# US 10,369,053 B2 · Corneal topography measurements and fiducial mark incisions in laser surgical procedures

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- Number: US 10,369,053 B2
- Document ID: US10369053B2
- Status: Granted
- Kind: B2
- Application number: 14/885,213
- Filed: 2015-10-16
- Published: 2016-04-07
- Granted: 2019-08-06
- Earliest claimed: 2013-04-17
- Assignees: Optimedica Corporation
- Applicants: OptiMedica Corporation
- Inventors: Rajeshwari Srinivasan; Jeffrey A. Golda; Javier G. Gonzalez; David D. Scott; David A. Dewey; Noah Bareket; Georg Schuele
- Web page: https://patentgrep.com/patent/US10369053B2

## CPC

- A61F 9/00825: {for photodisruption}
- A61B 3/107: for determining the shape or measuring the curvature of the cornea
- A61F 9/00827: {Refractive correction, e.g. lenticle}
- A61F 9/00829: {Correction of higher orders}
- A61F 9/00834: {Inlays; Onlays; Intraocular lenses [IOL]}
- A61F 2009/00846: {Eyetracking}
- A61F 2009/00851: {Optical coherence topography [OCT]}
- A61F 2009/00853: {Laser thermal keratoplasty or radial keratotomy}
- A61F 2009/0087: {Lens}
- A61F 2009/00872: {Cornea}
- A61F 2009/00876: {Iris}
- A61F 2009/0088: {based on wavefront}
- A61F 2009/00882: {based on topography}
- A61F 2009/00887: {Cataract}
- A61F 2009/00889: {Capsulotomy}
- A61F 2009/00897: {Scanning mechanisms or algorithms}
- 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 (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A method of cataract surgery in an eye of a patient includes identifying a feature selected from the group consisting of an axis, a meridian, and a structure of an eye by corneal topography and forming fiducial mark incisions with a laser beam along the axis, meridian or structure in the cornea outside the optical zone of the eye. A laser cataract surgery system a laser source, a topography measurement system, an integrated optical subsystem, and a processor in operable communication with the laser source, corneal topography subsystem and the integrated optical system. The processor includes a tangible non-volatile computer readable medium comprising instructions to determine one of an axis, meridian and structure of an eye of the patient based on the measurements received from topography measurement system, and direct the treatment beam so as to incise radial fiducial mark incisions.

## Claims

### Claim 1

A laser cataract surgery system, comprising:
a laser source configured to produce a treatment beam that includes a plurality of laser pulses;
a topography measurement system configured to measure a topography of the cornea of the eye;
an integrated optical system configured to receive and direct the treatment beam,
a processor in operable communication with the laser source, the topography measurement system, and the integrated optical system, wherein the processor is configured to control the laser cataract system to:
determine one of an axis, meridian and structure of an eye of a patient based on measurements produced by the topography measurement system, and
direct the treatment beam so as to incise one or more radial fiducial mark incisions in the cornea at the periphery of the eye and centered on one of a limbus, iris or scanned capsule of the eye, wherein the one or more radial fiducial mark incisions are disposed along the axis, meridian or structure.

### Claim 2 (depends on 1)

The system of claim 1, wherein the topography measurement system further comprises a removable corneal topography measurement structure.

### Claim 3 (depends on 2)

The system of claim 2, further comprising a patient interface, wherein the processor is further configured to cause the laser cataract surgery system to measure the eye with the topography measurement structure and the patient interface away from the eye.

### Claim 4 (depends on 1)

The system of claim 1, wherein the system further comprises a patient user interface.

### Claim 5 (depends on 4)

The system of claim 4, wherein the processor is further configured to cause the laser cataract surgery system to determine the axis, meridian and structure while the patient interface structure is coupled to the eye of the patient.

### Claim 6 (depends on 1)

The system of claim 1, wherein the feature is a meridian of the cornea.

### Claim 7 (depends on 6)

The system of claim 6, wherein the meridian is a steepest meridian.

### Claim 8 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions are intrastromally corneal incisions.

### Claim 9 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions do not alter optical properties of the eye.

### Claim 10 (depends on 9)

The system of claim 9, wherein the length of each radial fiducial mark incision is less than 1.5 mm.

### Claim 11 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions include at least first and second radial fiducial mark incisions disposed within an interior of the cornea between an anterior corneal surface and a posterior corneal surface, and wherein the first and second radial fiducial mark incisions define a line which is aligned with or parallel to an astigmatic axis of the eye.

### Claim 12 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions include at least first and second radial fiducial mark incisions disposed within an interior of a stroma of the cornea between an anterior corneal surface and a posterior corneal surface, and wherein the first and second radial fiducial mark incisions define a line which is transverse to an astigmatic axis of the eye.

### Claim 13 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions consists of a single radial fiducial mark incision disposed within an interior of a stroma of the cornea between an anterior corneal surface and a posterior corneal surface, and wherein the single radial fiducial mark incision and a center of a pupil of the eye together define a line which is aligned with or parallel to an astigmatic axis of the eye.

### Claim 14 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions each have a circular shape, and wherein markers of an implantable ocular lens (IOL) having a shape of a circular dot each fit inside the circular shape of a corresponding one of the radial fiducial mark incisions as viewed looking into the eye when the IOL is correctly aligned within the eye.

### Claim 15 (depends on 1)

The system of claim 1, wherein the one or more radial fiducial mark incisions are disposed within a stroma of the cornea, located 150 to 200 microns from an anterior surface of the cornea and 100 to 250 microns from a posterior surface of the cornea.