Lasik flap cutting patterns including bubble barrier layer in side cut for bubble management
A method implemented in an ophthalmic surgical laser system for forming a corneal flap in a patient's eye with improved bubble management. The flap includes a horizontal bed and a vertical or near vertical side cut around the periphery of the bed except for an uncut hinge area. The side cut has a bubble barrier layer that can prevent bubbles formed by the laser-tissue interaction from escaping into an interface between the corneal and the patient interface lens. In some embodiments, the bubble barrier layer is a thin uncut layer, located in the epithelium of the cornea, that separates the side cut into two portions. In other embodiments, the side cut does not reach the anterior corneal surface, leaving an uncut bubble barrier layer located with the epithelium. In other embodiments, an additional side cut portion is formed through the uncut bubble barrier layer as the last step.
1. A method implemented in an ophthalmic surgical laser system for incising a cornea of a patient's eye to form a corneal flap, the patient's eye being coupled to a patient interface device of the ophthalmic surgical laser system, the method comprising:
controlling a laser delivery system of the ophthalmic surgical laser system to deliver a pulsed laser beam to the cornea;
controlling the laser delivery system to scan the pulsed laser beam to form a bed of the flap in the cornea at a predefined bed depth; and
controlling the laser delivery system to scan the pulsed laser beam to form a side cut, wherein the side cut extends in lateral directions along a periphery of the bed except for a hinge portion, and extends in a depth direction from the bed depth to an anterior corneal surface, wherein the side cut defines a lower portion and an upper portion separated by an uncut bubble barrier layer, wherein the bubble barrier layer is located within an epithelium of the cornea, and wherein the upper portion of the side cut intersects the anterior corneal surface.
2. The method of claim 1 , wherein the bubble barrier layer has a thickness of between 5 and 20 microns.
3. The method of claim 1 , wherein the bubble barrier layer is located at a uniform distance from the anterior corneal surface.
4. The method of claim 1 , wherein the bubble barrier layer is located at variable distances from the anterior corneal surface.
5. The method of claim 4 , wherein the bubble barrier layer form a wave pattern extending in and angular direction of the flap.
6. The method of claim 1 , wherein the step of controlling the laser delivery system to scan the pulsed laser beam to form the bed includes forming a ring cut that defines a periphery of the bed, and forming a bed cut in a central portion of the bed surrounded by the ring cut, wherein the side cut is formed before the bed cut.
7. The method of claim 1 , wherein the step of controlling the laser delivery system to scan the pulsed laser beam to form the bed includes forming a ring cut that defines a periphery of the bed, and forming a bed cut in a central portion of the bed surrounded by the ring cut, wherein the side cut is formed after the bed cut.
8. The method of claim 1 , wherein the step of controlling the laser delivery system to scan the pulsed laser beam to form the side cut includes scanning the laser beam in the depth direction along the side cut and blanking the laser beam in predefined depth ranges when scanning the laser beam in the depth direction.
9. The method of claim 1 , further comprising controlling a high frequency scanner of the ophthalmic surgical laser system to scan the pulsed laser beam back and forth to form a laser scan line in the cornea;
wherein the side cut is formed by placing the laser scan line tangent to a circumference of the side cut, moving the laser scan line in a depth direction, simultaneously moving the laser scan line around the circumference, simultaneously rotating the scan line to keep it tangent to the circumference, and blanking the laser beam in predefined depth ranges when moving the laser beam in the depth direction.
10. An ophthalmic surgical laser system comprising:
a laser source configured to generate a laser beam;
a laser delivery system configured to deliver the laser beam to a cornea of a patient's eye; and
a controller configured to control the laser source and the laser delivery system to perform a method for incising a cornea of a patient's eye to form a corneal flap, the patient's eye being coupled to a patient interface device of the ophthalmic surgical laser system, the method comprising:
controlling the laser delivery system to deliver a pulsed laser beam to the cornea;
controlling the laser delivery system to scan the pulsed laser beam to form a bed of the flap in the cornea at a predefined bed depth; and
controlling the laser delivery system to scan the pulsed laser beam to form a side cut, wherein the side cut extends in lateral directions along a periphery of the bed except for a hinge portion, and extends in a depth direction from the bed depth to an anterior corneal surface, wherein the side cut defines a lower portion and an upper portion separated by an uncut bubble barrier layer, wherein the bubble barrier layer is located within an epithelium of the cornea, and wherein the upper portion of the side cut intersects the anterior corneal surface.
11. The ophthalmic surgical laser system of claim 10 , wherein the bubble barrier layer has a thickness of between 5 and 20 microns.
12. The ophthalmic surgical laser system of claim 10 , wherein the bubble barrier layer is located at a uniform distance from the anterior corneal surface.
13. The ophthalmic surgical laser system of claim 10 , wherein the bubble barrier layer is located at variable distances from the anterior corneal surface.
14. The ophthalmic surgical laser system of claim 13 , wherein the bubble barrier layer form a wave pattern extending in and angular direction of the flap.
15. The ophthalmic surgical laser system of claim 10 , wherein the step of controlling the laser delivery system to scan the pulsed laser beam to form the bed includes forming a ring cut that defines a periphery of the bed, and forming a bed cut in a central portion of the bed surrounded by the ring cut, wherein the side cut is formed before the bed cut.
16. The ophthalmic surgical laser system of claim 10 , wherein the step of controlling the laser delivery system to scan the pulsed laser beam to form the bed includes forming a ring cut that defines a periphery of the bed, and forming a bed cut in a central portion of the bed surrounded by the ring cut, wherein the side cut is formed after the bed cut.
17. The ophthalmic surgical laser system of claim 10 , wherein the step of controlling the laser delivery system to scan the pulsed laser beam to form the side cut includes scanning the laser beam in the depth direction along the side cut and blanking the laser beam in predefined depth ranges when scanning the laser beam in the depth direction.
18. The ophthalmic surgical laser system of claim 10 , wherein the method further comprises controlling a high frequency scanner of the ophthalmic surgical laser system to scan the pulsed laser beam back and forth to form a laser scan line in the cornea;
wherein the side cut is formed by placing the laser scan line tangent to a circumference of the side cut, moving the laser scan line in a depth direction, simultaneously moving the laser scan line around the circumference, simultaneously rotating the scan line to keep it tangent to the circumference, and blanking the laser beam in predefined depth ranges when moving the laser beam in the depth direction.