WO2017135035A1

WO2017135035A1 - Ophthalmic laser refractive correction device, ophthalmic photo-tuning setting device, ophthalmic photo-tuning system, ophthalmic photo-tuning setting device, program used in same, and ophthalmic laser surgery device

Info

Publication number: WO2017135035A1
Application number: PCT/JP2017/001609
Authority: WO
Inventors: 羽根渕昌明; 田中真樹
Original assignee: 株式会社ニデック
Priority date: 2016-02-03
Filing date: 2017-01-18
Publication date: 2017-08-10
Also published as: JP6973086B2; JPWO2017135035A1

Abstract

An ophthalmic laser refractive correction device for condensing laser light to the inside of a translucent body provided to a patient eye, the ophthalmic laser refractive correction device being provided with: an irradiation optical system for guiding laser light to the inside of a translucent body provided to the patient eye, the laser light being emitted from a laser light source unit and being for adjusting the refractive index of the translucent body; a scanning unit for causing the laser light to scan a condensing position, the scanning unit being disposed in an optical path of the irradiation optical system; and a control means for controlling the scanning unit and causing the laser light to scan a condensing position in an irradiation region corresponding to a pre-set lens pattern of a multilevel-phase-type diffractive lens, and thereby forming the multilevel-phase-type diffractive lens in the inside of the translucent body.

Description

Ophthalmic Laser Refractive Correction Device, Ophthalmic Photo Tuning Setting Device, Ophthalmic Photo Tuning System, Eyeglass Photo Tuning Setting Device, Program Used for These, and Ophthalmic Laser Surgery Device

This disclosure relates to correcting the refractive properties of the eye by optically adjusting the refractive index of the translucent body using laser irradiation.

An ophthalmic laser surgical apparatus is known that treats a patient's eye by condensing a laser beam in a tissue of the patient's eye (see Patent Document 1). Typically, according to such an apparatus, corneal refraction correction by cutting the patient's eye cornea, cataract surgery by crushing the lens opacity portion of the patient's eye, and the like can be mentioned.
In addition, as a phototuning method, for example, a method of adjusting a refractive index using a photochemical reaction proposed by Norbert Hampp et al. (For example, Patent Document 2), a hydrophobicity filed by Perfect Lens, Inc. A method of adjusting the refractive index by changing the hydrophilicity of the conductive material (for example, Patent Document 3), a method of adjusting the refractive index by changing the hydrophilicity of the hydrogel material proposed by Way Knox et al. A technique (for example, Patent Document 5) of changing the refractive index of the cornea is known by Patent Document 4) or Way Knox et al.

JP 2015-37474 A US Patent Publication No. 2009-157178 US Patent Publication No. 2014-135920 US Registration No. 8337553 US Registration No. 8617147

However, there are no examples where such phototuning has been commercialized. The reason is that, for example, when a saw-type phase-type diffractive lens is formed, a laser light source having a repetitive frequency much higher than that of a laser generally used in ophthalmology is required. As another issue, when phototuning is performed on a translucent body provided in a patient's eye, the position of the translucent body in the eye is unknown, and a specific method for deriving a lens pattern suitable for the patient's eye Lacks means.
However, there is still no device that combines the above ophthalmic laser surgical device and phototuning.

The present disclosure relates to an ophthalmic laser refraction correction device, an ophthalmic photo tuning setting device, an ophthalmic photo tuning system, a spectacle photo tuning setting device, and a program used therefor, ophthalmology, which can solve at least one of the above problems An object of the present invention is to provide a laser surgical apparatus for medical use.

In order to solve the above problems, the present disclosure is characterized by having the following configuration.

(1) An ophthalmic laser refraction correction apparatus for adjusting a refractive index of a light transmitting body by condensing laser light inside a light transmitting body provided in a patient's eye,
An irradiation optical system for guiding laser light emitted from a laser light source unit to adjust the refractive index of the translucent body, into the translucent body provided in the patient's eye;
A scanning unit that is disposed in the optical path of the irradiation optical system and scans the condensing position of the laser beam;
The scanning unit is controlled to scan the condensing position of the laser beam in an irradiation region corresponding to a preset lens pattern of the multilevel phase type diffractive lens, thereby allowing the multilevel phase type diffractive lens to pass through the translucent light. Control means formed inside the body;
It is characterized by providing.
(2) An ophthalmic laser refraction correction apparatus for adjusting the refractive index of the light transmitting body by condensing the laser light inside the light transmitting body provided in the patient's eye,
An irradiation optical system for guiding laser light emitted from a laser light source unit to adjust the refractive index of the translucent body, into the translucent body provided in the patient's eye;
A scanning unit that is disposed in the optical path of the irradiation optical system and scans the condensing position of the laser beam;
Control means for controlling the scanning unit,
The laser beam is applied to an irradiation region corresponding to a lens pattern set in advance based on positional information of the translucent body in a tomographic image captured by a tomographic imaging device and a refraction characteristic of a patient's eye measured by a refraction measuring device. A control means for forming a lens inside the translucent body by scanning the condensing position of
It is characterized by providing.
(3) An ophthalmic photo-tuning setting device for setting a lens pattern formed by condensing laser light inside a translucent body provided in a patient's eye,
Characterized by comprising setting means for setting the lens pattern based on positional information of the translucent body in a tomographic image captured by a tomographic imaging device and refraction characteristics of a patient's eye measured by a refraction measuring device. To do.
(4) (3) Ophthalmic photo-tuning setting device;
A tomographic imaging device for capturing a tomographic image of the patient's eye including the translucent body;
A refraction measuring device for measuring refraction characteristics of the patient's eye including the translucent body;
Ophthalmic photo tuning system.
(5) A spectacle photo-tuning setting device for setting a lens pattern formed by condensing laser light inside a spectacle lens,
(6) A setting unit that sets the lens pattern based on the refractive characteristics of the entire eyeball when wearing spectacles and the optical arrangement information of the anterior segment with respect to the spectacle lens when wearing spectacles. When executed by the processor of the apparatus according to any one of 1) to (5), at least one of the control of the scanning unit by the control unit and the setting of the lens pattern by the setting unit is performed on the apparatus. A program characterized by being executed.
(7) An ophthalmic laser surgical apparatus for treating the patient's eye by condensing laser light in the tissue of the patient's eye,
A laser light source unit capable of selectively emitting a first laser beam for treating the patient's eye and a second laser beam for adjusting the refractive index of the transparent body;
A scanning unit that is arranged in an optical path of an irradiation optical system and scans a condensing position of the first laser beam or the second laser beam;
A first operation mode for treating the patient's eye using a first laser beam, and a second operation for performing phototuning using a second laser beam for adjusting the refractive index of the light transmitting body Mode switching means for switching between modes,
When the first switching mode is set by the mode switching means, the patient's eye is treated by controlling the scanning unit to scan the condensing position of the first laser beam,
When the second operation mode is set by the mode switching means, the scanning unit is controlled to scan the condensing position of the second laser light in the irradiation area corresponding to the preset lens pattern. A control means for forming a lens inside the translucent body,
It is characterized by providing.

It is a figure when an example of the transparent body which concerns on a present Example is seen from the front. It is a figure when an example of the transparent body which concerns on a present Example is seen from the side. It is a figure which shows an example at the time of a lens being formed in the translucent body which concerns on a present Example. It is a side view showing an example of a lens pattern concerning a saw type phase type diffraction lens. It is a side view which shows an example of the lens pattern which concerns on a multilevel type | mold phase type | mold diffraction lens. It is a front view which shows an example of the lens pattern which concerns on a multilevel type | mold phase type | mold diffraction lens. It is a flowchart which shows an example in the case of setting the lens pattern which concerns on a present Example. It is an optical diagram which shows an example of the ophthalmic laser refractive correction apparatus which concerns on a present Example. It is an optical diagram which shows an example of the optical arrangement | positioning at the time of treating a patient's eye in the ophthalmic laser refractive correction apparatus which concerns on a present Example. It is an optical diagram which shows an example of optical arrangement | positioning at the time of performing photo tuning in the ophthalmic laser refraction correction apparatus which concerns on a present Example. It is a figure which shows an example of the eyeball interface which concerns on a present Example. It is a flowchart which shows an example of the planning which concerns on a present Example. It is a flowchart which shows an example at the time of performing the additional photo tuning which concerns on a present Example. It is a figure which shows an example of the tomogram before the eyeball interface which concerns on a present Example is mounted | worn with a patient's eye. It is a figure which shows an example of the tomogram after the eyeball interface which concerns on a present Example is mounted | worn with a patient's eye.

Exemplary embodiments of the present disclosure are described below.
<Overview>
<Photo tuning reaction>
One aspect of this embodiment is to correct the refractive characteristics of the eye (eg, eye refractive power, aberration) by optically adjusting the refractive index of the translucent body using laser irradiation. It can be used in the fields of ophthalmology and glasses. In the following description, an optical technique for optically adjusting the refractive index of a light transmitting body will be described as phototuning. The transparent body subjected to phototuning may be used to correct myopia, hyperopia, astigmatism, higher-order aberration, chromatic aberration, and the like of the eye to be examined. In addition, multifocality adjustment may be performed. In the photo-tuning technique, one or a plurality of lenses different from the refractive index of the light transmitting body may be written in the light transmitting body by adjusting the refractive index of the light transmitting body.

Another aspect of this embodiment is to form (manufacture) a photo-tuned lens by optically adjusting the refractive index of the translucent body using laser irradiation. For example, the ophthalmic medical field It can be used in the field of glasses.

As a photo-tuning method, for example, a method of adjusting a refractive index using a photochemical reaction proposed by Norbert Hamp et al. (For example, US Patent Publication No. 2009-157178), which is filed by Perfect Lens Company. A method of adjusting the refractive index by changing the hydrophilicity of the hydrophobic material (for example, US Patent Publication No. 2014-135920), refraction by changing the hydrophilicity of the hydrogel material proposed by Way Knox et al. A method for adjusting the rate (for example, US registration 8337553) or a method for changing the refractive index of the cornea (for example, US registration 8617147) by Way Knox et al. Is not limited to this.

<Translucent material for photo tuning>
The translucent body may be, for example, a translucent body having a first refractive index and having optical transparency. The refractive index of the transparent body is adjusted by phototuning. Typically, the light-transmitting body to which photo-tuning is applied may be an artificial light-transmitting body (see the light-transmitting body 600 in FIGS. 1 and 2), for example, an ophthalmic lens, For example, an artificial lens (for example, an intraocular lens (IOL, ICL), a spectacle lens, a contact lens, or an artificial cornea may be used. A general optical material may be used as the artificial translucent body. Moreover, a natural lens (for example, an eye cornea, a crystalline lens) may be used as a translucent body to which photo tuning is applied.

In the case of an artificial translucent body, an optical material dedicated to phototuning (for example, an optical polymer material that is designed to have a relatively high ultraviolet absorption characteristic) may be used. The two-photon absorption of the laser can be promoted by the high absorption property of ultraviolet rays.

When the artificial translucent body is an intraocular lens, the intraocular lens may be, for example, an intraocular lens designed to be inserted into either the anterior chamber of the eye, the posterior chamber of the eye, or the lens. Good. The intraocular lens may be, for example, an intraocular lens that is inserted into the eye and has lens characteristics in advance. Moreover, the intraocular lens to which a lens characteristic is added by performing photo tuning with respect to the optical material inserted in the eye may be sufficient.

When phototuning is performed on an artificial translucent body, phototuning is performed at least before the artificial translucent body is provided to the eye, or at least before the artificial translucent body is provided to the eye. May be. As an example in which an artificial translucent body is provided for the eye, a translucent body may be inserted into the eye, or a lens may be provided in front of the eye via a spectacle frame.

The translucent body may include a main body having a front surface and a rear surface, in which lens characteristics are formed. That is, the translucent body may be formed with a characteristic that refracts or diffracts light to diverge or focus the light. In this case, the front surface and the rear surface may be substantially flat. Of course, the front surface and the rear surface may be curved surfaces. In the present embodiment, the front surface is described as the outer side, and the rear surface is described as the retinal side. In the case of an intraocular lens, a support part (loop) may be provided in addition to the main body. The main body is used as an optical unit having lens characteristics.

Note that one lens or a plurality of lenses may be formed inside the translucent body by phototuning (for example, the first lens 600 and the second lens in FIG. 3). 620).

The focal point of the laser beam is moved to write the lens inside the translucent body. By condensing the laser beam inside the light transmitting body, the refractive index inside the light transmitting body is corrected. As a result, the refractive index of the region irradiated with the laser is adjusted to a second refractive index different from the first refractive index. By utilizing this, the focus of the laser beam is moved to the irradiation region corresponding to the preset lens pattern, so that the lens corresponding to the lens pattern is formed inside the translucent body. The laser irradiation region is a refractive index changing region having a second refractive index, and functions as a lens having the second refractive index inside the light transmitting body.

The laser beam may be irradiated sequentially from the surface (front surface or rear surface) of the light transmitting body, for example. Of course, the laser beam may be irradiated from the middle between the front surface and the rear surface of the transparent body. Note that the irradiation start position may be appropriately set by a phototuning technique. In this case, the laser beam may be irradiated in order from the rear surface side. As a result, the refractive index change region is not arranged in the optical path of the next laser beam, so that a predetermined lens pattern can be formed smoothly.

<Writing of multilevel phase type diffractive lens>
In the photo-tuning technique according to the present embodiment, one or a plurality of multi-level phase type diffractive lenses (hereinafter, may be abbreviated as MP diffractive lenses) may be written in the light transmitting body (FIG. 5). Lens 610). The processor may control a scanning unit that scans a condensing position of the laser light, and may scan the condensing position of the laser light in the irradiation region of the light transmitting body corresponding to the lens pattern of the multilevel phase type diffractive lens. . Thereby, a multi-level phase type diffractive lens can be formed inside the light transmitting body. The processor can preset the lens pattern.

When a plurality of MP diffractive lenses are written, each MP diffractive lens may be formed in different regions with respect to the front-rear direction (optical axis direction) of the light transmitting body.

The multi-level phase-type diffractive lens is a lens that approximates the phase-type diffractive lens (Kinoform) to a multi-level. The multilevel phase type diffractive lens is formed, for example, by approximating a diffractive lens having a saw-like cross-sectional shape (see lens 610 in FIG. 4) with a step-like cross-sectional shape (lens 610 in FIG. 5).

The multilevel (the number of steps) in the MP diffraction lens may be, for example, 9 levels or less and 4 levels or more, for example, the multilevel may be 8. When the multilevel is 8, 95% diffraction efficiency can be obtained, and when the multilevel is 9, 96% diffraction efficiency can be obtained. The diffraction efficiency is 81% at the 4th level, 87.5% at the 5th level, 91.2% at the 6th level, and 93.4% at the 7th level. Incidentally, at 3 levels, the diffraction efficiency is 68.4%, and at 10 levels, the diffraction efficiency is 96.8%.

By setting the multi-level to 9 levels or less, diffraction efficiency sufficient for correction can be obtained, and the laser irradiation pattern can be simplified. The simplification of the irradiation pattern leads to shortening of the operation time, for example, and the burden on the eye to be examined in the operation can be reduced.

The number of multi levels may be changed according to the refractive characteristics of the eye. The number of multi-levels is counted as the number of layers, and one layer may be formed by, for example, an integral multiple of the thickness of the refractive index change region generated by one pulse of the pulse laser. Each layer may be formed substantially parallel to the front surface. In the case of correction of myopia or hyperopia, the MP diffraction lens pattern may be, for example, an annular ring pattern when viewed from the front-rear direction of the transparent body (see FIG. 6). In the case of correction of astigmatism or higher-order aberration, the lens pattern may be another pattern.

For example, when writing an MP diffractive lens, the laser beam may be irradiated at every distance from the surface of the transparent body. For example, after scanning the focal point of the laser beam with respect to the XY direction by an XY scanner at a first distance, The focal point of the laser beam may be changed to the second distance by scanning the focal point of the laser beam in the Z direction with a Z scanner. In this case, the XY direction is defined as a direction orthogonal to the front-rear direction (optical axis direction) of the translucent body, and the Z direction is defined as the front-rear direction (optical axis direction) of the translucent body. Of course, you may irradiate a laser beam for every cross section in the radial direction of a lens. As for the method of forming the MP phase type lens on the transparent body, for example, a method of writing a plurality of multi-level phase type lenses in silica glass by a femtosecond laser by Yamada et al. (K. Yamada, K. Itoh, See “Multilevel phase-type diffractive lenses in silica glass induced by filamentation of femtosecond laser pulses”, Opt.Let., 29 (16), p1846-1848 (2004)).

When the light incident on the light transmissive body subjected to phototuning passes through the refractive index change region, an optical path difference (phase change) due to the second refractive index occurs. Furthermore, the magnitude of the optical path difference varies depending on the thickness of the refractive index changing region in the front-rear direction. Therefore, by adjusting the thickness of the refractive index change region, it is possible to obtain a phase type diffractive lens pattern corresponding to desired refractive characteristics. In this case, the pattern of the multi-level phase type diffractive lens can be obtained by approximating the phase type diffractive lens (Kinoform) corresponding to the desired refractive characteristics.

One specific example for planning lens patterns is shown below.

1) The aberration We (x, y) of the entire eyeball is measured at the pupil position 2) The anterior eyeball shape from the cornea to the translucent body (for example, IOL) is measured by the tomographic image 3) The target after the operation Set the aberration Wt (x, y) of the entire eyeball 4) Convert We (x, y) and Wt (x, y) to aberration at depth I where we want to create a lens in the translucent body based on the result of 2) To do. Here, the converted aberration is represented by We ′ (x, y) and Wt ′ (x, y), respectively. For example, the conversion process may be performed by reverse ray tracing.
5) Next, let I be the δx (x, y), δy (x, y) of the deflection in the x and y directions.

Approximate angles θx (x, y) and θy (x, y) in the x direction and y direction are approximately,

The distribution of the small prisms may be created at the depth I in the IOL. Here, n ′ is the refractive index of the light transmitting body after adjustment, and n is the refractive index of the light transmitting body before adjustment.
6) A pattern corresponding to a refractive lens or a diffractive lens is created based on θx (x, y) and θy (x, y). That is, θx (x, y) and θy (x, y) are changed to lens patterns. Here, the refractive lens can be expressed as a lens using a light refraction phenomenon, and the diffractive lens can be expressed as a modulo 2pπ kinoform, and may be approximated to a multilevel.

In the above 1 to 6), chromatic aberration may be corrected by using a so-called higher-order diffractive lens in which p is an integer larger than 1. In this case, one or more layers may have a function of correcting chromatic aberration. In chromatic aberration correction, resolution or depth of focus may be controlled in consideration of chromatic aberration of the entire eyeball.

It should be noted that a plurality of different refractive lenses or diffractive lenses (kinoforms) may be created in a region perpendicular to the optical axis at the depth I of the translucent body so as to be multifocal.

Alternatively, it is possible to reduce the diffraction efficiency by using a positive value that is not an integer as p, and to increase the number of focal points. Alternatively, a plurality of aberrations Wt (x, y) for the target eyeball as a whole may be set to achieve multifocality in which lenses are superimposed.

It should be noted that a spherical aberration value may be added separately in order to control the depth of focus when obtaining the target wavefront in the translucent body.

In calculating Wt ′ (x, y), KHBrenner, “Method for designing arbitrary two-dimensional continuous phase elements”, Opt.Let., 25 (1), p31-33 ( 2000) may be used. In other words, the phase distribution of the phase plate may be obtained from the target PSF distribution (KHBrenner, “Method for designing arbitrary two-dimensional continuous phase elements”, Opt. Let., 25 (1), p31-33 (2000 )). In this case, the phase distribution of a lens including multiple focal points may be designed and approximated to a multilevel.

In the above description, We (x, y) may be calculated based on the anterior ocular segment shape obtained with the axial length 2), the shape of the translucent body (for example, IOL), and the refractive index. . Further, We (x, y) may be calculated based on the subjective value and the objective value (for example, auto-ref value).

In addition, when the transparent body has lens characteristics in advance, the total of the lens characteristics provided in advance and the lens characteristics written by phototuning is the refractive characteristics of the transparent body. Further, when the translucent body does not have lens characteristics in advance, the lens characteristics written by phototuning become the refractive characteristics of the translucent body.

Note that the amount of change from the first refractive index may be changed for each irradiation position in the translucent body. That is, the second refractive index may be different from the first refractive index that the light transmitting body basically includes. That is, the amount of change in refractive index due to phototuning may be changed according to the required refractive characteristics. In this case, the pattern of the MP diffraction lens may be optically designed with a set of the thickness of the refractive index change region and the refractive index change amount. Further, gradient index lens in which the average refractive index is adjusted by changing the pulse energy or the irradiation interval may be formed.

In addition, you may make it give a translucent function the function of multi-focus (for example, a double focus, a triple focus). The number of multi-levels and the p value may be adjusted to achieve multi-focus. For example, in a translucent body, a plurality of diffractive structures may be overlapped to be multifocal, or a plurality of diffractive structures may be provided at different positions in the optical axis direction to be multifocal. Further, the translucent body (for example, on the IOL or the cornea) is divided in a direction orthogonal to the optical axis direction (front-rear direction), and different lenses are formed in the divided segment units to achieve multifocalization. Also good. Further, a chromatic aberration may be corrected by forming a phase Fresnel lens using a light diffraction phenomenon on a light transmitting body.

As described above, by writing the multilevel phase type diffractive lens inside the translucent body, the laser irradiation pattern is simplified, and it is not always necessary to use a laser light source having a very high repetition frequency such as several tens of MHz. . That is, as a result, a repetition frequency (for example, several hundred KHz) comparable to that of an ophthalmic laser surgical apparatus mainly used for treatment of a patient's eye (for example, cutting of a cornea, crushing of a turbid portion of a cataract). A laser light source can be used. Therefore, the writing of the multi-phase type diffractive lens is suitable for performing treatment on the patient's eye tissue and phototuning with the same ophthalmic laser surgical apparatus.

The processor may form the multi-level phase type diffractive lens inside the light transmitting body by changing the size of the irradiation region in the radial direction of the lens stepwise according to the front-rear direction of the light transmitting body. Good.

<Planning>
Next, an example of setting a lens pattern in the case where phototuning is performed in a state where a translucent body is provided in a patient's eye (see FIG. 7). Pattern setting is typically performed by a processor.

For example, the pattern of the lens to be written may be set based on the refractive characteristics RC of the eye and the position information TP of the translucent body. The refraction characteristic RC of the eye here is the refraction characteristic of the eye in a state where a translucent body to which phototuning is applied is inserted into the eye. The refractive characteristic of the eye to be examined may be, for example, any of wavefront aberration of the entire eyeball, subjective eye refractive power of the eye, and objective eye refractive power of the eye. The refractive property RC of the eye may be measured by a refractometer device.

The position information TP of the translucent body may be acquired based on, for example, an anterior segment tomographic image captured by a tomographic imaging device. The anterior segment tomogram is an anterior segment tomogram including a translucent body to which phototuning is applied. For example, the anterior segment tomogram is tomographic image data obtained by imaging the cornea and a translucent body to which phototuning is applied. There may be. If the crystalline lens remains, the crystalline lens is also imaged. The anterior segment tomographic image may be tomographic data in the meridian direction of the anterior segment or may be three-dimensional tomographic data of the entire anterior segment.

The position information of the translucent body may be automatically detected by image processing, or may be detected by position designation by manual operation of the examiner. When the translucent body is an artificial translucent body, the positional information of the natural lens (cornea or crystalline lens) of the patient's eye may be acquired based on the anterior ocular segment tomographic image together with the positional information of the artificial translucent body. . Thereby, the positional information of the tissue and the artificial object related to the refractive characteristics of the eye can be acquired and used for pattern setting. In the case where the translucent body is a natural lens, the positional information of the natural lens (cornea or crystalline lens) of the patient's eye may be acquired based on the anterior segment tomogram.

The processor obtains optical arrangement information of the anterior segment including the translucent body based on the positional information of the cornea and the positional information of the translucent body. The optical arrangement information of the anterior segment may be a relative positional relationship between the cornea and the translucent body, or may be an absolute position of the cornea and the translucent body. The optical arrangement information may be one-dimensional position information regarding the optical axis direction of the eye, or may be two-dimensional position information based on one direction orthogonal to the optical axis direction of the eye and the optical axis direction of the eye. Alternatively, it may be three-dimensional position information. In this case, if the crystalline lens remains, an optical arrangement including the crystalline lens is required.

Next, the processor obtains a correction amount of the refraction characteristic to be performed by phototuning based on the refraction characteristic RC of the eye. As the correction amount, a difference between the refractive characteristic RC of the eye with respect to a preset target refractive characteristic may be obtained. The target refractive characteristic may be arbitrarily set for each operator or patient, or may be set as a fixed value in advance. The target refractive characteristic may be, for example, any one of a three-dimensional PSF distribution of the entire eyeball, wavefront aberration, and eye refractive power. Further, as the correction amount, a refractive power characteristic (for example, an eye refractive power (spherical power, astigmatic power, etc.) and aberration (illegal astigmatism, spherical aberration, etc.) to be corrected may be obtained in the refractive characteristics RC of the eye.

The correction amount may be defined as the amount of change in the refractive characteristics of the entire eye (photo tuning amount) corrected by photo tuning. The correction amount corresponds to information on changes in refractive characteristics of the eye that are set in advance to be corrected by phototuning.

When the correction amount is obtained, the processor calculates a refraction characteristic to be written to the light transmitting body in order to obtain a preset correction amount by using the optical arrangement information of the anterior segment including the light transmitting body. . Here, the processor takes into account the optical arrangement information of the anterior segment including the translucent body, the refractive index of each tissue of the anterior segment, and the first refractive index of the translucent body, and the correction is set in advance. The refractive characteristics of the lens necessary for correcting the amount may be calculated. In this case, for example, by using an optical simulation such as a ray tracing method for the image formation state of the light by the lens to be written, the refraction characteristics of the lens to be written to the translucent body can be obtained. In this case, the refraction characteristic of the lens may be obtained as the refraction characteristic of a lens system including a plurality of lenses, or may be obtained as the refraction characteristic of one lens.

When forming an MP diffractive lens, the refractive characteristics of the phase type diffractive lens are approximated to a multi-level, and the refractive characteristics of the MP diffractive lens are calculated.

Further, the refractive characteristics that are the basis of the MP diffraction lens may be obtained by repeated calculation in consideration of the target optical characteristics, and may be approximated to the multilevel in consideration of a preset multilevel. In this case, the target refraction characteristic may be approximated to a multilevel in consideration of a preset multilevel by multiplying a spatial frequency filter. More specifically, when the target refractive characteristic is set as a three-dimensional PSF, the phase distribution is obtained by repeating the three-dimensional PSF related by the diffraction integration and the phase distribution of the phase type diffractive lens.

When the refractive characteristic of the lens to be written is calculated as described above, a lens pattern corresponding to this is set. In this case, the lens position may be set on the basis of the surface position of the translucent body. By using the position information of the translucent body as a reference, reliable laser irradiation is possible. In this case, as a lens pattern to be written, a pattern of each lens in the lens system may be set based on a refractive characteristic of a lens system including a plurality of lenses. In this case, a plurality of lens patterns are set.

In this case, the processor may cause the irradiation area of the light transmitting body corresponding to the lens pattern based on the position information of the light transmitting body and the refraction characteristics of the patient's eye to scan the condensing position of the laser light. Thereby, a lens corresponding to the set lens pattern is formed inside the light transmitting body.

According to the above method, for example, the correction amount of photo tuning can be obtained in consideration of the optical arrangement of the translucent body in the anterior segment. Thus, phototuning can be performed with high accuracy according to the characteristics of the patient's eyes.

In addition to the anterior segment tomogram, the axial length information (distance from the cornea to the retina) may be obtained. The processor obtains optical arrangement information of the entire eyeball including the cornea, the translucent body, and the retina based on the anterior segment tomogram and the axial length information. Thereby, it is possible to more accurately simulate the imaging state of the lens formed on the translucent body with respect to the retina. In this case, the processor may obtain the optical arrangement information of the entire eyeball including the cornea, the transparent body, and the retina based on the tomographic image of the entire eyeball from the cornea to the retina.

Note that when determining the refractive characteristics of the lens to be written on the translucent body, a refraction measuring device provided in the ultrashort pulse laser apparatus may be used as a technique for obtaining the refractive characteristics of the eye, or an ultrashort pulse laser. A refraction measuring device arranged at a different position from the apparatus may be used. Similarly, as a method for obtaining tomographic information of the eye, a tomographic imaging device provided in an ophthalmic laser apparatus (for example, an ophthalmic laser refractive correction apparatus or an ophthalmic laser surgical apparatus) may be used, or an ophthalmic laser may be used. A tomographic imaging device arranged at a position different from the apparatus may be used.

The processor acquires first position information, which is position information of the translucent body in the first tomographic image, based on the first tomographic image acquired in advance for planning the lens pattern to be written. Also good. Further, the processor is the position information of the translucent body in the second tomographic image based on the second tomographic image acquired after the lens pattern is planned and with the eyeball interface attached. You may acquire 2nd positional information. Further, the processor may associate the first position information and the second position information, and set a lens pattern for the translucent body in the second tomographic image (see FIG. 12).

<Laser device for photo tuning>
In the photo-tuning according to the present embodiment, an ultrashort pulse laser device (for example, a femtosecond laser device or a picosecond laser device) that can effectively generate a laser for writing a lens on a transparent body may be used (see FIG. 8). Of course, the invention is not limited to the ultrashort pulse laser device as long as phototuning can be realized.

The ultrashort pulse laser device for phototuning may be a combined machine with an ophthalmic ultrashort pulse laser device for treating anterior ocular tissue (eg, cornea, lens), or for phototuning It may be a single machine. Typically, the treatment of the anterior ocular tissue is crushing / cutting, such as crushing of the lens turbid part in cataract, refractive surgery by cutting inside the cornea, CCC surgery by cutting the front of the lens, etc. is there.

The ultrashort pulse laser device may include at least a laser light source that generates a laser for photo tuning and an irradiation optical system that guides laser light for photo tuning to a light transmitting body. The irradiation optical system may be used to guide the laser light for adjusting the refractive index of the light transmitting body to the inside of the light transmitting body provided in the patient's eye.

The laser beam emitted from the laser light source causes a change in the refractive index at the laser focal point to the translucent body by a nonlinear effect (for example, multiphoton absorption). As a laser light source for phototuning, it is advantageous to use an ultrashort pulse laser in the visible band (for example, the green band) in order to generate a two-photon absorption effect in the ultraviolet band. Of course, even with an ultrashort pulse laser in the near infrared region, a certain effect can be obtained.

The irradiation optical system may include, for example, a relay optical system, an optical scanner, and an objective lens. The optical scanner may include an XY scanner and a Z scanner. See, for example, Japanese Patent Application Laid-Open No. 2015-37474 for a specific configuration.

Note that the irradiation optical system may be an optical system for guiding laser light for phototuning to a translucent body arranged in the eye. In this case, an eyeball interface may be disposed between the irradiation optical system and the eye.

<Multifunction machine>
The ophthalmic laser apparatus is a multi-function machine that can generate both a first laser that is a laser for treating an anterior ocular tissue and a second laser that is a laser for writing a lens on a light transmitting body. It may be present (see FIG. 8). Unlike the laser for photo tuning, the first laser emits a laser capable of treating the anterior segment tissue. That is, the characteristic of the first laser is to crush or cut a part of the anterior eye tissue, whereas the characteristic of the second laser is to change the material of the light transmitting body to change the refractive index of the light transmitting body. It differs in that it is changed. In the complex machine, the irradiation optical system can guide the first laser and the second laser to the light transmitting body. The first laser and the second laser may be selectively applied to the light transmitting body.

The ophthalmic laser apparatus may include at least a laser light source unit, an irradiation optical system, and a scanning unit. The laser light source unit may be capable of selectively emitting a first laser beam for treating the patient's eye and a second laser beam for adjusting the refractive index of the translucent body. The scanning unit may be disposed in the optical path of the irradiation optical system, and may scan the condensing position of the first laser light or the second laser light.

The ophthalmic laser apparatus may be provided with a mode switching unit, a first operation mode for treating the patient's eye using the first laser light, and a second for adjusting the refractive index of the translucent body. The second operation mode for performing phototuning may be switched using the laser beam.

The control unit provided in the ophthalmic laser device treats the patient's eye by controlling the scanning unit to scan the condensing position of the first laser light when the first operation mode is set. May be. In addition, when the control unit is set to the second operation mode, the control unit controls the scanning unit so that the irradiation position corresponding to the preset lens pattern is scanned with the condensing position of the second laser light. The lens may be formed inside the translucent body.

According to the above multi-function machine, treatment (crushing, cutting) and photo-tuning of the patient's eyes can be realized with one device.

More specifically, at least one of the emission wavelength and the laser output of the first laser is different from that of the second laser. Typically, the center wavelength may be in the near infrared region for the characteristics of the first laser. The laser output may have an output that is higher than a threshold at which the anterior segment tissue is crushed or cut. Further, with respect to the characteristics of the second laser, the center wavelength may be a visible region (for example, a green region), the laser output is lower than a threshold value at which the anterior ocular tissue is crushed or cut, and the translucent light is transmitted. It may have an output that can adjust the refractive index of the body. .

The multi-function peripheral includes a first laser light source for generating a first laser and a second laser light source for generating a second laser, which is different from the first laser light source. May be provided.

The multifunction machine includes a laser light source (see light source 312 in FIGS. 9 and 10) for generating laser light having a wavelength corresponding to one of the first laser and the second laser, and laser light from the laser light source. A wavelength conversion optical element (see the wavelength conversion optical element 314 in FIGS. 9 and 10) for converting the wavelength of the first laser into a wavelength corresponding to the other of the first laser and the second laser. May be. As the wavelength conversion optical element, for example, a nonlinear optical crystal may be used. Typical examples of the nonlinear optical crystal include, but are not limited to, a KTP crystal, a BBO crystal, an LBO crystal, and the like for converting the wavelength of 1064 nm, which is the fundamental wavelength, to the second harmonic of 532 nm.

When the wavelength conversion optical element is used, the irradiation optical system includes a first optical system for guiding the first laser to the eye without passing through the wavelength conversion optical element, and the wavelength conversion optical element. And a second optical system for converting the laser into a second laser and guiding the second laser to the eye. In this case, a first optical path corresponding to the first optical system and a second optical path corresponding to the second optical system may be arranged, respectively, and an optical path switching unit (optical path switching in FIGS. 9 and 10). The optical system may be selected by the unit 318). Further, the present invention is not limited to this, and the optical system may be selected by inserting / removing the wavelength conversion optical element with respect to the optical path by the driving unit.

The ophthalmic laser apparatus according to the present embodiment may include a correction optical member (see the correction optical member 500 in FIG. 8) for correcting a difference in laser characteristics between the first laser and the second laser. . For example, when the wavelength characteristics are different between the first laser and the second laser, the imaging performance of the focal point of the laser beam (for example, focal position, aberration characteristics) even if the position of the optical scanner is the same. Is different. Therefore, for example, an optical member (for example, an aberration correction lens) for correcting the focusing performance of the laser beam may be inserted into and removed from the optical path of the irradiation optical system. The correction optical member may be an optical path of the irradiation optical system, and may be disposed between the laser light source and the objective lens, or may be disposed between the objective lens and the eye. In this case, the correction optical member is designed to ensure optical performance capable of achieving the purpose of the laser (crushing or cutting of anterior segment tissue, phototuning).

According to the correction optical member, it is possible to accurately perform both anterior segment tissue treatment and phototuning. For example, the above correction is advantageous when an additional phototuning function is provided for an ultrashort pulse laser device having an optical system optimized for crushing or cutting an anterior segment tissue. In photo-tuning, it is necessary to accurately irradiate a predetermined irradiation site in a translucent body arranged in the eye, and high-precision imaging performance is required. Therefore, an optical system optimized for crushing or cutting anterior segment tissue may not be able to satisfy this. Therefore, providing the correction optical system is advantageous because it can sufficiently satisfy the imaging performance in the phototuning while sufficiently satisfying the imaging performance in the crushing or cutting of the anterior segment tissue.

As another example, the above correction may be applied to an ultrashort pulse laser device having an optical system optimized for phototuning, in addition to providing an anterior ocular tissue crushing or cutting function. It is advantageous.

As the correction optical member, for example, a wavefront compensation device may be used. The wavefront compensation device may be, for example, a variable shape mirror, a digital micromirror device, or an LCOS (optical phase modulation element). The wavefront compensation device may be controlled, for example, to correct the imaging performance of the focus of the laser beam between the first laser and the second laser. For example, the difference in imaging performance of the focal point of the laser beam between the first laser and the second laser is calculated in advance (for example, simulation). First aberration compensation data corresponding to the first laser and second aberration compensation data corresponding to the second laser are stored in the storage unit. The processor may read out aberration compensation data corresponding to the selected laser from the storage unit and operate the wavefront compensation device. Of course, an aberrometer for measuring the aberration related to the irradiation optical system may be provided in the ultrashort pulse laser apparatus, and the processor may control the wavefront compensation device based on the measurement result of the aberrometer.

Further, the correction optical member may be an eyeball interface disposed between the irradiation optical system and the eye. For example, a first eyeball interface corresponding to the first laser and a second eyeball interface corresponding to the second laser may be prepared. In this case, the lens characteristics, refractive index, and the like of the optical member provided in the eyeball interface are set according to the laser.

<Doughnut-shaped beam>
The characteristic of the laser beam may be a donut beam. As a method for forming a donut-shaped beam, for example, an optical vortex method (for example, US Pat. No. 2015-164688) or an axicon lens may be used. Further, a donut-shaped beam may be formed using polarized light. According to the donut-shaped beam, the focal range of the laser beam in the XY directions can be widened (transverse resolution can be improved), which is particularly advantageous when performing step-like processing, that is, writing an MP diffraction lens.

<Installation of refraction measuring device>
The ophthalmic laser apparatus may include a refraction measurement device (measurement optical system) for measuring the refractive characteristics of the eye (see the refraction measurement device 90 in FIG. 7). By providing the refraction measuring device, for example, a lens pattern can be set without necessarily using an external device. As another application, the correction effect by photo tuning can be confirmed without necessarily using an external device.

The processor may display the measurement result of the refractive characteristics of the patient's eye on the display unit. Note that the processor may simulate and display the measurement result when the eyeball interface is not attached when the refractive characteristics of the eye with the eyeball interface attached are measured. In this case, the refractive characteristics of the eyeball interface may be obtained in advance, and the influence of the refractive characteristics may be canceled.

The refraction measurement device may be a patient eye to which an eyeball interface is attached, and may measure refraction characteristics after at least one lens is formed inside the translucent body by phototuning.

The refraction measuring device may be arranged coaxially with the optical axis of the irradiation optical system or may be a different axis. The refraction measuring device includes: a light projecting optical system that projects a measurement index on the fundus through the optical path of the irradiation optical system; and a light receiving optical system that receives fundus reflected light from the measurement index through the optical path of the irradiation optical system. You may prepare. The refraction measurement device may be a refraction measurement device for measuring the refractive properties of the eye via the eyeball interface.

The refraction measurement device may be an aberration measurement device (typically a wavefront sensor) for measuring the wavefront aberration of the eye, and can accurately measure the refractive characteristics of the eye. The refractive power measuring device may be an eye refractive power measuring device (typically an autorefractometer) for measuring the refractive power of the eye, and can measure the refractive characteristics of the eye at a low cost.

The refraction measuring device may be used for measuring the refractive characteristics of the eye at least one of before, during and after laser irradiation. The refraction measuring device may be used to measure the refractive characteristics of the eye before or when the eyeball interface is attached to the eye.

As an example of using the refraction measuring device, for example, by measuring the refractive characteristics of the eye after completion of photo tuning using the refraction measuring device, the operator can easily confirm the correction effect by photo tuning.

More specifically, the first refractive characteristic may be measured in a state where the eye is attached to the eyeball interface and before the photo tuning is started. Next, the second refractive characteristic may be measured in a state where the eye is attached to the eyeball interface and after phototuning is performed. The processor may determine a difference D between the first refractive characteristic and the second refractive characteristic. When the processor obtains the difference D, the correction effect by the lens written in the light transmitting body by phototuning can be easily obtained.

The processor may display the first refractive characteristic and the second refractive characteristic on the same screen of the monitor. By obtaining the difference D, even if the measurement result by the measurement optical system changes due to the influence of the optical part of the eyeball interface, the correction effect by the phototuning can be evaluated.

The processor may determine whether or not the photo-tuning is performed as expected by comparing the correction amount by the photo-tuning set in advance with the difference D. Further, the processor may display a preset correction amount and the difference D on the same screen of the monitor. According to the above control, the operator can easily confirm whether or not the photo-tuning is performed as expected and the target correction effect is obtained.

When measuring the refractive characteristics of the eye, an aberration measuring device such as a wavefront sensor can be used to accurately confirm the correction effect of writing the lens on the translucent body in the eye, including high-order aberrations. .

When the ophthalmic laser apparatus is provided with a refraction measuring device, the refraction measuring device may be used for calibration of phototuning in addition to confirming the correction effect after actual surgery. For example, using a change in refractive characteristics before and after irradiating a laser to a calibration transparent body (for example, a model eye on which the transparent body is installed), control the laser irradiation optical system or set a lens pattern Calibration may be performed with respect to the calculation method used when performing the above.

The refraction measuring device has a configuration that captures a tomographic image of the entire eyeball, for example, and measures the refractive characteristics of the eye based on the shape information of the entire eyeball (for example, anterior eye shape information and the axial length). Also good. In addition, the refraction measurement device may include a configuration for capturing an anterior ocular segment tomogram including a cornea and a lens, and may measure the refractive characteristics of the eye based on anterior segment morphological information and an axial length. . For the axial length, data obtained by a known axial length measuring device may be used. The refractive measurement device may measure the refractive characteristics of the eye using a tomographic imaging device described later. As another example of the refractive measurement device, a configuration capable of measuring the cornea shape and the axial length of the eye may be used, and for example, it can be used for prescription of a photo-tuning intraocular lens that substitutes for a natural crystalline lens. The power of the phototuning intraocular lens may be determined based on the cornea shape of the eye and the axial length. Further, the refraction measuring device may be a phoropter for measuring eye refractive power, for example.

<Photo tuning feedback control based on refraction characteristics>
The processor may set a lens pattern to be additionally formed on the light transmitting body based on a refractive characteristic after at least one lens is formed inside the light transmitting body by phototuning. In this case, the change information of the refractive characteristics before and after the photo tuning with the eyeball interface attached, and the change information of the refractive characteristics set in advance to be corrected by the photo tuning (the target refractive characteristics and the refractive characteristics before the operation). Change). If the difference is large, additional photo tuning may be performed. In addition, change information of refractive characteristics before and after photo tuning before and after mounting the eyeball interface is obtained in advance, and the change information is subtracted from the refractive characteristics after photo tuning with the eyeball interface mounted. The refraction characteristics and the target refraction characteristics may be compared. If the difference is large, additional photo tuning may be performed.

For example, if the refraction characteristics are measured in a state where the eye is attached to the eyeball interface, it is easy to additionally perform phototuning when the correction effect by phototuning is different from the assumed one (see FIG. 14). For example, the processor may calculate a deviation amount between the correction amount set in advance and the difference D, and obtain a lens pattern corresponding to the calculated deviation amount. When obtaining the lens pattern, the processor may calculate the refraction characteristics to be written to the light transmitting body in order to obtain the amount of deviation using the optical arrangement information of the anterior segment including the light transmitting body.

The additional correction of the correction effect can be made by additionally writing the required lens pattern on the light transmitting body. In this case, a lens that compensates for the excess may be newly written if overcorrection, and a lens that compensates for the lack may be newly written if correction is insufficient.

When a plurality of lenses are written, the refraction characteristics may be obtained after all the preset number of lenses are written. In this case, in addition to the plurality of lenses already written, a lens corresponding to the amount of deviation is newly written.

When a plurality of lenses are written, the refraction characteristics may be obtained at a stage where the number of written lenses is smaller than a preset number. In this case, the processor may change at least one of the refractive characteristics of the lens to be written next and the number of lenses based on the amount of deviation.

As described above, the refractive characteristics measured by the refractometer after the first phototuning are fed back to the tuning amount by the second phototuning (for example, the refractive characteristics of the lens, the number of lenses, etc.) The optometry can be corrected more accurately.

In the above description, the refractive characteristics are measured with the eye attached to the eyeball interface. However, the present invention is not limited to this. For example, the correction effect can be confirmed by measuring the refractive characteristics before and after phototuning in the state where the eyeball interface is not disposed between the irradiation optical system and the eye. Further, additional photo-tuning after confirming the correction effect is possible, and photo-tuning feedback based on the measurement result of the refraction characteristics is also possible.

Note that, in the above, the processor may obtain the refractive characteristics before the eye is mounted on the eyeball interface and the refractive characteristics after the eye is mounted on the eyeball interface and before the phototuning is performed. Good. Accordingly, the processor can obtain the change C of the refractive characteristics before and after the eye is attached to the eyeball interface.

After the eye is attached to the eyeball interface, the processor subtracts the change C of the refraction characteristic from the refraction characteristic after the phototuning is performed, so that the eye after the eyeball interface is removed from the eye. The refraction characteristics may be obtained as expected values. Thereby, the correction effect by photo tuning can be confirmed in a state where the eye is attached to the eyeball interface. The processor may be configured to compare the eye refractive characteristic obtained as the predicted value with the target refractive characteristic. As a comparison method, the processor may display these in parallel or may obtain a difference.

<Installation of tomographic imaging device>
The ophthalmic laser apparatus may include a tomographic imaging device (tomographic imaging system) for imaging a tomographic image of the eye (see the tomographic imaging device 71 in FIG. 8). As a result, for example, an external device is not necessarily required for acquiring the position information of the transparent body.

The tomographic imaging device may be arranged coaxially with the irradiation optical system or may be on a different axis. The tomographic imaging device may be a device that images a tomographic image using, for example, light, ultrasound, or magnetism. Of course, it is not limited to these. As a device (optical system) for optically imaging a tomogram, for example, an OCT optical system or a Scheinproof optical system may be used. The tomographic imaging device may be a tomographic imaging device that images a tomographic image of the eye via an eyeball interface. The tomographic image may be, for example, two-dimensional tomographic data or three-dimensional tomographic data.

The tomographic imaging device may be, for example, a tomographic imaging device for capturing a tomographic image of the anterior segment. The tomographic imaging device may capture an anterior ocular tomogram including a translucent body to which phototuning is applied, and further includes an anterior ocular tomogram including a cornea and a translucent body to which phototuning is applied. May be imaged. The tomographic imaging device may be a tomographic imaging device that can capture a tomographic image of the entire eyeball (including the cornea, the translucent body, and the retina). In this case, if the lens remains in the eye, the lens may be imaged.

The processor may acquire the position information of the translucent body using a tomographic imaging device provided in the ophthalmic laser apparatus. In this case, the processor can accurately detect the position of the light transmitting body when performing phototuning by obtaining tomographic information in a state where the eyeball interface is attached to the eye. As a result, the lens pattern to be written on the translucent body is calculated in a form close to the state of the eye at the time of photo tuning, so that photo tuning can be performed with high accuracy. The position information of the light transmitting body may be position information of at least one of the front surface and the rear surface of the light transmitting body. The processor may calculate the lens pattern using the tomographic information before the eyeball interface is attached to the eye. The processor may set the irradiation position in the irradiation optical system using a tomographic image in a state where the eyeball interface is mounted on the eye in order to write the lens pattern calculated before the mounting.

In addition, by arranging both the refraction measuring device and the tomographic imaging device in the ophthalmic laser apparatus, it is possible to acquire both the refractive characteristics of the eye and the tomographic data in a state close to that during photo tuning. By using both the refraction characteristics and the tomographic data, it is possible to carry out photo tuning more accurately.

For example, after performing phototuning, the refractive characteristics may be measured and a tomographic image may be acquired. The processor may calculate a lens pattern to be written using the obtained refractive characteristics and tomographic image. Accordingly, even when the state of the eye to be examined is changed in the first phototuning (for example, the position of the light transmitting body is changed), the position of the light transmitting body can be accurately detected. Photo tuning can be performed well.

Note that the tomographic imaging device may capture a tomographic image of the eye during laser irradiation, and the processor may detect (monitor) the movement of the eye based on the captured tomographic image. Further, the processor may correct the laser irradiation position according to the movement of the eye. Further, the processor may stop the laser irradiation in accordance with the eye movement.

Note that the processor may detect the position of the translucent body to which phototuning is applied based on the captured tomographic image of the eye. Further, the processor may correct the laser irradiation position according to the position of the light transmitting body. Further, the processor may stop the laser irradiation according to the position of the translucent body.

The tomographic imaging device may capture a tomographic image of the eyeball interface during laser irradiation, and the processor may detect the position of the eyeball interface based on the captured tomographic image. Further, the processor may correct the laser irradiation position according to the position of the eyeball interface. The processor may stop the laser irradiation according to the position of the eyeball interface.

Note that examples of the aforementioned ophthalmic laser apparatus include an ophthalmic laser surgical apparatus, an ophthalmic laser refractive correction apparatus, and the like. In addition, the technology related to the photo tuning of the present embodiment is applied as, for example, an ophthalmic laser refraction correction apparatus, an ophthalmic photo tuning setting apparatus, an ophthalmic photo tuning system, a spectacle photo tuning setting apparatus, and a program used for these. Can be done.

<Application of photo tuning to spectacle lenses>
Hereinafter, an application example of photo tuning to a spectacle lens will be described. Of course, basically, the same method as that described above can be used, so that the above description can be referred to for specific contents.

For example, the processor may set the lens pattern for the spectacle lens based on the refractive characteristics of the entire eyeball when wearing the spectacles and the optical arrangement information of the anterior segment with respect to the spectacle lens when wearing the spectacles. In this case, the processor may calculate a refraction characteristic to be written to the spectacle lens, set a lens pattern corresponding to the calculated refraction characteristic, and perform photo-tuning with the set lens pattern.

In this case, the refraction characteristics of the entire eyeball when wearing glasses may be acquired using at least an eye refraction measuring device. In this case, the refractive characteristics of the entire eyeball with the naked eye may be acquired by the refraction measuring device, and the refractive characteristics of the spectacle lens may be acquired by a lens meter or a design value of the lens. By combining the refractive characteristics with the naked eye and the refractive characteristics of the spectacle lens, the refractive characteristics of the entire eyeball when wearing spectacles can be obtained. When combining the refraction characteristics, for example, it may be calculated by replacing with a predetermined position (for example, the pupil position of the eye) on the optical axis. In addition, the refraction measurement device measures the eye when wearing glasses (for example, projects a measurement index through a spectacle lens to obtain fundus reflection light), thereby refraction of the entire eyeball when wearing glasses. The characteristic may be obtained directly.

The optical arrangement information of the anterior segment with respect to the spectacle lens when wearing spectacles may be acquired using, for example, an eye position meter (eye position measuring device (for example, see Japanese Patent Application No. 2013-202632)) or a major (for example, , A ruler), or a design value of a lens or a spectacle frame, or the like. The optical arrangement information of the anterior segment with respect to the spectacle lens may be, for example, a three-dimensional position of the eye with respect to the spectacle lens, and a two-dimensional position (for example, up / down / left / right position) is obtained, and other directions (for example, the front / rear direction) ) May be used as an estimated value. Further, the vertical and horizontal positions of the eyes with respect to the spectacle lens may be the positions of the eyes with respect to the spectacle frame. Furthermore, the optical arrangement information inside the anterior segment may be acquired by the tomographic imaging device. In addition, optical arrangement information of the lens itself (for example, the shape of the lens) may be acquired by a lens shape measuring apparatus (for example, a tomographic imaging device), or a setting value of the lens may be used. As the lens shape measuring device, the lens shape may be measured by the amount of movement of the measuring element when the measuring element is brought into contact with the lens.

More specifically, when setting the lens pattern for the spectacle lens, for example, the wavefront aberration W1 of the entire eyeball with the naked eye, the eye position (eye position) EP with respect to the spectacle frame when wearing spectacles, and the fundus macular portion when wearing spectacles A lens pattern to be written to the spectacle lens may be obtained based on the light beam position LEP on the spectacle lens when the light beam condensed on the spectacle lens passes through the spectacle lens and the frequency distribution M of the spectacle lens at the position LEP. .

For example, by obtaining the eye position EPF in the far vision state, the light beam position LEPF corresponding to the eye position EPF in the far vision state is obtained. Furthermore, the power distribution MF of the spectacle lens at the light beam position LEPF is obtained from the design data of the lens meter or the spectacle lens.

For example, the light beam position LEPN corresponding to the eye position EPF in the near vision state is obtained by obtaining the eye position EPN in the near vision state. Furthermore, the power distribution MN of the spectacle lens at the light beam position LEPN can be obtained from a lens meter capable of measuring the power distribution or design data of the spectacle lens.

The processor obtains the wavefront aberration W2 of the entire eyeball when wearing spectacles based on the wavefront aberration W1 of the entire eyeball with the naked eye and the frequency distribution MF of the spectacle lens, and performs by phototuning based on the obtained wavefront aberration W2 The correction amount of the refraction characteristic to be obtained is obtained. When the correction amount is obtained, the processor calculates a refraction characteristic to be written to the spectacle lens in order to obtain a preset correction amount by using the optical arrangement information of the anterior segment with respect to the spectacle lens. Here, the processor corrects a preset correction amount in consideration of the optical arrangement information of the spectacle lens and the anterior segment, the refractive index of each tissue of the anterior segment, and the first refractive index of the spectacle lens. It is also possible to calculate the refraction characteristics of the lens necessary for this. Further, the processor sets a lens pattern corresponding to the refractive characteristic to be written.

Thereafter, the processor sets (matches) the obtained lens pattern to the light beam position LEP on the spectacle lens to set the irradiation position. Photo tuning is performed on the spectacle lens at the set irradiation position. When irradiating, a soft gel close to the refractive index of the spectacle lens material is sandwiched between and closely adhered to the lens surface of the spectacle lens, so that the effect of the refractive index on the spectacle lens surface is reduced. It may be irradiated in a liquid.

In addition, when performing photo tuning with respect to a spectacle lens, you may carry out in the state which fixed spectacles with respect to the ultrashort pulse laser apparatus. In this case, the irradiation position may be set for the spectacle lens by detecting the position of the spectacle lens using a tomographic imaging device. Further, if the positional relationship between the spectacle lens and the apparatus is known, the irradiation position may be set using the known positional relationship. Photo tuning may be performed on the glasses worn by the patient.

In the above description, it is assumed that photo-tuning is performed at a lens position corresponding to far vision, or photo-tuning is performed at a lens position corresponding to near vision, but the present invention is not limited to this. Similarly, photo tuning may be performed.

Note that the spectacle lens subjected to photo tuning may be a spectacle lens actually worn by the patient or a new spectacle lens. When photo-tuning is performed on a new lens, the irradiation position may be set on the assumption that the lens is arranged on the spectacle frame. In the case of a new spectacle lens, it is possible to manufacture a lens using a photo tuning by providing a laser device at a lens factory.

In addition, when obtaining the wavefront aberration W2 of the entire eyeball when wearing glasses, the wavefront aberration W2 of the entire eyeball when wearing glasses may be directly obtained by a wavefront sensor.

Note that the technique related to phototuning according to the present embodiment can be applied to an ophthalmic laser surgical apparatus that treats a patient's eye by condensing laser light into the tissue of the patient's eye. In addition, the technique related to phototuning according to the present embodiment can be applied to a spectacle laser device that corrects a patient's eye by condensing laser light inside a spectacle lens. In the following example, an ophthalmic laser surgical apparatus will be described as an example. However, the present invention is not limited to this and can be applied to other apparatuses.

In this embodiment, the setting device for setting the photo tuning lens pattern is not limited to the configuration arranged in the laser device. For example, the setting apparatus may be provided in a tomographic imaging device, a refraction measuring device, or an external PC. In addition, transmission / reception of each data may be performed by wire or wireless.

<Example>
Hereinafter, one typical example of the present embodiment will be described with reference to the drawings. In the following description, as an example, the direction along the optical axis of the laser light applied to the patient's eye E is defined as the Z direction. One of the directions intersecting the Z direction (vertically intersecting in the present embodiment) is defined as the X direction. A direction that intersects both the Z direction and the X direction (vertically intersects in this embodiment) is defined as a Y direction. The X, Y, and Z directions may be set as appropriate. For example, when the direction is defined based on the patient's vertical and horizontal directions, the X direction may be the patient's horizontal direction, the Y direction may be the patient's vertical direction, the X direction is the patient's vertical direction, and the Y direction is the patient's horizontal direction. The Z direction may be the axial direction of the eye E.

<Overall configuration>
The ophthalmic laser surgical apparatus 1 according to the present embodiment is used for treating a tissue of a patient's eye E and performing phototuning on an artificial translucent body (see FIG. 8). In this embodiment, an ophthalmic laser surgical apparatus 1 capable of treating a crystalline lens of a patient's eye E and performing phototuning on an artificial translucent body inserted into the eye is illustrated. This technique may of course be applied to the treatment of anterior segment tissues including the cornea and the lens. Photo tuning may also be applied to a natural translucent body, that is, the tissue of the patient's eye E.

The laser irradiation unit 300 includes a laser light source unit 310 and a laser irradiation optical system (laser delivery) 320. The laser light source unit 310 is disposed inside the main body 2. The laser irradiation optical system (light guide optical system) 320 is an optical system arranged to guide the laser light from the laser light source unit 310 to the eye E.

The interface unit 50 is close to the cornea of the patient's eye E, reduces the difference in refractive index, and reduces the aberration of laser light generated by the refractive index difference. This reduces surface reflections at the cornea and lens, for example. The observation / imaging unit 70 captures a front image of the anterior segment of the patient's eye E and a tomographic image of the anterior segment. The observation / imaging unit 70 includes, for example, a tomographic imaging device 71 and a front imaging unit 75. The tomographic imaging device 71 captures (acquires) a tomographic image of the patient's eye E. The front imaging unit 75 captures an anterior segment image of the patient's eye E. The operation unit 400 is provided for operating the apparatus 1. The control unit 100 performs overall control of the entire apparatus.

<Laser irradiation unit>
The laser irradiation unit 300 may include, for example, a laser light source unit 310 and a laser irradiation optical system (laser delivery) 320. The laser light source unit 310 emits surgical laser light (laser beam). The laser irradiation optical system 320 includes an optical member for guiding laser light. The laser irradiation optical system 320 includes, for example, a scanning unit 330, an objective lens 305, and various optical members. The objective lens 305 is provided on the optical path between the scanning unit 330 and the patient's eye E. The objective lens 305 focuses the laser light that has passed through the scanning unit 330 on the tissue of the patient's eye E.

The laser light emitted by the laser light source unit 310 is used to induce plasma in the tissue by nonlinear interaction. Non-linear interaction is one of the interactions caused by light and a substance, and is an effect in which a response that is not proportional to the intensity of light (that is, the density of photons) appears. The ophthalmic laser surgical apparatus 1 according to the present embodiment condenses (focuses) the laser light in the transparent tissue of the patient's eye E, so that the condensing position (also referred to as “laser spot”) or the condensing position. Rather, it causes multiphoton absorption slightly upstream of the optical path (light flux). The probability that multiphoton absorption occurs is not proportional to the intensity of light and is nonlinear. When an excited state is generated by multiphoton absorption, a plasma bubble is generated in the tissue, and the tissue is cut and crushed. The above phenomenon is sometimes referred to as photodisruption. In optical breakdown due to nonlinear interaction, the influence of heat from laser light is unlikely to be applied around the condensing position. Therefore, a fine treatment is possible. As the pulse width of the laser beam is reduced, optical destruction is efficiently performed with less energy.

The laser light source unit 310 can also adjust the photorefractive index (photo tuning) by multiphoton absorption.

The laser light source unit 310 can emit a first laser that is a laser for crushing or cutting an anterior ocular tissue and a second laser that is a laser for writing a lens on a light transmitting body. More specifically, the laser light source unit 310 includes a laser light source 312 for generating laser light having a wavelength corresponding to the first laser, and a wavelength corresponding to the second laser from the first laser light from the laser light source. And a wavelength conversion optical element 314 for converting into a wavelength.

As the laser light source 312, a device that emits laser light having a pulse width of 1 femtosecond to 10 nanoseconds is used. As the laser light source 312, for example, a device that emits infrared laser light having a pulse width of 500 femtoseconds and a center wavelength of 1040 nm (wavelength width is ± 10 nm) may be used. The laser light source unit 310 uses a laser light source capable of emitting laser light having an output that causes breakdown when the spot size of the laser spot is 1 to 15 μm.

When the wavelength conversion optical element 314 is used, the irradiation optical system 320 includes a first optical system (see FIG. 9) for guiding the first laser to the eye without passing through the wavelength conversion optical element, and the wavelength conversion optical element 314. And a second optical system (see FIG. 10) for converting the first laser into the second laser and guiding the second laser to the eye. In this case, a first optical path corresponding to the first optical system and a second optical path corresponding to the second optical system may be respectively arranged. The optical system may be selected by driving the optical path switching unit 318.

In the laser irradiation optical system 320, the laser light source unit 310 is upstream and the patient eye E is downstream. Then, the mirror 301, the mirror 302 to the lens 303, the lens 304, and the beam combiner 72 may be arranged along the optical axis L1 downstream from the laser light source unit 310.

Mirrors

301 and 302 adjust the optical axis of the laser beam. The lens 303 is used to form an intermediate image of the scanning unit 330 and laser light. The lens 304 forms a pupil conjugate position. The beam combiner 72 combines the optical axis L1 and the optical axis L3 of the observation / photographing unit 70. The

mirrors

301 and 302 are configured such that their reflection surfaces are orthogonal to each other, and are held by tiltable holding members. The optical axis of the laser light emitted from the laser light source unit 310 can be adjusted by moving and tilting the reflecting surfaces of the

mirrors

301 and 302. By adjusting the

mirrors

301 and 302, the axis of the laser beam is aligned with the optical axis L1.

<Correction optical member>
The correction optical member 500 is a correction optical member for correcting a difference in laser characteristics between the first laser and the second laser. The correction optical member 500 is disposed in the optical path of the second laser light during phototuning. The correction optical member 500 may be disposed in the optical path of the irradiation optical system 320 by driving the driving unit 510. The correction optical member 500 may be disposed in the vicinity of the wavelength conversion optical element 314.

<Scanning unit>
The scanning unit 330 may scan the condensing position of the laser light condensed by the objective lens 305 by scanning the laser light. That is, the scanning unit 330 moves the condensing position of the laser light to the target position. The scanning unit 330 of this embodiment may include a Z scanning unit 350 and an XY scanning unit 360. The scanning unit 330 may be disposed in the optical path of the laser irradiation optical system (laser delivery) 320.

The Z scanning unit 350 may include, for example, a concave lens 351, a convex lens 352, and a driving unit 353. The drive unit 353 moves the concave lens 351 along the optical axis L1. As the concave lens 351 moves, the divergence state of the beam that has passed through the concave lens 351 changes. As a result, the laser beam condensing position (laser spot) moves in the Z-axis direction.

The XY scanning unit 360 may include an X scanner 361 and a Y scanner 364. The X scanner 361 may scan the laser light in the X direction by swinging the galvano mirror 363 by the driving unit 362. The Y scanner 364 may scan the laser light in the Y direction by swinging the galvanometer mirror 366 by the driving unit 365. The

lenses

367 and 368 conjugate the two galvanometer mirrors 363 and 366.

The scanning unit 330 may have any configuration that can scan the laser light in the XY directions. For example, the scanning in the main scanning direction (for example, the X direction) may be a polygon mirror, and the scanning in the sub scanning direction (for example, the Y direction) may be a galvanometer mirror. A resonant mirror may be used corresponding to the X direction and the Y direction. Moreover, the structure which rotates two prisms independently may be sufficient. In addition, an acousto-optic deflector (AOD) may be used in the main scanning direction. In this manner, the laser spot may be moved three-dimensionally (in the XYZ directions) within the eyeball tissue (in the target) of the patient's eye E by the scanning unit 330.

Between the scanning unit 330 and the objective lens 305, a beam combiner (beam splitter) 72 for making the laser optical axis coaxial with the observation / photographing optical axis may be disposed. The combiner 72 has a characteristic of reflecting laser light and transmitting illumination light of the observation / photographing unit 70. The objective lens 305 is a lens that is fixedly disposed with respect to the irradiation end unit 42. The objective lens 305 forms an image on the target using laser light as a laser spot. The spot size of the laser spot is, for example, about 1 to 15 μm.

<Interface unit>
The interface unit 50 (see FIG. 11) is close to the cornea of the patient's eye E, has a role of weakening the refractive power of the cornea and facilitating the laser light to reach (collect) the eyeball tissue such as a crystalline lens. The interface unit 50 of the present embodiment is configured to cover at least a part of the cornea without directly contacting the cornea. The interface unit 50 mainly includes a cover glass 51. The cover glass 51 is an optical member that covers the cornea, for example. The cover crow 51 may be, for example, an applanation lens or an immersion lens. For example, an applanation lens transmits laser and applanates the front surface of the cornea.

The cover glass 51 is a member that covers the cornea and may have a size that covers at least the NA on which the laser spot is focused. The cover glass 51 is a transparent member having translucency, and is formed of, for example, glass or resin. The cover glass 51 may be positioned on the liquid surface and may have a role of covering the liquid.

The interface unit 50 is close to the cornea of the patient's eye E adsorbed by the suction ring 281. Alternatively, the suction ring 281 may be adsorbed after the positions of the patient eye E and the interface unit 50 are determined in advance. The suction ring 281 is filled with, for example, a liquid (saline). The refractive power of the cornea is canceled by the cover glass 51 and the liquid. This suppresses the laser light from being refracted from the objective lens 305 to the target crystalline lens.

Note that the interface unit 50 may be configured to be in direct contact with the cornea. For example, the interface unit 50 may be a unit that contacts the cornea with the cover glass 51 to applanate the cornea. As a result, the cornea comes into contact with the cover glass 51 so that the position of the cornea is positioned with respect to the laser irradiation optical system 320. The cover glass 51 may have a contact surface that covers the cornea so as to cover a laser irradiation region such as the inside of the cornea.

<Fixing guidance unit>
The fixation guidance unit 120 projects, for example, a fixation target for fixing the eye to be examined (see FIG. 3). The fixation guidance unit 120 may change the line-of-sight direction of the patient's eye E before docking by changing the presentation position of the fixation target. The fixation guidance unit 120 guides the fixation direction of the eye E in order to guide the irradiation optical axis of the surgical laser and the optical axis of the patient's eye to a predetermined positional relationship.

<Eyeball fixing unit>
The eyeball fixing unit 280 (see FIGS. 4 and 5) is a unit for fixing the patient's eye E to the objective lens 305. By fixing the patient's eye E to the objective lens 305, the laser can be suitably focused on the patient's eye E. The eyeball fixing unit 280 transmits (adds) suction pressure applied from a suction pump (not shown) to the suction ring 281 via a suction pipe. Note that the present invention is not limited to this, and laser irradiation may be performed without fixing the eyeball. Further, laser irradiation may be performed without using the interface unit 50. In this case, a tracking mechanism for correcting the laser irradiation position according to the movement of the eyes may be provided.

<Observation optical system 70>
An observation optical system 70 (also referred to as an observation / imaging unit) 70 (see FIG. 3) causes the operator to observe the patient's eye E and images the tissue to be treated. As an example, the observation optical system 70 of this embodiment includes a tomographic imaging device 71 and a front imaging unit 75. The optical axis L3 of the observation optical system 70 is made coaxial with the optical axis L1 of the laser beam by the beam combiner 72. The optical axis L3 is branched by the beam combiner 73 into an optical axis L4 of the tomography unit 71 and an optical axis L5 of the front imaging unit 75.

<Tomographic imaging device>
The tomographic imaging device 71 may acquire a tomographic image of the tissue of the patient's eye E using, for example, an optical interference technique. The tomographic imaging device 71 acquires, for example, a tomographic image of the anterior segment of the patient's eye E.

As an example, the tomographic imaging device 71 may be an OCT (optical coherence tomography) device. The tomographic imaging device 71 may include a light source, a light splitter, a reference optical system, a scanning unit, and a detector.

The light source emits light for acquiring a tomographic image. The light splitter divides the light emitted from the light source into reference light and measurement light. The reference light enters the reference optical system, and the measurement light enters the scanning unit. The reference optical system has a configuration that changes the optical path length difference between the measurement light and the reference light. The scanning unit scans the measurement light in a two-dimensional direction on the anterior segment. The detector detects an interference state between the measurement light reflected by the tissue and the reference light that has passed through the reference optical system. The ophthalmic laser surgical apparatus 1 scans the measurement light and detects the interference state between the reflected measurement light and the interference light, thereby acquiring information in the depth direction of the anterior segment.

断層 Acquire a tomographic image of the anterior segment based on the acquired depth information. The ophthalmic laser surgical apparatus 1 according to the present embodiment associates the target position where the pulsed laser light is collected with the anterior segment tomogram of the patient's eye E. As a result, the ophthalmic laser surgical apparatus 1 can create data for controlling the operation of irradiating and scanning the pulsed laser beam using the anterior ocular segment tomographic image. Various configurations can be used for the tomography unit 71. For example, any of SS-OCT, SD-OCT, TD-OCT, etc. may be adopted as the tomographic imaging device 71. The ophthalmic laser surgical apparatus 1 may capture a tomographic image using a technique other than optical interference.

<Front shooting unit>
The front imaging unit 75 (see FIG. 8) acquires a front image of the patient's eye E. The front imaging unit 75 images the patient's eye E illuminated with visible light or infrared light. The front image of the patient's eye E imaged by the front imaging unit may be displayed on the display unit 420 (described later). The surgeon can observe the patient's eye E from the front by looking at the display unit 420.

<Refraction measurement device>
The refraction measurement device 90 is a refraction measurement device for measuring the refraction characteristics of the eye, and in this embodiment, a wavefront sensor is used. The refraction measuring device 90 is coaxial with the tomographic imaging device 71 via the beam combiner 92.

<Operation unit>
The operation unit 400 may include, for example, a trigger switch 410, a display unit 420, and the like. The trigger switch 410 inputs a trigger signal for emitting treatment laser light from the laser irradiation unit 300. The display unit 420 is used as a display unit that displays a tomographic image and an anterior segment image of the patient's eye E, and displays surgical conditions. The display unit 420 may have a touch panel function, and may also serve as input means for setting surgical conditions and setting a surgical site (laser irradiation position) on a tomographic image. A mouse that is a pointing device, a keyboard that is an input device for inputting numerical values, characters, and the like can also be used as input means.

<Control unit 100>
The control unit 100 includes a CPU 101, a ROM 102, a RAM 103, a nonvolatile memory (not shown), and the like. The CPU 101 as a processor performs various controls of the ophthalmic laser surgical apparatus 1 (for example, control data creation control described later, control of the laser light source unit 310, control of the scanning unit 330, control for adjusting the scanning speed of the condensing position). To manage. The ROM 102 stores various programs, initial values, and the like for controlling the operation of the ophthalmic laser surgical apparatus 1. The RAM 103 temporarily stores various information. A nonvolatile memory is a non-transitory storage medium that can retain stored contents even when power supply is interrupted.

The control unit 100 is connected with a laser irradiation unit 300, an observation / imaging unit 70, an operation unit 400, a fixation guidance unit 120, a suction pump, a perfusion suction unit, and the like.

The control unit 100 sets position information for irradiating the surgical laser light based on the surgical site (area) set in the tomographic image display area before the surgical laser light irradiation. The control unit 100 emits laser light from the laser light source unit 310 based on the set surgical site, surgical conditions, and irradiation pattern, and controls the scanning units (galvanomirrors 363 and 366) to make the laser spot in the eyeball tissue. The eyeball tissue is cut, crushed, or phototuned to a translucent body.

In this embodiment, a first operation mode for crushing or cutting an anterior segment tissue and a second operation mode for performing phototuning can be selectively set. The examiner can select the operation mode using the operation unit 400. In this case, an operation program corresponding to each operation mode, laser irradiation conditions, and the like are stored in the memory.

When set to the first surgical mode, the irradiation optical system 320 is set to an optical arrangement for irradiating the eye E with the first laser (FIG. 9). In this case, the correction optical member 500 is out of the optical path of the irradiation optical system 520. For specific operations in the first operation mode, refer to, for example, Japanese Patent Application Laid-Open No. 2015-195922.

When set to the second surgical mode, the irradiation optical system 320 is set to an optical arrangement for irradiating the eye E with the second laser (FIG. 10). In this case, the correction optical member 500 is disposed in the optical path of the irradiation optical system 520.

<Preoperative planning>
FIG. 13 is a diagram illustrating an example of a procedure in the second operation mode, and is a diagram illustrating an example of preoperative planning. In the present embodiment, the tomographic information and refraction characteristics of the patient's eye E are acquired before surgery, and planning for photo tuning is performed.

The surgeon acquires the tomographic information of the eye E with a tomography device, for example, several days before the operation. The tomography device may be a tomography device arranged as a separate housing from the apparatus 1, and the tomography device may be an apparatus that images the patient's eye E in the sitting position. Further, the tomography device may be a tomography device 71 provided integrally with the apparatus 1, and the tomography device may be an apparatus that images the patient's eye E while lying on its side. Good.

Similarly, the surgeon acquires the refractive characteristics of the eye E with the refractive characteristics device, for example, several days before the operation. The refractive characteristic device may be a refractive characteristic device arranged as a separate housing from the apparatus 1, and the refractive characteristic device may be an apparatus that images the patient's eye E in a sitting position. In addition, the refractive characteristic device may be the refractive characteristic device 90 provided integrally with the apparatus 1, and the refractive characteristic device is a device that measures the refractive characteristic of the eye E when lying on its side. May be.

Regarding the tomography device and the refractive characteristic device, when an external device is used, it is preferable that data can be exchanged between the external device and the device 1. For example, it may be connected by wire or wireless, and data may be exchanged by a storage medium such as a flash memory.

The control unit 100 obtains the refractive characteristics of the lens to be written on the translucent body based on the tomographic information obtained by the tomographic device and the refractive characteristics obtained by the refractive characteristic device. Further, the control unit 100 obtains

lens patterns

610 and 620 to be written on the light transmitting body 600 based on the obtained refraction characteristics.

When the eyeball fixation is completed, the control unit 100 may acquire a tomographic image of the patient's eye E using the tomographic imaging device 71 provided in the apparatus 1. The control unit 100 determines between the first tomographic image (see FIG. 11) taken before the operation by the tomographic device and the second tomographic image (see FIG. 12) acquired by the tomographic imaging device 71 after eyeball fixation. Associate the positional relationship of. Thereby, the planning content set before the operation can be associated with the tomographic image at the time of photo tuning. Therefore, the control unit 100 can perform an operation according to an operation condition set before the operation. Note that when the first tomographic image is acquired by the external tomographic imaging device, the first tomographic image and the tomographic imaging device 71 are considered in consideration of the difference in imaging magnification between the external tomographic imaging device and the tomographic imaging device 71. The image magnification of at least one of the second tomographic images may be adjusted by image processing. Further, the lens pattern to be written may be corrected in consideration of the difference in imaging magnification.

More specifically, the control unit 100 associates the positional relationship between the translucent body in the first tomographic image and the translucent body in the second tomographic image, and transmits the translucent body in the second tomographic image. A lens pattern set in advance may be set inside the translucent body in the second tomographic image on the basis of this position. The control unit 100 sets the laser irradiation condition based on the lens pattern set for the translucent body in the second tomographic image. Furthermore, photo-tuning is performed with the second laser based on the set irradiation conditions.

The first tomographic image may be used for lens pattern planning, and the second tomographic image may be used for setting the irradiation position in the irradiation optical system. For example, the control unit 100 sets (matches) the lens pattern acquired using the first tomographic image with respect to the translucent body on the second tomographic image to set the irradiation position. Also good. For example, the lens pattern may be set based on the first tomographic image and the refractive characteristics of the eye.

In addition, the position of the translucent body in the state where the patient's eye E photographed by an external device before the operation is not docked matches the position of the translucent body after the docking of the patient's eye E photographed by the tomographic imaging device 71 May not. For example, the position of the transparent body changes depending on the inclination of the crystalline lens. Further, the translucent body and the eye (for example, the cornea) may be deformed due to the influence of the eyeball interface.

Therefore, as described above, the control unit 100 may correct the planning content set based on the pre-operative tomographic image to the content suitable for the intra-operative tomographic image. For example, the control unit 100 first detects a transparent body in the eye to be examined. Subsequently, the control unit 100 associates the translucent body in the first tomographic image with the translucent body in the second tomographic image. Accordingly, the surgical condition set for the translucent body of the first tomographic image is associated with the second tomographic image. Therefore, the control unit 100 can irradiate the second laser toward a predetermined position inside the preset light transmitting body. That is, the control unit 100 can perform phototuning under the surgical conditions set by planning.

For example, the control unit 100 may associate the first tomographic image and the second tomographic image based on the detected position information of the transparent body. In this case, the control unit 100 may perform association by detecting the surface of the transparent body by image processing.

Note that the control unit 100 may determine the presence or absence of a deformed state of the light transmitting body and the eyes (for example, the cornea) based on the second tomographic image. When the deformation is detected, the control unit 100 considers the deformation state between the first tomographic image before the deformation and the second tomographic image after the deformation when the deformation is detected. May be set.

In the above description, the tomographic information and refraction characteristics of the patient's eye E are acquired before the operation and the planning in the photo tuning is performed. However, the present invention is not limited to this. For example, the refractive characteristic of the patient's eye E is acquired in advance before the operation, and the control unit 100 performs planning based on the refractive characteristic obtained in advance and the tomographic image acquired by the tomographic imaging device 71 after fixing the eyeball. May be performed.

Note that the control unit 100 may perform planning in photo tuning using the refractive characteristic device 90 provided in the apparatus 1. Furthermore, the control unit 100 may confirm the correction effect in the photo tuning using the refraction characteristic device 90 provided in the apparatus 1, or may additionally perform the photo tuning.

DESCRIPTION OF SYMBOLS 1 Ophthalmic laser surgery apparatus 71 Tomographic imaging device 90 Refraction measuring device 100 Control unit 101 CPU (processor)
310 Laser light source unit 312 Laser light source 314 Wavelength conversion optical element 320 Laser irradiation optical system 330 Scan unit 500 Correction optical member

Claims

An ophthalmic laser refraction correction apparatus for adjusting the refractive index of the light transmitting body by condensing the laser light inside the light transmitting body provided in the patient's eye,
An irradiation optical system for guiding laser light emitted from a laser light source unit to adjust the refractive index of the translucent body, into the translucent body provided in the patient's eye;
A scanning unit that is disposed in the optical path of the irradiation optical system and scans the condensing position of the laser beam;
The scanning unit is controlled to scan the condensing position of the laser beam in an irradiation region corresponding to a preset lens pattern of the multilevel phase type diffractive lens, thereby allowing the multilevel phase type diffractive lens to pass through the translucent light. Control means formed inside the body;
An ophthalmic laser refraction correction apparatus comprising:
Characterized by comprising setting means for setting the lens pattern based on positional information of the translucent body in a tomographic image captured by a tomographic imaging device and refraction characteristics of a patient's eye measured by a refraction measuring device. The ophthalmic laser refractive correction apparatus according to claim 1.
An ophthalmic laser refraction correction apparatus for adjusting the refractive index of the light transmitting body by condensing the laser light inside the light transmitting body provided in the patient's eye,
An irradiation optical system for guiding laser light emitted from a laser light source unit to adjust the refractive index of the translucent body, into the translucent body provided in the patient's eye;
A scanning unit that is disposed in the optical path of the irradiation optical system and scans the condensing position of the laser beam;
Control means for controlling the scanning unit,
The laser beam is applied to an irradiation region corresponding to a lens pattern set in advance based on positional information of the translucent body in a tomographic image captured by a tomographic imaging device and a refraction characteristic of a patient's eye measured by a refraction measuring device. A control means for forming a lens inside the translucent body by scanning the condensing position of
An ophthalmic laser refraction correction apparatus comprising:
The ophthalmic laser refraction correction apparatus according to claim 3, further comprising setting means for setting a lens pattern to be formed on the translucent body by adjusting a refractive index based on positional information of the translucent body and refractive characteristics of the patient's eye. .
Comprising a tomographic imaging device for capturing a tomographic image of the patient's eye including the translucent body,
The ophthalmic laser refraction correction apparatus according to claim 4, wherein the setting unit acquires position information of the translucent body based on a tomographic image captured by a tomographic imaging device.
The setting means includes
First position information that is position information of the light transmitting body in a first tomographic image acquired to plan a lens pattern to be written in advance, and after the lens pattern is planned, the eyeball interface is Associating with the second position information that is the position information of the translucent body in the second tomographic image acquired after mounting,
6. The ophthalmic laser refraction correction apparatus according to claim 4, wherein the lens pattern is set for the translucent body in the second tomographic image.
The ophthalmic laser refraction correction apparatus according to any one of claims 3 to 6, further comprising a refraction measuring device for measuring a refraction characteristic of the patient's eye including the translucent body.
The ophthalmology according to claim 7, wherein the refraction measuring device is a patient eye to which an eyeball interface is attached, and measures the refraction characteristic of the patient eye after at least one of the lenses is formed inside the translucent body. Laser refraction straightening device.
9. The ophthalmic laser refraction correction apparatus according to claim 7, further comprising display control means for displaying a measurement result of the refractive characteristics of the patient's eye on a display means.
The setting unit sets a lens pattern to be additionally formed on the light transmitting body based on a refractive characteristic of the patient's eye after at least one of the lenses is formed inside the light transmitting body. The ophthalmic laser refraction correction apparatus according to any one of claims 7 to 9.
An ophthalmic laser surgical apparatus, wherein the irradiation optical system according to any one of claims 1 to 10 is capable of irradiating a donut-shaped beam.
An ophthalmic photo-tuning setting device for setting a lens pattern formed by condensing laser light inside a translucent body provided in a patient's eye,
Characterized by comprising setting means for setting the lens pattern based on positional information of the translucent body in a tomographic image captured by a tomographic imaging device and refraction characteristics of a patient's eye measured by a refraction measuring device. Ophthalmic photo tuning setting device.
An ophthalmic photo-tuning setting device according to claim 12,
A tomographic imaging device for capturing a tomographic image of the patient's eye including the translucent body;
A refraction measuring device for measuring refraction characteristics of the patient's eye including the translucent body;
Ophthalmic photo tuning system.
A spectacle photo-tuning setting device for setting a lens pattern formed by condensing laser light inside a spectacle lens,
Photon tuning for spectacles, comprising setting means for setting the lens pattern based on refractive characteristics of the entire eyeball when wearing spectacles and optical arrangement information of the anterior segment with respect to the spectacle lens when wearing spectacles Setting device.
The light transmitting body according to any one of claims 1 to 13 is an artificial light transmitting body provided in an eye.
When executed by the processor of the apparatus according to any one of claims 1 to 15, the apparatus executes at least one of control of the scanning unit by the control means and setting of the lens pattern by the setting means. A program characterized by letting
An ophthalmic laser surgical apparatus for treating a patient's eye by condensing a laser beam in a tissue of the patient's eye,
A laser light source unit capable of selectively emitting a first laser beam for treating the patient's eye and a second laser beam for adjusting the refractive index of the transparent body;
A scanning unit that is arranged in an optical path of an irradiation optical system and scans a condensing position of the first laser beam or the second laser beam;
A first operation mode for treating the patient's eye using a first laser beam, and a second operation for performing phototuning using a second laser beam for adjusting the refractive index of the light transmitting body Mode switching means for switching between modes,
When the first switching mode is set by the mode switching means, the patient's eye is treated by controlling the scanning unit to scan the condensing position of the first laser beam,
When the second operation mode is set by the mode switching means, the scanning unit is controlled to scan the condensing position of the second laser light in the irradiation area corresponding to the preset lens pattern. A control means for forming a lens inside the translucent body,
An ophthalmic laser surgical apparatus comprising:
The ophthalmic laser surgical apparatus according to claim 17, further comprising a correction optical member for correcting a difference in laser characteristics between the first laser beam and the second laser beam.
When the first laser beam is irradiated, the correction optical member is out of the optical path of the irradiation optical system,
19. The ophthalmic laser surgical apparatus according to claim 18, wherein the correction optical member is disposed in an optical path of the irradiation optical system when the second laser light is irradiated.
The laser irradiation unit is
A first laser light source for generating the first laser light;
20. A second laser light source for generating the second laser light, the second laser light source being different from the first laser light source, respectively. Laser surgery equipment for ophthalmology.
The laser irradiation unit is
A laser light source for generating a laser beam having a wavelength corresponding to one of the first laser beam and the second laser beam;
21. A wavelength conversion optical element for converting the wavelength of laser light from a laser light source into a wavelength corresponding to one of the first laser and the second laser. Any ophthalmic laser surgery device.
The first laser light for treating the patient's eye is in the near infrared region,
The ophthalmic laser surgical apparatus according to any one of claims 17 to 20, wherein the second laser light is in a visible range.