laser light beams, multiplexing the multi-spot pattern of laser light beams with an illumination light beam, and delivering the multiplexed light beam to a surgical probe <NUM> for simultaneously transmitting illumination light and a multi-spot pattern of laser light beams in accordance with a particular embodiment of the present disclosure.

The system <NUM> includes a surgical laser system <NUM> that includes one or more laser sources for generating laser beams used during an ophthalmic procedure. For example, the ophthalmic surgical laser system <NUM> can alternatively generate a surgical treatment beam with a wavelength of around <NUM> nanometers (nm) and a laser aiming beam with a wavelength of around <NUM>. A surgeon or surgical staff member can control the surgical laser system <NUM> (e.g., via a foot switch, voice commands, etc.) to alternatively emit the laser aiming beam and fire the treatment beam to treat patient anatomy (e.g., perform photocoagulation). The laser beams can be emitted through a port <NUM> in the surgical laser system <NUM>.

The system <NUM> also includes an illumination light source <NUM> that can include one or more of a xenon illumination, an RGB light-emitting diode (LED) illuminator, a white light LED illuminator, a laser-pumped phosphor illuminator, a supercontinuum white laser illuminator, etc. The illumination light source <NUM> can be a surgical console that can monitor and control a wide variety of aspects of an ophthalmic procedure. For example, the surgical console can be configured for use in vitreoretinal surgery and can power and control vitrectomy probes, can integrate pressurized infusion delivery and intraocular pressure compensation, can provide surgical illumination, etc. In some cases, the illumination light source <NUM> can deliver the illumination light via an illumination cable <NUM>.

The system <NUM> also includes a laser system port adaptor <NUM> containing optical elements (not shown) for creating a multi-spot pattern of laser light beams from a laser light beam from the ophthalmic surgical laser system <NUM> and multiplexing the multi-spot pattern of laser light beams with an illumination light beam received from the illumination light source <NUM>. The adaptor <NUM> can include a plurality of port arms <NUM>, <NUM>, <NUM> that couple with the surgical laser source <NUM>, the illumination light source <NUM>, and to the surgical probe <NUM>, respectively.

The system <NUM> can deliver the multiplexed light beam from the port arm <NUM> to the surgical probe <NUM> via a multi-core optical fiber cable <NUM> to provide the surgical probe <NUM> the ability of simultaneously providing illumination light and a multi-spot pattern of laser light beams to the retina <NUM> of a patient's eye <NUM>. The surgical probe <NUM> includes a probe body <NUM> and a probe tip <NUM> that house and protect the multi-core optical fiber cable <NUM>. A distal end <NUM> of the probe tip <NUM> also contains a lens (not shown, described in greater detail below) that translates the multiplexed light beam from the distal end of the multi-core optical fiber cable onto the retina <NUM>.

As disclosed herein, various systems and methods can be employed for creating a multi-spot pattern of laser light beams multiplexing the multi-spot pattern of laser light beams with an illumination light beam. As briefly mentioned above, in some cases, a port adaptor can contain optical elements for creating a multi-spot pattern and multiplexing light beams. <FIG> illustrates a laser system port adaptor <NUM> according to some embodiments of the present disclosure. The laser system port adaptor <NUM> includes a first port arm <NUM> for coupling with a laser source, a second port arm <NUM> for coupling with an illumination system, and a third port arm <NUM> for coupling with a fiber optic cable of a laser probe. The laser system port adaptor <NUM> also includes a multiplexing intersection region <NUM> where the first port arm <NUM>, the second port arm <NUM>, and the third port arm <NUM> intersect. In some cases, the second port arm <NUM> and the third port arm <NUM> are substantially collinear across the multiplexing intersection region <NUM>, and the first port arm <NUM> is substantially orthogonal to the second port arm <NUM> and the third port arm <NUM> at the multiplexing intersection region <NUM>.

The first port arm <NUM> includes a ferrule <NUM> that functions as a male coupling for a female chimney port (not shown) of the laser system. The ferrule <NUM> has an opening <NUM> that allows laser light from the laser source to enter the first port arm <NUM>. Also, the ferrule <NUM> can house an optical element <NUM> contained within the ferrule <NUM>. The optical element <NUM> is configured to collimate laser light received from the laser source. For example, the optical element <NUM> can be a graded-index (GRIN) lens with a length and a pitch selected such that the optical element <NUM> collimates laser light received at the opening <NUM> at a selected distance adjacent to a diffractive optical element (DOE) <NUM> contained within the multiplexing intersection region <NUM>, as described in more detail below.

The first port arm <NUM> also includes an external threading <NUM> to draw the first port arm substantially all the way into the female port of the surgical laser system <NUM> when a nut is tightened on the external threading. In some cases, the optical element <NUM> is positioned within the ferrule <NUM> that is flush with the opening <NUM>, and the surgical laser system <NUM> is configured to focus a laser spot at the terminal end of the female port. Accordingly, the external threading <NUM> can facilitate the optical element <NUM> being positioned at a point relative to the surgical laser system <NUM> such that a focused laser spot of a laser produced by the surgical laser system falls substantially incident onto the end of the optical element <NUM>.

The second port arm <NUM> for coupling with an illumination system can comprise a female port having a substantially cylindrical external frame <NUM>, an internal cavity <NUM>, a collimating lens <NUM> at a first end of the internal cavity <NUM>, and an opening <NUM> at the second end of the internal cavity <NUM>. The internal cavity <NUM> of the second port arm <NUM> can be configured to receive a ferrule of an optical cable <NUM> that delivers an illumination light beam from the illumination light source <NUM>. In some cases, the ferrule of the optical cable that delivers an illumination light beam is secured to the second port arm <NUM> with a nut such that the illumination emitted from an optical fiber contained within the optical cable spreads to fall incident onto the collimating lens <NUM> such that the collimating lens <NUM> delivers substantially collimated illumination light to a beamsplitter <NUM> contained in the multiplexing intersection region <NUM>.

The third port arm <NUM> for coupling with a fiber optic cable of a laser probe can comprise a female port having a substantially cylindrical external frame <NUM>, an internal cavity <NUM>, a condensing lens <NUM> at a first end of the internal cavity <NUM>, and an opening <NUM> at the second end of the internal cavity <NUM>.

The internal cavity <NUM> of the third port arm <NUM> can be configured to receive a ferrule of a multi-core optical fiber cable <NUM> that delivers multiplexed light to the surgical probe <NUM>, as explained in greater detail below. In some cases, the ferrule of a multi-core optical fiber cable is secured to the third port arm <NUM> with a nut such that the condensing lens <NUM> precisely focuses the multiplexed light onto an interface <NUM> of the terminal end of the multi-core optical fiber cable such that an illumination beam and laser aiming/treatment beams are propagated down an entire length of the multi-core optical fiber cable, as explained in greater detail below.

As explained above, the laser system port adaptor <NUM> also includes a multiplexing intersection region <NUM> where the first port arm <NUM>, the second port arm <NUM>, and the third port arm <NUM> intersect. The multiplexing intersection region can contain a diffractive optical element (DOE) <NUM> configured to receive a collimated laser light beam from the optical element <NUM> of the first port arm <NUM> and to create a multi-spot laser pattern of laser light beams. The DOE <NUM> can be selected to diffract incident laser light into a multi-spot pattern that will align with an intended target geometry. For example, the DOE <NUM> can be selected to create a 2X2 array pattern of laser light beams that substantially matches a 2X2 array of inner cores of a multi-core optical fiber cable that delivers the multiplexed light to the surgical probe <NUM>, as explained in greater detail below.

The multiplexing intersection region <NUM> also contains a beamsplitter <NUM> configured to reflect a portion of the light spectrum and transmit a remaining portion of the light spectrum. More specifically, the beamsplitter <NUM> can be configured to both: a) reflect laser aiming and treatment beams from the surgical laser system <NUM> toward the third port arm <NUM> and the condensing lens <NUM>, and b) transmit the illumination light from the illumination light source <NUM> toward the third port arm <NUM> and the condensing lens <NUM>. Also, as mentioned above, the condensing lens <NUM> can be selected to precisely focus the multiplexed light onto an interface <NUM> of the terminal end of the multi-core optical fiber cable <NUM> such that an illumination beam and laser aiming/treatment beams are propagated down an entire length of the multi-core optical fiber cable <NUM>, as explained in greater detail below.

As explained above, vitreoretinal procedures frequently utilize light in a red band of the electromagnetic spectrum for a laser aiming beam and light in a green band of the electromagnetic spectrum for a laser treatment beam. Accordingly, the beamsplitter <NUM> can be configured to highly reflect light in a narrow band of the red spectrum and a narrow band of the green spectrum and configured to transmit the remaining electromagnetic spectrum. In some embodiments, the beamsplitter <NUM> reflects light in a first narrow band around <NUM> nanometers (nm) and in a second narrow band around <NUM> and transmits the remaining spectrum. The beamsplitter <NUM> can be a dichroic beamsplitter cube, a beamsplitter plate, etc..

Since portions (e.g., red and green portions) of the illumination light from the illumination light source <NUM> are reflected by the beamsplitter <NUM>, the system port adaptor <NUM> can include a light collection module <NUM>. For example, the light collection module <NUM> can be a beam dump, power monitor, etc..

<FIG> illustrates the laser system port adaptor <NUM> coupled with a surgical laser system <NUM>, a ferrule <NUM> of an optical cable <NUM> that delivers an illumination light beam from the illumination light source <NUM>, and a ferrule <NUM> of the multi-core optical fiber cable <NUM> that delivers multiplexed light to the surgical probe <NUM>.

The surgical laser system <NUM> includes a female port <NUM> with an opening <NUM> in the proximal end of the female port <NUM> that allows laser light to exit the surgical laser system <NUM>. The female port <NUM> is configured to receive the first port arm <NUM> of the laser system port adaptor <NUM> such that the optical element <NUM> in the first port arm <NUM> is substantially adjacent to the opening <NUM>. The surgical laser system <NUM> is configured to focus laser light substantially onto an interface plane at the opening <NUM> and the optical element <NUM>. Also, a nut <NUM> can be used to secure the laser system port adaptor <NUM> with the surgical laser system <NUM> and maintain the proximity of the optical element <NUM> with the opening <NUM> in the female port <NUM>.

As explained above, an ophthalmic surgical laser system <NUM> can alternatively generate a surgical treatment beam with a wavelength of around <NUM> nanometers (nm) (i.e., green) and a laser aiming beam with a wavelength of around <NUM> (i.e., red). However, red and green incident laser light diffract off a DOE with different diffraction angles. When the laser beams are not collimated then their focus is also affected, i.e. red and green will focus at different axial locations. This greatly complicates trying to focus both green and red laser beams into the same inner-core regions of the multi-core fiber, as explained in greater detail below. Therefore, some embodiments involve collimating the multiple beams that fall incident on the DOE so that the multiple beams generated from the DOE are also collimated. To achieve a multi-spot laser pattern with sufficient focus, the laser light from the surgical laser system <NUM> should be collimated when it falls incident on the DOE <NUM>. Therefore, in some cases, the optical element <NUM> can selected to be long enough (e.g., <NUM>) to collimate laser light from the surgical laser system <NUM>, bring the laser light back into focus, and collimate the laser light a second time such that the laser light is collimated at the DOE <NUM>.

In some cases, the optical element <NUM> is a <NUM> pitch, <NUM> NA GRIN relay lens that receives laser focused input beam and outputs a collimated beam at the distal end of the GRIN lens. The GRIN lens is long enough to collimate the beam then bring it to a focus and then collimate is a second time. In some other cases, the optical element <NUM> is a refractive-lens relay system.

The DOE <NUM> receives the collimated laser light and creates a multi-spot pattern of laser light beams. For example, in some cases, the DOE <NUM> can create a 2X2 array pattern of laser light beams that substantially matches a 2X2 array of inner cores of the multi-core optical fiber cable <NUM> that delivers the multiplexed light to the surgical probe <NUM>, as explained in greater detail below. In some other cases, the DOE <NUM> can be replaced by an assembly of prisms and/or beamsplitters to create the multi-spot pattern of laser light beams.

As also shown in <FIG>, the second port arm <NUM> of the laser system port adaptor <NUM> is also coupled with a ferrule <NUM> of an optical cable <NUM> that delivers an illumination light beam from the illumination light source <NUM>. In some cases, the length of the internal cavity of the second port arm <NUM> is selected such that a terminal end of an optical fiber contained within the optical cable <NUM> is positioned a predetermined distance from the collimating lens <NUM>. The collimating lens <NUM> and/or the predetermined distance of the optical fiber from the collimating lens <NUM> can be selected such that the illumination light is substantially fully collimated at the beamsplitter <NUM>. Also, a nut can secure the ferrule <NUM> in the internal cavity <NUM> and maintain the predetermined distance of the optical fiber <NUM> from the collimating lens <NUM>.

Also, as mentioned above, the beamsplitter <NUM> can be configured to both: a) reflect laser aiming and treatment beams from the surgical laser system <NUM> toward the third port arm <NUM> and the condensing lens <NUM>, and b) transmit the illumination light from the illumination light source <NUM> toward the third port arm <NUM> and the condensing lens <NUM>.

As also shown in <FIG>, the third port arm <NUM> of the laser system port adaptor <NUM> is coupled with a ferrule <NUM> of the multi-core optical fiber cable <NUM> that delivers multiplexed light to the surgical probe <NUM>. Also, the condensing lens <NUM> can be selected to precisely focus the multiplexed light onto an interface <NUM> of the terminal end of the multi-core optical fiber cable <NUM> such that an illumination beam and laser aiming/treatment beams are propagated down an entire length of the multi-core optical fiber cable <NUM>, as explained in greater detail below.

<FIG> illustrates a method <NUM> for multiplexing a multi-spot pattern of laser light beams and illumination light in accordance with a particular embodiment of the present disclosure. The method <NUM> involves collimating a laser light beam by directing a laser light beam to a graded-index (GRIN) lens <NUM>, creating a multi-spot pattern of laser light beams by directing the collimated laser light beam onto a diffractive optical element (DOE) <NUM>, and directing the multi-spot pattern of laser light beams to a beamsplitter <NUM>.

The method <NUM> also involves collimating an illumination beam using a collimating lens <NUM> and directing the collimated illumination beam to the beamsplitter <NUM>. Next, the method <NUM> involves multiplexing, using the beamsplitter, the multi-spot pattern of laser light with the collimated illumination beam <NUM>. More specifically, in some cases, multiplexing the multi-spot pattern of laser light with the collimated illumination beam can involve the beamsplitter reflecting laser aiming and treatment beams from the surgical laser system toward a condensing lens and transmitting the illumination light from the illumination light source towards the condensing lens.

The method <NUM> also involves focusing, with a condensing lens, the multiplexed beam of multi-spot pattern of laser light and illumination light onto an interface with a multi-core optical fiber cable of a surgical handpiece <NUM> and, subsequently, directing the multiplexed beam of multi-spot pattern of laser light beams and illumination light through a lens in the surgical handpiece <NUM>, as described in more detail below.

In some cases, the intensities of the white illumination and the laser aiming beams can be adjusted (e.g., at the illumination light source and surgical laser system, respectively) to provide the right amount of laser aiming beam contrast against the white while providing enough white illumination to easily see the retina.

The system <NUM> illustrated in <FIG> and described herein involves a modular approach with a separate surgical laser system and illumination light source. However, in some cases, the surgical laser system and illumination light source can be integrated in a single module and the module can contain the appropriate optics for creating a multi-spot pattern of laser light beams, multiplexing the multi-spot pattern of laser light beams with an illumination light beam, and delivering the multiplexed light beam to a surgical probe for simultaneously transmitting illumination light and a multi-spot pattern of laser light beams.

<FIG> illustrates a system <NUM> that includes a light multiplexing component <NUM> containing a laser source <NUM> and an illumination light source <NUM> in accordance with a particular embodiment of the present disclosure. The laser source can generate substantially collimated laser beams (e.g., red aiming beams, green treatment beams) and direct the laser beams towards a beamsplitter <NUM>. Also, a linear slide <NUM> (or rotating wheel) can be positioned in the beam path between the laser source <NUM> and the beamsplitter <NUM>. The linear slide <NUM> can include multiple optical features that can be alternatively slid into the beam path between the laser source <NUM> and the beamsplitter <NUM>. For example, the linear slide <NUM> can include a diffractive optical element (DOE) that creates a multi-spot pattern of laser light beams and a clear window or a hollow section that allows the laser light to pass through unaffected, resulting in a single spot laser beam.

The illumination light source <NUM> can be a white LED, an RGB LED, a xenon laser, a pumped phosphor laser, discreet lasers, supercontinuum laser, etc. The illumination light source can generate and direct illumination light to a collimating lens <NUM> and towards the beamsplitter <NUM>.

The beamsplitter <NUM> can be configured to both reflect laser aiming and treatment beams from the laser source <NUM> toward a condensing lens <NUM> and transmit the collimated illumination light from the illumination light source <NUM> toward the condensing lens <NUM>. The condensing lens <NUM> can be selected to precisely focus the multiplexed light onto an interface <NUM> of the terminal end of the multi-core optical fiber cable <NUM> such that an illumination beam and laser aiming/treatment beams are propagated down an entire length of the multi-core optical fiber cable <NUM> and into a surgical hand piece <NUM>, as explained in greater detail below.

<FIG> illustrates another system <NUM>' that includes a light multiplexing component <NUM>' containing a laser source <NUM> and an illumination light source <NUM>. Here, the beamsplitter <NUM> can multiplex laser light from the laser source <NUM> and collimated illumination light from the illumination light source <NUM> before the multiplexed light beam falls incident on a rotating wheel <NUM>'. When the rotating wheel <NUM> positions a DOE into the beam path, the DOE can create a multi-spot pattern of laser light beams within the illumination light. Also, the system <NUM>' can include a condensing lens <NUM> to focus the multiplexed light beam onto an interface <NUM> of the terminal end of the multi-core optical fiber cable <NUM>.

<FIG> illustrates another system <NUM> in accordance with a particular embodiment of the present disclosure that includes a laser light multiplexing module <NUM> containing a laser source <NUM> and an illumination module <NUM> that includes an illumination light source <NUM>. The illumination module <NUM> includes a collimating lens <NUM> that collimates light from the light source <NUM> and a slidable mirror <NUM> that can be alternatively positioned into and out of the beam path of collimated light from the collimating lens <NUM>. When the slidable mirror <NUM> is positioned within the beam path of collimated light from the collimating lens <NUM>, the slidable mirror directs the collimated light to a fiber optic coupling <NUM> and into a fiber optic delivery cable <NUM>. When the slidable mirror <NUM> is positioned out of the beam path of collimated light from the collimating lens <NUM>, the collimated light is directed to a condensing lens <NUM> that focuses the light into a fiber optic cable <NUM> that is coupled to an illumination probe <NUM> used for delivery of purely illumination light.

The fiber optic delivery cable <NUM> delivers the illumination light from the illumination module to a collimating lens <NUM> in the laser light multiplexing module <NUM>. The collimating lens <NUM> collimates the illumination light and directs the collimated light to a beamsplitter <NUM>. Also, the laser source <NUM> directs substantially collimated (i.e., substantially collimated due to the substantially point-source nature of the laser light from the laser light source <NUM>) to the beamsplitter <NUM>. The beamsplitter <NUM> is configured to transmit a portion of the light spectrum that corresponds to the wavelengths emitted by the laser source (e.g., red and green laser light) and configured to reflect a remaining portion of the light spectrum. More specifically, the beamsplitter <NUM> can be configured to both reflect laser aiming and treatment beams from the laser source <NUM> and transmit the illumination light from the collimating lens <NUM>. In this configuration the beamsplitter <NUM> effectively multiplexes laser light from the laser source <NUM> and collimated illumination light from the illumination light source <NUM>. The multiplexed light beam falls incident on a linear slide <NUM> that alternatively positions a DOE into the beam path to create a multi-spot pattern of laser light beams within the illumination light. Also, the laser light multiplexing module <NUM> includes a condensing lens <NUM> to focus the multiplexed light beam onto an interface <NUM> of the terminal end of the multi-core optical fiber cable <NUM> for delivery to surgical hand piece <NUM>.

In some cases, the light multiplexing components <NUM>, <NUM>' and/ or the laser light multiplexing module <NUM> are also integrated into a surgical console that include means for controlling aspects of a surgical procedure. For example, the light multiplexing components <NUM>, <NUM>' and/ or the laser light multiplexing module <NUM> can be integrated within a surgical console configured for use in vitreoretinal surgery that can power and control vitrectomy probes, can integrate pressurized infusion delivery and intraocular pressure compensation, can provide surgical illumination, etc. Also, in some cases, the light multiplexing components <NUM>, <NUM>' and/ or the laser light multiplexing module <NUM> are a stand-alone modules that can be used alongside a surgical console.

As mentioned above, a condensing lens can be selected to precisely focus the multiplexed light onto an interface of the terminal end of the multi-core optical fiber cable such that an illumination beam and laser aiming/treatment beams are propagated down an entire length of the multi-core optical fiber cable and into a surgical hand probe. More specifically, the condensing lens can be selected such that resulting light cones of light from the illumination beam and laser aiming/treatment beams have an acceptance angle and a numerical aperture (NA) to interface with the various fiber core and cladding materials used in the multi-core optical fiber cable such that the illumination beam and the laser aiming/treatment beams are propagated down the appropriate core fibers the entire length of the multi-core optical fiber cable.

<FIG> illustrates the top view of a proximal end of a multi-core optical fiber cable <NUM> according to some embodiments of the present disclosure. The multi-core fiber cable <NUM> can include four inner core fibers <NUM> with a relatively small-diameter and a relatively small NA inside of an outer core fiber <NUM> having a relatively large diameter and a relatively large NA. The outer core fiber <NUM> can be contained within an outer-core cladding <NUM> with refractive index (nclad1) and the inner core fibers <NUM> can be contained within an inner-core cladding <NUM> with refractive index (nclad2). Also, the outer core <NUM> has a core diameter (dcore2) and the inner cores <NUM> can have a core diameter (dcore1).

<FIG> illustrates a side view of the interface of a plurality of light cones <NUM>, <NUM>, <NUM> onto a terminal end of a multi-core optical fiber cable <NUM> according to some embodiments of the present disclosure. The multi-core optical fiber cable <NUM> in <FIG> shows the outer core fiber <NUM> and two of the inner core fibers <NUM>. For the sake of image clarity, the outer-core cladding <NUM> and the inner-core cladding <NUM> is not depicted in <FIG>. Also represented are a wide-angle portion of the illumination light cone <NUM>, a narrow-angle portion of the illumination light cone <NUM>, and the laser light cone <NUM>. The selection of the condensing lens is related to the half-angle of each of the light cones. Therefore, selecting a condensing lens can involve selecting a condensing lens based on the NA of the light, the acceptance angle of the light cones, and the refractive indices of the materials of the outer core fiber <NUM>, the outer-core cladding <NUM>, the inner core fibers <NUM>, and the inner-core cladding <NUM>.

The condensing lens is designed to focus laser light down onto the multi-core fiber interface with the desired beam NA. The refractive indices of the inner core fibers <NUM> and inner cladding-core claddings <NUM> are selected according to an NA calculation (shown below) so that the NA of the inner cores is equal to or greater than the beam NA, thereby ensuring confinement of the beams within the inner core regions as they propagate down the lengths of the inner core fibers <NUM>.

Referring again to <FIG>, a refractive index (ncore2) of the outer core fiber <NUM> is greater than a refractive index (nclad2) of the outer-core cladding <NUM>. Also, a refractive index (ncore1) of each of the inner cores fibers <NUM> is greater than a refractive index (nclad1) of the inner-core cladding <NUM>. Further, the refractive index (ncore1) of each or the inner cores fibers <NUM> is larger than the refractive index (nclad1) of the outer-core cladding <NUM>.

The numerical aperture (NA<NUM>) for the outer core fiber <NUM> and the outer-core cladding <NUM> can be calculated as: <MAT>.

Likewise, the numerical aperture (NA<NUM>) for the inner core fibers <NUM> and the inner-core cladding <NUM> can be calculated as: <MAT>.

In some embodiments of the present disclosure, the materials for the outer core fiber <NUM>, the outer-core cladding <NUM>, the inner core fibers <NUM>, and the inner-core cladding <NUM> are selected such that NA<NUM> is much larger than NA<NUM>. In a specific embodiment, the outer core can be an undoped fused silica with an index of substantially <NUM>.

Also, in some embodiments, the red aiming laser beam has an NA of about <NUM> and the green treatment laser beam has an NA of about <NUM>. Therefore, as long as the numerical aperture (NA<NUM>) for the inner core fiber <NUM> is larger than <NUM>, the red and green laser beams will remain confined within the inner cores <NUM> as they propagate down the probe. So, a silica fiber with an NA of <NUM> used for the outer core <NUM> may confine the laser beams.

Also, the illumination light can have an NA of around <NUM> and the core diameter can be configured to under-fill or match dcore2. The numerical aperture (NA<NUM>) for the outer core fiber <NUM> and the outer-core cladding <NUM> can be designed to have a fiber NA ≥ <NUM>, e.g. a borosilicate fiber construction.

When the illumination beam etendue is greater than outer core <NUM> etendue, then coupling efficiency into outer core <NUM> is less than one hundred percent regardless of condenser lens focal length choice. However, if the illumination beam etendue (which is the product of the illumination beam angular width and spot width) is less than the outer core <NUM> etendue, then one hundred percent coupling efficiency (neglecting Fresnel reflection losses) can occur if the condensing lens focus is designed correctly. If the condensing lens has too short of a focus, the converging beam may have an NA greater than core <NUM> NA, and coupling efficiency may be degraded. If the condensing lens has too long of a focal length, then the focused beam diameter may be larger than the <NUM> diameter, and coupling efficiency may be degraded. However if the condensing lens focal length is adjusted so that beam NA is less than or equal to the fiber NA, and the beam diameter is less than or equal to the fiber core diameter, then one hundred percent or near one hundred percent coupling efficiency can occur.

Therefore, the illumination beam may both spatially and angularly underfill the outer core <NUM>, which will permit spatial and angular misalignments without a loss of coupling efficiency. Also, since the illumination beam NA is >> NA1, off-axis rays can frequently pass in and out of the inner cores <NUM> and inner core cladding <NUM> as the rays propagate down the length of the multi-core optical fiber cable <NUM>.

<FIG> illustrates the cut-away view of a multi-core optical fiber cable <NUM> according to some embodiments of the present disclosure. The multi-core fiber cable <NUM> includes four fused silica inner core fibers <NUM> with a <NUM> micrometer diameter and a numerical aperture (NA) of <NUM> inside of a non-doped fused silica outer core fiber <NUM> having a <NUM> micrometer diameter and an NA of <NUM>. The outer core fiber <NUM> can be contained within low-index polymer cladding <NUM> having a <NUM> micrometer thickness and the inner core fibers <NUM> can be contained within fluorine-doped fused silica inner-core cladding <NUM> having a <NUM> micrometer thickness. The multi-core optical fiber cable <NUM> can be further contained in an Ethylene Tetrafluoroethylene (ETFE) coating <NUM>.

The four fused silica inner core fibers <NUM> have a refractive index of <NUM> at <NUM> nanometers. The non-doped fused silica outer core fiber <NUM> have a refractive index of <NUM> at <NUM> nanometers. The fluorine-doped fused silica inner-core cladding <NUM> can have a refractive index of <NUM> at <NUM> nanometers. The low-index polymer cladding <NUM> can have a refractive index of <NUM> at <NUM> nanometers.

<FIG> illustrates a proximal, interface end of the multi-core optical fiber cable with a red laser aiming beam spot and a green laser treatment beam spot lining up with the inner cores <NUM> and the illumination light beam spot lining up with the outer core <NUM>. <FIG> illustrates the distal end of the multi-core optical fiber cable with all three beams spread out to totally spatially fill their respective cores. <FIG> illustrate the propagation of the multiplexed light through the multi-core optical fiber cable.

<FIG> illustrates a proximal, interface end of the multi-core optical fiber cable with a red laser aiming beam spot and a green laser treatment beam spot lining up with the inner cores <NUM>. <FIG> illustrates two light cones from the multi-spot pattern of laser light (with the multiplexed illumination light emitted for image clarity) propagating down the lengths of a multi-core optical fiber cable. <FIG> illustrates the laser beams spread out to totally spatially fill the inner cores <NUM>. Similarly, <FIG> illustrates the distal end of the multi-core optical fiber cable with the laser beams spread out to totally spatially fill the inner cores <NUM>.

<FIG> illustrates a proximal, interface end of the multi-core optical fiber cable with the illumination light spot lining up with the outer core <NUM>. <FIG> illustrates a light cone of the illumination light (with the multiplexed multi-spot pattern of laser light beams emitted for image clarity), with the light cone including a narrow half-angle portion of the light cone and a wide half-angle portion. The narrow half-angle portion of the light cone propagates the lengths of the outer cores <NUM>, but is excluded from the inner cores <NUM>. The wide half-angle portion of the illumination light cone fills the length of the outer core <NUM> and the inner cores <NUM>.

<FIG> illustrates the illumination beam spread out to totally spatially fill the outer core <NUM>. Similarly, <FIG> illustrates the distal end of the multi-core optical fiber cable with the illumination beam spread across the outer cores <NUM> and the inner cores <NUM>.

<FIG> illustrates the cut-away view of another multi-core optical fiber cable <NUM> according to some embodiments of the present technology. The multi-core fiber cable <NUM> includes four germanium-doped silica inner core fibers <NUM> with a <NUM> micrometer diameter and a numerical aperture (NA) of <NUM> inside of a non-doped fused silica outer core fiber <NUM> having a <NUM> micrometer diameter and an NA of <NUM>. The outer core fiber <NUM> can be contained within low-index polymer cladding <NUM> having a <NUM> micrometer thickness. The multi-core optical fiber cable <NUM> can be further contained in an Ethylene Tetrafluoroethylene (ETFE) coating <NUM>.

The four germanium-doped silica inner core fibers <NUM> have a refractive index of substantially <NUM> at <NUM> nanometers. The non-doped fused silica outer core fiber <NUM> have a refractive index of <NUM> at <NUM> nanometers. The low-index polymer cladding <NUM> can have a refractive index of <NUM> at <NUM> nanometers.

While specific geometries of the multi-core optical fiber cable are shown explicitly herein, those with ordinary skill in the art having the benefit of the present disclosure will readily appreciate that a wide variety of configurations for the multi-core optical fiber cable are possible. In the configuration shown in <FIG>, the white illumination spot at the distal end of the multi-core optical fiber is somewhat larger than the 2X2 array of laser spots. In some cases, this geometry is desired, because it provides illumination into both the retinal treatment target area as well as some surrounding retina and because the illumination spot small enough to keep the white light fairly concentrated. Also, the geometry enables adequate white irradiance at the retina with a relatively small core diameter fiber. Furthermore, as explained above, the intensities of the white illumination and the laser aiming beams can be adjusted (e.g., at the Illumination Light Source and Surgical Laser System, respectively) to provide the right amount of laser aiming beam contrast against the white while providing enough white illumination to easily see the retina.

In some embodiments of the present technology, the distal end of the multi-core optical fiber cable terminates within a tip of a surgical hand probe that is inserted into a patient's eye. The tip of the surgical hand probe can also include a lens to image the multiplexed beams onto patient anatomy, e.g. the retina.

<FIG> illustrates an open side view of a tip <NUM> of a surgical hand probe according to some embodiments of the present disclosure. The probe tip <NUM> can comprise a cannula <NUM> (e.g. a stainless steel cannula) with a cannula distal end <NUM> and the probe tip containing the multi-core optical fiber <NUM> and a lens <NUM>. The lens <NUM> can be a graded-index (GRIN) lens and an air gap <NUM> can be left open between the GRIN lens <NUM> and the distal end of the multi-core optical fiber <NUM>. The air gap <NUM> can be sized such that the light emitted from the multi-core optical fiber <NUM> experiences an amount of spread before falling incident on the GRIN lens <NUM> and such that the GRIN lens <NUM> images the light onto the patient anatomy.

In some cases, no air gap is allowed between the distal end of the multi-core optical fiber <NUM> and the proximal end of the lens <NUM>. Here, the multi-core optical fiber <NUM> and lens <NUM> are substantially butted up against one other with positive pressure to avoid air-gap tolerance concerns, allowing less chance for peripheral off-axis rays to travel far enough off axis to reflect off of the cylindrical side wall of the GRIN lens. However, using a conventional lens instead of the GRIN lens involves an air gap between the multi-core optical fiber <NUM> and lens <NUM> to focus the light properly.

In some cases, the lens <NUM> is secured within the probe tip <NUM> with an optical adhesive <NUM>. As shown in <FIG>, a multi-spot pattern of green, <NUM> laser light is projected retinal tissue located <NUM> millimeters from the cannula distal end <NUM>.

<FIG> illustrates an open side view of another tip <NUM> of a surgical hand probe according to some embodiments of the present disclosure. Again, the probe tip <NUM> can comprise a cannula <NUM> with a cannula distal end <NUM> and the probe tip containing the multi-core optical fiber <NUM> and a lens <NUM>. The lens <NUM> illustrated in <FIG> is a Plano-convex glass lens. Also, the Plano-convex lens <NUM> is secured in the cannula <NUM> by a retaining feature <NUM>. Again, an air gap <NUM> can be sized such that the light emitted from the multi-core optical fiber <NUM> experiences an amount of spread before falling incident on the Plano-convex lens <NUM> and such that the Plano-convex lens <NUM> images the light onto the patient anatomy.

<FIG> illustrates a method <NUM> of creating an image of a multiplexed beam of multi-spot pattern of laser light beams and illumination light in accordance with a particular embodiment of the present disclosure. The method involves: selecting materials for a multi-core optical fiber cable to ensure confinement of the beams within the various core regions as they propagate down the lengths fiber cable <NUM>, as explained above. The method <NUM> also involves determining a numerical aperture of laser light beams from a laser source and a numerical aperture of an illumination light beam from an illumination light source <NUM> and selecting a condensing lens to focus the multiplexed multi-spot pattern of laser light beams and illumination beam onto an interface plane of the multi-core optical fiber cable <NUM>.

Next, the method <NUM> involves multiplexing a multi-spot pattern of laser light beams with the illumination light beam <NUM>, focusing the multiplexed multi-spot pattern of laser light beams and illumination beam onto an interface plane of the multi-core optical fiber cable <NUM>, and directing the multiplexed beam of multi-spot pattern of laser light beams and illumination light through a lens in the surgical handpiece <NUM>.

As explained above, a wide variety of configurations for the multi-core optical fiber cable are possible. For example, an incoherent white light illumination light source can be replaced with a white laser system (e.g. a supercontinuum laser system). In this case, the etendue of the white laser beam is small enough that it is less than the nanofiber etendue and can be efficiently coupled into the nanofiber, such that a multi-core optical fiber cable as described above can be used to deliver multiplexed laser aiming and treatment beams and white laser illumination.

<FIG> illustrate another example of a system for multiplexing laser aiming and treatment beams and illumination light. <FIG> illustrates an end view of a multi-lumen tubing <NUM> for delivering multiplexed laser aiming and treatment beams and a laser illumination light beam. The multi-lumen tubing <NUM> includes a central nanofiber <NUM> and an array of glass laser fibers <NUM> contained within the multi-lumen tubing <NUM>. The central nanofiber <NUM> can be a large NA fiber for carrying a white laser beam and the glass laser fibers <NUM> can be small diameter, small NA glass fibers for carrying laser aiming and treatment beams (e.g. red aiming beams and green treatment beams). In some cases, the central nanofiber <NUM> can be enclosed within a tiny-diameter, rigid, cylindrical or square, black absorptive or reflective cannula for structural support, and can optionally be attached a focusing lens (described below) for structural support as well.

As shown in <FIG>, each of the laser aiming and treatment beams as well as the laser illumination light beam will spatially underfill their respective fiber cores at the proximal end (<FIG>), but will totally fill their cores at the distal end (<FIG>). In this case, in order to have the white laser illumination beam spatially larger than the multi-spot laser beam pattern at the retina, it is necessary to extend the distal end <NUM> of the nanofiber <NUM> past the distal end <NUM> of the array of glass fibers <NUM> in the multi-lumen tubing <NUM> until the distal end <NUM> of the nanofiber <NUM> is at or near a proximal end of a focusing lens <NUM> (e.g. a plano-convex lens), as shown in <FIG>.

Claim 1:
An illumination and multi-spot laser multiplexing system (<NUM>) comprising:
a laser source (<NUM>) that emits a collimated laser light beam;
a diffractive optical element, DOE, (<NUM>) configured to receive the collimated laser light beam and to create a multi-spot pattern of laser light beams and
an illumination system (<NUM>) that emits illumination light;
a collimating lens (<NUM>) that collimates the illumination light received from the illumination system into an illumination light beam;
a multi-core optical fiber cable (<NUM>);
a fiber optic cable port configured to couple with the multi-core optical fiber cable;
a condensing lens (<NUM>); and
a beamsplitter (<NUM>) configured to reflect the multi-spot pattern of laser light beams towards the condensing lens and to transmit the illumination light beam from the collimating lens towards the condensing lens, thereby multiplexing the multi-spot pattern of laser light beams and the illumination light beam,
wherein the condensing lens (<NUM>) is configured to focus the multiplexed multi-spot pattern of laser light beams and the illumination light beam onto an interface with the fiber optic cable port;
wherein the condensing lens (<NUM>) is configured to focus the multiplexed multi-spot pattern of laser light beams and the illumination light beam onto an interface (<NUM>) of a proximal end of the multi-core optical fiber cable such that the illumination light beam is propagated down an entire length of a first outer core of the multi-core optical fiber cable (<NUM>) and such that each of the laser light beams in the multi-spot pattern of laser light beams propagates down an entire length of one of a plurality of inner cores contained within the outer core.