Apparatus for connecting an element to an eye

(54) Title: DEVICE FOR

EYE ELEMENT SUCTION COUPLING (51) Int. Cl .: A61F 9/013 (30) Unionist Priority: 14/03/2007 EP 07005280.8 (73) Holder (s): WAVELIGHT GMBH (72) Inventor (s) : MICHAEL MROCHEN; MICHAEL BÜELER; CHRISTOF DONITZKY; CHRISTIAN WÜLLNER (74) Attorney (s): KASZNAR LEONARDOS INTELLECTUAL PROPERTY (86) International Application: PCT EP2008002014 of 13/03/2008 (87) International Publication: WO

2008/110368 of 09/18/2008

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DEVICE FOR SUCKING COUPLING OF AN EYE ELEMENT

The invention relates to an eye suction device which consists of a suction ring for ophthalmic surgery, with a first suction region that is designed to suck the suction ring into an eye, and with a second suction region, which it is designed to suction a functional element.

Pulsed laser radiation is used in eye surgery, for example, for making incisions in the cornea or for the resection (removal) of tissue outside the cornea. The irradiated laser radiation brings a certain photodisruptive or photoablative process to the corneal tissue, which results in the rupture or removal of tissue material. These corneal treatments occur, for example, within the scope of refractive processes to reduce or eliminate visual defects in the eye, in whose processes the cornea is remodeled and, in this way, its refractive properties are altered.

dominant refractive process of corneal surgery is called LASIK (laser in situ keratomileusis). In this case, a small covering, which remains attached to the cornea by a part of its border, is cut out of the cornea, mechanically (by means of an oscillating cutting blade in a so-called microkeratome), or optically (by means of laser radiation, for example, from femtosecond laser systems). Subsequently, this cover, which is usually also referred to as a flap, is folded on its side, with which the underlying stroma becomes accessible. Stromal tissue is then resected with laser radiation, according to an ablation profile determined for the respective patient. THE

2/25 cover is then folded back, resulting in the wound to heal relatively quickly.

For a precise coupling of laser radiation to the eyes, in this case it is known to fix the eye by means of a fixing device that is sucked into the eye by a partial vacuum. The fixing device may have a glass serving as a coupling element for laser radiation. Clamping devices of this type are also referred to as suction rings.

As soon as the suction ring has been placed in a patient's eye and fixed to the eye using a partial vacuum, energy is introduced into the cornea through pulses from a femtosecond laser. As a result, an incision is made in the cornea, the flap can be folded up, and correction of the visual defect can be done by a definite resection of exposed corneal tissue.

Suction rings are known as such by a person skilled in the art; for example, US 5,336,215 and US 5,549,632 disclose suction rings that in their peripheral region include openings, in the form of suckers, to be aspirated towards an eye. EP 0 993 814 A1 and US 6,342,053 Bl disclose suction rings in which a partial vacuum is generated in the region of a pressure measurement surface, so that the cornea of ​​the eye rests on it. US 6, 344.040 Bl has a suction ring, in which a partial vacuum is generated in the region of a pressure measurement surface, the suction ring also including a probe that in operation penetrates the cornea and extracts the resulting gases and particles during the photodisruptive process by means of suction. WO 03/002008 A1 discloses a suction ring with a suction region formed on the periphery of the suction ring, a support

3/25 tapered lens with a lens installed on the suction ring using a clamp.

WO 00/41660 A1 describes a device for performing an operation on the eye, with a first fixed annular vacuum region and with a central movable vacuum region. In operation, the mobile vacuum region is located above the cornea to be operated and is capable of giving said cornea a desired shape for the operation. The second vacuum region can include a plurality of elements, so as to its shape and, consequently, the contour of the cornea can be changed during the operation.

WO 03/001991 A1 discloses a contact lens with a plurality of pressure gauges for measuring intraocular pressure. The power supply for the pressure gauges and the communication are carried out in a non-contact way.

State-of-the-art suction rings include flattening elements that are coupled to the suction ring using elaborate mechanical devices.

During aspiration of the ring, intraocular suction pressure can result in damage, and so far the operating surgeon has not been informed of the treatment of an eye. In addition, the positioning of the suction ring, for example in relation to a femtosecond laser system, is critical, and in certain circumstances can lead to treatment errors or injuries as a result of displacement of the operating table. The position of the suction ring and the eye, especially in relation to an operating table and the laser beam, is relevant for safety. The mechanical force acting on the eye during laser treatment is influenced, in certain circumstances, by the mechanical forces that

4/25 arise in the course of a movement of the head, and can lead to injury. In the course of treatment, the water content and / or the biomechanical properties of the cornea may be important for the treatment outcome. Corneal transparency is also important for laser pulse treatment to improve the safety of the operation.

It is an object of the invention to extend the possible applications of a suction ring.

This objective is achieved through a device for coupling by suction of an element to the eye (suction device to the eye), which includes a first suction region that in operation is intended to suck the device to an eye, and a functional element . The eye suction device or the functional element includes a second suction region, which in operation is intended to suck the functional element into the eye suction device. The second suction region can be arranged on the functional element and / or on the suction device to the eye. Before, during and / or after the operation, the surgeon can simply attach the necessary arbitrary elements to the eye suction device, without the need for intricate, time-consuming work steps, which makes the treatment successful. assured. In addition, before a surgical procedure the surgeon can select the appropriate functional element more easily and attach it to the eye suction device. The term eye suction device encompasses any device that is designed to be sucked into an eye, for example, the so-called suction ring. The suction region can consist, for example, of an opening or a recess in which, in operation, a partial vacuum predominates. 0 partial vacuum can be generated, for example, by a suction pump

5/25 connected to the suction region. However, it is also possible that the partial vacuum will automatically arise when the functional element is coupled to the eye suction device or when the eye suction device is coupled to the eye by means of, for example, a sealing edge being shifted in a way that a vacuum suction region appears.

The functional element can be an optical element, for example, a glass or a lens, through which laser radiation is introduced into the cornea. In addition, the optical element can be a so-called flattening lens and or flattening plate. The functional element can be a retaining element that is designed in such a way that other elements can be arranged therein. An optical element can be arranged on the retaining element. As a result, a particularly versatile suction device for the eye originates, since the optical element can be exchanged very easily. A flattening element can also be arranged on the retaining element, in which case the optical element arranged on the retaining element can also take the form of a flattening lens. The functional element can be designed to be coupled with an optical device. 0 Optical device can be a laser system, for example, a femtosecond laser system, with an associated optics. The functional element can also be a mechanical microkeratome mentioned in the introduction. The functional element can also be an adapter cone, with which the suction ring is coupled to an ophthalmic device. The functional element may have been provided, both for maintaining the flattening element and for engaging the suction device in the eye with the ophthalmic device. In the following, such a functional element will be designated as a retaining element.

The eye suction device may include a first partial vacuum feed, which is connected to the first suction region, and a second partial vacuum feed, which is connected to the second suction region. Partial vacuum feeds can be connected to one or more suction pumps. In operation, a partial vacuum may predominate in the first partial vacuum supply which is different from that in the second partial vacuum supply, resulting in different partial vacuums appearing in the first and second suction regions. As a result, it is possible to safely couple the functional element to the suction device to the eye without such a high partial vacuum being generated in the first suction region that could injure the eye.

The eye suction device can be designed in such a way that, in operation, at least one region of the cornea of ​​an eye rests against the functional element and / or against an element disposed therein. As a result, an exact fixation of the cornea appears, ensuring a safe surgical procedure. The suction device to the eye may include a third suction region which in operation is in fluid communication with the surface of the functional element and / or with the surface of the element attached to it, against which the cornea of ​​the eye rests in the operation. As a result, the cornea is fixed in its position particularly well, since the region between the cornea and the functional element or an element disposed on the retaining element is evacuated or is subject to a partial vacuum. In addition, it is possible to establish the partial vacuum predominant in the region between the cornea and the functional element and / or an element disposed in it independently of the partial vacuum in the first and second suction regions. As a result, the risk of injury is minimized and / or the comfort of treatment for a patient is increased, since strength

7/25 with which the suction device to the eye is sucked into the eye may be different from the force with which the cornea is sucked into the functional element and / or an element disposed therein. In addition, a particularly safe suction device for the eye also appears, which exhibits redundancy, since two partial vacuum systems are used in order, on the one hand, to attach the suction device to the eye and, on the other hand hand, attach the cornea to a functional element and / or an element disposed therein. The suction device to the eye can be formed elasticly in the first, second and / or third suction region.

In a simplified embodiment the third partial vacuum supply can be in fluid communication with the first or second partial vacuum region.

The optical element can be a flattening element. The flattening element can be attached to the suction device to the eye. After an operation in which you have been exposed to laser radiation, the flattening element must be replaced. The suction device to the eye may include, in operation, a flattening element attached to it inseparably. The flattening element is therefore integrated with the suction device to the eye. The suction device to the eye can be provided with the flattening element attached to it inseparably in the operation in the form of a sterile disposable article. As a result, a better cost-effectiveness of the suction device to the eye can be obtained. Furthermore, with such an eye suction device the mechanical tolerance chain can be reduced to the flattening element and to the aspirated reusable retaining element which is also referred to as an adaptation cone. Due to the reduced tolerance chain, the final treatment result is improved.

The functional element can take the form of a container (retaining element) that includes a first axial end, which in operation is aspirated by the second region of the suction device to the eye, a second axial end, opposite the first, and a wall extending from the first to the second axial end. 0 container can be opened at its first and second axial ends and can be closed by the wall around the axial direction, and an optical element can be arranged at the second axial end. The wall may have a first opening, through which a fluid can enter, and a second opening, through which a fluid can exit. The optical element can be a focusing lens for a laser beam. Due to the retaining element, the focusing lens has a fixed corneal spacing, resulting in a safe treatment is guaranteed.

If a liquid is introduced through the first opening, a moisture film, which guarantees a particularly good seal of the first suction region, is located close to the first suction region, resulting in the suction device being attached to the eye. particularly safe way. The higher the viscosity of the liquid, the better the additional sealing effect.

container can be filled with a fluid, whose refractive index corresponds approximately to the corneal refractive index. As a result, no optical deviation of light occurs at the transition to the cornea, resulting in good focusability and high optical quality of the laser beam. The fluid may have a r

refractive index q_flUi_d approximately 1.35 to 1.40, preferably from about 1.36 to 1.38, plus

9/25 preferably approximately 1.37. The refractive index r |_Çcornea is about 1.37 6, and if the fluid refractive index has a similar refractive index, the quality and / or intensity of a beam of light or a laser beam in the transition from the optical contact element for the cornea are not reduced.

Reflection losses R are calculated as follows:

/ _ \²R = - cornea 7 fluid ^ Jlcomea + η fluid J

Given that ⁵⁸ Ofiuid r concludes that there is almost no loss of reflection.

Through the second opening, air can escape while filling the retaining element.

In addition, in this embodiment a flattening element 20 is not required, resulting in the eye pressure not being increased during treatment. In addition, no deviation, for example, a wavefront error, can arise due to spherical or aspheric flattening as in the case where a flattening element is used. As a result, 25 laser radiation with a low wavefront error is obtained, which is advantageous with regard to focusing, since the focal positions are dispersed less intensely and the laser radiation is concentrated in a smaller region of focus.

'The applicant reserves the right to make a separate application for protection for the aspect described above, with respect to a suction device

10/25 eye with a retaining element, where the suction device to the eye and the retaining element can also be constituted as a single piece or can be linked to each other, not only by means of partial vacuum, but also mechanically, for example in a positive way or by friction.

The suction device to the eye may include at least one measuring means. The term means of measurement in this context also encompasses qualitative and / or quantitative determination or verification of geometric, physical and / or chemical measurements. The eye suction device can include a plurality of measurement means. Functional elements can include at least one measuring medium.

Since the well-known suction ring has to be frequently disinfected, sterilized and replaced, and the eye is a particularly sensitive organ, a person skilled in the art has so far been deterred from having more elaborate means of measurement in a suction or to create more elaborate means of measurement that are arranged on or inside a suction ring in direct proximity to the eye, especially since during operation a very sensitive part of the cornea is folded upwards.

At least one of the measuring means of the suction device to the eye can be designed to perform a measurement with respect to an eye property. The measurement medium can be designed to determine the intraocular pressure, in which case the intraocular pressure can be checked, for example, by means of tactile, mechanical, acoustic and optical processes, in particular also resonance processes.

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At least one means of measuring the suction device to the eye can be designed to measure the properties of the cornea of ​​the eye. The measuring medium for measuring the corneal properties of the eye can measure the water content, a biomechanical property, and / or the corneal transparency. 0 water content can be determined, for example, by means of an optical spectrometer; the biomechanical properties of the cornea can be determined, for example, by spectroscopic mechanical processes, and the transparency of the cornea can be determined by the scattering of light.

suction device to the eye may include a measuring means for measuring a quantity acting on the eye. The measuring means for measuring the quantity acting on the eye can measure a force acting on the eye. For this purpose, pressure sensors, for example piezoelectric pressure sensors, or force sensors can be integrated into the suction ring. In addition, it is possible to use microelectromechanical systems (MEM systems), which, for example, are placed on the optical element through which the laser radiation is introduced.

The eye suction device may include at least one measurement means for measuring an eye property and / or eye suction device in relation to the environment. The measuring means for measuring an eye property and / or an eye suction device with respect to the environment can measure, for example, the position, in space, of the eye and / or the eye suction device. The means for measuring the property of the eye and / or the suction ring in relation to the environment can be designed to interact with means of positioning the operating table and / or with means of positioning for laser radiation. As a result, it is possible to ensure that the eye is always located in the

12/25 correct position and that the laser radiation reaches the cornea of ​​the eye at the correct position and angle. The measurement of the position of the eyes and / or the suction ring can be based on mechanical detection, based on high frequency, acoustic or (three-dimensional) optical. The measuring means can be arranged in a functional element that is sucked into the suction device to the eye.

The measurement means can be designed to transmit the verified measurement data. The measurement data can be transmitted by induction, via a cable, via an optical interface or via an electromagnetic interface. The measuring means may include a battery, may be supplied with current inductively or may be supplied with current through a supply line. The measurement means may further include a communications device. For example, the measuring means can take the form of a transponder, so that an inductive or electromagnetic excitation is carried out from the outside and the communication device of the measuring means transmits the measured values ​​inductively or electromagnetically. The applicant expressly reserves the right to claim protection separately for an ocular suction ring or an eye suction device with a measuring device, without the need for a functional element to be aspirated into the suction ring.

The invention will be elucidated in more detail below based on the drawings presented. In them are presented:

Figure 1: a schematic section, out of scale, of a first embodiment of the invention;

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Figure 2a: a schematic section, out of scale, of a second embodiment of the invention;

Figure 2b: a schematic section, out of scale, of a third embodiment of the invention, in which the second suction region is located in the functional element;

Figure 3: a schematic front view of the invention;

Figure 4: a schematic view, out of scale, of a fourth embodiment of the invention, in which a fluid is located between a focusing lens and the cornea during treatment;

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<td>scale,</td><td>of a farm</td><td>embodiment of the invention,</td><td>at</td><td>which one</td><td>one</td>

<td>element</td><td colspan="2">planer is attached suction device</td><td>to</td><td>eye</td><td> ;</td>

<td></td><td>Figure</td><td>6: a schematic view</td><td>r</td><td>out</td><td>in</td>

<td>scale,</td><td>of a friday</td><td>embodiment of the invention,</td><td>at</td><td>which one</td><td>one</td>

<td>element</td><td>planer is</td><td>attached to the device</td><td colspan="2">suction</td><td>to</td>

<td>eye;</td><td>Figure</td><td>7: a perspective, outside</td><td colspan="2">scale,</td><td>in</td>

a seventh embodiment of the invention, which includes an eye suction device with a measuring device;

and

Figure 8: a schematic section, out of scale, of the seventh embodiment of the invention.

14/25

Figure 1 shows a suction device for eye 2 with a first suction region 4, which in the operation is intended to suction the suction device for eye 2 for an eye 18, and with a second suction region 10, which in The operation is intended to suck a functional element 12. The functional element 12 includes an optical element 11 that takes the form of a lens or plate 11. In addition, functional element 12 includes a connection region 13 with which the functional element can be coupled to the optical device (not shown) of a laser system, for example, a femtosecond laser system.

The suction device to the eye also includes a third suction region that is in fluid communication with the space between the functional element 12 and the cornea 19 of an eye 18 and, at least partially, evacuates that space, so that at least part of it the cornea rests against the functional element 12. The region against which the cornea 19 rests can take the form of a lens or flattening plate 11. The eye suction device includes a plurality of partial vacuum feeders 20, 22, 24 (in figure 1, only one is discernible) that are connected to a suction pump or each to a suction pump or a suction pump. suction with three separate controls or three separate control valves. As a result, different partial voids can be generated in the first 4, the second 10 and the third 6 suction regions. In the second suction region 10 a high partial vacuum can be defined, so that the functional element 12 is firmly arranged on the suction device to the eye. In the first suction region 4 and / or the third suction region 6 a lower partial vacuum can be set, so that eye 18 is not injured. In addition, before the operation, the surgeon can apply a partial vacuum only in the second region of

15/25 suction 10, in order to accommodate the functional element 12 on the suction device to eye 2. In the course of positioning the suction device to eye 2 on the patient's eye 18 a partial vacuum can be generated in the first region of suction 4 in order to accommodate the suction device to eye 2 firmly over eye 18. Finally, a partial vacuum can be generated in the third suction region 6, in the sense that the cornea 19 of the eye 18 is firmly arranged on the functional element 12. However, it is also conceivable in the first place to accommodate the suction device to the eye 2 over the eye 18 and subsequently generate a vacuum in the second suction region 10, in order to accommodate the functional elements 12.

The eye suction device according to the invention prevents damage to the eye, since in the first suction region 4 a partial vacuum can be defined which is different from that of the second suction region 10 and / or the third suction region 6. In addition, the present invention creates redundancy, since the suction device to the eye is attached to the eye by both suction regions, the first 4 and the third 6.

The first suction region 4 is in the form of a peripheral groove in the eye suction device. However, other configurations are also possible, for example, a plurality of peripheral grooves, one or more peripheral or non-peripheral indentations or a plurality of openings. The second suction region 10 is formed by two peripheral grooves in the form of a circle on the front or top of the suction device to the eye. In this case too, the configurations described above with respect to the first suction region are possible. The third suction region 6 in the first embodiment is located

16/25 in the transition region from the suction device to eye 2 to the functional element 12. As a result, it is possible to ensure that a part of the cornea 19 is sucked into the surface of the functional element 12.

Functional element 12 can be easily changed, without special tools and / or complicated operational steps being necessary for this. In operation, the functional element 12 can be easily replaced by another that, for example, includes another optical element 11, flattening element 11 and / or another connection region 13.

Figure 2a shows a second embodiment of the invention, in which identical reference symbols designate identical elements. With regard to the configuration of the first, second and third suction regions, as well as the partial vacuum feeds, reference is made to the description of the embodiment according to Figure 1.

In contrast to the embodiment according to Figure 1, in the embodiment according to Figure 2a a retaining element 14 is disposed on the suction device to eye 2 by means of a partial vacuum in the second suction region 10. The retaining element 14 can be any element on which or for which new elements can be arranged or attached. The retaining element 14 includes in its region facing the eye suction device 2 a peripheral recess in the form of a circle, in which an optical element 16 is arranged. Optical element 16 can take the form of a flattening element or a flattening lens. The retaining element 14 also includes a connection region (not shown) with which the retaining element can be coupled with the optics of a laser system.

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By virtue of the partial vacuum in the third suction region 6 the cornea 19 is sucked into the optical element 16 disposed in the retaining element 14.

Figure 2b shows a third embodiment of the invention, reminiscent of the second embodiment. In contrast to the second embodiment, the eye suction device 2 'in the third embodiment does not include a second suction region. The second suction region 10 'is arranged on the functional element 14'. Through the second partial vacuum supply 22 'a partial vacuum is generated in the second suction region 10'. The remaining configurations of the eye suction device 2 'and the functional element 14' correspond to the configurations of the eye suction device 2 and the functional element 14 of the second embodiment.

Figure 3 shows a front view of the suction device according to the invention, without the assembly of the functional element in operation.

The eye suction device includes a first partial vacuum supply 20 which is connected to the first suction region, a second partial vacuum supply 22 which is connected to the second suction region, and a third partial vacuum supply 24 which is connected to the third suction region. The suction device to the eye does not have to be substantially circular. It can also take the form, for example, of an elliptical or polygonal ring.

Figure 4 shows a fourth embodiment of a suction ring 2 according to the invention, in which a fluid is located between a focusing lens 64 and the cornea of ​​the eye 18 during treatment of the eye 18. With the help of a first region partial vacuum 4, the

18/25 suction device to eye 2 is coupled to eye 18, for example, on the sclera or limbus. The region of the eye suction device 2 that touches eye 18 is modeled on the anatomical shape of eye 18 in that region, so that eye pressure is not increased or is only slightly increased. However, the suction device for eye 2 and the elements disposed therein do not touch and / or cover eye 18 in the region of the cornea to be treated, resulting in a numerical opening of approximately 10 mm.

eye suction device 2 includes a first suction region 4 which aspirates the retaining element 50 at its first axial end 56. Located opposite the first axial end 56 of the retaining element 50 is a second axial end 58, wherein a focusing lens 64 can be installed. A wall 52 extends from the first axial end 56 to the second axial end 58 of the retainer 50 and around the longitudinal axis of the retainer 50 in the axial direction. The retaining element is, therefore, closed laterally by the wall 52, superiorly by the focusing lens 64, and inferiorly by the cornea of ​​the eye 18.

The wall 52 shows a first opening 60, through which a fluid can be supplied, and a second opening 62, through which a fluid can be removed. If a fluid is supplied through the first opening 60, the air inside the retaining element 66 escapes through the second opening 62. 0 liquid supplied into the retaining element 66 has a refractive index η which is preferably approximately similar or the same as that of the cornea, whose refractive index g_Çoil θ of approximately 1,376. But it is also possible to use water, whose refractive index g_watera is approximately

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1,333. Due to the adaptation of the retraction indices, optical anomalies of the light do not occur in the transition to the cornea, resulting in the guarantee of a good focusing of the laser beam and a high optical quality of the laser beam.

If a humectant film is located in the vicinity of the first suction region 6, a particularly good seal of the first suction region 6 is guaranteed, as mentioned above, resulting in the eye suction device being attached to the eye particularly safely. The higher the viscosity of the liquid, the better the additional sealing effect.

Furthermore, as mentioned earlier, in this embodiment no flattening element is required, with the result that the eye pressure is not increased during treatment. In addition, no anomaly, for example, a wavefront error, can arise due to a spherical or aspheric flattening as in the case where a flattening element is used. Consequently, laser radiation with a low wavefront error is obtained, which is advantageous with regard to focusing, since the focal positions disperse less intensely and the laser radiation is concentrated in a small focus region. .

retaining element 50 and the suction device to the eye 2 can be made of a single set or they can be connected firmly or by friction to each other.

Figures 5 and 6 show the fifth and sixth embodiment of the invention. The optical element 16 is a flattening element. The flattening element 16 is attached to the eye suction device 2a, 2b. As previously mentioned, the planing element 16 has to be changed after an operation

20/25 where they were exposed to laser radiation. Eye suction device 2a, 2b can be provided with the flattener element 16 attached to it in the form of a disposable sterile article. As a result, better cost-effectiveness of the suction device to the eye can be achieved. In addition, with such an eye suction device the mechanical tolerance chain can be reduced to the planing element 16 and the aspirated reusable retaining element 14a, 14b, which is also referred to as an adaptation cone. Due to the reduced tolerance chain, the treatment result is improved.

By virtue of the first vacuum supply 20, a partial vacuum is generated in the first suction region 4, as described above, so that the suction device to eye 2a, 2b is attached to eye 18. A second vacuum supply 21 it generates a second partial vacuum 10a, 10b, in the second suction region 10a, 10b, so that the retaining element or the fitting cone 14a, 14b is securely attached to the planing element 16.

In the fifth embodiment according to Figure 5, the retaining element or fitting cone 14a touches both the flattening element 16 and the eye suction device 2a. In this embodiment of the eye suction device 2a the edge of the flattening element 16 is completely surrounded by the eye suction device.

In the sixth embodiment according to Figure 6, the retaining element or fitting cone 14b touches only the flattening element 16 and not the suction device to the eye 2b. In this embodiment of the suction device for eye 2b, the flattening element 16 can rest on the suction device for eye 2b only with its edge

Bottom 21/25. It can be additionally fixed, for example, using an adhesive. Also in this embodiment, it is possible for the suction device to the eye 2b to completely surround the planing element 16, so that no adhesive is necessary. In this case, on its side facing the planing element 16, the retaining element 14b must have a smaller diameter than the planing element.

Figures 7 and 8 show a seventh embodiment of the invention that includes an eye suction device 116, a retaining element 102, a flattening element 104, a delivery device 110 with at least a partial vacuum line and also with a source supply and with a signal connection for at least one measuring medium. At the bottom of the eye suction device 116 is located a first suction region 128 with which the eye suction device 116 is attached to eye 122. Eye suction device 116 is capable of securing retaining element 102 via of a second suction region 124 in which a partial vacuum prevails. The retaining element 102 attaches to the flattening element 104 through an optional third suction region 126. Due to the flattening element 104, radiation from a laser system (not shown), for example a femtosecond laser system, is introduced. The flattening element can also take the form of a lens. At its lower end, the flattening element 104 rests against the cornea of ​​the eye 122, as a result of which the position of the cornea is fixed.

On the upper side of the retaining element 102, a plurality of mechanical guides 106 are formed to couple the path of the laser beam and / or a closing mechanism.

*

Mechanical guides 106 may include a force sensor (not shown). In addition, the force sensor can be

22/25 installed in the mechanical guides, the optics of the laser, in this case, being associated with the force sensors. The force sensor may be, for example, a piezoelectric sensor, or it may have been built using voltage meters.

Measuring means 104 for measuring intraocular pressure can be arranged in the flattening element 104. The measurement medium can be provided by microelectromechanical systems (MEM systems). At the edge of the flattening element 104 there are a plurality of fiber sensors 108 for carrying out a spectroscopic process, for example, in the region near the infrared, and / or for carrying out a process for determining light scattering. With these fiber sensors, properties of the cornea, for example, its water content, can be determined. Due to the determination of the light scattering, the transparency of the cornea can also be determined. In the fifth embodiment, however, a separate transparency sensor 114 is provided which, for example, by determining the dispersion of light by the cornea, verifies its transparency. A mechanical spectroscopic device 112 checks the biomechanical properties of the cornea, for example, on the basis of mechanical resonance. Partial vacuum is supplied to the suction device to the eye via the supply device 110. In addition, a power supply is secured with the supply device 110, and the measurement signals from the measurement means are transmitted to an evaluation device (not shown), via an electrical cable, a glass fiber and / or radio. In the flattening element 104 and on the suction device to the eye 102, there may be contact elements in order to transmit electrical signals and to provide a power source.

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In the retention element 102, there are also means measuring positions l20, in order to determine the position of the suction device to the eye 116 or the retention element 102, in the space. The position measuring means 120 can be, for example, acoustic or optical sensors, which determine the position in relation to a geometry reference. In addition, in the case of position sensors 120, it may be a matter of merely passive sensors receiving a beam of radiation from a reference location, the position of the eye suction device 116 or the retaining element 102 being determined based on the received signal. Likewise, the position measuring means l20 can be merely active elements that emit an optical or acoustic beam that is received by a corresponding receiving device at a reference location, the position of the measuring means position 120 in space being determined based on the received signal. In the eye suction device 102, reference marks may also be arranged which are recorded by a camera arranged in space. Likewise, optical sensors, which record the position of the eyes, can be arranged inside the suction device to the eye. With the help of the registered position of the eyes, in relation to the suction ring to the eye 102, and the position of the suction ring to the eye in space, registered through the measuring means of position 120, the position of the eye 122, in space, can be determined.

The means for determining the position of the suction ring in space can be combined with a position control (not shown) from an operating table or with a position control (not shown) from a laser system.

In operation, the eye suction device 116 touches the eye. In the eye suction device 116, a force sensor 118 is integrated in order to measure the force that

24/25 acts on the eye, from which the intraocular pressure can be determined. A plurality of force sensors 118 can be arranged in the eye suction device 116. As a result, a force profile along the periphery of the contact element 116 can be created, resulting in the corneal profile being determined and, consequently, intraocular pressure can be checked more precisely.

The eye suction device 116 or retainer 102 may further include a fourth suction region (not shown) that evacuates the region between the flattening element and the cornea, so that the cornea of ​​the eye 122 rests firmly against the element planer 104.

The eye suction device 116 and the retaining element 102 can be made in one piece or can be connected in a positive or non-positive way.

The present invention has the advantage that it creates redundancy, since, on the one hand, the suction device to the eye is sucked into the eye and, on the other hand, a part of the cornea is sucked into a functional element or to an element in it. Furthermore, the invention has the advantage that, before, during and / or after the operation, the surgeon can simply exchange a functional element, for example, a lens, a flattening lens or a connection region for the optics of a laser system - without using a tool that is difficult to operate. The invention also has the advantage that mechanical fastening elements are not necessary to dispose the functional elements, which contributes to the miniaturalization of the suction device to the eye and its weight reduction. Since no mechanical fastening elements are required, the eye suction device can

25/25 be constructed from fewer components and more simply resulting in that the surgeon is given a better view of the operative field, the suction device to the eye is given a greater numerical opening, and the risk of failure is reduced. In addition, the eye suction device according to the invention allows greater manufacturing tolerances than those related to the state of the art.

It will be understood that each of the suction regions can be divided into a plurality of self-sufficient suction regions, as a result of which further redundancy with enhanced security arises.

The eye suction device 116 and the retaining element 102 can be integrally constituted or can be non-positive or positively connected.

The present invention has the advantage that measurement data relating to the eyes is available before, during and / or after an operation. The invention provides measurement data with respect to intraocular pressure, the position of the suction ring in space, the mechanical force acting on an eye, the measurement data relating to the cornea, for example, its water content, its biomechanical properties and its transparency. In addition, it is not necessary to provide additional measuring instruments to monitor the eye during an operation.

The invention has been described by means of several embodiments. A person skilled in the art will understand that the characteristics and combinations of characteristics of the different embodiments can be combined.