DE102016206541A1 - Ophthalmological examination and / or therapy device with coupled articulated arms - Google Patents

Abstract

The invention relates to an ophthalmological examination and / or therapy device (01) comprising a main body (10), a first (21) and a second articulated arm (22) with a first (51) and a second applicator (52) for the application of an examination or a therapy on a patient's eye and a coupling system (02) with a first (70) and a second coupling element (80), wherein the first coupling element (80) is adapted to be fitted and fixed in the second coupling element (70) Coupling of the first (21) and second articulated arm (22). The present invention further relates to a coupling system (02) and a method for coupling two articulated arms (21, 22). Its object is to describe systems and methods with which a simple, controlled and tension-free coupling of the articulated arms (21, 22) is possible, without obstructing the function of the ophthalmological examination and / or therapy device (01). This object is achieved by a coupling system (02), in which the first coupling element (70) contains a cardanic suspension (75). The object is further achieved by a method for coupling two articulated arms (21, 22), in which an automatic adjustment in position and direction is initiated.

Description

The present invention relates to an ophthalmological examination and / or therapy device comprising a base body, a first articulated arm with a first applicator for applying a study or therapy to a patient's eye, a second articulated arm having a second applicator for applying an examination or therapy to a Patient eye and a coupling system having a first and a second coupling element for coupling the first and second articulated arm.

The present invention further relates to a coupling system for coupling two articulated arms of an ophthalmological examination and / or therapy device and to a corresponding method for coupling two articulated arms of an ophthalmological examination and / or therapy device.

Devices and methods for the examination and therapy of eye diseases have been developing for some years both towards a higher complexity and towards a more compact design: The space occupied by a treatment system for ophthalmological purposes should be as low as possible, since such treatments are sterile Environment should take place. On the other hand, such systems should also be used so that the patient does not have to be changed in his position. This is a great advantage, in particular for methods in which examination and therapy alternate, since the subsystems used can then be calibrated to each other.

In ophthalmic laser therapy systems, it is now common to combine a laser therapy device for generating sections in an eye tissue, or for ablation or coagulation of an eye tissue by means of laser radiation with an examination device and preferably to integrate in a common system.

For example, this is very advantageous in laser-assisted ophthalmic surgery for the correction of ametropia or for the treatment of other ocular diseases, such as a cataract by means of cataract surgery, where operations for characterizing the eye structures alternate with surgical procedures and steps to verify the surgical procedure or to assist the surgical procedure. Thus, the eye structures can first be characterized by means of a surgical microscope, by means of optical coherence tomography (OCT) or by means of ultrasound. Thereafter, an eye tissue can be cut by means of a pulsed laser beam, in this case, for example, be separated by means of photodisruption. The result can then be verified by means of a surgical microscope and subsequent steps, such as, for example, in cataract surgery, the aspiration of a clouded eye lens, previously cut with the laser beam and / or smashed by ultrasound, under the control of the surgical microscope.

For this purpose, it is possible to work with a treatment system having movable articulated arms, each having a corresponding applicator positioned to the patient's eye such that e.g. a therapy laser radiation is focused in an eye tissue or by means of a surgical microscope, the corresponding eye can be observed.

In particular, when using a therapy laser radiation for ophthalmological purposes, it is advantageous to establish a fixed positional relationship between the eye to be treated and the applicator of the therapy laser beam. As a rule, this is achieved by means of a liquid patient interface or in a simple manner by means of a contact lens with which the eye is fixed to the applicator of the corresponding articulated arm.

It is desired that the corresponding articulated arms can also be coupled. In cataract surgery, for example, it makes sense to couple a surgical microscope, which is arranged on a first articulated arm, to the laser applicator, which is arranged on a second articulated arm.

However, a number of requirements must be met:
The operator, usually the treating physician, must be able to perform the coupling procedure during a treatment. Therefore, simply finding the coupling positions is extremely important to the operator because his attention must continue to be dedicated to the patient. In this case, an offset in the lateral direction and a rotation about the vertical axis should be easily compensated for the first contact of the coupling elements in order to realize an exact coupling. A slight deviation from a parallelism of the coupling elements should correct itself.

For a reliable function of an ophthalmological examination and / or therapy system also a tension-free coupling of the articulated arms and a very small clearance between the articulated arms is necessary because the occurrence of stresses has an influence on the optical paths and, for example, to an unintentional Distraction or a displacement of an examination or therapy radiation would lead.

Also, a coupling system must be set up so that it does not hinder the beam path of an examination or therapy radiation or the function of optical elements.

Furthermore, it is desirable that the operator can clearly determine in which position the coupling of the articulated arms takes place.

Not least, it is advantageous to support the operator during the coupling process by an automatic or motor. Also an interchangeability of the coupling system against other accessories of the articulated arms of the ophthalmological examination and / or therapy system and its applicators is advantageous.

The object of the present invention is therefore to describe an ophthalmological examination and / or therapy device with coupling articulated arms, a coupling system for these purposes and a corresponding method for coupling two articulated arms of an ophthalmological examination and / or therapy device with which a simple, controlled and tension-free coupling of the articulated arms is possible without obstructing the function of the ophthalmological examination and / or therapy device.

This object is achieved by an ophthalmological examination and / or therapy device according to claim 1, a coupling system according to claim 11 and a method for coupling two articulated arms of an ophthalmological examination and / or therapy device according to claim 13.

An ophthalmological examination and / or therapy device comprises a main body, a first articulated arm, on which a first applicator for application of an examination or a therapy is arranged on a patient's eye, and a second articulated arm, on which a second applicator for the application of an examination or a Therapy is arranged on a patient's eye.

The articulated arms have a movably or immovably fixed to the main body end, a free end and mutually movable articulated members. They are movable in space. The ophthalmological examination and / or therapy device with a first and a second articulated arm can in this case also comprise further articulated arms in addition to these two articulated arms.

The articulated arm can be fastened directly or indirectly to the base body with a fixed end: If it is fastened indirectly to the base body, the base body has an extension for this purpose, for example in the form of a column or axle rod protruding from the base body. By attachment to this extension of the articulated arm is indirectly attached to the body.

A movably fixed to the main body end of the articulated arm defines a fixation, in which the articulated arm directly at the location of fixation has an axis or a universal joint around which it is pivotally or rotatably mounted. An immovably fixed to the body end of the articulated arm means a rigid attachment of this end, so that the position of the articulated arm in the room can be changed only with its first joint member.

Individual joint members are connected to each other by joints containing rotary heads or axes of rotation.

By contrast, the main body of the ophthalmological examination and / or therapy device is fixed in its spatial position and comprises devices necessary for the respective application, such as radiation sources or one or more control units. For example, it may be moved as a whole by a pulley system, but all the components it contains are fixed in place.

The term applicator first designates a device from which an interaction of the treatment system with the patient's eye takes place. For example, the applicator designates an exit location of an examination and / or treatment radiation or the location from which observation of the patient's eye is made possible.

The first applicator is preferably arranged at the free end of the first articulated arm, the second applicator is preferably arranged at the free end of the second articulated arm. Due to the arrangement of the applicator at the free end of the articulated arm this is according to its design freely in a three-dimensional working volume movable.

An examination of the patient's eye comprises any method for the qualitative and / or quantitative characterization of the patient's eye, its structures and its tissue, localized or in a larger area of the patient's eye. Even simple observation procedures fall under the term investigation.

The therapy of the patient's eye includes methods for altering the structures and / or the tissue of the patient's eye, but especially surgical applications such as laser therapy. It also includes the removal or replacement of ocular tissue, such as the removal of the natural vitreous of the patient's eye and its replacement by an intraocular lens (IOL) in cataract surgery.

The ophthalmological examination and / or therapy device according to the invention furthermore comprises a coupling system for coupling the first and second articulated arm. The coupling system has a first coupling element on a lower side of the first articulated arm and a second coupling element on an upper side of the second articulated arm. The first coupling element is adapted to be fitted and fixed in the second coupling element.

In this case, fitting the first coupling element into the second coupling element does not necessarily mean that the first coupling element is subsequently encompassed by the second coupling element, but only that mutually coordinated structures of the first and the second coupling element interlock: as a result, the first coupling element can equally well be displaced from the second coupling element Coupling element may be included or arise but a toothed structure.

According to the invention, the first coupling element now contains a gimbal with which it is arranged on the first articulated arm.

Although it is the most likely case of the coupling system of the ophthalmic examination and / or therapy device, the upper and lower sides of an articulated arm do not necessarily characterize a "top" or "bottom" but two opposing sides or two oppositely positionable ones Pages of the articulated arms, because it is quite possible that only after the first approach of the two articulated arms to be coupled before the coupling process, the articulated arms are aligned with each other so that a "top" of one articulated arm facing a "bottom" of the other articulated arm.

Now, in the most likely embodiment of the ophthalmological examination and / or therapy device, the underside of the first articulated arm is directed down to a ground plane on which the main body of the ophthalmological examination and / or therapy device is placed, then the upper side of the second articulated arm is therefrom As a consequence, the bottom surface of the first articulated arm and the top of the second articulated arm at the free end of the articulated arm are approximately horizontal opposite to the coupling before coupling.

The coupling element on the first as well as on the second articulated arm can now be arranged on the articulated arm itself next to the applicator, on the applicator itself or on a connecting element to the applicator or to the articulated arm. In an arrangement of the coupling element to a connecting element, this may for example be arranged so that the coupling element is exchangeable by simple means against another accessory element.

The use of a gimbal suspension of the first coupling element allows to fit during the coupling process, the first coupling element in the second coupling element and to fix without tensions due to a slight tilting of the two coupling elements to each other at the beginning of the coupling process, because the gimbal ensures a appropriate orientation.

In a preferred embodiment of the coupling system of the ophthalmological examination and / or therapy device, the first coupling element of the coupling system comprises a coupling ring, which is rotatably suspended in an intermediate ring about a first axis, and the intermediate ring in turn on the first articulated arm or on the applicator of the first articulated arm around a second, perpendicular to the first axis axis is rotatably suspended.

This also includes a suspension of the intermediate ring in a connecting part to the applicator of the first articulated arm.

The rotation angle for the first axis as well as for the second axis may include a range of +/- 5 ° each. Advantageously, it is in each case +/- 2 °, whereby deviations of the parallelism of up to 4 ° in both axes can be compensated.

It is advantageous if the coupling system of the ophthalmological examination and / or therapy device is designed such that the first applicator of the first articulated arm acts through the coupling system and unaffected by it.

Preferably, the first applicator thus acts in the coupled state of the two articulated arms through the first and the second coupling element, without being disturbed or even influenced by it. In particular, an optical axis or the optical beam path of the first applicator advantageously leads centered through a central opening of the first and the second coupling element. The coupling elements are advantageously configured so that they do not touch the optics or the active elements of the applicators.

It is particularly advantageous if the coupling system of the ophthalmological examination and / or therapy device has means and / or structures for increasing the capture range of the second coupling element by the first coupling element.

While it allows the gimbal suspension, two articulated arms without the occurrence of tension in the not exactly parallel state of the coupling elements of the two articulated arms to couple, ie, to start the coupling process, although no exact parallelism is made and this in the connection "judge" allowed There is an enlargement of the capture area to begin the coupling process, although the coupling elements of the two articulated arms and thus the two applicators are not exactly aligned laterally: The coupling elements finally slide with the help of the means and structures to increase the capture area after the start of the coupling process in the right position to each other.

By a combination of the gimbal of the first coupling element and the means and structures to increase the capture area thus a centering and Verdrehausrichtung is ensured.

In one embodiment of the coupling system of the ophthalmological examination and / or therapy device, the second coupling element has a coupling funnel. The first coupling element advantageously contains a coupling ring, which slides into the coupling funnel during the coupling process.

In principle, all combinations of structures of the first coupling element to the second coupling element are advantageous here, which allow a self-adjustment due to their shape.

It is furthermore advantageous if the first and / or the second coupling element of the coupling system of the ophthalmological examination and / or therapy device has guide elements.

Such guide elements, which also contribute to increasing the capture area, but then support the alignment of the two coupling elements to each other after "catching" are, for example, lugs, grooves or segments of the coupling elements having chamfers.

For easy operation during the coupling process of an ophthalmological examination and / or therapy device according to the invention, the articulated arms and / or the coupling elements preferably have predefined coupling positions.

Preferably, the coupling positions are defined by the coupling system. In particular, for this purpose, the first coupling element and the second coupling element may have markings which unambiguously indicate coupling positions corresponding to an operator of the ophthalmic examination and / or therapy device and facilitate a twisting direction during the coupling process. Advantageously, the use of such predefined coupling positions at -90 °, 0 ° and 90 °, that is, the two articulated arms can take apart at a distance of 90 ° distinguishable coupling positions ..

Again, the markers are preferably of visual and physical nature, that is, predetermined by corresponding structures that are visible and "feelable." Of course, it is also possible to work only with visually displayed marks and to let them be aligned manually by the operator accordingly. However, a mark physically present through appropriate structuring further facilitates alignment because it allows guidance.

In an advantageous embodiment of the ophthalmological examination and / or therapy device, the articulated arms and / or the coupling elements have a sensor system which is set up to uniquely determine the coupling positions.

A sensor system that determines the coupling positions does not necessarily have to be arranged directly on the coupling elements. By determining the position of the articulated arms, a determination of the coupling position is also possible. However, it is advantageous, in particular more precisely, to determine the coupling position directly by detecting the position of the first and second coupling elements relative to each other.

For an ophthalmological examination and / or therapy device with three coupling positions at -90 °, 0 ° and 90 °, it is possible, for example, to arrange three sensors at intervals of 90 ° on the second coupling element. In the first coupling element then again three detectable by the sensors elements are arranged at a distance of 90 °, so that depending on the coupling position all three sensors or two sensors, ie the central sensor and one of the outer sensors are activated.

In a preferred embodiment, the coupling system of the ophthalmological examination and / or therapy device comprises a Locking system for fixing the coupling of the first and second articulated arm.

Advantageously, the locking system comprises a locking motor for fixing the coupling of the first and second coupling element, which rotates a fixing ring, for example a bayonet ring, correspondingly and spends it into a fixing position.

In a preferred embodiment of the ophthalmological examination and / or therapy device, the first applicator on the first articulated arm comprises a surgical microscope and the second applicator on the second articulated arm comprises a laser applicator.

In this preferred ophthalmic examination and / or therapy device, the main body contains a therapeutic laser source for generating a therapy laser radiation. This is in particular a short-pulse laser radiation, preferably a femtosecond or picosecond laser radiation. For this purpose, the main body and the second articulated arm additionally comprise a device for controlled focusing and deflection of the therapeutic laser radiation, which has focusing elements such as, for example, lenses and deflection elements, such as scanners, wherein the laser applicator is arranged such that the therapeutic laser radiation emanates from the laser applicator Treatment system exits in the direction of the patient's eye.

With the a surgical microscope, which is arranged on the first articulated arm, in the coupled state of the two articulated arms, in which the surgical microscope is fixed above the laser applicator and the patient's eye can be observed through the laser applicator with the surgical microscope, the effect of Therapy laser radiation can be examined in a comparison of the images before and after the application or directly during the application.

On the other hand, however, the surgical microscope can also be used in the uncoupled state for examining the patient's eye.

The arrangement of further devices for the examination and / or the therapy of a patient's eye is possible on further articulated arms, possibly with a further coupling system in the same manner to the already coupled first and second articulated arms or to the first or to the second articulated arm can be coupled. For such a multiple coupling or a variable coupling, an articulated arm may also include a coupling element, which corresponds to the first coupling element, on a lower side of the articulated arm and a coupling element, which corresponds to the second coupling element, on an upper side of the articulated arm.

Thus, an optical coherence tomography device (OCT) can either be coupled directly via the laser applicator and consequently integrated into the first and / or second articulated arm, or arranged on an additional articulated arm. In this case, the respective articulated arm contains at least part of the device for the controlled focusing and deflection of the examination radiation. A corresponding radiation source, the further part of the device for the controlled focusing and deflection of the examination radiation as well as a control for the OCT device is preferably arranged in the base body.

A coupling system for coupling two articulated arms of an ophthalmological examination and / or therapy device comprises a first coupling element and a second coupling element, wherein the first coupling element is adapted to be fitted and fixed in the second coupling element.

According to the invention, the first coupling element now has a device for a cardanic suspension. This gimbal is adapted to be placed on a first articulated arm.

In a preferred embodiment, the coupling system is set up to pass a radiation or active elements unaffected by the coupling system in the coupled state.

In an ophthalmological examination and / or therapy device, radiation is usually used. In particular, light or laser radiation is used here. The coupling system according to the invention is therefore in particular designed to pass an optical beam path through the coupling system. However, a radiation passed through here can also be ionizing radiation or other particle radiation. By contrast, active elements include mechanical waves, such as ultrasound

An unaffected passage through the coupling system is characterized by an absence of interactions with the coupling system of the radiation or the active elements. Thus, there is no deflection or deflection, no reflection, no influence of the intensities by components of the coupling system.

It is therefore necessary to provide a corresponding area in the center of the coupling system in which radiation or other active elements can pass through without components of the Coupling system in any form to be modified or steered. Advantageously, the material to be used of the components of the coupling system is tuned to the radiation or the active elements.

• – das erstes Koppelelement manuell oder automatisch vorzentriert zum zweiten Koppelelement ausgerichtet, und
• – das erste Koppelelement in das zweite Koppelelement abgesenkt und eine automatische Einpassung in Lage und Richtung initiiert.

In a method for coupling two articulated arms of an ophthalmological examination and / or therapy device according to the invention

• - The first coupling element manually or automatically pre-centered aligned with the second coupling element, and
• - Lowered the first coupling element in the second coupling element and initiated an automatic adjustment in position and direction.

Finally, the first and the second coupling element is fixed to each other, wherein the step of fixing is either already set during fitting in motion, or completed after completion of the fitting.

A pre-centering is in this case a coarse centering at a level that the operator can achieve in the manual coupling method without much effort: He brings the two coupling elements under visual control in an opposite position.

The approach of the two articulated arms and their coupling elements can also be supported by an automatic or by a motorized movement of the articulated arms.

After pre-centering, the ophthalmological examination and / or therapy device or its coupling system according to the invention makes it possible to carry out a precise automatic fitting, in particular with respect to any tilting of the two coupling elements to one another, and to correct any deviations existing after pre-centering.

Due to the complete fixation of the two coupling elements to each other, the method for coupling two articulated arms is finally completed.

An automatic fit with the aid of a gimbal suspension can be accomplished by a further manual movement of one or both articulated arms by the operator or by an automatic movement of one or both articulated arms. It is important, however, that the two coupling elements find their correct position to each other without further alignment by the operator: The automatic fit brings the first coupling element in exactly parallel position to the second coupling element and thereby enables a distortion-free coupling.

In a method according to the invention for coupling two articulated arms, means and / or structures for increasing the capture range for a lateral alignment of the first to the second coupling element are preferably used, so that a precise automatic adjustment takes place both in the lateral direction and with respect to any tilting that may be encountered can be. This provides the operator with further ease of pre-centering: both positional errors in the lateral alignment and in the parallelism of the two coupling elements are tolerated.

Another help for the operator provides a method according to the invention for coupling two articulated arms, in which the coupling takes place in a predefined coupling position of the first coupling element to the second coupling element. It is also advantageous if the coupling takes place in a fixed storage or rest position of the second articulated arm.

Thus, the method for coupling two articulated arms, for example, in a storage device of the second articulator arranged on the second applicator, in particular during storage of the second applicator in a parking shell, performed.

The present invention will now be explained with reference to exemplary embodiments. It shows:

the 1 an exemplary example of the ophthalmological examination and / or therapy device according to the invention.

the 2a and 2 B two mutually perpendicular sectional views of a first coupling element and its gimbal suspension.

the 3a and 3b a side view of a coupling ring of the first coupling element and a coupling funnel of the second coupling element before and after the coupling.

the 4 a section through the coupled coupling ring in its coupling hopper with a locking motor.

the 5 a section through a locked coupling ring in its coupling funnel.

the 6 a coupling ring with details in a side view.

the 7a a coupling ring in a plan view and in the 7b and 7c in different cutting planes.

In the 1 is an embodiment of the ophthalmic examination and / or therapy device according to the invention 01 shown. In this embodiment, the treatment system includes 100 a basic body 10 , a first articulated arm 21 with a surgical microscope 51 as applicator of the first articulated arm 21 , and another articulated arm 22 with a laser applicator 52 for applying a therapy laser radiation to the patient's eye. Both articulated arms 21 . 22 are with one end of the articulated arm 21 . 22 each over an extension 11 at the base body 10 fastened while the laser applicator 52 and the surgical microscope 51 at the other, free end of the articulated arm 21 . 22 is arranged. The articulated arms 21 . 22 have mutually movable hinge members, which are about horizontal hinge axes 30-O3 . 30-O4 . 30-L3 . 30-L4 and vertical hinge axes 30-O1 . 30-O2 . 30-O5 . 30-L1 . 30-L2 . 30-L5 are mobile.

The articulated arm 22 holding the laser applicator 52 includes means for deflecting and focusing the therapy laser radiation contained in a femtosecond laser source 61 is generated in the body 10 the ophthalmic examination and / or therapy device according to the invention 01 is arranged. The laser applicator 52 contains the exit opening of this steered and focused femtosecond laser radiation.

By appropriate positioning over the patient's eye to be treated, such that the patient's eye to the laser exit opening in a fixed relationship, which here by fixing the patient's eye to the laser applicator 52 By means of a patient interface (not shown here) it is ensured that the focus of the femtosecond laser radiation can be moved in a defined scan pattern in a tissue of the patient's eye. In this case, the eye tissue is separated by photodisruption at the respective site of action of the focus of the femtosecond laser radiation. Along the scan pattern of the femtosecond laser radiation thus creates a cut in the tissue of the patient's eye. The generation of the femtosecond laser radiation as well as its deflection and focusing are performed by a control unit 60 controlled, which also also all other functions of the ophthalmic examination and / or therapy device 01 controls.

Both articulated arms 21 . 22 each have a weight compensation device. This is in this embodiment in each case in the form of a special joint member, a so-called Paralleltragarms 31 , which contains a compensation spring (not shown here). The parallel arm 31 of the articulated arm 22 holding the laser applicator 52 comprises substantially four joints, so the first turret 30-L2 with the two parallel axes 30-L3 and the second turret 30-L5 with the two parallel axes 30-L4 , as well as the joint limbs 31 , The weight balance for all masses to be compensated takes place with respect to the lower hinge axis 30-L3 ,

The spring balance of the surgical microscope articulated arm 21 can be adjusted by hand and is operated by the operator to the respective weight of the surgical microscope 51 attached accessories or to the coupled articulated arm 22 with laser applicator 52 customized.

The embodiment of the ophthalmic examination and / or therapy device according to the invention described here 01 also contains a coupling system 02 for coupling the articulated arms 21 . 22 , the two coupling elements 70 . 80 one of which is on the underside of the surgical microscope 51 and the other at the top of the laser applicator 52 is arranged so that the two coupling elements 70 . 80 can interlock according to a key-lock principle. This allows the surgical microscope 51 with the laser applicator 52 coupled, and the progress of the laser therapy, so for example, the progress of a cut in the cornea, sclera, capsular bag or the eye lens, by a with the laser applicator 52 Applied femtosecond laser radiation through the surgical microscope 51 to be watched.

The first coupling element 70 of the coupling system 02 contains a gimbal suspension 75 and includes a coupling ring 71 , which is tiltable by the gimbal about two mutually perpendicular axes. The first coupling element 70 is doing so at the bottom of the surgical microscope 51 arranged the optics of the surgical microscope and the beam path between the front lens of the surgical microscope 51 and the patient's eye is not obstructed. For this purpose contains the first coupling element 70 and in particular the coupling ring 71 a correspondingly large, to the optical axis of the surgical microscope 51 centered, circular opening 74 ,

The second coupling element 80 includes a coupling funnel 81 , also with a correspondingly large, to the optical axis of the laser applicator 52 and thus also the coupled surgical microscope 51 centered, circular opening to no obstruction in the beam path between the front lens of the surgical microscope 51 and the patient's eye. The coupling ring 71 is in the coupling funnel 81 adjustable, coupling ring 71 and coupling funnels 81 are fixable to each other.

During the coupling process is the laser applicator 52 in a park bowl 40 of the second articulated arm 52 of the ophthalmic examination and / or therapy system 01 stored. The coupling ring 71 is at the surgical microscope 51 centered on the front lens. The coupling funnel 81 is on the laser applicator 52 centered to the optical axis of the exit opening of the laser applicator 52 to the patient's eye or centered to an optical interface to the patient's eye, such as a patient interface arranged. For coupling, the operator must use the surgical microscope 51 arranged coupling ring 71 , in which the articulated arm with the surgical microscope centric to the coupling funnel 81 align with the laser applicator.

The 2a and 2 B shows two sectional views of an embodiment of a first coupling element 70 and its gimbal 75 in a first sectional plane of a first axis of rotation A1 and in a direction perpendicular to the first sectional plane second sectional plane of a second axis of rotation A2 of the gimbal 75 ,

The example of a coupling system according to the invention 02 includes two coupling elements 70 . 80 , the gimbal-mounted coupling ring 71 on the surgical microscope 51 and the coupling funnel 81 on the laser applicator 52 , Both coupling elements 70 . 80 have, as already described, a central opening 74 for the optical beam path of the surgical microscope 51 on.

The coupling ring 71 is gimbaled to a connector herein 79 to the surgical microscope 51 suspended. Such a suspension is very beneficial because surgical microscope 51 and laser applicator 52 not ideally horizontally or ideally parallel to each other can be aligned. The possible deviations are so great that they are not affected by a larger clearance between coupling ring 71 and coupling funnels 81 can be compensated. A larger game would also lead to a non-value-enhancing impression in the operator, since the coupled surgical microscope 51 clatters in this game.

However, it is particularly critical that there are tensions, if the existing game is not enough. These tensions deform the laser applicator 52 in its suspension on the second articulated arm 22 and thus have a direct influence on the adjustment state of the laser applicator 52 and on the beam quality of the therapy laser beam. In addition, tensions also lead to a difficult coupling by a motor-driven bayonet 86 , because the torque of the engine 85 is due to the limited space limited expandable.

The cardanic suspension 75 thus allows an almost backlash coupling without distortion. This is realized by a rotatable suspension of the coupling ring 71 in an intermediate ring 76 by means of first tenon screws 77 , by which a first axis of rotation A1 is realized. The intermediate ring 76 is in turn by means of second peg screws 78 rotatable about an axis of rotation A2 in the connecting part 79 to the surgical microscope 51 suspended. Both axes of rotation A1 and A2 are perpendicular to each other.

The angle of rotation about both axes A1, A2 is respectively +/- 2 °. In this way deviations of the parallelism of up to 4 ° in both axes A1, A2 can be compensated. Tensions are thus excluded, and the coupling of the two coupling elements 70 . 80 and thus the coupling of surgical microscope 51 of the first articulated arm 21 and laser applicator 52 of the second articulated arm 22 can be realized almost without play.

The connection part 79 is provided with a swallow, which allows coupling with an adapter part, which at the bottom of the surgical microscope 51 is fixed. This adapter part is usually for the coupling of other accessories of the surgical microscope 51 used. The coupling element 70 So it can easily be used against other accessory components of the surgical microscope 51 be replaced.

The 3a and 3b show a side view of a coupling ring 71 of the first coupling element 70 and a coupling funnel 81 of the second coupling element 80 before and after the coupling.

When coupling, the operator must make sure that he is the surgical microscope 51 rotates about the vertical axis so that the coupling lugs 72 of the coupling ring 71 to the grooves 82 in the coupling funnel 81 are aligned. The coupling ring 71 includes four coupling noses 72 and the coupling funnel 81 four grooves 82 , lying opposite each other in the cross, that is, at regular intervals of neighboring coupling noses 72 or adjacent grooves 82 of 90 °, as exemplified by the coupling lugs 72 of the coupling ring 71 in the 7a shown. This ensures that it can be coupled in the 90 ° grid.

coupling noses 72 and grooves 82 are provided with chamfers, so structures for increasing the capture area, to find the two components 72 . 82 and thus also the two coupling elements 70 . 80 to facilitate. Because the coupling noses 72 and grooves 82 arranged crosswise, they take over both the task of centering and the direction of rotation in the 90 ° grid. In addition, the inner cylinder of the coupling ring 71 still with a chamfer 73 provided (see in particular 6 ), in combination with a funnel-shaped chamfer 83 in the coupling funnel 81 also centering acts. The two bevels 73 and 83 are cross-sectionally intersected on the perimeter segment-like, so that the segments of the chamfer 73 when inserting the coupling ring 71 into the gaps of the coupling funnel 81 can be introduced. The segments of the chamfer 73 on the coupling ring 71 are up with a ramp 87 provided, which is required for the lock.

The generously sized bevels on coupling noses 72 , Grooves and coupling ring 71 and coupling funnels 81 These are necessary to increase the capture range as much as possible to help the operator find the right position. In addition, on the coupling ring 71 as well as on the outer cylinder of the coupling funnel 81 mark 90 attached, which should facilitate the Verdrehausrichtung the operator, so that he can quickly find the respective defined, so for his purposes desired, coupling position (0 °, 90 ° and -90 °) can be found. The operator must therefore only the respective marking 90 and the desired coupling nose 72 by twisting the surgical microscope 51 Align and then lower the surgical microscope, and thus the coupling ring 71 of the first coupling element 70 in the coupling funnel 81 of the second coupling element 80 introduce and connect.

In the 4 is a section through the coupled coupling ring 71 in his coupling funnel 81 with a locking motor 85 shown.

The segment-like interruptions of the chamfer rings 73 and 83 are necessary to the pinion of the locking motor 85 cover. Otherwise, the pinion and gear would be the locking motor 85 not covered at the top and not protected against any ingress of liquids.

In the coupling funnel 81 is located under the funnel-shaped segments 83 a bayonet ring 86 that of the locking motor 85 is twisted. The bayonet ring 86 is provided with an internal toothing and rotates driven by a pinion on the motor gear via a slope 7 on the segments of the coupling ring 71 on the segments 73 , The state after locking, and thus the fixation of the two coupling elements 70 . 80 to each other, is in the 5 shown, which is a section through a locked coupling ring 71 in his coupling funnel 81 shows.

The 6 shows for better understanding of the example described a coupling ring 71 with details, in particular its chamfers having coupling noses 72 as well as the chamfer 73 of the coupling ring 71 itself and its ramp 87 in a side view.

The 7a describes a coupling ring in a plan view and in the 7b and 7c in the in 7a shown sectional planes BB and FF, so on the one hand by a sectional plane in which the chamfer ring 73 interrupted and another cutting plane in which the chamfer ring 73 of the coupling ring 71 is visible.

In addition, the shows 7a an example of the arrangement of sensors 91 and corresponding counter-elements of a sensor system 91 . 92 , which allows unambiguous determination of the coupling positions.

In the coupling funnel 81 is located below the grooves 82 a circuit board. On the circuit board are three Hall sensors 91 arranged, of which the first has a distance of 90 ° to the second, and this in turn a distance of 90 ° to the third Hall sensor. In the coupling ring 71 in turn, three permanent magnets are embedded 92 , of which in turn the first a distance of 90 ° to the second and this in turn a distance of 90 ° to the third permanent magnet 92 having. Depending on the position, either all three sensors 91 or in each case two sensors, ie the central sensor and one of the outer sensors activated. This clearly indicates which position of the laser applicator 52 to the surgical microscope 51 or whether it was correctly connected. If only one sensor is activated, for example, the coupling ring 71 tilted and / or not properly locked.

The above-mentioned and explained in various embodiments features of the invention are not only in the exemplary combinations, but also in other combinations or alone, without departing from the scope of the present invention.

A description of a device based on process characteristics applies analogously to these features for the corresponding method, while process features represent correspondingly functional features of the device described.

Claims (15)

Ophthalmic examination and / or therapy device ( 01 ), which - a basic body ( 10 ), - a first articulated arm ( 21 ) to which a first applicator ( 51 ) is arranged to apply a test or therapy to a patient 's eye, and A second articulated arm ( 22 ), to which a second applicator ( 52 ) is arranged to apply a test or therapy to a patient's eye, and - a coupling system ( 02 ) for the coupling of the first ( 21 ) and second articulated arm ( 22 ), wherein the articulated arms ( 21 . 22 ) a movable or immovable on the base body ( 10 . 11 ) fixed end, a free end and mutually movable joint members ( 31 ), and - wherein the coupling system ( 02 ) a first coupling element ( 70 ) on an underside of the first articulated arm ( 21 ) and a second coupling element ( 80 ) on an upper side of the second articulated arm ( 22 ), and the first coupling element ( 80 ) is arranged in the second coupling element ( 70 ) to be fitted and fixed, characterized in that the first coupling element ( 70 ) a gimbal ( 75 ) contains. Ophthalmic examination and / or therapy device ( 01 ) According to claim 1, characterized in that the first coupling element ( 70 ) of the coupling system ( 02 ) a coupling ring ( 71 ), which in an intermediate ring ( 76 ) is rotatably suspended about a first axis (A1), and the intermediate ring ( 76 ) on the first articulated arm ( 21 ) or on the applicator ( 51 ) of the first articulated arm ( 21 ) is rotatably suspended about a second axis (A2) perpendicular to the first axis (A1). Ophthalmic examination and / or therapy device ( 01 ) according to claim 1 or 2, characterized in that the coupling system ( 02 ) is configured so that the first applicator ( 51 ) of the first articulated arm ( 21 ) through the coupling system ( 02 ) and acts unaffected by this effect. Ophthalmic examination and / or therapy device ( 01 ) according to one of claims 1 to 3, characterized in that the coupling system ( 02 ) Means and / or structures ( 73 . 81 . 83 ) for increasing the capture range of the second coupling element ( 80 ) by the first coupling element ( 70 ) having. Ophthalmic examination and / or therapy device ( 01 ) according to claim 4, characterized in that the second coupling element ( 80 ) a coupling funnel ( 81 ) having. Ophthalmic examination and / or therapy device ( 01 ) according to claim 4 or 5, characterized in that the first ( 70 ) and / or the second coupling element ( 80 ) Guide elements ( 72 . 82 ) having. Ophthalmic examination and / or therapy device ( 01 ) according to one of claims 1 to 6, characterized in that the articulated arms ( 21 . 22 ) and / or the coupling elements ( 70 . 80 ) have predefined coupling positions. Ophthalmic examination and / or therapy device ( 01 ) according to one of claims 1 to 7, characterized in that the articulated arms ( 21 . 22 ) and / or the coupling elements ( 70 . 80 ) a sensor system ( 91 . 92 ), which is set up to uniquely determine the coupling positions. Ophthalmic examination and / or therapy device ( 01 ) according to one of claims 1 to 8, characterized in that the coupling system ( 02 ) a locking system ( 85 . 86 ) for fixing the coupling of the first ( 21 ) and second articulated arm ( 22 ). Ophthalmic examination and / or therapy device ( 01 ) according to one of claims 1 to 9, characterized in that the first applicator ( 51 ) on the first articulated arm ( 21 ) a surgical microscope and the second applicator ( 52 ) on the second articulated arm ( 22 ) comprises a laser applicator. Coupling system ( 02 ) for coupling two articulated arms of an ophthalmological examination and / or therapy device ( 01 ), which is a first coupling element ( 70 ) and a second coupling element ( 80 ), wherein the first coupling element ( 80 ) is arranged in the second coupling element ( 70 ) to be fitted and fixed, characterized in that the first coupling element ( 70 ) a device for a cardanic suspension ( 75 ) having. Coupling system ( 02 ) according to claim 11, which is arranged, in the coupled state, a radiation or active elements unaffected by the coupling system ( 02 ). Method for coupling two articulated arms ( 21 . 22 ) an ophthalmological examination and / or therapy device ( 01 ) according to one of claims 1 to 10, wherein - the first coupling element ( 70 ) manually or automatically precentered to the second coupling element ( 80 ), - the first coupling element ( 70 ) in the second coupling element ( 80 ) and an automatic fit in position and direction is initiated, and - the first ( 80 ) and the second coupling element ( 80 ) is fixed to each other. Method according to claim 13, wherein means and / or structures ( 73 . 81 . 83 ) to increase the capture range for a lateral orientation of the first ( 70 ) to the second coupling element ( 80 ) are used. The method of claim 13 or 14, wherein the coupling in a predefined coupling position of the first coupling element ( 70 ) to the second coupling element ( 80 ) and / or in a fixed storage or rest position of the second articulated arm ( 22 ) he follows.

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