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EP-4312919-B1 - CONTROLLING THE TEMPERATURE OF THE CORNEA DURING OPHTHALMIC SURGERY

EP4312919B1EP 4312919 B1EP4312919 B1EP 4312919B1EP-4312919-B1

Inventors

  • ABRAHAM, MARIO
  • WITTNEBEL, Michael

Dates

Publication Date
20260506
Application Date
20220316

Claims (11)

  1. An ophthalmic surgical system (10) for controlling a temperature of a cornea (23) of an eye (22) for a surgical procedure, comprising: a plurality of controllable components (12, 16, 17, 18) comprising: a laser source (12) configured to generate a laser beam having a plurality of ultrashort pulses, a propagation direction of the laser beam defining a z-axis; a scanner (16) configured to direct a focal point of the laser beam in an xy-plane orthogonal to the z-axis; and an objective (18) configured to focus the focal point towards the cornea (23) of the eye (22); a fluid management system (40) configured to manage fluid within a channel structure (50) created within the cornea (23) of the eye (22); and a computer (30) configured to: instruct one or more of the controllable components (12, 16, 17, 18) to create the channel structure (50) within the cornea (23), the channel structure (50) providing a passageway between an interior (52, 70) of the eye (22) and an exterior (54, 74) of the eye (22), the channel structure (50) comprising a first passage (70) between the exterior (54) of the eye (22) and the interior (52) of the eye (22), a second passage (74) between the interior (52) of the eye (22) and the exterior (54) of the eye (22), and an interior portion (72) within the cornea (23) of the eye (22) that provides fluid communication between the first passage (70) and the second passage (74), the channel structure (50) proximate to a treatment site (56); and instruct the fluid management system (40) to manage fluid within the channel structure (50) in order to control the temperature of the cornea (23) of the eye (22).
  2. The ophthalmic surgical system (10) of Claim 1, wherein: the interior portion (72) is posterior to the treatment site (56); and the first passage (70), the interior portion (72), and the second passage (74) have substantially the same cross-sectional area.
  3. The ophthalmic surgical system (10) of Claim 1, wherein: the interior portion (72) is posterior to the treatment site (56); and the interior portion (72) has a substantially elliptical shape in the xy-plane.
  4. The ophthalmic surgical system (10) of Claim 1, wherein the interior portion (72) comprises a plurality of channels (86), one or more of the channels (86) providing fluid communication between the first passage (70) and the second passage (74).
  5. The ophthalmic surgical system (10) of Claim 1, wherein the interior portion (72) comprises a plurality of channels (86), one or more of the channels (86) providing fluid communication between the first passage (70) and the second passage (74), the channels (86) posterior to the treatment site (56).
  6. The ophthalmic surgical system (10) of Claim 1, wherein the interior portion (72) comprises a plurality of channels (86), one or more of the channels (86) providing fluid communication between the first passage (70) and the second passage (74), at least one of the channels (86) proximate to a z-position of at least a part of the treatment site (56).
  7. The ophthalmic surgical system (10) of Claim 1, wherein the interior portion (72) has a shape designed with respect to the treatment site (56).
  8. The ophthalmic surgical system (10) of Claim 1, wherein: the interior portion (72) has an anterior side and a posterior side; and the anterior side is connected to the posterior side by tissue (80) at one or more locations.
  9. The ophthalmic surgical system (10) of Claim 1, wherein the fluid management system (40) comprises a fluid dispenser configured to dispense fluid into the channel structure (50).
  10. The ophthalmic surgical system (10) of Claim 1, wherein the fluid management system (40) comprises a fluid aspirator configured to aspirate fluid from the channel structure (50).
  11. The ophthalmic surgical system (10) of claim 1, the fluid management system (40) comprising: a fluid dispenser configured to dispense fluid into the channel structure (50); and a fluid aspirator configured to aspirate fluid from the channel structure (50); and the channel structure (50) consisting of: a first channel structure (50) comprising: a first passage (70) between the exterior (54) of the eye (22) and the interior (52) of the eye (22); a second passage (74) between the interior (52) of the eye (22) and the exterior (54) of the eye (22); and an interior portion (72) through the interior (52) of the eye (22) that provides fluid communication between the first passage (70) and the second passage (74), wherein the first channel structure (50) is shaped according to a design selected from a group consisting of: a first design wherein: the interior portion (72) is posterior to the treatment site (56); and the first passage (70), the interior portion (72), and the second passage (74) have substantially the same cross-sectional area; a second design wherein: the interior portion (72) is posterior to the treatment site (56); and the interior portion (72) has a substantially elliptical shape in the xy-plane; a third design wherein: the interior portion (72) comprises a plurality of channels (86), one or more of the channels (86) providing fluid communication between the first passage (70) and the second passage (74); a fourth design wherein: the interior portion (72) has a shape designed with respect to the treatment site (56); and a fifth design wherein: the interior portion (72) has an anterior side and a posterior side; and the anterior side is connected to the posterior side by tissue (80) at one or more locations.

Description

TECHNICAL FIELD The present disclosure relates generally to ophthalmic surgical systems, and more particularly to controlling the temperature of the cornea during ophthalmic surgery. BACKGROUND Ophthalmic laser systems are used to perform surgical procedures on eye tissue. In general, a laser delivers laser pulses to the eye tissue. In some procedures, the pulses may create photo-disruptions that form photo-disrupted regions, such as incisions. In other procedures, the pulses may ablate and shape the tissue. During the procedure, the laser pulses increase the temperature of the tissue. This temperature increase may cause damage that negatively affects the healing process and/or treatment outcome. To avoid such damage, the temperature of the operating room may be lowered or a cooling solution may be applied to the surface of the eye. However, these efforts may fail to provide adequate cooling. Laser pulses may be applied with a lower energy, smaller spot size, or lower frequency to reduce the temperature increase of the tissue. These efforts, however, may extend the treatment time of the procedure. US 2004/243112 A1 discloses a femtosecond lamellar keratoplasty procedure where a lens-shaped block of tissue may be removed from the stroma through a side incision. For removing the tissue, the lens-shaped block may be flushed with a saline steam from a small jet. US 2015/0290030 A1 discloses an eye lens surgical procedure where two micro-channels may be created that extend from the surface of the cornea to a multi-photon ablated cavity. One of the micro-channels allows the multi-photon ablated lens tissue to exit out of the cavity, and the other of the micro-channels allows injecting a transformable material into the multi-photon ablated cavity. BRIEF SUMMARY An ophthalmic surgical system for controlling a temperature of a cornea of an eye for a surgical procedure with the features of claim 1 is provided. Further, optional features are defined in the dependent claims. According to the embodiments, an ophthalmic surgical system for controlling a temperature of a cornea of an eye for a surgical procedure comprises controllable components, a fluid management system, and a computer. The controllable components comprise a laser source, a scanner, and an objective. The laser source generates a laser beam having ultrashort pulses, where a propagation direction of the laser beam defines a z-axis. The scanner directs a focal point of the laser beam in an xy-plane orthogonal to the z-axis. The objective focuses the focal point towards the cornea of the eye. The fluid management system manages fluid within a channel structure created within the cornea of the eye. The computer instructs one or more of the controllable components to create the channel structure within the cornea. The channel structure provides a passageway between an interior of the eye and an exterior of the eye, and is proximate to a treatment site. The computer instructs the fluid management system to manage fluid within the channel structure in order to control the temperature of the cornea of the eye. The channel structure comprises: a first passage between the exterior of the eye and the interior of the eye; a second passage between the interior of the eye and the exterior of the eye; and an interior portion through the interior of the eye that provides fluid communication between the first passage and the second passage. Embodiments may include none, one, some, or all of the following features: The interior portion may be posterior to the treatment site, and the first passage, the interior portion, and the second passage may have substantially the same cross-sectional area. The interior portion may be posterior to the treatment site, and may have a substantially elliptical shape in the xy-plane. The interior portion may have a shape designed with respect to the treatment site. The interior portion may have an anterior side and a posterior side, and the anterior side may be connected to the posterior side by tissue at one or more locations. The channel structure comprises: a first passage between the exterior of the eye and the interior of the eye; a second passage between the interior of the eye and the exterior of the eye; and an interior portion through the interior of the eye that provides fluid communication between the first passage and the second passage. The interior portion may comprise channels. One or more of the channels may provide fluid communication between the first passage and the second passage. The channels may be posterior to the treatment site. At least one of the channels may be proximate to a z-position of at least a part of the treatment site. The fluid management system comprises a fluid dispenser configured to dispense fluid into the channel structure. The fluid management system comprises a fluid aspirator configured to aspirate fluid from the channel structure. According to certain embodiments not belonging to the present in