WO2001050990A2 - Vorrichtung für die ophtalmologische augenbehandlung mit fixierlichtstrahl - Google Patents
Vorrichtung für die ophtalmologische augenbehandlung mit fixierlichtstrahl Download PDFInfo
- Publication number
- WO2001050990A2 WO2001050990A2 PCT/EP2001/000393 EP0100393W WO0150990A2 WO 2001050990 A2 WO2001050990 A2 WO 2001050990A2 EP 0100393 W EP0100393 W EP 0100393W WO 0150990 A2 WO0150990 A2 WO 0150990A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- fovea
- fixation light
- pupil
- camera
- eye
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F9/00802—Methods or devices for eye surgery using laser for photoablation
- A61F9/00804—Refractive treatments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B2018/2015—Miscellaneous features
- A61B2018/2025—Miscellaneous features with a pilot laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
- A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
- A61B3/113—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining or recording eye movement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00844—Feedback systems
- A61F2009/00846—Eyetracking
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
- A61F2009/00872—Cornea
Definitions
- fixation light source is positioned so that the patient can fix it visually. The patient is asked to do this. The aim of this is to keep the eye still as constant as possible by the patient continuously fixing the fixation light source. Since the patient has to recognize the fixation light source, it goes without saying that the fixation light source emits a fixation light beam with wavelengths in the visible range, e.g. B. in the green.
- this goal is achieved by a camera with which the image of the fixation light beam on the retina, in particular in the area of the fovea, and the fovea are recorded.
- the spot of the fixation light lies exactly on the fovea if the patient fixes the fixation light source correctly. If, on the other hand, the patient does not fix the fixation light source correctly, the fixation light is not imaged exactly on the fovea, but at another location on the retina. This can then be recognized with the camera provided according to the invention.
- the optical imaging elements of this camera are thus designed so that the camera images in the retinal plane in the area of the fovea in sharp focus.
- the ophthalmologist can determine whether the patient has "fixed” the fixation light source in accordance with the regulations. This check can also be automated by image processing.
- the camera system is at least approximately focused on the retinal surface at the level of the fovea and an image of the fovea and the adjacent areas of the retina is recorded. Image processing can then be used to determine whether or not the spot of the fixation light lies sufficiently precisely on the fovea. If it is determined that the patient is not fixing the fixation light source with sufficient accuracy, ie with sufficiently few deviations (in terms of time and distance), the doctor can draw conclusions for the treatment and, if necessary, take measures.
- the fixation light spot with the fovea is often not centered with respect to the pupil, i.e. H. on the overlaid image, the fixation light spot with the fovea is offset with respect to the pupil center.
- the subsequent ablation is carried out with this finding centered with respect to a point which is eccentric with respect to the pupil and which is defined by the center of the fixation light spot and fovea (this is one and the same with precise fixation) Point) .
- the two images mentioned above i.e. pupil on the one hand and fixation light spot with fovea on the other hand, can be produced by a single camera if the image level (focus) for the two shots is varied in the manner of an autofocus effect. This can be done periodically in a short time sequence with suitable zoom means, so that the above-mentioned overlay image can be generated.
- a first camera records the pupil and another camera simultaneously the fovea with the fixation light spot. Both images can be merged and superimposed in a computer and can be shown on a display in the superimposed state or can be fed to automated image processing in the manner described above.
- the cameras used are preferably video cameras, particularly preferably solid-state video cameras such. B. CCD or the like.
- a camera can preferably be used, which is present in the ophthalmic treatment system anyway for the purposes of "eye tracking".
- 3 and 4 schematically overlay images of pupil, fovea and fixation light spot in different situations.
- the eye 10 shown schematically in FIG. 1 has a cornea 12, an iris 14, a lens 16 and a pupil 18.
- a fixing light source 22 known as such emits a fixing light beam 24 which pierces the front surface of the cornea 12 at the point 20.
- the wavelength of the fixing light beam 24 is such that it is visible to the patient.
- a diode is usually used as the fixing light source 22.
- the fixation light beam 24 is stationary and the patient is required to fix the fixation light source which appears to him to be punctiform.
- the point 20 at which the fixing light beam 24 penetrates the front surface of the cornea 12 can be selected as the center for the ablation, ie the ablation profile according to which the ablation beam UV is guided ("scanned") over the cornea 12 is brought to the point 20 centered, in which the fixing light beam 24 penetrates the exposed front surface of the cornea 12.
- the front surface of the cornea is the exposed surface after opening the so-called flap.
- a centering light source 32 is used, which emits a laser beam in the infrared range in the exemplary embodiment shown.
- This centering light beam 34 is directed via a partially transparent mirror 26 coaxially with the fixing light beam 24 onto the cornea 12.
- the fixing light beam 24 and the centering light beam 34 are drawn in parallel next to one another, but they actually run coaxially, ie on a common central axis.
- the centering light beam 34 has a wavelength in the infrared range, for. B. in the range of 800 to 1100 nm.
- a special centering light beam 34 for the determination of the penetration point 20 of the fixed radiation on the front surface of the cornea has the advantage in comparison to the use of the fixing light beam 24 that a relatively bright reflection and not overexposed by other images by means of the camera 36 and a downstream evaluation computer 38 can be evaluated. Also will the scattered light / Fresnel reflection of the fixation light itself outshines the Purkinje-Sanson image, so that this reflection is difficult to evaluate.
- the camera 36 and the computer 38 into which the camera measured values are input, form a so-called eye tracking system (cf. the prior art mentioned above).
- the eye is exposed to independent radiation, e.g. IR radiation 46, generated by a light source 44, illuminated and z. B. measure the pupil 18 by means of its edge, in particular to determine the geometric center of the pupil (the so-called "pupil center of gravity").
- the system of camera 36 and computer 38 now also measures the position of the scattered light / Fresnel reflection of the centering light beam 34 on the front surface of the cornea 12, i. H. at the point of the penetration point 20.
- the camera 36 is therefore IR-sensitive in the exemplary embodiment shown.
- the system from camera 36 and computer 38 preferably determines the relative position between penetration point 20 and geometric center (“center of gravity”) of pupil 18.
- a further camera 40 is provided in the exemplary embodiment according to FIG. 1.
- the camera 40 is e.g. B. a video camera (CCD) and the image signals are also electrically input into the computer 38.
- the optical means (not shown) of the camera 40 are designed so that they take an image in the plane of the fovea 30 of the eye 10. In the ideal case, ie when the patient fixes the fixation light source 22 exactly, the depicted spot of the fixation light beam 24 will lie exactly on the fovea 30. If the fixation on the part of the patient is inaccurate, the fixation light spot lies next to the fovea 30.
- FIG. 2 shows the edge P of the pupil, the fovea F and the fixation light spot Sp, as can be obtained with the aid of an overlay image of the two cameras 36 and 40 described above in the computer 38 and can optionally be displayed on a suitable screen.
- the patient does not fix the fixation light source correctly.
- the doctor recognizes this from the fact that the fixation light spot Sp is not exactly in the fovea F, but is offset from it. this has As a result, the doctor must take appropriate measures to induce the patient to fixate exactly.
- the location of the fixation light spot Sp and fovea F found as eccentric with respect to the pupil P can be selected as the ablation center, ie. H. the ablation is centered with respect to the center of Sp and F. This choice has also given good results.
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE50107347T DE50107347D1 (de) | 2000-01-13 | 2001-01-15 | Vorrichtung für die ophtalmologische augenbehandlung mit fixierlichtstrahl |
EP01911483A EP1200026B1 (de) | 2000-01-13 | 2001-01-15 | Vorrichtung für die ophtalmologische augenbehandlung mit fixierlichtstrahl |
AU40509/01A AU4050901A (en) | 2000-01-13 | 2001-01-15 | Device for ophthalmologically treating the eye using a fixation light beam |
US09/949,254 US20020007178A1 (en) | 2000-01-13 | 2001-09-07 | Device for ophthalmologically treating the eye using a fixation light beam |
US11/360,119 US7998135B2 (en) | 2000-01-13 | 2006-02-22 | Device and method for ophthalmologically treating the eye using a fixation light beam |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10001131.4 | 2000-01-13 | ||
DE10001131A DE10001131A1 (de) | 2000-01-13 | 2000-01-13 | Vorrichtung für die ophtalmologische Augenbehandlung mit Fixierlichtstrahl |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2001050990A2 true WO2001050990A2 (de) | 2001-07-19 |
WO2001050990A3 WO2001050990A3 (de) | 2002-02-14 |
Family
ID=7627383
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP2001/000393 WO2001050990A2 (de) | 2000-01-13 | 2001-01-15 | Vorrichtung für die ophtalmologische augenbehandlung mit fixierlichtstrahl |
Country Status (6)
Country | Link |
---|---|
US (2) | US20020007178A1 (de) |
EP (1) | EP1200026B1 (de) |
AU (1) | AU4050901A (de) |
DE (2) | DE10001131A1 (de) |
ES (1) | ES2245684T3 (de) |
WO (1) | WO2001050990A2 (de) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2010028663A1 (de) * | 2008-09-09 | 2010-03-18 | Wavelight Ag | Lasereinrichtung für die ophthalmologische chirurgie |
Families Citing this family (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7252661B2 (en) * | 2003-12-23 | 2007-08-07 | Alcon Refractivehorizons, Inc. | Method and system for patient optical fixation |
EP1974703B1 (de) * | 2007-03-19 | 2010-01-20 | WaveLight AG | Augenschonendes Lasersystem für die refraktive Chirurgie |
US8900221B2 (en) * | 2009-04-01 | 2014-12-02 | Wavelight Gmbh | Apparatus for treating an eye with laser radiation |
EP2510882B1 (de) * | 2009-04-03 | 2017-02-01 | Mitchell A. Hardenbrook | Chirurgisches Rückzugsystem |
DE102009030465A1 (de) * | 2009-06-23 | 2011-01-05 | Carl Zeiss Meditec Ag | Fixationskontrolleinrichtung und Verfahren zur Kontrolle einer Fixation eines Auges |
US8512319B2 (en) * | 2010-12-28 | 2013-08-20 | Nidek Co., Ltd. | Ophthalmic laser treatment apparatus |
US8947351B1 (en) | 2011-09-27 | 2015-02-03 | Amazon Technologies, Inc. | Point of view determinations for finger tracking |
US9248358B2 (en) * | 2012-04-10 | 2016-02-02 | Apexk Inc. | Interactive cognitive-multisensory interface apparatus and methods for assessing, profiling, training, and improving performance of athletes and other populations |
US9265458B2 (en) | 2012-12-04 | 2016-02-23 | Sync-Think, Inc. | Application of smooth pursuit cognitive testing paradigms to clinical drug development |
US9380976B2 (en) | 2013-03-11 | 2016-07-05 | Sync-Think, Inc. | Optical neuroinformatics |
US11712161B2 (en) | 2019-08-14 | 2023-08-01 | Alcon Inc. | Eye tracking fixation monitoring systems and methods |
Citations (1)
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DE19702335C1 (de) | 1997-01-23 | 1998-08-27 | Wavelight Laser Technologie Gm | Vorrichtung für die Materialbearbeitung mit einem gepulsten Laser |
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US4973149A (en) * | 1987-08-19 | 1990-11-27 | Center For Innovative Technology | Eye movement detector |
US6099522A (en) * | 1989-02-06 | 2000-08-08 | Visx Inc. | Automated laser workstation for high precision surgical and industrial interventions |
US5029220A (en) * | 1990-07-31 | 1991-07-02 | The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration | Optical joint correlator for real-time image tracking and retinal surgery |
US5214455A (en) * | 1991-04-01 | 1993-05-25 | General Electric Company | Objective eye alignment measurement method and system |
US5520679A (en) * | 1992-12-03 | 1996-05-28 | Lasersight, Inc. | Ophthalmic surgery method using non-contact scanning laser |
US5644642A (en) * | 1995-04-03 | 1997-07-01 | Carl Zeiss, Inc. | Gaze tracking using optical coherence tomography |
US6159202A (en) * | 1995-09-29 | 2000-12-12 | Nidex Co., Ltd. | Corneal surgery apparatus |
US5782822A (en) * | 1995-10-27 | 1998-07-21 | Ir Vision, Inc. | Method and apparatus for removing corneal tissue with infrared laser radiation |
DE19618883A1 (de) * | 1996-05-10 | 1997-11-20 | Jurca Optoelektronik Gmbh | Vorrichtung und Verfahren zur photorefraktiven Korrektur von Fehlsichtigkeiten |
US6271914B1 (en) * | 1996-11-25 | 2001-08-07 | Autonomous Technologies Corporation | Objective measurement and correction of optical systems using wavefront analysis |
US5777719A (en) * | 1996-12-23 | 1998-07-07 | University Of Rochester | Method and apparatus for improving vision and the resolution of retinal images |
JP3828626B2 (ja) * | 1996-12-27 | 2006-10-04 | 株式会社ニデック | 眼科手術装置 |
AU737530B2 (en) * | 1997-04-17 | 2001-08-23 | Avimo Group Limited | Ocular microcirculation examination and treatment apparatus |
JP3695900B2 (ja) * | 1997-06-02 | 2005-09-14 | 株式会社ニデック | レーザ治療装置 |
US6027216A (en) * | 1997-10-21 | 2000-02-22 | The Johns University School Of Medicine | Eye fixation monitor and tracker |
US6406473B1 (en) * | 1999-10-01 | 2002-06-18 | Visx, Incorporated | Patient fixation system and method for laser eye surgery |
DE19962107A1 (de) * | 1999-12-22 | 2001-06-28 | Wavelight Laser Technologie Ag | Vorrichtung für die photorefraktive Keratektomie des Auges mit Zentrierung |
US6419671B1 (en) * | 1999-12-23 | 2002-07-16 | Visx, Incorporated | Optical feedback system for vision correction |
US6439720B1 (en) * | 2000-01-27 | 2002-08-27 | Aoptics, Inc. | Method and apparatus for measuring optical aberrations of the human eye |
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US6609794B2 (en) * | 2001-06-05 | 2003-08-26 | Adaptive Optics Associates, Inc. | Method of treating the human eye with a wavefront sensor-based ophthalmic instrument |
US7766903B2 (en) * | 2003-12-24 | 2010-08-03 | The Board Of Trustees Of The Leland Stanford Junior University | Patterned laser treatment of the retina |
-
2000
- 2000-01-13 DE DE10001131A patent/DE10001131A1/de not_active Withdrawn
-
2001
- 2001-01-15 WO PCT/EP2001/000393 patent/WO2001050990A2/de active IP Right Grant
- 2001-01-15 EP EP01911483A patent/EP1200026B1/de not_active Expired - Lifetime
- 2001-01-15 DE DE50107347T patent/DE50107347D1/de not_active Expired - Lifetime
- 2001-01-15 AU AU40509/01A patent/AU4050901A/en not_active Abandoned
- 2001-01-15 ES ES01911483T patent/ES2245684T3/es not_active Expired - Lifetime
- 2001-09-07 US US09/949,254 patent/US20020007178A1/en not_active Abandoned
-
2006
- 2006-02-22 US US11/360,119 patent/US7998135B2/en active Active
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE19702335C1 (de) | 1997-01-23 | 1998-08-27 | Wavelight Laser Technologie Gm | Vorrichtung für die Materialbearbeitung mit einem gepulsten Laser |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2010028663A1 (de) * | 2008-09-09 | 2010-03-18 | Wavelight Ag | Lasereinrichtung für die ophthalmologische chirurgie |
Also Published As
Publication number | Publication date |
---|---|
US20020007178A1 (en) | 2002-01-17 |
EP1200026A2 (de) | 2002-05-02 |
EP1200026B1 (de) | 2005-09-07 |
US20060142742A1 (en) | 2006-06-29 |
AU4050901A (en) | 2001-07-24 |
ES2245684T3 (es) | 2006-01-16 |
DE50107347D1 (de) | 2005-10-13 |
WO2001050990A3 (de) | 2002-02-14 |
US7998135B2 (en) | 2011-08-16 |
DE10001131A1 (de) | 2001-07-19 |
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