CN111407508B - Ophthalmic cutting system and ophthalmic cutting method - Google Patents
Ophthalmic cutting system and ophthalmic cutting method Download PDFInfo
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- 238000007493 shaping process Methods 0.000 claims abstract description 17
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
- A61F9/008—Methods or devices for eye surgery using laser
- A61F2009/00853—Laser thermal keratoplasty or radial keratotomy
Abstract
The invention provides an ophthalmic cutting system, which comprises a self-mode-locking all-fiber femtosecond laser, a beam shaping system, a spectroscope, a laser galvanometer scanning system, an optical coherence tomography imaging system, a cornea topographic map, a human eye docking system, a data analysis processing system, a head-up display system and a control system. In addition, the invention also provides an ophthalmic cutting method.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an ophthalmic cutting system and an ophthalmic cutting method.
Background
When the instantaneous power density of the femtosecond laser reaches or exceeds a specific threshold value after the femtosecond laser is emitted from the laser instrument, the irradiated tissue forms plasma due to the multiphoton absorption effect, and the plasma micro-blasting effect is generated together with the irradiation tissue to form a certain degree of shock wave. The continuous micro-blasting effect enables each micro-blasting point to be connected into a line, and the line is connected into a surface, so that an extremely precise tissue cutting effect is achieved. Femtosecond lasers are increasingly used in a variety of ophthalmic diseases, including anterior ocular segment laser treatment and fundus laser treatment. The anterior ocular segment and fundus tissue vary widely in location, shape, density, thickness, etc.
Optical coherence imaging systems (OCT) are currently used to image the internal structure of ocular tissue to guide femtosecond laser ocular tissue cutting, but do not resolve ocular surface lesions of similar density and similar tissue structure. The corneal topography can be used for preoperative examination and postoperative efficacy evaluation of corneal refractive surgery, and the corneal character, especially astigmatism, is fully known and corneal distortion induced by keratoconus and contact lenses is eliminated before surgery according to the corneal topography; and evaluating the curative effect according to the corneal topography after operation. The aim of modern cataract surgery is not only to reduce surgically induced astigmatism, but also to neutralize preoperative astigmatism through the surgical incision. The procedure can be guided based on the topography of the cornea examined prior to the procedure. The cornea topographic map is used for accurately diagnosing the cornea astigmatism after cornea implantation operation, so as to guide and correct the astigmatism after cornea implantation operation.
In order to obtain the best cutting effect, an optical coherence imaging system (OCT) is used for collecting image information of a depth region of eye tissue in an operation, a corneal topography is used for collecting corneal character information, and the eye tissue is cut more accurately; meanwhile, the precise positioning and focusing of the femtosecond laser pulse are required to be synchronously guided in real time in the operation, and the precise cutting method has very urgent application requirements for precise cutting of the femtosecond laser eye tissue.
Disclosure of Invention
Accordingly, there is a need for an ophthalmic cutting system that is effective for precise cutting of ocular tissue, improving the accuracy and safety of the procedure, in view of the deficiencies of the prior art.
In order to achieve the above purpose, the present invention adopts the following technical scheme:
an ophthalmic cutting system comprises a self-mode-locking all-fiber femtosecond laser, a beam shaping system, a spectroscope, a laser galvanometer scanning system, an optical coherence tomography imaging system, a cornea topographic map, an eye docking system, a data analysis processing system, a head-up display system and a control system, wherein:
the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser enters the beam shaping system from a fiber transmission line, and the initial femtosecond pulse laser beam after passing through the beam shaping system is converted into a phase-modulated femtosecond pulse laser beam;
the phase-modulated femtosecond pulse laser beam enters the laser galvanometer scanning system through the spectroscope, enters the cornea topographic map and the optical coherence tomography imaging system after being scanned by the laser galvanometer scanning system, and the optical coherence tomography imaging system acquires image information of a depth area of eye tissue, and the cornea topographic map acquires image information of a cornea area;
the data analysis processing system processes the image information of the eye tissue depth area and the image information of the cornea area, the head-up display system displays the real-time image information processed by the data analysis processing system, the control system sends out an instruction to adjust the energy of the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser according to the real-time image information, and the human eye docking system focuses and docks the adjusted femtosecond pulse laser beam onto an eye tissue plane to be cut, so that accurate cutting of eye tissue is realized.
In some preferred embodiments, the self-mode-locking all-fiber femtosecond laser has a wavelength of 1064+ -5 nm, a pulse width of 300fs-500fs, a pulse frequency of 10kHz-200kHz, a pulse energy of 10 μJ-30 μJ, a beam diameter of 3+ -1 μm, and a beam quality M2<1.2.
In some preferred embodiments, the beam shaping system includes a spatial light modulator, a first convex lens and a second convex lens sequentially disposed, the first convex lens and the second convex lens are located on a micro self-locking sliding rail, and the first convex lens and the second convex lens can move along the micro self-locking sliding rail.
In some preferred embodiments, the optical fiber transmission line is an active optical fiber, the active optical fiber is made of quartz, the core diameter is 120 μm-180 μm, and the rare earth element is doped in the fiber core.
In some preferred embodiments, the rare earth element is one or more of neodymium, ytterbium, erbium, thulium, holmium, dysprosium, praseodymium, etc.
In some preferred embodiments, the negative pressure ring center, focus center and region center of the ocular tissue of the ocular docking system are on the same horizontal line.
In addition, the invention also provides an ophthalmic cutting method of the ophthalmic cutting system, which is characterized by comprising the following steps:
step S110: the femtosecond pulse laser beam enters the beam shaping system through an optical fiber transmission line, the initial femtosecond pulse laser beam after passing through the beam shaping system is converted into a phase-modulated femtosecond pulse laser beam, and the phase-modulated femtosecond pulse laser beam enters the laser galvanometer scanning system through the spectroscope;
step S120: the laser galvanometer scanning system scans the position information determined by the eye tissue in real time and transmits the position information to the optical coherence tomography imaging system and the cornea topographic map;
step S130: the optical coherence tomography imaging system and the cornea topographic map focus the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser on eye tissues, perform real-time three-dimensional measurement on depth areas and cornea areas of the eye tissues, and immediately transmit the results to the data analysis processing system;
step S140: the data analysis processing system processes the real-time image information of the depth area and the cornea area of the eye tissue acquired by the optical coherence tomography imaging system and the cornea topographic map and transmits the result to the head-up display system;
step S150: the head-up display system displays the real-time image information analyzed by the data analysis processing system and then transmits the data information to the control system;
step S160: the control system sends out an instruction to adjust the energy of the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser according to the real-time image information;
step S170: the human eye docking system focuses and docks the regulated femtosecond pulse laser beam onto the eye tissue plane to be cut, so that the eye tissue is accurately cut.
The invention adopts the technical proposal has the advantages that:
the ophthalmic cutting system and the cutting method provided by the invention can use the optical coherence imaging system (OCT) and the cornea topography to collect the image information of the depth area and the cornea area of the eye tissue in real time, realize the precise focusing and positioning of the femtosecond laser beam during the cutting of the eye tissue, so as to move the reflecting lens to the cutting tissue plane, effectively be used for precisely cutting the eye tissue, and improve the accuracy and safety of the operation.
Drawings
In order to more clearly illustrate the embodiments of the invention or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described, it being obvious that the drawings in the following description are only some embodiments of the invention, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic structural diagram of an ophthalmic cutting system according to embodiment 1 of the present invention.
Fig. 2 is a flowchart showing the steps of the ophthalmic cutting method according to embodiment 2 of the present invention.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
Example 1
Referring to fig. 1, a schematic structural diagram of an ophthalmic cutting system provided by the present invention includes a self-mode-locking all-fiber femtosecond laser 110, a beam shaping system 120, a beam splitter 130, a laser galvanometer scanning system 140, an optical coherence tomography imaging system 150, a cornea topography 160, a human eye docking system 170, a data analysis processing system 180, a head-up display system 190 and a control system 210.
The ophthalmic cutting system provided by the invention has the following working modes:
the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser 110 enters the beam shaping system 120 from a fiber transmission line, and the initial femtosecond pulse laser beam after the beam shaping system is converted into a phase-modulated femtosecond pulse laser beam.
The phase modulated femtosecond pulse laser beam enters the laser galvanometer scanning system 140 through the spectroscope 130, and enters the cornea topographic map 160 and the optical coherence tomography imaging system 150 after being scanned by the laser galvanometer scanning system 140.
The optical coherence tomography imaging system 150 acquires image information of the depth region of the ocular tissue and the corneal topography 160 acquires image information of the corneal region.
The data analysis processing system 180 processes the image information of the depth region of the eye tissue and the image information of the cornea region, the head-up display system 190 displays the real-time image information processed by the data analysis processing system 180, the control system 210 adjusts the energy of the femtosecond pulse laser beam emitted by the self-mode all-fiber femtosecond laser 110 according to the real-time image information, and the human eye docking system 170 focuses and docks the adjusted femtosecond pulse laser beam onto the eye tissue plane to be cut, so as to realize accurate cutting of the eye tissue.
In some preferred embodiments, the optical beam transmission line is an active optical fiber, the active optical fiber is made of quartz, the core diameter is 120 μm-180 μm, and rare earth elements are doped in the fiber core.
In some preferred embodiments, the rare earth element is one or more of neodymium, ytterbium, erbium, thulium, holmium, dysprosium, praseodymium, etc.
It will be appreciated that the active optical fiber produces a new light wave or amplified light signal, enabling a range of laser outputs in a narrow linewidth, single frequency, continuous or pulsed laser.
In some preferred embodiments, the self-mode-locking all-fiber femtosecond laser 110 has a wavelength of 1064+ -5 nm, a pulse width of 300fs-500fs, a pulse frequency of 10kHz-200kHz, a pulse energy of 10 μJ-30 μJ, a beam diameter of 3+ -1 μm, and a beam quality M2<1.2.
It will be appreciated that the energy of the femtosecond pulse laser beam emitted from the self-mode all-fiber femtosecond laser 110 can be adjusted according to the instruction of the control system 210.
In some preferred embodiments, the beam shaping system 120 includes a spatial light modulator 121, a first convex lens 122 and a second convex lens 123 sequentially disposed, wherein the first convex lens 122 and the second convex lens 123 are located on a micro self-locking sliding rail, and the first convex lens 122 and the second convex lens 123 can move along the micro self-locking sliding rail.
In some preferred embodiments, the laser galvanometer scanning system 140 is a three-dimensional scanning galvanometer combination that directs a femtosecond pulsed laser beam in real time to scan at a focal position.
It can be understood that the position of the light beam in the XYZ axis direction can be adjusted under the action of the laser galvanometer scanning system 140, and the three-dimensional scanning time is shortened and the operation time is saved due to the extremely high galvanometer deflection speed of the laser galvanometer scanning system 140.
In some preferred embodiments, the optical coherence tomography imaging system 150 has an imaging depth of up to 8mm; the number of scanning frames per second is 100 frames; the scanning times are 20 ten thousand times/second; the withdrawal speed is 20mm/s; wavelength is 820-880nm; the sensitivity of the system is 6dB/3mm-20dB/3mm; the maximum power is 2.5mW-3.0mW.
In some preferred embodiments, the corneal topography 160 can be used for pre-operative examination and post-operative evaluation of efficacy of corneal refractive surgery, guiding cataract surgery, diagnosing and correcting corneal astigmatism following corneal grafting.
It will be appreciated that during actual surgery, the optical coherence tomography imaging system 150 acquires image information of the depth region of the eye tissue and the corneal topography 160 acquires image information of the cornea region, thereby providing accurate guidance for focusing and positioning of the surgical laser beam to adjust and verify the position and orientation of the selected surgical mode, and the determined corneal shape change information is used to direct laser pulses to the surgical laser system within the eye lens for effective use in accurate surgical procedures within the eye.
In some preferred embodiments, the negative pressure ring center, focus center, and region center of the ocular tissue of the ocular docking system 170 are on the same horizontal line.
It can be understood that the eyeball is sucked by the negative pressure suction ring, and the eyeball is prevented from moving in the femtosecond laser cutting process, so that the use of the negative pressure suction ring can greatly improve the operation safety of laser.
It will be appreciated that based on the real-time determined image information of the depth area of the eye tissue scanned by the optical coherence tomography imaging system 150 and the real-time determined image information of the cornea area scanned by the cornea topography 160, the control system 210 adjusts the energy level of the femtosecond pulsed laser beam emitted by the self-mode all-fiber femtosecond laser according to the real-time image information emission instructions to precisely cut the eye tissue such as cornea, limbus, pupil, sclera, iris, lens, ciliary muscle, vitreous body, or retina, and can correct the surgical scheme in real time.
In some preferred embodiments, the heads-up display system 190 includes a CCD camera that receives reflected light from the eye tissue and displays image information acquired by the OCT imaging system 150, the corneal topography 160, and the laser galvanometer scanning system 140.
It will be appreciated that the data display screen of the heads-up display system 190 is a touch screen, and that the doctor can perform laser data selection, image viewing, and device startup and shutdown at any time.
It will be appreciated that integrating the heads-up display system 190 into the surgical microscope enables simultaneous display of the images of the optical coherence tomography imaging system 150, the corneal topography 160, and the laser galvanometer scanning system 140, eliminating the need for three separate image display systems, ensuring that the physician visualizes the data without interrupting the procedure (in real time); in addition, the position and orientation of the selected surgical mode can be adjusted and verified by capturing positional information in the image to guide the control of the focus and positioning of the surgical laser during surgery.
The control system 210 can adjust the energy level of the femtosecond pulse laser beam emitted by the self-mode all-fiber femtosecond laser 110 according to the real-time determined image information of the depth area of the eye tissue scanned by the optical coherence tomography imaging system 150 and the real-time determined image information of the cornea area scanned by the cornea topographic map 160, precisely cut the eye tissue such as cornea, limbus, pupil, sclera, iris, lens, ciliary muscle, vitreous body or retina, and correct the surgical scheme in real time.
It can be understood that the femtosecond laser pulse changes the energy according to the real-time eye tissue shape change information, so that the intraocular damage is not caused, the postoperative feeling of a patient is better, the operation is simple and quick, the treatment course is short, and the method is a humanized, safe and effective cutting technology.
The ophthalmic cutting system provided by the invention can acquire the image information of the depth area and the cornea area of the eye tissue in real time by using an optical coherence imaging system (OCT) and a cornea topographic map, and can accurately focus and position the femtosecond laser beam during cutting the eye tissue so as to move the reflecting lens onto a cutting tissue plane, thereby being effectively used for accurately cutting the eye tissue and improving the accuracy and safety of an operation.
In addition, the eye tissue cutting device provided by the invention adopts a non-contact type and infiltration type butt joint interface, and the cornea is directly contacted with the liquid instead of the conical lens, so that the cornea extrusion is small, and the phenomenon that the cornea folds are generated by the contact type patient interface to cause irregular scattering to damage cornea tissues or stimulate the iris to cause pupil contraction is avoided.
Example 2
Referring to fig. 2, a flowchart of steps of an ophthalmic cutting method of an ophthalmic cutting system according to an embodiment of the present invention is provided, including the steps of:
step S110: the femtosecond pulse laser beam enters the beam shaping system through an optical fiber transmission line, the initial femtosecond pulse laser beam after passing through the beam shaping system is converted into a phase-modulated femtosecond pulse laser beam, and the phase-modulated femtosecond pulse laser beam enters the laser galvanometer scanning system through the spectroscope;
step S120: the laser galvanometer scanning system scans the position information determined by the eye tissue in real time and transmits the position information to the optical coherence tomography imaging system and the cornea topographic map;
step S130: the optical coherence tomography imaging system and the cornea topographic map focus the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser on eye tissues, perform real-time three-dimensional measurement on depth areas and cornea areas of the eye tissues, and immediately transmit the results to the data analysis processing system;
step S140: the data analysis processing system processes the real-time image information of the depth area and the cornea area of the eye tissue acquired by the optical coherence tomography imaging system and the cornea topographic map and transmits the result to the head-up display system;
step S150: the head-up display system displays the real-time image information analyzed by the data analysis processing system and then transmits the data information to the control system;
step S160: the control system sends out an instruction to adjust the energy of the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser according to the real-time image information;
step S170: the human eye docking system focuses and docks the regulated femtosecond pulse laser beam onto the eye tissue plane to be cut, so that the eye tissue is accurately cut.
The ophthalmic cutting method provided by the invention can be used for acquiring the image information of the depth area and the cornea area of the eye tissue in real time by using an optical coherence imaging system (OCT) and a cornea topographic map, and realizing the precise focusing and positioning of the femtosecond laser beam during the cutting of the eye tissue so as to move the reflecting lens to the cutting tissue plane, thereby being effectively used for precisely cutting the eye tissue and improving the accuracy and safety of the operation.
In addition, the eye tissue cutting device provided by the invention adopts a non-contact type and infiltration type butt joint interface, and the cornea is directly contacted with the liquid instead of the conical lens, so that the cornea extrusion is small, and the phenomenon that the cornea folds are generated by the contact type patient interface to cause irregular scattering to damage cornea tissues or stimulate the iris to cause pupil contraction is avoided.
The technical features of the above-described embodiments may be arbitrarily combined, and all possible combinations of the technical features in the above-described embodiments are not described for brevity of description, however, as long as there is no contradiction between the combinations of the technical features, they should be considered as the scope of the description.
Of course, the positive electrode material of the ophthalmic cutting system of the present invention may have various changes and modifications, and is not limited to the specific structure of the above-described embodiment. In general, the scope of the present invention should include those variations or alternatives and modifications apparent to those skilled in the art.
Claims (6)
1. The ophthalmic cutting system is characterized by comprising a self-mode-locking all-fiber femtosecond laser, a beam shaping system, a spectroscope, a laser galvanometer scanning system, an optical coherence tomography imaging system, a cornea topographic map, a human eye docking system, a data analysis processing system, a head-up display system and a control system, wherein:
the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser enters the beam shaping system from a fiber transmission line, and the initial femtosecond pulse laser beam after passing through the beam shaping system is converted into a phase-modulated femtosecond pulse laser beam;
the phase-modulated femtosecond pulse laser beam enters the laser galvanometer scanning system through the spectroscope, and enters the cornea topographic map and the optical coherence tomography imaging system after being scanned by the laser galvanometer scanning system;
the optical coherence tomography imaging system acquires image information of a depth region of eye tissue, and the cornea topographic map acquires image information of a cornea region;
the data analysis processing system processes the image information of the eye tissue depth area and the image information of the cornea area, the head-up display system displays the real-time image information processed by the data analysis processing system, the control system sends out an instruction to adjust the energy of the femtosecond pulse laser beam emitted by the self-mode-locking all-fiber femtosecond laser according to the real-time image information, and the human eye docking system focuses and docks the adjusted femtosecond pulse laser beam onto an eye tissue plane to be cut, so that accurate cutting of eye tissue is realized.
2. The ophthalmic cutting system of claim 1, wherein the self-mode-locking all-fiber femtosecond laser has a wavelength of 1064±5nm, a pulse width of 300fs-500fs, a pulse frequency of 10kHz-200kHz, a pulse energy of 10 μj-30 μj, a beam diameter of 3±1 μm, and a beam quality M2<1.2.
3. The ophthalmic cutting system of claim 1, wherein the beam shaping system comprises a spatial light modulator, a first convex lens, and a second convex lens disposed in sequence, the first convex lens and the second convex lens being positioned on a micro-scale micro self-locking slide rail, the first convex lens and the second convex lens being movable along the micro-scale micro self-locking slide rail.
4. The ophthalmic cutting system of claim 1, wherein the optical fiber transmission line is an active optical fiber, the active optical fiber is made of quartz, the core diameter is 120 μm-180 μm, and the rare earth element is doped in the core.
5. The ophthalmic cutting system of claim 4, wherein the rare earth element is one or more of neodymium, ytterbium, erbium, thulium, holmium, dysprosium, praseodymium.
6. The ophthalmic cutting system of claim 1, wherein the negative pressure ring center, focus center, and region center of eye tissue of the human eye docking system are on the same horizontal line.
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| CN202010346842.8A CN111407508B (en) | 2020-04-27 | 2020-04-27 | Ophthalmic cutting system and ophthalmic cutting method |
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| CN112587306B (en) * | 2021-03-04 | 2021-06-18 | 季华实验室 | Ophthalmological laser treatment system |
| CN113974965B (en) * | 2021-12-28 | 2022-04-22 | 广东麦特维逊医学研究发展有限公司 | Laser capsulorhexis device |
| CN114668582B (en) * | 2022-05-30 | 2022-08-19 | 季华实验室 | Ophthalmologic light source operation system |
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