Re-treatable corneal lenticular incisions with re-treatment options using a femtosecond ophthalmic laser system

An ophthalmic laser system comprising:

• a laser device configured to generate a pulsed laser beam;
• an optical delivery system configured to deliver the pulsed laser beam to a cornea of a patient's eye, including one or more scanners configured to scan a laser beam focal spot of the pulsed laser beam within the cornea;
• and
• a controller configured to control the laser device and the scanners to form a lenticule in the cornea, including to:
• (a) scan the laser beam focal spot in the cornea by executing a treatment plan, the treatment plan including, in a sequence, an entry segment defining an entry cut, a bottom segment defining a bottom lenticule incision, and a top segment defining a top bed incision, wherein the bottom lenticule incision includes an optical zone having a shape determined by a defined optical power of the lenticule, the top bed incision has a flat shape, the top bed incision is located above the bottom lenticule incision, the top bed incision and the bottom lenticule incision intersect each other near their respective peripheries to define an isolated lenticule volume, and the entry cut extends upwardly from an outer edge of the bottom lenticule incision;
• and
• either:
• (b) in response to an interruption while executing the entry segment of the treatment plan after the entry cut is partially formed, revise the treatment plan to define a new entry cut that is located at a different angular position from the partially formed entry cut without coinciding with or intersecting the partially formed entry cut, a new bottom lenticule incision, and a new top bed incision, and scan the laser bean by executing the revised treatment plan to complete the entry cut and to form the new bottom lenticule incision and the new top bed incision;
• or:
• (c) in response to an interruption while executing the bottom segment of the treatment plan after the entry cut is formed and the bottom lenticule incision is partially formed, revising the treatment plan to define a new bottom lenticule incision which has an identical shape as the bottom lenticule incision and is located below the partially formed bottom lenticule incision without coinciding with or intersecting the partially formed bottom lenticule incision, and a new top bed incision located above the new bottom lenticule incision, and scanning the laser beam focal spot by executing the revised treatment plan to form the new bottom lenticule incision and the new top bed incision;
• or:
• (d) in response to an interruption while executing the top segment of the treatment plan after the entry cut and the bottom lenticule incision are formed and the top bed incision is partially formed, revising the treatment plan to define a new top bed incision which has an identical shape as the top bed incision and is located above the partially formed top bed incision without coinciding with or intersecting the partially formed top bed incision, and scanning the laser beam focal spot by executing the revised treatment plan to form the new top bed incision.

An ophthalmic laser system comprising:

• a laser device configured to generate a pulsed laser beam;
• an optical delivery system configured to deliver the pulsed laser beam to a cornea of a patient's eye, including one or more scanners configured to scan a laser beam focal spot of the pulsed laser beam within the cornea;
• and
• a controller configured to control the laser device and the scanners to form a lenticule in the cornea, including to:
• (a) scan the laser beam focal spot in the cornea by executing a treatment plan, the treatment plan including, in a sequence, an entry segment defining an entry cut, a ring segment defining a ring cut, a bottom segment defining a bottom lenticule incision, and a top segment defining a top bed incision, wherein the bottom lenticule incision includes an optical zone having a shape determined by a defined optical power of the lenticule, the top bed incision has a flat shape, the top bed incision is located above the bottom lenticule incision, the ring cut has a ring shape and extends between the top bed incision and the bottom lenticule incision, both the top bed incision and the bottom lenticule incision intersect the ring cut near their respective peripheries to define an isolated lenticule volume, and the entry cut extends upwardly from an outer edge of the bottom lenticule incision;
• and
• either:
• (b) in response to an interruption while executing the entry segment of the treatment plan after the entry cut is partially formed, revising the treatment plan to define a new entry cut that is located at a different angular position from the partially formed entry cut without coinciding with or intersecting the partially formed entry cut, a new ring cut, a new bottom lenticule incision, and a new top bed incision, and scanning the laser bean by executing the revised treatment plan to complete the entry cut and to form the new ring cut, the new bottom lenticule incision and the new top bed incision;
• or:
• (c) in response to an interruption while executing the ring segment of the treatment plan after the entry cut is formed and the ring cut is partially formed, revising the treatment plan to define a new ring cut that has a radius larger than a radius of the partially formed ring cut and is aligned concentrically with the partially formed ring cut and without coinciding with or intersecting the partially formed ring cut, a new bottom lenticule incision, and a new top bed incision, and scanning the laser bean by executing the revised treatment plan to form the new ring, the new bottom lenticule incision and the new top bed incision;
• or:
• (d) in response to an interruption while executing the bottom segment of the treatment plan after the entry cut and the ring cut are formed and the bottom lenticule incision is partially formed, revising the treatment plan to define a new bottom lenticule incision which has an identical shape as the bottom lenticule incision and is located below the partially formed bottom lenticule incision without coinciding with or intersecting the partially formed bottom lenticule incision, and a new top bed incision located above the new bottom lenticule incision, and scanning the laser beam focal spot by executing the revised treatment plan to form the new bottom lenticule incision and the new top bed incision;
• or:
• (e) in response to an interruption while executing the top segment of the treatment plan after the entry cut, the ring cut and the bottom lenticule incision are formed and the top bed incision is partially formed, revising the treatment plan to define a new top bed incision which has an identical shape as the top bed incision and is located above the partially formed top bed incision without coinciding with or intersecting the partially formed top bed incision, and scanning the laser beam focal spot by executing the revised treatment plan to form the new top bed incision.