_of eye tracking on ablation profile在消融轮廓跟踪眼球效应课件

Introduction and Overview 2018/10/24 General Operational FlowGeneral Operational Flow AstraMaxAstraMax AstraProAstraPro LaserScan LSX LaserScan LSX AstraScan and AstraScanAstraScan and AstraScan XL XL ConfigurationsConfigurations Surgery planningSurgery planning Diagnostic exams (AstraMax, Diagnostic exams (AstraMax, refraction, rigid contact lens refraction, rigid contact lens fitting, wavefront)fitting, wavefront) AstraPro: Custom Ablation Planning Software Data is input from AstraMax which includes: Shape, pupil sizes, registration data, pachymetry, asphericity(Q), and other proprietary data points Refractive data is input New shape is calculated to maintain the eyes natural prolate asphericity while correcting the refractive error to the best fit elipsoid model New shape is calculated with respect to the scotopic pupil AstraPro Principals: Volume Description The volume of the ablation is described by the intersection of the existing, detected anterior surface of the cornea and the ideal cornea surface targeting the pre-operative asphericity The intersection between the measured surface and the ideal surface must be as large as the scotopic pupil seen projected at the anterior surface of the cornea Required Data SHAPE The shape of the cornea must be measured using triangulation methods to derive elevation with very high resolution (0) and are termed Oblate Myopic refractive surgical treatments increase + asphericity, i.e., moves shape towards Oblate Exaggerates the effects of spherical aberration, i.e., more night vision problems Prolate Vs. Oblate (Asphericity) Oblate (Q 0) Prolate (Q Pupil Pupil Center Offset Visual Axis Pupil Center Optical Zone Initial Surface Final Surface Blend ZoneBlend Zone Blend between optical and treatment zonesBlend between optical and treatment zones Gaussian function ensures continuous curve Gaussian function ensures continuous curve along the target eye surfacealong the target eye surface Profile is blended to the target eye, not to a Profile is blended to the target eye, not to a flat surfaceflat surface Blend ZoneBlend Zone Ablation Modulation FunctionAblation Modulation Function Maintains or improve Maintains or improve prolate prolate shapeshape Corrects for laser fluence reduction in Corrects for laser fluence reduction in peripheryperiphery This algorithm may be extensible to the laser This algorithm may be extensible to the laser platform directlyplatform directly Laser Fluence Reduction Fluence = Area Energy B1 B2 The area of B2 is larger than the area of B1, so B2 has less fluence if the energy remains constant. Advanced Surgical PlanningAdvanced Surgical Planning Aspheric Ellipsoid ModelAspheric Ellipsoid Model Contact Lens Over-Refraction MethodContact Lens Over-Refraction Method Target RefractionTarget Refraction Optical and Treatment ZonesOptical and Treatment Zones Nomogram AdjustmentNomogram Adjustment Target Z-Axis OffsetTarget Z-Axis Offset Effective Refractive ChangeEffective Refractive Change Aspheric Ellipsoid ModelAspheric Ellipsoid Model Initial and final eye surfacesInitial and final eye surfaces Parameters: KParameters: K 1 1 , K, K 2 2 , axis, asphericity (Q), , axis, asphericity (Q), defined as the apical keratometrydefined as the apical keratometry Corrects for the keratometric index of Corrects for the keratometric index of refractionrefraction Novel algorithm to add spherical refraction to Novel algorithm to add spherical refraction to aspherical surfacesaspherical surfaces Contact Lens Over-RefractionContact Lens Over-Refraction CLOR method for irregular or asymmetric CLOR method for irregular or asymmetric surfacessurfaces Set of rigid contact lensesSet of rigid contact lenses May provide best correctionMay provide best correction Target RefractionTarget Refraction Allows surgeon to record target refraction Allows surgeon to record target refraction separately from spectacle or contact lens separately from spectacle or contact lens refractionrefraction Ideal for mono-vision patientsIdeal for mono-vision patients Optical and Treatment ZonesOptical and Treatment Zones The default OZ is set to the scotopic pupil The default OZ is set to the scotopic pupil diameter or 6mm, whichever is largerdiameter or 6mm, whichever is larger The TZ is set to 1mm (SER myopia) or The TZ is set to 1mm (SER myopia) or 2.5mm (SER hyperopia) larger than the 2.5mm (SER hyperopia) larger than the optical zone.optical zone. The surgeon may modify the OZ and TZ The surgeon may modify the OZ and TZ within the range 3-9mmwithin the range 3-9mm Nomogram AdjustmentNomogram Adjustment Persistent Sphere/Cylinder adjustments Persistent Sphere/Cylinder adjustments separately for myopic astigmatism, hyperopic separately for myopic astigmatism, hyperopic astigmatism, and mixed astigmatismastigmatism, and mixed astigmatism Sphere/Cylinder adjustment may be modified Sphere/Cylinder adjustment may be modified for individual treatmentsfor individual treatments Applied to refraction, prior to AMFApplied to refraction, prior to AMF Target Z-Axis OffsetTarget Z-Axis Offset Provides an offset to the Target Z-AxisProvides an offset to the Target Z-Axis Automatically computed by the softwareAutomatically computed by the software Optimizes treatment plan (saves tissue) for Optimizes treatment plan (saves tissue) for irregular surfacesirregular surfaces Effective Refractive ChangeEffective Refractive Change Estimated from the corneal topography and Estimated from the corneal topography and apical keratometryapical keratometry Computed in terms the surgeon can Computed in terms the surgeon can understand, using the spherical understand, using the spherical approximation of the initial and final surfacesapproximation of the initial and final surfaces Safety FeaturesSafety Features Treatment depth computed normal to the eye Treatment depth computed normal to the eye surface and compared with pachymetry at all surface and compared with pachymetry at all pointspoints Warning messages and restrictionsWarning messages and restrictions Patient data (name, gender, eye) provided for Patient data (name, gender, eye) provided for visual confirmationvisual confirmation Advanced Visual DisplayAdvanced Visual Display Visual DisplayVisual Display Keratometric axial power map duplicates Keratometric axial power map duplicates image from topographer, as a double-checkimage from topographer, as a double-check Preop elevation difference map from best fit Preop elevation difference map from best fit asphere of keratometryasphere of keratometry Predicted postop elevation difference map Predicted postop elevation difference map from best fit asphere of keratometryfrom best fit asphere of kerato