# US 2014/0194860 A1 · Ophthalmologic laser device and method for preventing and treating aftercataract > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2014/0194860 A1 - Document ID: US20140194860A1 - Status: Published application - Kind: A1 - Application number: 14/235,810 - Filed: 2012-07-26 - Published: 2014-07-10 - Earliest claimed: 2011-07-29 - Assignees: Carl Zeiss Meditec AG - Inventors: Manfred Dick; Juergen Kuehnert; Matthias Reich - Web page: https://patentgrep.com/patent/US20140194860A1 ## CPC - A61F 9/0084: {Laser features or special beam parameters therefor} - A61F 9/00825: {for photodisruption} - A61F 2009/00846: {Eyetracking} - A61F 2009/00853: {Laser thermal keratoplasty or radial keratotomy} - A61F 2009/0087: {Lens} - A61F 2009/00872: {Cornea} - A61F 2009/00887: {Cataract} - A61F 2009/00889: {Capsulotomy} - 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) ## Abstract An ophthalmologic laser device includes a pulsed laser configured to produce radiation focused along at treatment beam path. A variably adjustable beam deflector unit and a focusing lens system are disposed in the treatment beam path. The deflector unit is configured to focus the radiation in different target volumes. Measuring equipment is configured to determine a shape and position of optical interfaces along a detection beam path. A control unit is configured to control the laser and the deflector unit and to implement steps including determining a shape and position of an interface of a membrane of a capsular bag of an eye located in a treatment area using the measuring equipment, determining coordinates of a target volume such that, on irradiation of the target volume, a pressure wave runs from the target volume to the anterior or posterior membrane, and adjusting the deflector unit to the target determined volume. ## Claims ### Claim at position 1 1-25. (canceled) ### Claim 26 An ophthalmologic laser device comprising: a pulsed laser configured to produce radiation focused along at treatment beam path; a variably adjustable beam deflector unit and a focusing lens system disposed in the treatment beam path, the deflector unit being configured to focus the radiation in different target volumes; measuring equipment configured to determine a shape and position of optical interfaces along a detection beam path; and a control unit for controlling the laser and the deflector unit, the control unit being configured to implement the following steps: determine a shape and position of at least one interface of a membrane of a capsular bag of an eye located in a treatment area using the measuring equipment, determine coordinates of a target volume such that, on irradiation of the target volume with a laser pulse of predetermined pulse energy, a pressure wave runs from the target volume at least up to the anterior or posterior membrane without tearing the respective membrane, and adjust the deflector unit to the determined target volume so as to irradiate the target volume with at least one laser pulse of the predetermined pulse energy using the laser. ### Claim 27 (depends on 26) The laser device according to claim 26, wherein the at least one laser pulse has a duration and/or an energy such that in tissue located in the target volume photodisruption occurs and triggers the pressure wave, or a photodisruption-free, non-linear interaction occurs which detaches cells or molecules from a membrane or deactivates them. ### Claim 28 (depends on 26) The laser device according to claim 26, wherein the control unit determines the coordinates of the target volume such that completely lies completely in an interior space of the capsular bag. ### Claim 29 An ophthalmologic laser device comprising: an ultra-short pulse laser configured to produce radiation focused along a treatment beam path; a variably adjustable beam deflector unit and a focusing lens system disposed in the treatment beam path, the deflector unit being configured to focus the radiation in different target volumes; measuring equipment configured to determine a shape and position of optical interfaces along a detection beam path; and a control unit for controlling the laser and the deflector unit, the control unit being configured to implement the following steps: determine a shape and position of at least one interface of an anterior membrane of a capsular bag of an eye located in a treatment area using the measuring equipment, determine coordinates of several target volumes such that each target volume lies at least partially in the anterior membrane and, on irradiation of the target volume with a laser pulse of predetermined pulse energy, a border of a region of the anterior membrane is perforated photodisruptively, the region lying away from a visual axis penetration zone of the anterior membrane, and adjust the deflector unit, respectively, to each determined target volume so as to irradiate the respective target volume with at least one laser pulse of the predetermined pulse energy using the laser. ### Claim 30 (depends on 29) The laser device according to claim 29, wherein the control unit is configured to determine the coordinates of several different target volumes and for successive adjustment of the deflector unit to the target volumes and irradiation of the target volumes such that these each lie at least partially in the anterior membrane and, on irradiation of the target volumes with in each case at least one laser pulse of predetermined pulse energy, edges of several regions of the anterior membrane are perforated photodisruptively, these regions lying away from a visual axis penetration point of the anterior membrane. ### Claim 31 An ophthalmologic laser device comprising: an ultra-short pulse laser configured to produce radiation focused along at treatment beam path; a variably adjustable beam deflector unit and a focusing lens system disposed in the treatment beam path, the deflector unit being configured to focus the radiation in different target volumes; measuring equipment configured to determine a shape and position of optical interfaces along a detection beam path; and a control unit for controlling the laser and the deflector unit, the control unit being configured to implement the following steps: determine a shape and position of at least one interface of a posterior membrane of a capsular bag of an eye located in a treatment area using the measuring equipment, determine coordinates of several target volumes such that each target volume lies at least partially in the posterior membrane and, on irradiation of the target volume with a laser pulse of predetermined pulse energy, a border of a region of the posterior membrane is perforated photodisruptively, the region border lying around a visual axis penetration zone of the posterior membrane, and adjust the deflector unit, respectively, to each determined target volume so as to irradiate the target volume with at least one laser pulse of the predetermined pulse energy using the laser. ### Claim 32 (depends on 31) The laser device according to the claim 31, further comprising a short pulse laser, wherein the control unit is additionally configured to determine the coordinates of a target volume in an area of the perforated region such that on irradiation of this target volume with at least one laser pulse of predetermined short pulse energy, tissue is dislodged from the perforated region with the short pulse laser. ### Claim 33 (depends on 26) The laser device according to claim 26, wherein the control unit is configured to determine the coordinates of the target volume with the aid of the shape and position determined for at least one of the interfaces. ### Claim 34 (depends on 26) The laser device according to claim 26, further comprising a fixing device for releasable fixing of a position of the eye relative to the focusing lens system, wherein the control unit is configured to fix the eye by means of the fixing device before the first determination of the shape and position of the interface(s) and to release the fixing only after the last irradiation of a target volume. ### Claim 35 (depends on 34) The laser device according to claim 34, wherein the control unit is configured to carry out, after the fixing and before the release of the fixing, at least one of the following additional incisions using the laser or an additional laser: capsulorhexis incisions in an anterior capsular bag membrane, fragmentation incisions in a lens, corneal access incisions, limbal relaxing incisions. ### Claim 36 (depends on 26) The laser device according to claim 26, wherein the treatment beam path runs as a free beam through the cornea and pupil of the eye. ### Claim 37 (depends on 26) The laser device according to claim 26, comprising an ultra-short pulse laser and a short pulse laser, wherein the beams of these two lasers run partially coaxially in the treatment beam path. ### Claim 38 (depends on 26) The laser device according to claim 26, wherein the device is switchable between an emission with image-recording radiation output and an emission with treatment radiation output, wherein the control unit is configured for adjustment of the emission with image-recording radiation output for determination of the shape and position of the at least one interface, and adjustment of the emission with treatment radiation output for irradiation of the target volume or several target volumes. ### Claim 39 A fixing device for an eye comprising: a suction device and a disc for transmission of laser radiation, wherein the suction device surrounds the disc, wherein the suction device is interrupted at least at one point, the at least one interruption being configured for passing through an irrigation/aspiration device for lens fragments. ### Claim 40 (depends on 39) The fixing device according to claim 39, wherein the disc has on its edge at least one recess corresponding to the interruption, for passing through the irrigation/aspiration device, in particular with the disc being movable relative to the suction device. ### Claim 41 (depends on 39) The fixing device according to claim 39, wherein the suction device protrudes from the disc on a side of the disc facing the eye, in particular to the extent that an irrigation/aspiration device can be passed through the interruption to an incision lying in the area of the disc. ### Claim 42 (depends on 41) The fixing device according to claim 41, wherein an opening, is disposed in the interruption such that the suction device and the opening together close off from the surroundings of the fixing device, in a liquid-tight manner, a space enclosed by the projection with the disc and the eye. ### Claim 43 A method for the prophylaxis of posterior capsule opacity, wherein by means of a short pulse laser or an ultra-short pulse laser a target volume is irradiated by at least one laser pulse such that at least one pressure wave emanates from the target volume and hits at least one membrane of the capsular bag of an eye without tearing the membrane, such that the membrane remains tear-free, in particular with the position of the target volume, completely in an interior space of the capsular bag. ### Claim 44 (depends on 43) The method according to claim 43, wherein the pressure wave bits the anterior and/or the posterior capsular bag membrane, in particular hits the capsular bag membrane in the area of an equator of the capsular bag. ### Claim 45 A method for the prophylaxis of posterior capsule opacity, wherein by means of an ultra-short pulse laser several target volumes, which each lie at least partially in a posterior membrane of a capsular bag of an eye, are irradiated by in each case at least one laser pulse such that a region of the posterior membrane which lies around a visual axis penetration zone of this membrane is partially or completely perforated along its periphery. ### Claim 46 A method for the prophylaxis of posterior capsule opacity, wherein by means of an ultra-short pulse laser several target volumes, which each lie at least partially in an anterior membrane of a capsular bag of an eye, are irradiated by in each case at least one laser pulse such that a region of the anterior membrane which lies away from a visual axis penetration zone of this membrane is partially or completely perforated along its periphery, in particular with perforation of further such regions. ### Claim 47 (depends on 46) The method according to claim 46, wherein the various regions lie on a closed curve, in particular on a ring. ### Claim 48 (depends on 43) The method according to claim 43, wherein the irradiation is carried out while a natural eye lens is located in the interior space. ### Claim 49 (depends on 43) The method according to claim 43, wherein the irradiation is carried out while an artificial eye lens is located in the interior space. ### Claim 50 (depends on 43) The method according to claim 43, wherein a shape and a position of at least one interface of a membrane of the capsular bag is determined before the irradiation, and a site of the target volume is determined with the aid of the shape and the position of the interface.