Concept for image-guided vitreo-retinal fs-laser surgery: adaptive optics and optical coherence tomography for laser beam shaping and positioning

Matthias, Ben; Brockmann, Dorothee; Hansen, Anja; Horke, Konstanze; Knoop, Gesche; Gewohn, Timo; Zabic, Miroslav; Krüger, Alexander; Ripken, Tammo

doi:10.1117/12.2077606

Cited by 4 publications

(2 citation statements)

References 7 publications

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“…In Ref. 32, we demonstrated that the OCT lateral resolution could be slightly improved from 9 to 7 μm after reducing wavefront errors by AO aberration correction using fs-laser pulses reflected at a PTFE band inside the eye model as a point source. This minor impact of AO aberration correction on image quality of our parallel OCT system might be due to noncommon path aberrations introduced by the beam expander in the OCT beam path and the telescope between the DM and the SHS (refer to Fig.…”

Section: Discussionmentioning

confidence: 99%

Adaptive optics assisted and optical coherence tomography guided fs-laser system for ophthalmic surgery in the posterior eye

et al. 2016

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While fs-lasers are clinically established for surgery in the anterior eye, their use in the posterior eye is impeded by aberrations and focus position errors. We implemented a laboratory system to investigate whether fs-laser surgery in the posterior eye is made more feasible by aberration correction and tomographic image guidance. Aberration correction is obtained by adaptive optics (AO) and the image guidance is accomplished by optical coherence tomography (OCT). System characteristic measurements and cutting experiments were performed inside an eye model. By aberration correction, wavefront errors were reduced from 270 nm root-mean-square (rms) to 64 nm rms, ignoring Zernike terms for tilts and focus. The Strehl ratio of the assigned point spread function is improved from 0.11 to 0.78. The threshold pulse energy of laser-induced optical breakdown in water is lowered from about 3.0 to about 1.3???J measured at the eye model entrance. After laser cutting of a synthetic foil placed 300???m in front of porcine retinal tissue with the corrected system, postoperative three-dimensional OCT imaging showed no lesions in the tissue. Our results corroborate that AO and OCT will be two essential assistive components for possible clinical systems for fs-laser–based surgery in the posterior eye.

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Section: Discussionmentioning

confidence: 99%

Adaptive optics assisted and optical coherence tomography guided fs-laser system for ophthalmic surgery in the posterior eye

et al. 2016

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“…The application of fs-lasers in the posterior eye segment still lacks the necessary accuracy, safety and effectiveness. 8 Because of the relatively large aberrations in the human eye, 9 adaptive optics (AO) is indispensable to reduce the laser power for fs-laser treatments close to the light sensitive posterior retina. 10 In traditional AO systems, originally invented for astronomical purposes, a wavefront sensor (e.g.…”

Section: Introductionmentioning

confidence: 99%

Wavefront sensorless adaptive optics for optical coherence tomography guided femtosecond laser surgery in the posterior eye

Zabic

Matthias

Hahn

et al. 2019

Adaptive Optics and Wavefront Control for Biological Systems V

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Surgery with fs-laser in the posterior part of the eye could be useful for separation of tractional epiretinal membrane and vitreous floaters treatment. However, focus degradation occurs near the retina due to induced aberrations by cornea and lens. To overcome this issue, adaptive optics with wavefront sensor and wavefront modulator can be utilized. We demonstrate an alternative concept for image guided femto second laser (fs-laser) surgery in the posterior eye with wavefront sensorless adaptive optics (WFSLAO). Our laboratory setup consists of an 800 nm fs-laser and a superluminescent diode (SLD) with 897.2 nm central wavelength. The SLD is used for optical coherence tomography (OCT) whereby the light for the OCT sample arm and the fs-laser share the same optical path which contains a deformable mirror, scanner and focusing optics. Energy calibrated photodiodes are used to measure the threshold energy for a laser induced optical breakdown inside a water filled chamber that acts as simple eye model. OCT image based metrics were used to determine a set of Zernike polynomials that describe a near optimal deformable mirror state. Such a mirror state improved OCT resolution and at the same time lowered the required fs-laser energy for a laser induced optical breakdown inside the eye model substantially.

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Femtosecond Lasers in Ophthalmology

et al. 2016

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Presbyopia is the most common visual defect of the human eye. Beginning with the age of 45 years, most people lose the ability to focus on near objects due to the loss of accommodation ability of the crystalline lens. Within the research network IKARUS, a femtosecond laser system has been realized, which is able to generate microscopic sliding into the crystalline lens, to restore the accommodative capacity of the eye. The surgical procedure only takes a few seconds and is non‐invasive. As a consequence, there is no risk of infection for the patient and the pro cedure can be carried out in non‐sterile environment. In addition, other clinical applications with extremely high market potential were evaluated in the context of ex vivo investigations. It could be shown that, using adaptive optics, it is possible to create precise cuts even in the posterior segment of the eye (retina) and thus open up a multitude of new treatment options.

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Concept for image-guided vitreo-retinal fs-laser surgery: adaptive optics and optical coherence tomography for laser beam shaping and positioning

Cited by 4 publications

References 7 publications

Adaptive optics assisted and optical coherence tomography guided fs-laser system for ophthalmic surgery in the posterior eye

Adaptive optics assisted and optical coherence tomography guided fs-laser system for ophthalmic surgery in the posterior eye

Wavefront sensorless adaptive optics for optical coherence tomography guided femtosecond laser surgery in the posterior eye

Femtosecond Lasers in Ophthalmology

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