Method and system for modifying eye tissue and intraocular lenses

1. A system for ophthalmic surgery, the system comprising:

a laser system comprising an optical system and a laser source configured to deliver a laser beam to intraocular targets and for physically modifying at least one of the intraocular targets, the laser beam comprising a plurality of laser pulses having pulse energies, a pulse duration between 400 and 700 picoseconds, and a wavelength between 320 nanometers and 400 nanometers, the optical system being operatively coupled to the laser source and configured to focus the laser beam to a focal spot and scan the focal spot within the intraocular targets;

a confocal imaging subsystem configured to detect light from the intraocular targets and form images based on the detected light; and

a controller operably coupled to the laser system and the confocal imaging subsystem, wherein the controller is configured to operate the laser system and confocal imaging subsystem to:

control the laser system to deliver interleaved higher energy treatment laser pulses and lower energy probe laser pulses to the intraocular targets, the treatment laser pulses having pulse energies configured to physically modify the intraocular targets, wherein the pulse energy, the pulse duration, and the focal spot of the treatment laser pulses are configured such that a laser beam irradiance of the treatment laser pulses at the focal spot is sufficiently high to physically modify the at least one of the intraocular targets by photodecomposition but not exceeding a threshold of formation of a plasma and associated cavitation event, the probe laser pulses having pulse energies lower than the pulse energies of the treatment laser pulses;

control the confocal imaging subsystem to detect back-reflected light or auto fluorescence light generated by the intraocular targets in response to the probe pulses, and based on the detected back-reflected light or auto fluorescence light in response to the probe pulses, to determine whether cavitation bubbles have been formed by the treatment laser pulses previously delivered into the intraocular targets; and

adjust the pulse energies of the treatment laser pulses based on a determination that cavitation bubbles have been formed by the treatment laser pulses.

2. The system of claim 1 , wherein the wavelength is 355 nanometers.

3. The system of claim 1 , wherein the pulse energies are between 0.01 microJoules and 500 microJoules.

4. The system of claim 1 , wherein the pulse energies are between 0.5 microJoules and 10 microJoules.

5. The system of claim 1 , wherein the plurality of laser pulses have a repetition rate of between 500 Hertz and 500 kiloHertz.

6. The system of claim 1 , wherein the focal spot has a size between 0.5 microns and 10 microns.

7. The system of claim 1 , wherein at least one of the intraoculartargets is selected from the group consisting of a cornea, a limbus, a sclera, a lens capsule, a crystalline lens, and a synthetic intraocular lens implant.

8. The system of claim 1 , wherein the treatment laser pulses are delivered to the intraocular targets in a treatment pattern which is configured to create one or more cuts in the at least one of the intraocular targets in a configuration selected from the group consisting of corneal relaxing incisions, limbal relaxing incisions, astigmatic keratomies, capsulotomies, corneal flaps, and corneal transplant shapes.

9. The system of claim 1 , wherein an index of refraction of the modified intraocular target is changed.

10. The system of claim 1 , wherein a laser beam irradiance of the treatment laser pulses is 120 gigaWatts per square centimeter.