CN113974964B

CN113974964B - Laser capsulorhexis device and working method thereof

Info

Publication number: CN113974964B
Application number: CN202111619214.3A
Authority: CN
Inventors: 周辉; 曹海峰; 张道森; 王月虹
Original assignee: Guangdong Medical Research And Development Co ltd
Current assignee: Guangdong Medical Research And Development Co ltd
Priority date: 2021-12-28
Filing date: 2021-12-28
Publication date: 2022-04-22
Anticipated expiration: 2041-12-28
Also published as: CN113974964A

Abstract

The laser capsulorhexis device comprises a laser (1), a relay optical module (2), a spatial light modulator (3), a beam splitting cube (4), a galvanometer (5), a beam expanding module (6), a first dichroic mirror (7), an imaging lens (8), a human eye illumination light source (9), a second dichroic mirror (11), an optical coherent chromatography module (12), a camera (13), a wavefront detection module (14) and a computer (15), and solves the problems that the human eye is fixed by a human eye butt joint interface in the traditional technology, the capsulorhexis shape, the size and the position precision are difficult to guarantee when a doctor tears the capsulorhexis manually in the doctor operation, the cutting of a front capsular membrane is realized in real time, dynamically and accurately and safely, and the capsulorhexis operation is finished, the precision and the reliability of the operation are greatly improved.

Description

Laser capsulorhexis device and working method thereof

Technical Field

The invention belongs to the technical field of medical instruments, and particularly relates to a laser capsulorhexis device and a working method thereof.

Background

In the field of lens replacement surgery such as cataract surgery and presbyopia surgery, the original lens of a patient needs to be replaced by an artificial lens to achieve the aim of improving eyesight. The most central step in the lens replacement operation is capsulorhexis, and the prior art is mainly a way for a doctor to tear the capsulorhexis by a manual operation. At present, the ultrasonic emulsification technology is very mature, the manual nucleus crushing technology of doctors is also very mature, and the biggest difficulty in the field of lens replacement is the capsulorhexis link. If the circular capsular bag becomes eccentric or too small, the capsular bag may shrink into a continuous circular capsular bag with a smaller diameter after surgery, causing decentration of the intraocular lens, resulting in capsular bag shrinkage syndrome. Once capsular contraction syndrome occurs, the material of the intraocular lens stimulates the patient to cause inflammatory reaction, so that the aqueous humor barrier of the patient is broken, epithelial cells under the anterior capsule are generated to promote fibrosis and proliferation growth, and the postoperative symptoms such as reduction of the area of a capsulorhexis area, eccentricity of the intraocular lens, contraction and narrowing of the capsular bag, ametropia, visual dysfunction, glare and the like of the patient are caused.

The key of capsulorhexis lies in the control of the shape, size and smoothness of the cut edge of the capsulorhexis membrane. The doctor relies on experience to accomplish manual operation and tears a bag operation uncertainty big, tears a bag uniformity and is difficult to guarantee, tears a bag shape and size precision low, tears the cyst membrane edge comparatively roughly, may cause postoperative bad symptom when serious. All of these operations need to be done manually after the human eyes are fixed, which causes great psychological stress on the patients.

Disclosure of Invention

In view of the above, there is a need to provide a laser capsulorhexis device capable of accurately performing the cutting and capsulorhexis of the anterior capsule in real time.

In order to solve the problems, the invention adopts the following technical scheme:

the application provides a laser capsulorhexis device, includes: laser instrument (1), relay optical module (2), spatial light modulator (3), beam splitting cube (4), galvanometer (5), beam expanding module (6), first dichroic mirror (7), imaging lens (8), people's eye light source (9), second dichroic mirror (11), optical coherence tomography module (12), camera (13), wavefront detection module (14) and computer (15), computer (15) electric connection in laser instrument (1), optical coherence tomography module (12) and camera (13), wherein:

the first laser emitted by the laser (1) is guided to the spatial light modulator (3) through the relay optical module (2) to be subjected to wave front quantitative modulation so as to form second laser;

after the second laser passes through the beam splitting cube (4), a part of light beams of the second laser are reflected to the wavefront detection module (14), the wavefront detection module (14) performs real-time wavefront detection on the second laser, and the laser after real-time detection enters the galvanometer (5) and is transmitted to the beam expanding module (6) to be expanded to form third laser;

the third laser light is incident to the first dichroic mirror (7), wherein a part of light beams are reflected to the imaging lens (8) through the first dichroic mirror (7) to be focused and then incident to human eyes (10) to be focused into light spots, and the other part of light beams are transmitted to the first dichroic mirror (7), then pass through the second dichroic mirror (11) and then are transmitted to the optical coherence tomography module (12);

the imaging lens (8) and the optical coherence tomography module (12) detect the spatial pose of human eyes in real time, the imaging lens (8) and the camera (13) image the human eyes under the illumination of the human eye illumination light source (9) and transmit the acquired image information to the computer (15);

and the computer (15) performs comprehensive processing according to the eye space pose information detected by the optical coherence tomography module (12) and the image information of the human eyes on the image plane acquired by the camera (13), and adjusts the position of the laser spot emitted by the laser (1) and the quality deviation of the laser spot.

In some of these embodiments, the spatial light modulator (3) is a transmissive spatial light modulator or a reflective spatial light modulator.

In some embodiments, the galvanometer (5) can adjust the direction of the light beam incident to the human eye (10) so as to restrict the position of the light spot incident into the human eye (10) in the X/Y/Z axis direction.

In some of the embodiments, the galvanometer (5) is coaxial with the optical axis of the imaging lens (8), and the direction pointed to the camera (13) by the human eye (10) is the Z-axis direction.

In some of these embodiments, the human eye illumination source (9) is a frequency stabilized flicker free LED illumination source.

In some of the embodiments, the optical coherence tomography module (12) is a spectral domain optical coherence tomography system or a swept frequency optical coherence tomography system or a combination thereof, and the optical coherence tomography module (12) acquires corneal topography and spatial position of an anterior capsule by three-dimensional imaging of an anterior segment of a human eye and monitors the spatial position of the human eye at the time of surgery.

In some of these embodiments, the human eye's anterior segment comprises the cornea or anterior chamber or iris or ciliary body.

In some of these embodiments, the wavefront sensing module (14) is a Shack-Hartmann wavefront sensing system, a curvature sensing wavefront sensing system, or a shearing interference wavefront sensing system, and combinations thereof.

In some of these embodiments, the computer (15) is also electrically connected to the spatial light modulator (3), the galvanometer (5), and the wavefront detection module (14).

The technical scheme adopted by the application has the following effects:

the laser capsulorhexis device comprises a laser (1), a relay optical module (2), a spatial light modulator (3), a beam splitting cube (4), a galvanometer (5), a beam expanding module (6), a first dichroic mirror (7), an imaging lens (8), a human eye illumination light source (9), a second dichroic mirror (11), an optical coherent chromatography module (12), a camera (13), a wavefront detection module (14) and a computer (15), and solves the problems that the human eye is fixed by a human eye butt joint interface in the traditional technology, the capsulorhexis shape, the size and the position precision are difficult to guarantee when a doctor tears the capsulorhexis manually in the doctor operation, the cutting of a front capsular membrane is realized in real time, dynamically and accurately and safely, and the capsulorhexis operation is finished, the precision and the reliability of the operation are greatly improved, the operation uniformity is good, and the requirements on the experience of a doctor performing the operation are greatly reduced.

Drawings

In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments of the present invention or in the description of the prior art will be briefly described below, and it is obvious that the drawings described below are only some embodiments of the present invention, and it is obvious for those skilled in the art that other drawings can be obtained according to the drawings without creative efforts.

Fig. 1 is a schematic structural diagram of a laser capsulorhexis device provided in embodiment 1 of the present invention.

Fig. 2 is a flowchart of the operation of the laser capsulorhexis device provided in embodiment 2 of the present invention.

Detailed Description

Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention.

In the description of the present invention, it is to be understood that the terms "upper", "lower", "horizontal", "inside", "outside", and the like, indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings, are only for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the referred device or element must have a specific orientation, be constructed in a specific orientation, and be operated, and thus, should not be construed as limiting the present invention.

Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of the present invention, "a plurality" means two or more unless specifically defined otherwise.

In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is described in further detail below with reference to the accompanying drawings and embodiments.

Example 1

Please refer to fig. 1, which is a schematic structural diagram of a laser capsulorhexis device provided in the present application, including: the device comprises a laser (1), a relay optical module (2), a spatial light modulator (3), a beam splitting cube (4), a vibrating mirror (5), a beam expanding module (6), a first dichroic mirror (7), an imaging lens (8), a human eye illumination light source (9), a second dichroic mirror (11), an optical coherence tomography module (12) (OCT), a camera (13), a wavefront detection module (14) and a computer (15). The computer (15) is electrically connected to the laser (1), the spatial light modulator (3), the galvanometer (5), the optical coherence tomography module (12), the camera (13) and the wavefront detection module (14).

The operation of the respective components and their connection relationship will be described in detail below.

In particular, the laser (1) functions to provide a laser light source. It can be understood that the laser (1) emits or shuts off the laser under the control of the computer (15), and the single pulse energy, the pulse time length and the repetition frequency of the laser can be adjusted in real time under the control of the computer (15).

Specifically, the relay optical module (2) can guide the laser light emitted by the laser (1) to the spatial light modulator (3). The spatial light modulator (3) is used for modulating the laser wave front.

Further, the spatial light modulator (3) is a transmissive spatial light modulator or a reflective spatial light modulator.

Specifically, the galvanometer (5) can adjust the direction of a light beam incident to the human eye (10), and controllably restricts the position of a light spot incident into the human eye (10) in the X/Y/Z axis direction.

Further, the direction coaxial with the optical axis of the imaging lens (8) and pointed to the camera (13) by the human eye (10) is the Z-axis direction of the system control.

Specifically, the imaging lens (8) can focus the laser beam accurately, and also can be used as a focusing lens of the OCT (12) and an imaging lens of the camera (13).

Further, the human eye illumination light source (9) can provide illumination for a video surveillance system consisting of the camera (13) and the imaging lens (8).

Optionally, the human eye illumination light source (9) is a frequency-stabilized flicker-free LED illumination light source.

Further, the OCT (12) is spectral domain optical coherence tomography system (SD-OCT), swept frequency optical coherence tomography system (SS-OCT), or a combination thereof.

It is understood that OCT (12) acquires corneal topography and spatial location of the anterior capsule by three-dimensional imaging of the anterior segment of the eye and monitors the spatial location of the eye during surgery.

Further, the anterior segment of the human eye comprises: cornea, anterior chamber, iris, ciliary body, etc.

It can be understood that the OCT (12) is configured to measure the spatial pose of the cornea of the human eye, and fuse the human eye position data acquired by the camera to obtain the real-time position and pose of the human eye, and the computer 15 analyzes the real-time position and pose of the human eye, the data acquired by the galvanometer 5, and the topographic map of the cornea of the human eye and the corneal aberration data acquired before the operation to obtain corneal wavefront data incident on the optical path of the cornea of the human eye after passing through the imaging lens.

Further, the wavefront sensing module (14) is a Shack-Hartmann wavefront sensing system, a curvature sensing wavefront sensing system, or a shear interference wavefront sensing system, and combinations thereof.

It can be understood that the wavefront detection module (14) performs real-time detection and analysis on the laser wave modulated by the spatial light modulator 3 and uploads the data to the computer 15 for analysis and processing.

The laser capsulorhexis device provided by the above embodiment 1 of the present application has the following working mode:

Furthermore, the computer (15) can also obtain an optical path of the convergent light beam which is incident to the human eye (10) through the imaging lens (8) on the cornea of the human eye according to the data of the galvanometer (5) and the real-time space position and posture of the human eye; wavefront correction information of a spatial light modulator (3) is obtained through corneal aberration information and three-dimensional structure information on the optical path and is transmitted to the spatial light modulator (3), the spatial light modulator (3) loads correction wavefront, and the position deviation of a light spot entering a human eye and the quality reduction of the light spot caused by corneal aberration on the optical path are compensated.

The laser capsulorhexis device provided by the above embodiment 1 of the present application has the following advantages:

(1) in the traditional ultrasonic emulsification operation, the capsulorhexis of a patient depends on manual operation of a doctor, and the accuracy and the repeatability are low. The laser technology calculates the position of a light spot through a computer, the change of the action position of the light spot is realized by a high-precision vibrating mirror, the cutting size of the anterior capsular sac can be accurately controlled, and the cutting precision is high, the stability is good, and the repeatability is high.

(2) The laser technology has obvious effect of controlling the size precision of the incision diameter of the anterior capsule of a patient, can enable the edge of the opening of the capsule to completely shield the artificial crystal, ensures the accuracy of the position of the artificial crystal in the capsule and avoids the offset risk of the artificial crystal.

(3) The smoothness of the laser-assisted anterior capsulotomy is higher than that of the manual capsulorhexis.

(4) The roundness and the coverage of the opening of the front capsular sac cut by the aid of second laser are superior; the laser is more accurate to be put in the middle of, and the postoperative more can effectively wrap up IOL optical part, prevents the back and send out the barrier. Irregular manual capsulorhexis, in turn, can lead to asymmetric capsular contraction and vector forces that can exacerbate IOL decentration over time.

(5) The manual capsulorhexis learning curve is long, the manual capsulorhexis learning curve excessively depends on the experience of doctors and the operation skill, and is a great challenge for young doctors.

(6) The laser cutting of the edge of the capsular sac has good continuity, and the capsular sac has no tear.

Example 2

Referring to fig. 2, a flowchart of steps of a working method of the laser capsulorhexis device provided in embodiment 2 of the present application includes the following steps:

step S110: the first laser emitted by the laser (1) is guided to the spatial light modulator (3) through the relay optical module (2) to be subjected to wave front quantitative modulation so as to form second laser;

step S120: after the second laser passes through the beam splitting cube (4), a part of light beams of the second laser are reflected to the wavefront detection module (14), the wavefront detection module (14) performs real-time wavefront detection on the second laser, and the laser after real-time detection enters the galvanometer (5) and is transmitted to the beam expanding module (6) to be expanded to form third laser;

step S130: the third laser light is incident to the first dichroic mirror (7), wherein a part of light beams are reflected to the imaging lens (8) through the first dichroic mirror (7) to be focused and then incident to human eyes (10) to be focused into light spots, and the other part of light beams are transmitted to the first dichroic mirror (7), then pass through the second dichroic mirror (11) and then are transmitted to the optical coherence tomography module (12);

step S140: the imaging lens (8) and the optical coherence tomography module (12) detect the spatial pose of human eyes in real time, the imaging lens (8) and the camera (13) image the human eyes under the illumination of the human eye illumination light source (9) and transmit the acquired image information to the computer (15);

step S150: and the computer (15) performs comprehensive processing according to the eye space pose information detected by the optical coherence tomography module (12) and the image information of the human eyes on the image plane acquired by the camera (13), and adjusts the position of the laser spot emitted by the laser (1) and the quality deviation of the laser spot.

The detailed working steps are also described in detail in embodiment 1, and are not described again here.

The above-mentioned embodiment 2 of this application provides a working method of above-mentioned laser capsulorhexis device, realize that the people's eye tears the bag operation under unmanned eye interface or other realization people's eye fixed function devices, it relies on the fixed people's eye of people's eye butt joint interface to have solved traditional technique, tear the bag shape when the manual bag that tears in the doctor's operation, size, the difficult problem that the position precision is difficult to guarantee, in real time, developments, realize the cutting of anterior capsule membrane accurately, accomplish the operation of tearing the bag accurately and safely, the precision and the reliability of operation have been improved greatly, and the operation uniformity is good, greatly reduced the requirement to the doctor's of carrying out the operation experience.

The above are merely examples of the present application and are not intended to limit the present application. Various modifications and changes may occur to those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the scope of the claims of the present application.

Claims

1. A laser capsulorhexis device, comprising: laser instrument (1), relay optical module (2), spatial light modulator (3), beam splitting cube (4), galvanometer (5), beam expanding module (6), first dichroic mirror (7), imaging lens (8), people's eye light source (9), second dichroic mirror (11), optical coherence tomography module (12), camera (13), wavefront detection module (14) and computer (15), computer (15) electric connection in laser instrument (1), optical coherence tomography module (12) and camera (13), wherein:

the optical coherence tomography module (12) acquires a corneal topography and an anterior capsular space position by three-dimensional imaging of an anterior segment of a human eye and monitors the space position of the human eye during surgery;

the computer (15) performs comprehensive processing according to the eye space pose information detected by the optical coherence tomography module (12) and the image information of the human eyes on the image plane acquired by the camera (13), and adjusts the position of a laser spot emitted by the laser (1) and the quality deviation of the laser spot;

the computer (15) can also obtain an optical path of the convergent light beam which is incident to the human eye (10) through the imaging lens (8) on the cornea of the human eye according to the data of the galvanometer (5) and the real-time spatial position and posture of the human eye; obtaining wavefront correction information of a spatial light modulator (3) through corneal aberration information and three-dimensional structure information on the optical path and transmitting the wavefront correction information to the spatial light modulator (3), wherein the spatial light modulator (3) loads a correction wavefront to compensate for the position deviation of a light spot incident into a human eye and the quality reduction of the light spot caused by corneal aberration on the optical path;

the spatial light modulator (3) is a transmission type spatial light modulator or a reflection type spatial light modulator;

the wavefront detection module (14) is a Shack-Hartmann wavefront detection system, a curvature sensing wavefront detection system or a shearing interference wavefront detection system and a combination thereof;

the computer (15) is also electrically connected with the spatial light modulator (3), the galvanometer (5) and the wavefront detection module (14);

the wave front detection module (14) detects and analyzes the laser wave modulated by the spatial light modulator (3) in real time, and data are uploaded to the computer (15) for analysis and processing.

2. The laser capsulorhexis device according to claim 1, wherein the galvanometer (5) is capable of adjusting the direction of the light beam incident on the human eye (10) so as to restrict the position of the light spot incident on the human eye (10) in the X/Y/Z axis direction.

3. The laser capsulorhexis device according to claim 2, wherein the galvanometer (5) is coaxial with the optical axis of the imaging lens (8), and the direction pointed by the human eye (10) towards the camera (13) is the Z-axis direction.

4. The laser capsulorhexis device according to claim 1, wherein said human eye illumination source (9) is a frequency stabilized flicker free LED illumination source.

5. The laser capsularhexis device of claim 1, wherein the optical coherence tomography module (12) is a spectral domain optical coherence tomography system or a swept frequency optical coherence tomography system or a combination thereof.

6. The laser capsulorhexis device of claim 5, wherein the human eye anterior segment comprises a cornea or an anterior chamber or an iris or a ciliary body.