Hybrid ophthalmic interface apparatus and method of interfacing a surgical laser with an eye

Abstract

Apparatus and methods are provided for interfacing a surgical laser with an eye using a patient interface device that minimizes aberrations through a combination of a contact lens surface positioning and a liquid medium between an anterior surface of the eye and the contact lens surface.

1 . An interface for coupling a patient's eye to a surgical laser system, the interface comprising:
 an attachment ring configured to overlay the anterior surface of the eye, the attachment ring comprising an inner surface;   a lens cone defining a first plane surface and configured to couple to a delivery tip of the surgical laser such that the delivery tip is positionally referenced to the first plane surface, the lens cone comprising:
 an apex ring coupled to the first plane surface, the apex ring comprising a distal end; and 
 an applanation lens disposed at a distal end of the apex ring and positioned in a second plane surface parallel to the first plane surface such that the delivery tip is positionally referenced to the second plane; 
   a gripper comprising:
 a first receptacle configured to receive the attachment ring; 
 a gripper portion having an inner surface; 
 a receiver portion having an inner surface; and 
 a central orifice configured to receive the lens cone, the gripper stabilizing the relative positions of the lens cone and the attachment ring when the lens cone and attachment ring are received within the gripper; and 
   a chamber configured to receive a liquid, the chamber formed by the inner surface of the attachment ring, the inner surface of the gripper portion, the inner surface of the receiver portion, and the applanation lens when the lens cone and attachment ring are received within the gripper.   
     
     
         2 . The interface according to  claim 1 , wherein the applanation lens comprises a surface shape selected from the group consisting of a flat surface, a concave surface and a convex surface. 
     
     
         3 . The interface according to  claim 1 , wherein the applanation lens comprises a flexible surface. 
     
     
         4 . The interface according to  claim 3 , wherein the applanation lens comprises a membrane. 
     
     
         5 . The interface according to  claim 1 , further comprising a fluid received in the chamber. 
     
     
         6 . The interface according to  claim 5 , wherein the fluid is selected from the group consisting of balanced salt solution and ophthalmic viscoelastic devices. 
     
     
         7 . The interface according to  claim 5 , wherein the fluid comprises a refractive index equivalent to a refractive index of a cornea of the eye. 
     
     
         8 . The interface according to  claim 1 , the attachment ring further comprising:
 a flexible annular outer shroud, the shroud configured to engage the surface of the eye when in proximity thereto, the shroud defining an outer wall surface; and   an annular suction cavity formed in an upper surface of the attachment ring and in proximate contact with the outer wall surface of the shroud.   
     
     
         9 . The interface according to  claim 8 , the attachment ring further comprising a fluid communication channel coupled between the suction cavity and a vacuum source, wherein as the attachment ring is positioned proximate to an eye, a suction is communicated to the annular suction cavity thereby engaging the attachment ring to the eye. 
     
     
         10 . An interface for coupling a patient's eye to a surgical laser system, the interface comprising:
 an attachment ring configured to overlay an anterior surface of the eye, the attachment ring having an inner surface;   a lens cone defining a first plane surface and configured to couple to a delivery tip of the surgical laser system such that the delivery tip is positionally referenced to the first plane surface, the lens cone comprising:
 an apex ring coupled to the first plane surface; and 
 an applanation lens disposed at a distal end of the apex ring; 
   a gripper comprising:
 a receptacle receiving the attachment ring to couple the attachment ring to the gripper; 
 a central orifice receiving the lens cone to coupled the lens cone to the gripper, the gripper stabilizing the relative positions of the lens cone and the attachment ring when the cone and ring are received within the gripper; 
 a gripper portion having an inner surface; 
 a pair of expandable jaws configured to expand a diameter of the central orifice when opened and further configured to contract the diameter of the central orifice when allowed to relax, the jaws having an inner surface; and 
 a pair of opposed lever handles coupled to the jaws, the lever handles configured to apply an opening pressure to the jaws when the opposed handles are squeezed together; and 
   a chamber configured to receive a liquid, the chamber formed by the inner surface of the attachment ring, the inner surface of the gripper portion, the inner surface of the jaws, and the applanation lens.   
     
     
         11 . The interface according to  claim 10 , wherein the applanation lens comprises a surface shape selected from the group consisting of a flat surface, a concave surface and a convex surface. 
     
     
         12 . The interface according to  claim 10 , wherein the apex ring has an outer diameter, and wherein the central orifice defines an inner diameter, the inner diameter sized to be smaller than the outer diameter of the apex ring, the central orifice expandable to the inner diameter sufficient to receive the apex ring upon application of opening pressure to the lever handles. 
     
     
         13 . The interface according to  claim 12 , wherein the apex ring has a height, and wherein the jaws engage an outer surface of the apex ring along at least a portion of the height of the apex ring upon relaxation of opening pressure applied to the lever handles, thereby retaining the apex ring and the lens cone in a generally fixed relationship with respect to the gripper. 
     
     
         14 . The interface according to  claim 10 , wherein the applanation lens comprises a flexible surface. 
     
     
         15 . The interface according to  claim 14 , wherein the applanation lens comprises a membrane. 
     
     
         16 . The interface according to  claim 10 , further comprising a fluid received in the chamber. 
     
     
         17 . The interface according to  claim 16 , wherein the fluid is selected from the group consisting of balanced salt solution and ophthalmic viscoelastic devices. 
     
     
         18 . The interface according to  claim 16 , wherein the fluid comprises a refractive index equivalent to a refractive index of a cornea of the eye. 
     
     
         19 . A method for interfacing an eye to a surgical laser, the method comprising:
 coupling a lens cone to a delivery tip of the surgical laser, the lens cone defining a first plane surface and the delivery tip being positionally referenced to the first plane surface, the lens cone comprising:
 an apex ring coupled to the first plane surface, the apex ring comprising a distal end; and 
 an applanation lens disposed at a distal end of the apex ring and positioned in a second plane surface parallel to the first plane surface such that the delivery tip is positionally referenced to the second plane; 
   coupling an attachment ring to an anterior surface of the eye, the attachment ring having an inner surface and comprising a gripper, the anterior surface of the eye and the inner surface of the attachment ring forming a first receptacle, the gripper comprising:
 a second receptacle configured to receive the attachment ring, the second receptacle having an inner surface; and 
 a central orifice configured to receive a lens cone; 
   receiving a liquid into the first receptacle;   positioning the lens cone in the central orifice;   stabilizing the relative positions of the lens cone and the attachment ring with the gripper when the lens cone and attachment ring are received within the gripper, a chamber containing the liquid being formed by the first receptacle and the applanation lens when the lens cone and attachment ring are received within the gripper.   
     
     
         20 . The method of  claim 19 , further comprising releasing a portion of the liquid out of the chamber while displacing the applanation lens toward the eye.