Electronically controlled fixation light for ophthalmic imaging systems.

(54) Title: ELECTRONICALLY CONTROLLED FIXING LIGHT FOR OPHTHALMIC IMAGE PROCESSING SYSTEMS.

(54) Title: ELECTRONICALLY CONTROLLED FIXATION LIGHT FOR OPHTHALMIC IMAGING SYSTEMS.

(57) Summary

An electronically controlled fixation light system for ophthalmic systems is described. The ophthalmic system may include an ophthalmic image processing device that generates an image of a portion of an eye graphically processed, a fixation light controller including an input module, configured to receive input relative to the image generated by the ophthalmic image processing device, and a control signal generator that generates an electronic fixation light control signal in response to the received input, and a fixture light source, configured to receive the fixture light control signal, and to generate a fixture light according to the fixture light control signal received. A surgeon can graphically process a portion of an eye with the image processing device, determine a misalignment of the graphically processed eye relative to the image-based image processing device, and control the fixation light with a control signal. electronic to reduce certain misalignment.

(57) Abstract

An electronically controlled fixation light system is described for ophthalmic systems. The ophthalmic system can include an ophthalmic imaging device that generates an image of a portion of an imaged eye, a fixation light controller that ineludes an input module, configured to receive an input in relation to the image generated by the ophthalmic imaging device, and a control signal generator that generates an electronic fixation light control signal in response to the received input, and a fixation light source, configured to receive the fixation light control signal, and to generate a fixation light according to the received fixation light control signal. A emergedon can image a portion of an eye with the imaging device, determine a misalignment of the imaged eye relative to the imaging device based on the image, and control the fixation light with an electronic control signal to reduce the determined misalignment.

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PATENT TITLE No. 354151

Owner (s): ALCON LENSX, INC.

Home:

Journey, Suite 175, Aliso Viejo, California, 92656, E UA

D nomination:

Classification:

ELECTRONICALLY CONTROLLED FIXING LIGHT FOR OPHTHALMIC IMAGE PROCESSING SYSTEMS.

CIP: A61 B3 / 0.0; A6163110 ^ 1 $ 3414; A61 F9 / 008

CPC: Α61β3 / 007&gt; Αέΐ B3 / 0091; '' áS &amp; 3 / ^ 2; A61F9 / 008

TIBOR JUHASZ; GUY HOLLA

Inventor (s):

The referei patent

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Number: '*

MX / a / 2C¡ 13/002828 n International:

from 2011

Number:

12/885,193

Validity: Vei | rtj&gt; yeará⁴. _π &lt;and ζ ΧΛ '

Date of V ^ rÑ ^ hnien ^ 1 ^

Exgí file | &lt;9ition: / | 5 dqftphjenode 201 &lt;.?^? 'Q ine ^ se ^ &amp; ga with eh los

Pursuant to the Law of ProJdadLJ as of the date of presenneoi ^ B the soliCSta ^ intacnacioh ^

Who subscribes to this title, based on the provisions of the Official Gazette of the Federation ^{, to}01/25/2006. 05/06 / 2009.06 / 01/2010 Regulations of the Mexican Institute articles 1^or, 3^or, 4^or, 5^or fraction V subsection to 12/27/1999, amended on 10/10/2002, 29/0

Deputy Generals, Coordinator, Departmental Directors and other subordinates of the Institute 04/08/2004 and 09/13/2007).

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yS ^ el ^ cies la Industrial, will be credited with twenty non-expendable stores, counted to current mSpMhfer^{* 1 * *} rights

III and 7. &lt;Bjs 2 of the LWy of Industrial Property 12/1997, .47 / 05/1999, 01/26/2004, 06/16/2005 ,, 3^or fraeplon V Undeci ded a), 4^or and 12th fractions I and III of “'^TO'“'~^TO~, 'WtoT / 2₀0₄, 07/28/2004 and 09/07/2007); of the Industrial Property (DOF that delegates faculties to the Divisional bdirectors Directors, Coordinators ^ 5βΊ2 / 1999, reformed the 04/02/2000, 07/29/2004,

This letter is signed with an advanced electronic signature (FIEL), based on articles 7 BIS 2 of the Industrial Property Law; 3 of its Regulations, and 1 fraction III, 2 fraction V, 26 BIS and 26 TER of the Agreement establishing the guidelines for the use of the Electronic Payment and Services Portal (PASE) of the Mexican Institute of Industrial Property, in the procedures indicated.

THE DIVISIONAL DIRECTOR OF PATENTS

NAHANNY CANAL REYES

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Sand! No 550. Floor 1, Pueblo Santa María Tepepan. Xochimilco, 16020 Mexico City.

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MX / 2018/13754

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MEXICAN INSTITUTE&gt;

OF THE IPC PROPlÉÍMEi “INDUSTRIAL

ELECTRONICALLY CONTROLLED FIXING LIGHT FOR SYSTEMS

PROCESSING OF OPHTHALMIC IMAGES

TECHNICAL FIELD

This patent document refers to systems and

<td>techniques</td><td>of</td><td colspan="2">processing</td><td>magnet</td>

<td>detail,</td><td>the</td><td>document</td><td>of</td><td>patent</td>

<td>methods</td><td>for</td><td>provide</td><td>a</td><td>light of</td>

controlled to improve ophthalmic s. With more refers to systems and fixation electronically precision coupling of an ophthalmic image processing system in the eye of a patient.

BACKGROUND OF THE INVENTION

A variety of advanced image processing devices have been developed over the years for imaging,

For some applications, these image processing devices perform best when their optical axis is aligned with the optical axis of the graphically processed eye. Once the eye is placed in a position aligned with the optical axis of the image processing device, some devices improve the accuracy of the images by keeping the eye essentially immobilized in this position aligned with a patient interface of an image coupling system. eye. Optical axis alignment is typically accomplished by orienting the eye so that its optical axis is parallel to that of the system

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images and then coupling the 'interface ~ cTeÍL in a concentric way. By Γδ EarrE'o · / 'of the processing devices the demand for the patient processing in the eye is also increased when the imaging precision is improved, image processing coupling systems that provide more accurate alignment.

Achieving good alignment can be challenging, since without feeding and guiding systems the patient module often ends up mating with the eye in an off-center or out of place position with the optical axis of the eye tilted relative to that of the processing system of pictures.

In some systems, the operator of the image processing device may improve alignment by adjusting the image processing system, the patient's eye, or both during the coupling process. The operator can iteratively direct the coupling by directing the patient verbally, manually orienting the eyeball, or adjusting portions of the image processing device, such as its target or support structure. However, the inaccuracy of these methodologies can make the coupling process quite consuming and frustrating.

In some systems, such as in some surgical systems when using excimer lasers, the alignment is assisted by a fixation light. Light centering with the optical axis of the system

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INSTITUTO Z4EXICZ.NO - DE Ι.Λ itq: ¡;_WD (-1 ..; · s INPUyUML fixation can be image processing. The patient can be instructed to prepare their eye in the fixation light, aligning the patient's eye. However, even these fixation light systems have limitations.

BRIEF DESCRIPTION OF THE INVENTION

This patent document describes fixation light controller systems with improved functionalities. In some systems, the fixation light is simply focused with the optical axis of the image processing device. In such systems, in the typical case of the graphically processed eye center that is outside the optical axis of the image processing device, even if the patient looks at the fixation light, their eye will not be properly aligned with the optical axis of the device.

In some systems, including some YAG lasers and slit lamps, the fixation light is not fixed and can therefore be adjusted manually. However, since the adjustment is only mechanical, it typically lacks precision. Furthermore, such mechanical adjustments are still time consuming and frustrating due to their limited precision.

The described lack of precision of some systems may impede the performance of these devices, including ophthalmic surgery, imaging and diagnostic systems.

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This patent document -'deooribe — ε · ϊ · 6 fixation light controller topics that offer solutions to the problems described above. The described examples and implementations can control the fixation light of an ophthalmic magnet processing system using non-mechanical control systems. For example, a control system may include an ophthalmic image processing device that generates an image of a portion of an eye graphically processed, a fixation light controller, including a data input or input module, configured to receive a input relative to the image generated by the ophthalmic image processing device, and a control signal generator that generates a fixation light control signal in response to the received input, and a fixation light source, configured to receive the fixation light control signal and generate a fixation light according to the received fixation light control signal.

In some implementations, where the ophthalmic image processing device is configured to generate the essentially optical image, the ophthalmic image processing device may include a microscope, an ophthalmic microscope, or a stereo microscope. In some implementations, where the ophthalmic image processing device is corrected / jiTt to generate the image at least in part the eóctóní'CáMentS,

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ophthalmic image processing device may include an electronic detection system that detects an image processing light collected from the graphically processed eye, including at least one matrix of

Load Coupling Device (CCD), an array of

Complementary Oxide Semiconductor

Metallic (CMOS), a pixel array, and an electronic sensor array.

The ophthalmic image processing device may also include an electronic display system that displays the image of a portion of the eye graphically processed in relation to the detected collected image processing light, including at least one of a Light Emitting Diode indicator. (LED), a plasma screen, an electronic indicator, a computer monitor, a Liquid Crystal Display (LCD), a Cathode Ray Tube (CRT) monitor, a video module, a video microscope indicator, a stereoscopic video microscope indicator, a high definition (HD) video microscope, a microprocessor-based imaging system, and an opto-mechanical projector. In some implementations, the ophthalmic image processing device may include an anoptic coherence tomographic image processing (OCT) system.

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In some implementations, ophthalmic image processing may image processing,

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INSTITUTO Mí.XlC.V-'O CE LA I ROI'ILO.VD INDUSTRIAL r * device to include a module configured to indicate a misalignment of the graphically processed eye and a reference component of the ophthalmic image processing device. In some implementations, the reference component of the image processing device may be a lens, a patient module, a coupling tip, an interface, a contact lens, a pupil, a frame of vision, a frame of reference, or an internal lens of the ophthalmic system. The image processing module can be configured to display a reference pattern related to the reference component that can assist an operator in estimating the misalignment of the graphically processed eye and reference component of the image processing device.

In some implementations, the ophthalmic image processing device may include an image processor, configured to analyze the image of the graphically processed portion of the eye and the reference standard, and to determine misalignment of the graphically processed eye and the processing device. Image processing is reference component of image, and the module is configured to display an indication of misalignment, determined by the processor

In some implementations, the input module is imaged.

configures detected.

include a command, a

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MEXICAN INSTITUTE V 'DE LA Fn. VIf.lj.cj INDUSTRIAL to receive a mechanical, optical, or

The image processing module can be a touch panel, a touch screen, an electro-mechanical sensor lever, a position sensor, an optical sensor, a voice-activated actuator, or an electro-mechanical controller. In some implementations, the fixation light source may include at least one of an LED array, a plasma display, an electronic indicator, a computer monitor, an LCD display, a video module, an opto-mechanical projector, a CRT monitor, a slit lamp, a microprocessor imaging system, and a mobile light source using an electromechanical actuator.

In some implementations, the fixation light source is configured to display the fixation light from an eye not graphically processed by the patient, and to move the displayed fixation light according to the received fixation light control signal to assist a reduction in misalignment between the graphically processed eye and a reference component of the ophthalmic system. In some implementations, the fixation light source is configured to generate the fixation light for the graphically processed eye, and to adjust the generated fixation light from

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MHXiCAI'O INSTITUTE OF LA PROPJEDAO

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according to the received industrial fixation light control signal to help reduce misalignment between the graphically processed eye and a reference component of the ophthalmic system.

In some implementations, a method of aligning an eye with an ophthalmic system may include providing an image processing device and an electronically adjustable fixation light system, positioning a component of the image processing device, and a graphically processed eye to generate a image of a portion of the graphically processed eye, graphically process a portion of the graphically processed eye, determining a misalignment of the graphically processed eye relative to the image-based image processing device, and controlling a fixation light of the fixation light system with a determined electronic misalignment control signal.

In some implementations, the provision of the image processing device according to that may include providing a microscope, an ophthalmic microscope, a stereo microscope, a video microscope, a Light Emitting Diode (LED) indicator, a plasma display, an electronic indicator, a computer monitor, a Liquid Crystal Display (LCD), a Cathode Ray Tube (CRT) monitor, a video module, a video microscope indicator,

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INDUSTRIAL UÍ -Λ¹ a stereoscopic video microscope indicator, a high definition (HD) video microscope, a microprocessor-based imaging system, or an opto-mechanical projector. In some implementations, the provision of the image processing device may include providing an optical coherence tomography (OCT) system.

In some implementations, positioning of the image processing device component may include positioning at least one of a target, a patient module, a coupling tip, a contact lens, a pupil, a viewing frame, a marking reference, and an internal lens of the ophthalmic system in a spatial relationship with a graphically processed eye structure suitable for image processing. In some implementations, misalignment determination may include determining at least one of lateral misalignment and rotational misalignment.

In some implementations, misalignment determination may include determining misalignment with passive assistance from the image processing device, the image processing device that displays an image of a portion of the graphically processed eye, and a reference pattern. In some implementations, misalignment determination may include determining misalignment with active assistance from the

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INDUSTRIAL C&gt; · image processing, the image processing device that displays a graphically processed image of a portion of the eye, a reference pattern, and a misalignment indicator.

In some implementations, the fixation light control may include generating the electronic control signal with a fixation light controller, wherein the fixation light controller may include a touch panel, a touch screen, a joystick, an electro-mechanical sensor, a position sensor, an optical sensor, an activated actuator

<td>by voice, or a</td><td>electro-mechanical controller. In some</td>

<td>implementations,</td><td>the electronic control signal can</td>

<td>include generate the</td><td>electronic control signal to make it</td>

<td>a light source</td><td>of fixation generate the fixation light that</td>

<td>guides the patient to</td><td>reduce the misalignment determined.</td>

<td>In some</td><td>implementations the light source of</td>

fixation can be an LED matrix, a plasma display, an electronic indicator, a computer monitor, a display

LCD, CRT monitor, video module, slit lamp, microprocessor imaging system, or a mobile light source using an electro-mechanical actuator.

In some implementations, the generation of the electronic control signal may include the electronic control signal in at least one of the graphically processed eye and one non-graphically processed eye. In some implementations,

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misalignment determination and fixation light control can be repeated iteratively.

In some implementations, a method of aligning an eye with an ophthalmic system may include graphically processing a portion of an eye under a patient's procedure using an ophthalmic image processing device, displaying the image of the procedure eye using a procedure processing module. images, displaying a reference pattern relative to the displayed image to indicate misalignment of the graphically processed eye and a reference element of the ophthalmic system that receives a fixation light control command by a fixation light controller, and visualize the light Fixation using a fixation light source in response to the fixation light control command to help the patient reduce alignment.

In some implementations, receiving the fixation light control command may include receiving the fixation light control command through at least one touchpad, touchscreen, joystick, electro-mechanical sensor , a position sensor, an optical sensor, a voice activated actuator, and an electromechanical controller. In some implementations, the fixation light display may include at least one of an LED array, a plasma display, an electronic indicator, a monitor

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<td colspan="2">opto-mechanical projector, one lamp</td><td>of</td><td colspan="2">cleft,</td><td>a system</td>

<td>of images by</td><td>microprocessor, and</td><td>a</td><td>source</td><td>of</td><td>moving light</td>

<td>by means of a</td><td>electric actuator</td><td colspan="2">-mechanic.</td><td>In</td><td>some</td>

<td>implementations</td><td>, the display of</td><td>the</td><td>light of</td><td colspan="2">fixing can</td>

include viewing the fixation light for one of the eyes under procedure or the non-procedure eye.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a human eye.

FIG. 2 illustrates an ophthalmic image processing apparatus.

FIGS. 3A-C illustrate various misalignments of an eye and a target.

FIG. 4A illustrates an ophthalmic system 100 with a fixation light system 120.

FIG. 4B illustrates a view of an ophthalmic image processing device 110 and fixation light system 120 as seen by a patient.

FIGS. 5A-C illustrate an image processing interface of image processing module 115, a fixation light controller 130 and a fixation light source 140.

FIG. 6 illustrates a method of operation 200 of the fixation light system.

FIGS. 7A-D illustrate an implementation of the

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MEXICAN INSTITUTE

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FIG. 8 illustrates a method 300 for aligning an eye with an ophthalmic image processing system.

FIGS. 9A-B illustrate a single optical path implementation of a surgical ophthalmic system 100 '.

FIG. 10 illustrates an implementation 100 of an ophthalmic system with a surgical ophthalmic apparatus and a fixation light system with a secondary image processing system.

FIGS. 11A-D illustrate an operation of the ophthalmic system 100 of FIG. 10.

DETAILED DESCRIPTION

FIG. 1 illustrates a human eye 1 in some detail. Eye 1 includes a cornea 2 that receives and refracts incoming light, an iris 3, a pupil 4 that provides an opening for light to enter the inner eye, and a lens 5 that focuses light from the retina 6.

The implementations and embodiments in this patent document provide a fixation light system for ophthalmic image processing devices to increase the alignment accuracy of the graphically processed eye and the image processing device.

FIG. 2 illustrates an ophthalmic image processing system 100 and its operation. A patient 7 can

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place a support table on top of it

An image light source 11 can emit an image processing light from a graphically processed eye li.

A portion of the image processing light reflected by the graphically processed eye can be collected by a target 12 and guided as a collected image processing light to an optical or eye system 14.

Optic 14 can guide the collected image processing light to an image processing module.

A professional medical surgeon can analyze the image provided by the image processing module 15 and instruct the patient to move the processed eye graphically to improve its alignment with an optical axis of the image processing system 10. In other cases, the surgeon can manipulate the graphically processed li eye manually to improve alignment. These steps can be practiced to prepare the coupling of the graphically processed li eye in the patient interface. Such patient interfaces can be used to simply graphically process the li eye, or to perform an ophthalmic surgical procedure. In other systems, a non-contact image processing procedure can be performed after alignment. In still other systems, alignment can be followed by a diagnostic procedure. However, system 10

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MEXICAN INSTITUTE OF PROFIFDAC, INDUSTRIAL

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Image processing cannot provide the surgeon with a high enough precision image because the alignment is provided only roughly, limiting its accuracy.

FIGS. 3A-B illustrate that after use of this limited precision ophthalmic image processing system 10, residual misalignment may persist between eye 1 and ophthalmic image processing system 10. In detail, a distal end 20 of an ophthalmic system 10 may be the target 12, or a contact module, a coupling unit, a distal tip, an interface, or a flattening module. In either of these designs, the distal end 20 may include a housing 21 that supports a distal lens 22. An optical axis 28 of the ophthalmic image processing system 10, typically shared with an optical axis of the distal lens 22, may remain misaligned with an optical axis 8 of the eye 1 even after the above limited precision coupling procedure has been performed.

FIG. 3A illustrates that misalignment may be a lateral misalignment characterized by a vector (Ax, ñy) between the optical axes 8 of the eye and the optical axis 28 of objective 12, lying approximately in the lateral plane perpendicular to optical axis 28.

FIG. 3B illustrates that alignment can also be

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<img file="MX354151B_D0023.tif" />

MEXICAN INSTITUTE 'OF PROPERTY

INDUSTRIAL a rotational misalignment. In general, rotational misalignment can be characterized by Euler angles (θ, &lt;p) between the optical axis 8 of the eye and the optical axis 28 of the objective

12. In many cases, misalignment can be a combination of a lateral and rotational misalignment.

FIG. 30 illustrates that in an image processing interface of the image processing module 15 either misalignment may appear as a displacement of the iris 3 and pupil 4 relative to a focus pattern 17, such as a target or focus circle. The surgeon may verbally instruct the patient to move the graphically processed li eye, or to manipulate the li eye manually based on this displayed displacement.

However, verbal instructions may be unclear to an already disoriented patient, and manipulating the eye can be cumbersome and imprecise. Also, the patient is likely to change or resist the actions of the surgeon or technician.

Some ophthalmic systems may use a fixation light to assist the patient. However, fixation light devices still have shortcomings, as discussed above. Some devices provide adjustable fixation lights as an upgrade. However, even in such systems, the location of the fixation light is typically manually adjusted, resulting in

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FIGS. 4-5 illustrate an ophthalmic image processing system 100 that can be used to align the graphically processed eye li and the ophthalmic system 100 with improved precision. The ophthalmic system 100 may include an ophthalmic image processing device 110 and a fixation light system 120.

FIG. 4A illustrates that ophthalmic image processing device 110 that can generate an image of a portion of the eye li graphically processed. The ophthalmic image processing device 110 may include an image processing light source 111 that provides an image processing light to the graphically processed eye. The image processing light source 111 may be a single light, a 4, 6, or 8 light ring, or a light source with a continuous ring shape. A target 112 can collect a fraction of the image processing light, returned by the graphically processed eye, and direct the mima as a collected image processing light 113 to an optic 114. Optic 114 can guide the collected image processing light 113 to an image processing module 115. In general, optics 114 can be quite complex, including the large number of lenses, and mirrors. The optics can also be multifunctional, for example also configured to guide a beam

<img file="MX354151B_D0026.tif" />

graphically processed. The image processing-effe module 115 can provide an image to an ophthalmic system 100 operator through an image processing interface.

In some implementations, ophthalmic image processing device 110 can generate the image essentially optically. For example, the device

110 Ophthalmic imaging can include a microscope, an ophthalmic microscope, or a stereo microscope. An image processing interface of these microscopes can include the lens of these microscopes.

In some implementations, ophthalmic image processing device 110 can generate the image at least in part electronically. For example, ophthalmic image processing device 110 may include an electronic detection system that detects the collected image processing light 113. The electronic detection system may include a Charge Coupled Device (CCD) matrix, a Complementary Metal Oxide Semiconductor (CMOS) matrix, a pixel matrix, or, an electronic sensor matrix for detecting processing light 113 of collected images.

In these image processing systems

IMPI

MEXICAN INSTITUTE

OF THE ICDAO INDUS'IKIAL

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Electronic image processing module 115 may include an electronic display system as an image processing interface. This electronic indicator can display an electronic image of a portion of the eye li graphically processed based on the detected light 113. This electronic indicator or image processing interface may be, for example, a Light Emitting Diode (LED) indicator, a plasma display, an electronic indicator, a computer monitor, a Liquid Crystal Display (LCD), a Cathode Ray Tube (CRT) monitor, a video module, a video microscope indicator, a stereoscopic video microscope indicator, a high definition (HD) video microscope, a microprocessor-based image processing system, an opto-mechanical projector, or a mobile light source with an electromechanical actuator. In some implementations, elements of electronic and optical image processing systems can be combined.

In some implementations, the ophthalmic image processing device may include an optical coherence tomographic image processing (OCT) system, which is described in relation to FIGS. 9-10.

FIG. 5A illustrates that the image processing module 115 may indicate misalignment of the processed li eye.

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INSTITUTO MtXlCAX 'graphically and a reference component of the disp'aX'¿^FOphthalmic Image Processing Wo - ^ [ua - Simultaneously isolates an image portion of the graphically processed eye li and a reference or pattern

117 focus, such as a focus circle, through its image processing interface.

The reference component of the ophthalmic image processing device 110 may be an objective, a patient module, a coupling tip, an interface, a contact lens, a pupil, a viewing frame, a reference frame, a lens internal of the ophthalmic system, or any equivalent.

The location or display of the focusing pattern 117 can be fixed to the reference component, which in effect indicates the position of the reference component. Therefore, simultaneous visualization of the image portion of the graphically processed eye li and targeting pattern 117 by image processing module 115 can effectively assist in determining misalignment of the graphically processed eye li.

This aid may be passive, the image processing module 115 displays only the image portion of the graphically processed eye li and the targeting pattern 117, so that the system operator can determine a degree of misalignment of the processed eye li

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graphically and the reference component of the ophthalmic system 100.

In some implementations, such as in modules

115 Imaging module, the image processing module 115 can actively assist in determining the misalignment of the graphically processed eye li and the system reference component

100 ophthalmic. Such include an image processor that analyzes the image portion of the eye li graphically processed and the pattern

117 targeting and computes misalignment. The module

115 processing machine can then display an indication of computed misalignment for example in the form of an arrow

233 (as shown in FIG. 7A), a numerical indication, a proposed verbal command, or any equivalent.

In addition to ophthalmic image processing device 110, ophthalmic image processing system 100 may include electronically controlled fixation light system 120. This electronically controlled fixation light system 120 may include a fixation light controller 130 and a fixation light source 140.

FIG. 5B illustrates that the fixation light controller 130 may include an input module 135 that can receive input from a system operator relative to the

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IMPI

MEXICAN INSTITUTE OF INDUSTRIAL PROPERTY image generated by image processing module 115. For example, a urT stereo optical ophthalmic microscope module 115 may present an image of the iris 3 of the li eye graphically processed on a stereotypical microscope lens and superimposed thereon on the hair wire or crosshair 117 . In another implementation, a video viewer of an electronic image processing module 115 can display an image of the circular targeting pupil simultaneously and a pattern 117 of perhaps even actively displaying an arrow to indicate misalignment.

In either embodiment, an operator of the ophthalmic system 100 can analyze the image portion of the graphically processed eye li and the overlapping focus pattern 117 to determine a degree of misalignment of the graphically processed eye li and the ophthalmic system 100.

In response to the determined misalignment, the operator of the ophthalmic system 100 may generate an input or command for the fixation light system 120 through the input module 135 of the fixation light controller 130. This input may represent a command regarding how the graphically processed eye should move to reduce misalignment, in a manner described below. In one example, if, from the image of the image processing module 115, the operator determines that the center

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INS ί 1TU ί υ MEXJCaN '&gt; * «.« ^ui of the graphically processed eye is 2 millimeters from the center of target 112, then the operator can enter a command through input module 135 that will cause the patient to move the graphically processed eye 2 millimeters to the left to achieve alignment improved.

The input module 135 may be an electronic, mechanical, optical, or sensed input module. For example, input module 135 may be a touchpad, touchscreen, joystick, electro-mechanical sensor, position sensor, optical sensor, voice-activated actuator, or electro-mechanical controller. .

FIG. 5B illustrates an embodiment of the touch panel of the input module 135, where the input command is input by a touch and movement of a finger 9 of a system operator. Finger movement 9 may represent a command of how the patient moves the eye graphically processed to reduce misalignment with the ophthalmic system 100.

Once the command has been entered into input module 135, a control signal generator from input module 135 can generate a fixation light control signal in response to the received command. A wide variety of well known electronic signal generators can be used for this function.

FIG. 5C illustrates that the fixation light controller 130 can send the generated fixation light control signal to the fixation light source 140.

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INSTITUT '' Mf.XiCAN · ·

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The fixture light source χΛ »can receive the fixture light control signal and generate or display a fixture light 145 according to the fixture light control signal received.

Fixation light source 140 may include an LED array, a plasma display, an electronic indicator, a computer monitor, an LCD display, a video module, an opto-mechanical projector, a slit lamp, an imaging system by microprocessor a mobile light source by means of an electro-mechanical actuator.

FIG. 4B illustrates that in some implementations fixation light source 140 can generate and display fixation light 145 from an eye without the image, or control, of patient 7. Fixation light source 140 can first generate and display light Fixation 145, and then move the display fixation light 145 according to the received fixation light control signal.

Since the movements of the control eye and the graphically processed eye, the graphically processed eye moves in a correlated manner. Because this correlation between the movements of the graphically processed eye li and the control eye 1c, the fixation light system 120 can assist in reducing misalignment of the graphically processed eye li relative to the ophthalmic image processing device 110 .

MExican INSTITUTE. OF THE PROPERTY

Other modalities can simply visuali2'SMf^ri‘^IAthe

145 of fixation on the light source 140 of'1_'lj dUlün — in— «relia location according to the fixation light control signal, instead of moving. In either of these modalities, the patient may be instructed to follow the fixation lumen 145 with the control eye.

FIG. 4B illustrates the appearance of the patient's ophthalmic system 100 in some embodiments. The left panel shows that the graphically processed eye li can see target 112, surrounded for example by six image light sources 111. The right panel shows that the control eye / unprocessed eye can see the fixation light 145 displayed on the fixation light source 140. In this embodiment, the fixing light source 140 may be an LCD screen or equivalent, and the fixing light 145 may be a bright spot displayed on the dark LCD screen 140.

To facilitate procedures on both eyes, some modalities may include two fixation light sources 140, one on each side of objective 112.

FIG. 6 illustrates a method 200 for operating ophthalmic image processing system 100. Method 200 may include providing an image processing device - 210a, and an electronically adjustable fixation light system - 210b; position a component

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<img file="MX354151B_D0031.tif" />

<img file="MX354151B_D0032.tif" />

graphically processed from a patient for the pr¿&gt; CÉ5ydimeiiLw ti ** images - 220; graphically process a portion of the eye graphically processed - 230; determining misalignment of the graphically processed eye and the component of the image processing device - 240; and control a fixation light electronically according to the determined misalignment - 250.

The provision of the image processing device 210a may include providing a microscope, an ophthalmic microscope, a stereo microscope, a video microscope, a Light Emitting Diode (LED) indicator, a plasma display, an electronic indicator, a monitor computer, a Liquid Crystal Display (LCD), a Cathode Ray Tube (CRT) monitor, a video module, a video microscope indicator, a stereoscopic video microscope indicator, an HD high-definition video microscope, a microprocessor-based imaging system, an opto-mechanical projector, or an optical coherence tomography (OCT) system. In some of these ophthalmic image processing devices 110 the target 112 can capture the collected image processing light 113 returned by the graphically processed eye li. The optic 114 can guide the collected image processing light 113 to the image processing module 115 and display it by

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Π £ Ι.λ FRCFít: = Α · '' · Example using the iniSgénes interface of the image processing module 115.

The provision of the electronically adjustable fixation light system 210b may include providing the fixation light controller 130 and the fixation light source 140.

Positioning 220 may include positioning at least one of objective 112, the patient module, the coupling tip, the contact lens, the pupil, the viewing frame, the reference frame, or an internal lens of the ophthalmic system that is aligns with a graphically processed li eye structure. Positioning 220 may also include moving the graphically processed eye li to a suitable position to graphically process the graphically processed eye li. Positioning may also include moving both the target 112 of the ophthalmic image processing device 100 and the graphically processed eye li to the appropriate positions to graphically process the graphically processed eye li.

In some implementations, after positioning 220 the graphically processed eye li and ophthalmic image processing device 110 may be closed but not in physical contact. In others, it may be a partial physical contact that still allows for graphically processed eye movement by either the surgeon's patient.

Imaging of a portion of the graphically processed eye 230 may include surgeon imaging of a portion of the graphically processed eye with at least one of a microscope, an ophthalmic stereo microscope, a video microscope, a stereoscopic video microscope, a high definition (HD) video microscope, or an optical coherence tomography (OCT) system.

FIG. 7A illustrates that in some implementations, determining misalignment 240 may include determining at least one of a direction and a degree of misalignment, or an angle of rotation of a rotational misalignment that remains after positioning 220.

Determination of misalignment 240 can be performed by the operator of ophthalmic image processing system 100, such as a surgeon. In such implementations, the image processing device 110 may assist in determining 240 which passively displays a graphically processed portion of a graphically processed eye li of the graphically processed eye li and the targeting reference or pattern 117 via the image processing interface. of the image processing module 115. FIG. 7 A illustrates an example where the image of iris 3 and pupil 4 of the graphically processed eye li is superimposed with a display of pattern 117 of

<img file="MX354151B_D0033.tif" />

IMPI

MEXICAN INSTITUTE £ J £ LA l'RORIEDAÜ INDUSTRIAL targeting. By analyzing the two overlapping images, the surgeon can determine the misalignment.

In some implementations, ophthalmic image processing device 110 may assist in determination 240 by actively displaying the graphically processed portion of the graphically processed eye, the targeting pattern reference 117, and a computational salinity indicator 233 via the interface of image processing of the image processing module 115. FIG. 7A illustrates an example, where the image of the iris 3 and pupil 4 of the graphically processed li eye is displayed simultaneously with the focusing pattern 117. Furthermore, the ophthalmic image processing system 100 can determine the degree of misalignment and indicate it by displaying an arrow 233 indicating misalignment. Misalignment arrow 233, eg, the point from the center of focus pattern 117 to the center of pupil 4, or to the center of the limbus, which is determined by an image processing protocol.

Control of the fixation light 250 may include generating an electronic control signal according to the determined misalignment. In some implementations, the electronic control signal can be generated by operating at least one of a touch panel, a touch screen, a joystick, an electro-mechanical sensor, a position sensor,

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an optical sensor, an electro-mechanical controller actuator.

voice activated, or a

Control of fixation light 250 may also include generating the electrical control signal causing fixation light source 140 to display fixation light 145 to guide the patient to reduce misalignment between the graphically processed eye li and the device. Ophthalmic image processing 110.

FIG. 7B illustrates that in one example the surgeon can analyze the image of the graphically processed eye li and the targeting pattern 117 in the image processing module 115 and determine that the pupil of the graphically processed eye li is misaligned relative to pattern 117 of targeting in the upper left direction, using the image processing interface of the image processing module 115 as a reference. The surgeon's determination can be aided by misalignment indicator 233.

In response, the surgeon may decide that the fixation light 145 should be adjusted or moved in the lower right direction by the fixation light source 140 to guide the patient to reduce and compensate for this misalignment. Correspondingly, the surgeon may create a fixation light control command or input to represent the fixation light compensation setting 145. In this pT mcxican institute ··· · * ·! 1

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INDUSTRIAL example, the surgeon can move his touch from the lower right light controller 130. The entrance of this

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finger 9 on a panel 135

---- - - tea. /upi.t fixation in the fixation light control command direction can lead to the generation of an electronic control signal by the fixation light controller 130 causing the fixation light source 140 to move the light 145 fixing in the lower right direction of an LCD screen. In other embodiments, other types of surgeon finger movement may represent the necessary offset adjustment, such as movement in the upper left direction.

FIG. 7C illustrates that in the above example, movement of the surgeon's finger 9 in the lower right direction may cause the fixation light source 140 to correspondingly adjust the display of the fixation light 145 in the lower right direction on the LCD screen. of the fixing light source 140. The patient may be instructed to follow this adjustment of the fixation light 145 with the control eye not graphically processed. The movement of the eye of the control is followed or tracked by the movement of the eye li processed graphically. Therefore, method 200 can reduce the misalignment of the graphically processed eye and ophthalmic image processing device 110.

FIG. 7D illustrates some aspects of reducing

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in various implementations. In some examples, the goal

112 may include a 112-1 housing to hold a lens

112-2 distal. This distal 112-2 lens may be the application tip of the ophthalmic system 100, in some cases making direct contact with the eye. In these embodiments, the above system 100 and method 200 can be used to align the distal lens 112-2 with the graphically processed eye li.

In other examples, a possibly disposable patient interface 112-3 may be attached to target 112. Interface 112-3 may include a contact lens or flattening plate 1124 and a suction skirt or suction seal 112-5. In these embodiments, the above system 100 and method 200 can be used to align either the 112-4 or the distal 112-2 lens with the graphically processed li eye.

FIG. 7D illustrates that in any of the above modalities, the surgeon may enter an alignment compensation control command into the fixation light controller 130, which generates an electronic control signal causing the fixation light source 140 to adjust the fixing light 145. The patient can follow the adjusted fixation light 145 with the control eye, causing the graphically processed eye to move accordingly. The surgeon typically enters control commands that will cause the patient to move their eye free from misalignment with the

IMPI

INSTITUTO MEXICANO DE LA rKONENAD,,, INDUSTRIAL --- * graphically processed to reduce ophthalmic image processing device 110.

Lateral misalignment can be compensated by the patient by following the fixation lumen 145 adjusted to move the eye li processed graphically laterally by ZJ, or generally by the misalignment vector (Zlx, Zly). In other implementations, lateral misalignment can also be compensated by the surgeon by moving target 112 with a lateral ZJ 'setting, or generally by (ZJ'x, Δ'y). In some cases, both the graphically processed eye and the target

112 It can be adjusted to compensate for lateral misalignment together.

In still other modalities, a rotational misalignment can be reduced by the patient by following the adjusted fixation lumen 145 which causes the graphically processed eye to rotate by an angle a, or generally by Euler angles (Θ, &lt;P) Finally, in in some cases both lateral and rotational misalignment may be present between the graphically processed eye and the ophthalmic system 100. In such cases the surgeon can guide the compensation of rotational misalignment by adjusting the fixation lumen 145 and instructing the patient to follow the fixation lumen, while laterally moving target 112 to compensate for lateral misalignment.

<img file="MX354151B_D0037.tif" />

INSTITUTO MEXICANO DE LA FRCrlEDAL) INDUSTRIAL

<img file="MX354151B_D0038.tif" />

Since the first fixation lumen control command frequently results in a reduction of misalignment but not elimination, after the patient reacts to the adjusted fixation lumen 145, the surgeon may repeat the misalignment determination. 240 residual and the fixation light control with the control signal 250 to further reduce misalignment iteratively. This iteration can be continued until the misalignment has been compensated with a desired precision.

As before, the fixation light source 140 may include an LED array, a plasma display, an electronic indicator, a computer monitor, an LCD display, a video module, a slit lamp, a microprocessor imaging system, or a mobile light source through an electro-mechanical actuator.

FIG. 8 illustrates an operating method 300 of the ophthalmic image processing system 100 that describes the operations of the system.

Alignment method 300 of the graphically processed li eye with ophthalmic system 100 may include graphically processing a portion of an eye under a patient's procedure using an ophthalmic image processing device-310; visualize the eye image under procedure using the image processing module

IMPI

MEXICAN INSTITUTE OF INDUSTRIAL PROPERTY

- 320; displaying a reference pattern relative to the displayed image to indicate misalignment of the graphically processed eye and a reference element of the ophthalmic system - 330; receiving a fixation light control command via a fixation light controller - 340; and visualizing a fixation light using a fixation light source in response to the fixation light control command to help the patient reduce misalignment 350.

Actions 310-330 have been described in detail above from the point of view of the operator of the ophthalmic system 100, such as the surgeon. Receiving the fixation light controller command 340 may include receiving the fixation light control command through at least one of a touch panel, a touch screen, a joystick, an electro-mechanical sensor, a position sensor, an optical sensor, a voice activated actuator, or an electro-mechanical controller.

The display of the fixation light 350 may include displaying the fixation light by at least one of an LED array, a plasma display, an electronic indicator, a computer monitor, an LCD display, a video module, an opto projector -mechanical, a slit lamp, a microprocessor imaging system, or a mobile light source using an electro-mechanical actuator.

<img file="MX354151B_D0039.tif" />

<img file="MX354151B_D0040.tif" />

MEXICAN INSTITUTE OF THE INDUSTRIAL MO.'lrOAn

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The light display 350 fixation light display may include the one of the eye under procedure or the eye without procedure.

FIGS. 9A-B illustrate another implementation of the system

100 'ophthalmic.

The functionalities described before the elements

110-145 can characterize the present implementation of the elements

110-145 'will also not be repeated here.

Furthermore, the elements

110-145 'may have functionalities related to the characteristic that in this implementation of the system

100 ophthalmic light

Fixation 145 'is not displayed through a separate fixation light display or source 140 of the control eye 1c.

Instead, the fixation light controller 130 'can apply an electronic fixation light control signal to a source 140' that projects a light

Fixation 145 'projected into the optical path of the ophthalmic image processing device 110. As such, the device

110 ophthalmic image processing system and fixation light system 120 'share some elements, as shown by the dotted lines. In some implementations, the projected fixation light 145 'can be coupled to optic 114 which contains additional adjustable mirrors to adjust the optical path of the projected fixation light 145'. This coupling can take place between the

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IMPI

M EXICAN INSTITUTE. &lt;M

From LA FKCtTEOAij industrial optic 114 and image processing module 115, or somewhere along optic 114 for example by means of a beam splitter BS, shown. In other embodiments, the projected fixation light 145 'may have a separate optical path or train to adjust its path, and may be coupled into the optical path of the ophthalmic image processing device 110 just prior to the projector projector objective 112'.

FIG. 9B illustrates that in these implementations the projected fixation light 145 'can be projected by the projector 112' on the graphically processed eye li. In these modalities, the patient may be instructed to follow the fixation lumen 145 'projected directly by the graphically processed eye li to reduce misalignment.

FIG. 10 illustrates another implementation of the ophthalmic system 100. The first described functionalities of elements 110-145 can characterize the present implementation of elements 110-145 as well and will not be repeated here.

In addition, elements 110-145 may have feature related functionalities in which ophthalmic system 100 may include a secondary image processing device 150. Secondary image processing device 150 may be, for example, an optical coherence tomography (OCT) system. Numerous processing systems including OCT systems

OCT often with a

IMPI

MEXICAN INSTITUTE; '·

FROM THE RR! T1LI7Ai i

INDUSTRIAL time domain and spectrometer systems or a sweep source. A wide variety of these OCT systems can be used in the ophthalmic system 100 to achieve various advantages. The image processing beam for the secondary image processing device 150 can be coupled into the main optical path through a beam splitter BS 1.

Some implementations of ophthalmic system 100 may also include a procedure laser 160 for various ophthalmic surgical procedures. Furthermore, some modalities may include a patient interface 170 to provide a firmer connection between the graphically processed eye li and the ophthalmic image processing device 110, for example with vacuum suction application.

This patient interface 170 may be analogous to the patient interface 112-3 in FIG. 7D.

In some implementations of the ophthalmic system 100, the image processing may be performed by the image processing module 115, in which case the system 100 and its operation may be largely analogous to the modalities described above.

In other implementations however, the secondary image processing device 150 can be used

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INSTITUTO MEXICASl ·&gt; fl “'i ··' -. # Can you graphically process the eye * 5?

OCT image processing useful for processing images of an eye structure that is not visible under an ophthalmic microscope. An example is image processing of lens 5 of the eye. Due to its soft support system, lens 5 is often not concentric with visible structures of the eye such as pupil 4. Furthermore, when the weight of objective 112 presses on the eye through interface 170, lens 5 can move and lean additionally. At the same time, the alignment of the ophthalmic system 100 with the lens rather than the pupil or limbus may be particularly important during cataract surgeries where the quality of the capsulotomy and other procedures can be improved by such alignment.

FIGS 11A-D illustrate an operation of this implementation of the ophthalmic system 100.

FIG. 11A illustrates that OCT imaging device 150 can quickly perform a dimensional scan (ID), such as one scan 181 per line. When lens 5, shown by a dotted line that may not be directly visible by a video microscope, is not concentric with pupil 4, typically a center 182 of the OCT scan does not coincide with a center 183 of lens 5.

FIG. 11B illustrates that in this case of runout

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the OCT image of lens 5 in

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OCT images displaying the ID scan along line 181 can display a partial 2c image of the cornea, a 5 image of the anterior capsular surface, and a 5p image of the posterior capsular surface. The off-center and inclined position of the capsular surfaces 5a and 5p may be indicative of the center 183 of the lens 5 which is outside the optical axis 28 of the image processing system 100 and the optical axis 8 of the lens 5 which is inclined relative to the axis 28 optical. Other OCT implementations can generate and display two-dimensional (2D) images by interlaced raster scanning of the lens 5.

FIGS 11C-D illustrate that the surgeon can determine the misalignment of a reference element of the imaging device 110 and the lens 5 graphically processed from the OCT image analysis displayed by the OCT image processing module 155 and then proceeding analogously. to method 200. In particular, the surgeon may enter a fixation light control command through the fixation light controller 130 input module 135 according to the determined misalignment. This command can generate an electronic control signal from the fixation light source 140 to adjust the fixation light 145 so that the adjusted light guides the patient to move their eyes to reduce misalignment.

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MEXICAN INSTITUTE OF IA PXOPIEUAU INOUSTKIAÍ

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Although this specification contains many specific details, these should not be construed as limitations on the scope of the invention or what can be claimed, but rather as descriptions of the specific characteristics for the particular embodiments.

Certain features described in this specification in the context of separate modes can also be implemented in combination in a single mode.

Conversely, various features that are described in the context of a single modality can also be implemented in multiple modalities separately or in any previously suitable subcombination. Furthermore, although the characteristics can be described to act in certain combinations and are even claimed as such initially, one or more characteristics of a claimed combination may in some cases be removed from the combination, and the claimed combination may be directed to a subcombination or variation of a subcombination.

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ICυ INDUSTR MEXICAN INDUSTRIAL PROPERTY

<img file="MX354151B_D0045.tif" />