Methods and Apparatus for Integrated Cataract Surgery

1 . A method for cataract eye surgery, comprising:

determining a surgical target region in a lens of the eye; and

applying laser pulses to photodisrupt a portion of the determined target region

before making an incision on a capsule of the lens, within an integrated surgical procedure.

2 . The method of claim 1 , wherein the applying laser pulses step is performed before making an incision on a cornea of the eye.

3 . The method of claim 1 , wherein the target region includes a nucleus of the lens.

4 . The method of claim 1 , wherein the integrated surgical procedure comprises:

using a pulsed laser source for photodisrupting the target region;

using the same laser source for making an incision on the capsule of the lens; and

using the same laser source for making an incision on the cornea of the eye.

5 . The method of claim 4 , wherein the incisions are one of

a multi-plane incision, a valved incision, a self-sealing incision a partial incision, and a full-thickness incision.

6 . The method of claim 4 , wherein the making of the capsular incision comprises:

creating an essentially closed loop of bubbles to define a capsular lid,

spacing the bubbles along the loop to make the removal of the capsular lid easy.

7 . The method of claim 4 , wherein the integrated surgical procedure comprises:

removing photodisrupted material through the capsular incision and the corneal incision.

8 . The method of claim 4 , wherein the integrated surgical procedure comprises:

inserting an intra ocular lens into the lens capsule through the existing corneal and capsular incisions.

9 . The method according to claim 8 , wherein the integrated surgical procedure comprises:

inflating the lens capsule during the insertion of the intra ocular lens; and

placing a haptic portion of the intraocular lens to optimize at least one of a centration and an anterior-posterior localization of an optic portion of the intraocular lens.

10 . A method according to claim 8 , wherein the integrated surgical procedure comprises:

deflating the lens capsule following the insertion of the intra ocular lens, thereby bringing an anterior portion and a posterior portion of the capsule closer to the intraocular lens in a controlled manner to optimize a centration and an anterior-posterior localization of the intraocular lens.

11 . The method of claim 1 , wherein the photodisruption comprises:

determining a boundary of the target region;

focusing the laser pulses on a posterior region of the target region; and

focusing the laser pulses on a region anterior to the posterior region of the target region.

12 . The method of claim 1 , further comprising:

inserting a trochar into the corneal and the capsular incisions.

13 . The method of claim 12 , wherein:

the trochar is inserted to create an essentially watertight contact with at least one of the cornea and the capsule.

14 . The method of claim 12 , wherein the integrated surgical procedure comprises at least one of:

inserting surgical tools through the trochar;

managing the eye-fluids during a period of the surgery through the trochar; and

inserting the intra ocular lens into the capsule through the trochar.

15 . The method of claim 1 , wherein the integrated surgical procedure comprises

maintaining a shape of a portion of the eye by infusing a physiologically suitable viscoelastic fluid into a volume of the eye.

16 . The method of claim 15 , wherein the maintaining the shape of an eye-portion comprises:

infusing a viscoelastic fluid into the lens in relation to the removal of a photodisrupted nucleus through the capsular incision.

17 . The method of claim 1 , wherein the integrated surgical procedure further comprises:

optically accessing a peripheral area of the lens via an angled mirror.

18 . A method for performing cataract surgery, comprising:

directing a beam of laser pulses with an integrated surgical device to fragment a portion of a lens for removal before making any physical incision on the eye;

performing a partial or full thickness capsular incision to access the fragmented lens portion with the integrated surgical device;

removing the fragmented lens portion from the eye through the incision; and

inserting an intraocular lens into the eye through the incision to a position of the removed fragmented lens portion.

19 . The method as in claim 18 , further comprising:

placing removable trochars to traverse a corneal incision and the capsule incisions to maintain an essentially watertight seal.

20 . An eye-surgical device, comprising:

a multi-purpose pulsed laser, configured:

to be directed at a lens of an eye to fragment a portion of the lens before making a physical incision on the eye; and

to perform a corneal incision and a capsular incision to access the fragmented lens portion with the multi-purpose laser; and

an aspiration device, configured

to remove the fragmented lens portion from the eye through the corneal incision and the capsular incision.