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

Fs-lasers are clinically established for surgical procedures in the anterior eye, e.g. for corneal flap cutting during LASIK or for cutting the crystalline lens in assisting cataract surgery. However, the use of fs-lasers in the posterior segment of the eye (vitreous body and retina) is impeded by aberrations and focus position errors. The distortion of the laser focus reduces the precision and raises the required pulse energy for cutting. Thus, the risk for peripheral implications and retinal damage is increased. We present a functional prototype for image-guided vitreo-retinal fs-laser surgery which combines optical coherence tomography for laser beam guidance and adaptive optics for aberration correction and spatial beam shaping. By targeted cutting of phantom structures close to porcine retinal tissue we prove that ophthalmic fs-laser surgery in the posterior eye is made more feasible by tomographic image guidance and aberration correction. Such a system could offer a minimally invasive alternative to conventional pars plana vitrectomy and opens up a multitude of new treatment options.