DE102021115740B3 - Surgical device with an injector and a camera - Google Patents

Abstract

Surgical device with an injector (2) which has an injector housing (8), an injector tip (7), an intraocular lens (3) which is arranged in the injector housing (8), a piston (4) which can be displaced longitudinally in the injector housing (8 ) is arranged, and has an actuator (5) which is set up to drive the piston (4), which is thereby set up to displace and thereby fold the intraocular lens (3) in the injector (2) and the intraocular lens (3 ) via the injector tip (7) to move out of the injector (2), a camera (9) which is set up to record a video sequence of the intraocular lens (3) moving in the injector (2) and leaving the injector (2), and a data processing unit (11) which is set up to carry out image processing of at least one image of the video sequence and to detect errors and/or imminent errors of the displacing intraocular lens (3) using the image processing, the data processing gunit (11), in the event that the error and/or the impending error is detected, is set up to stop the actuator (5) so that the piston (4) is no longer driven, and/or an operator of the operating device ( 1) to notify.

Description

The invention relates to an operating device with an injector for inserting an intraocular lens into the capsular bag of an eye and a camera.

Traditionally, treating an eye for cataract involves making only a small incision in the cornea of the eye, large enough to allow a tip of an injector to be inserted through the incision into the eye. After the incision has been made in the cornea, the lens of the eye z. B. crushed by phacoemulsification and then sucked out of the capsular bag of the eye. An intraocular lens is then placed in the eye. The intraocular lens is folded so that it fits through the tip of the injector. The tip is inserted through the incision into the capsular bag, and the folded intraocular lens is pushed by a plunger of the injector through the tip into the capsular bag, where the intraocular lens unfolds, replacing the original lens. An error may occur when the intraocular lens is pushed by the plunger. For example, a haptic of the intraocular lens can become pinched between the plunger and the tip of the injector. In an extreme case, the error can lead to damage to the intraocular lens.

U.S. 6,592,591 B2 discloses an automatic lens delivery device.

The object of the invention is therefore to provide an operating device for inserting an intraocular lens into the capsular bag of an eye, with the operating device being able to avoid errors that can occur when the intraocular lens is displaced.

The surgical device according to the invention has an injector which has an injector housing, an injector tip, an intraocular lens which is arranged in the injector housing, a piston which is arranged in a longitudinally displaceable manner in the injector housing, and an actuator which is set up to drive the piston, which is thereby is set up to displace the intraocular lens in the injector and thereby fold it and to displace the intraocular lens out of the injector via the injector tip, a camera that is set up to record a video sequence of the intraocular lens displacing in the injector and leaving the injector, and a data processing unit on, which is set up to carry out an image processing of at least one image of the video sequence and using the image processing to detect errors and/or impending errors of the shifting intraocular lens, the data processing unit in the event that the error and/or the bevo renden error is detected, is set up to stop the actuator so that the piston is not driven further, and / or to notify an operator of the surgical device. The operating device is set up by the camera and the data processing unit to automatically recognize the errors and/or the imminent errors. As a result, the errors can be avoided before they arise, or the errors can be avoided before they become larger and in particular before they can lead to damage to the intraocular lens.

It is preferred that the injector has a force-displacement measuring device that is set up to determine a force-displacement characteristic of a force acting on the piston and a path covered by the piston during its longitudinal displacement, the data processing unit being set up to recognize the error and/or the imminent error using the force-displacement characteristic. This makes the detection of the errors and/or imminent errors particularly reliable. For example, in the event that a strong increase in the force-displacement characteristic is determined, this can be taken as an indication that the error and/or the impending error is present. The image processing can then be used to decide whether the error and/or the impending error is actually present or whether the intraocular lens has a high refractive index, which is associated with a large volume of the intraocular lens and thus with the strong increase in the force-displacement characteristic.

The data processing unit is particularly preferably set up to form the first derivation of the force-displacement characteristic and to recognize the errors and/or impending errors on the basis of the first derivation. As a result, the strong increase in the force-displacement characteristic can be determined in a particularly simple manner.

The data processing unit particularly preferably has a memory in which a plurality of reference force-displacement characteristics are stored, with at least some of the reference force-displacement characteristics corresponding to intraocular lenses with a different refractive power range, the data processing unit being set up to compare the force-displacement characteristic with the corresponding reference force-displacement characteristic in order to detect the error and/or the imminent error. This takes account of the fact that an increasing refractive power of the intraocular lens is accompanied by an increasing volume of the intraocular lens. As the volume increases, the intraocular lens is squeezed more when the intraocular lens is pushed out of the injector by the plunger is pushed, whereby with the increasing refractive power the force-displacement curve rises more sharply.

It is also particularly preferred that at least some of the reference force-displacement characteristics correspond to different liquids arranged in the injector, each of which has a different viscosity, intraocular lenses with a different surface finish and/or intraocular lenses with a different type of haptic of the intraocular lens . As a result, the errors and/or impending errors can be detected even more reliably. The different surface properties can, for example, distinguish between hydrophobic intraocular lenses and hydrophilic intraocular lenses. The types of haptic can have a C-shaped haptic and/or a plate haptic, for example.

It is preferred that the surgical device has a surgical microscope and the camera is part of the surgical microscope or the surgical microscope. The surgical microscope is traditionally used in cataract treatment of the eye and is therefore available as standard. As a result, the camera can be provided inexpensively.

It is preferred that the defects have a pinched haptic of the intraocular lens, twisting of the intraocular lens about an injector axis, tilting of the intraocular lens against an injector axis, damage to the intraocular lens and/or an incompletely folded intraocular lens. The twisting and tilting can result in the intraocular lens being arranged the wrong way round in the capsular bag after it has been unfolded.

The camera is preferably set up to also record the video sequence from the end of the piston facing the intraocular lens while the piston is displaced in the injector housing and optionally while the end of the piston facing the intraocular lens leaves the injector, with the error causing damage to the end facing the intraocular lens have the piston. The failures of the cob may include excessive foreshortening of the cob due to cob crushing and/or cob blooming. If the piston is shortened too much, the intraocular lens is not pushed far enough out of the injector so that the intraocular lens cannot leave the injector.

The data processing unit is preferably set up to communicate wirelessly with the injector. This makes the injector particularly user-friendly.

The data processing unit is preferably set up to notify the operator by tactile means of the injector. This makes it possible for a user of the operation device to be able to concentrate on carrying out the cataract treatment. Alternatively or additionally, it is possible that the data processing unit is preferably set up to notify the user acoustically and/or visually.

• 1 zeigt eine schematische Ansicht der erfindungsgemäßen Operationsvorrichtung.
• 2 zeigt zwei beispielhafte Kraft-Weg-Kennlinien.

The invention is explained in more detail below with reference to the accompanying schematic drawings.

• 1 shows a schematic view of the surgical device according to the invention.
• 2 shows two example force-displacement characteristics.

like it out 1 As can be seen, an operating device 1 has an injector 2, which has an injector housing 8, an injector tip 7, an intraocular lens 3, which is arranged in the injector housing 8, a piston 4, which is arranged in a longitudinally displaceable manner in the injector housing 8, and an actuator 5 arranged to drive the piston 4 arranged thereby to displace and thereby fold the intraocular lens 3 in the injector 2 and to displace the intraocular lens 3 out of the injector 2 via the injector tip 7 . In addition, the operating device 1 has a camera 9, which is set up to record a video sequence of the intraocular lens 3 moving in the injector 2 and leaving the injector 2, and a data processing unit 11, which is set up to carry out image processing of at least one image of the video sequence and under Using image processing to detect errors and/or impending errors in the shifting intraocular lens 3, the data processing unit 11 being set up in the event that the error and/or the imminent error is detected to stop the actuator 5 so that the piston 4 does not is further driven, and/or to notify an operator of the operation device 1. The operation device 1 can have an image transmission line 17 which is set up to transmit the images of the video sequence from the camera 9 to the data processing unit 11 . The data processing unit 11 can be a computer. The actuator 5 can have an electric motor or be an electric motor. The piston 4 can be arranged in a longitudinally displaceable manner along an injector axis 19 .

1 shows that the camera 9 can have a field of view 10 . During a cataract treatment, an eye 15 to be treated and at least part of the injector 2 can be arranged in the field of view 10 . The injector 2 can have a folding have chamber 6 in which the intraocular lens 3 is folded. The folding of the intraocular lens 3 is particularly error-prone, so that it is particularly advantageous if the folding chamber 6 is arranged in the field of view 10 . The surgical device 1 can have a surgical microscope and the camera 9 can be part of the surgical microscope or the surgical microscope.

The data processing unit 11 can be set up to carry out the image processing using pattern recognition. An algorithm to perform the image processing can be trained by performing machine injection tests in which the video sequence of multiple injections is recorded. A person training the algorithm can divide the injections into different categories. For example, the different categories may include successful and unsuccessful injections. This allows the algorithm to be trained in such a way that the algorithm recognizes the errors as well as the impending errors.

1 shows that the operating device 1 can have a control line 14, which can in particular be wireless, by means of which the data processing unit 11 is connected to the actuator 5, so that the data processing unit 11 can stop the actuator 5 via the control line 14. The data processing unit 11 can be set up to notify the user in the event that the impending error is detected and there is sufficient reaction time for the user to stop the piston 4 before the error occurs. The data processing unit 11 can also be set up to stop the actuator 5 in the event that the imminent error is detected and there is not enough reaction time for the user to stop the piston 4 before the error occurs.

like it out 1 As can be seen, the injector 2 can have a force-displacement measuring device 13 which is set up to determine a force-displacement characteristic of a force 21 acting on the piston 4 and a path 22 covered by the piston 4 during its longitudinal displacement, where the data processing unit 11 is set up to recognize the errors and/or impending errors using the force-displacement characteristic. The force-displacement measuring device 13 can, for example, have a strain gauge and/or a piezoelectric crystal for measuring the force and/or have an optical displacement measuring device, a stepping motor and/or a differential transformer for measuring the displacement. The operation device 1 can have a signal line 16, which can in particular be wireless, by means of which the force 21 and the path 22 are transmitted to the data processing unit 11. In 2 two exemplary force-displacement characteristics 20a and 20b are shown. For example, the data processing unit 11 can be set up to form the first derivation of the force-displacement characteristic and to recognize the errors and/or imminent errors based on the first derivation.

The data processing unit 11 can have a memory in which a plurality of reference force-displacement characteristics 20a are stored, with at least part of the reference force-displacement characteristics 20a corresponding to intraocular lenses 3 with a different refractive power range, the data processing unit 11 is set up to compare the force-displacement characteristic with the corresponding reference force-displacement characteristic 20a in order to detect the error and/or the imminent error. It is also conceivable that at least some of the reference force-displacement characteristic curves 20a are different liquids arranged in the injector 2, each of which has a different viscosity, intraocular lenses 3 with a different surface finish and/or intraocular lenses 3 with a different type of haptic 23 of the intraocular lens 3 corresponds.

In 2 an exemplary reference force-displacement characteristic curve 20a is shown. It can be seen that the reference force-displacement characteristic curve 20a rises monotonically to a maximum and then falls abruptly. The monotonous increase results from increasing squeezing of the intraocular lens 3 and the abrupt decrease results from the intraocular lens 3 leaving the injector 2 . The reference force-displacement characteristic 20a corresponds to an error-free injection of the intraocular lens 3. In addition, an incorrect force-displacement characteristic 20b is shown. This is characterized in that it rises much steeper and also at an earlier distance 22 than the reference force-displacement characteristic curve 20a. It is conceivable that the reference force-displacement characteristic curves 20a are also included in the injection tests. In addition, in the injection tests, the algorithm can also be trained to recognize the errors and/or impending errors using the force-displacement characteristics.

In order to notify the operator, the operation device 1 may have a man-machine interface 12 . The operation device 1 can have a line 18 by means of which the data processing unit 11 is connected to the man-machine interface 12 . The line 18 can be implemented wirelessly, for example. The man-machine interface 12 can be set up, for example, to notify the operator visually and/or acoustically. Alternatively or additionally, the data processing unit 11 can be set up, the operator by means to notify the injector 2 tactile. To this end, the human-machine interface 12 can be part of the injector 2 .

• - eine eingeklemmte Haptik 23 der Intraokularlinse 3,
• - ein Verdrehen der Intraokularlinse 3 um eine Injektorachse 19,
• - ein Verkippen der Intraokularlinse 3 gegen eine Injektorachse 19,
• - eine Beschädigung der Intraokularlinse 3 und/oder
• - eine unvollständig gefaltete Intraokularlinse 3 aufweisen.

The mistakes can

• - a pinched haptic 23 of the intraocular lens 3,
• - a rotation of the intraocular lens 3 about an injector axis 19,
• - a tilting of the intraocular lens 3 against an injector axis 19,
• - damage to the intraocular lens 3 and/or
• - Have an incompletely folded intraocular lens 3.

The camera 9 can be set up to also record the video sequence from the end of the piston 4 facing the intraocular lens 3 (ie the end of the piston 4 facing the intraocular lens 3 can be arranged in the field of view 10, cf 1 ) while the plunger 4 is displaced in the injector housing 8 and optionally while the end of the plunger 4 facing the intraocular lens 3 exits the injector 2, the defects having damage to the end of the plunger 4 facing the intraocular lens 3.

Reference List

1

surgical device

2

injector

3

intraocular lens

4

Pistons

5

actuator

6

folding chamber

7

injector tip

8th

injector housing

9

camera

10

field of view

11

data processing unit

12

human-machine interface

13

Force-displacement measuring device

14

control line

15

Eye

16

signal line

17

image transmission line

18

Management

19

injector axis

20a

Reference force-displacement characteristic

20b

faulty force-displacement characteristic

21

power

22

path

23

feel

Claims (10)

Surgical device with an injector (2) which has an injector housing (8), an injector tip (7), an intraocular lens (3) which is arranged in the injector housing (8), a piston (4) which can be displaced longitudinally in the injector housing (8 ) is arranged, and has an actuator (5) which is set up to drive the piston (4), which is thereby set up to displace and thereby fold the intraocular lens (3) in the injector (2) and the intraocular lens (3 ) via the injector tip (7) to move out of the injector (2), a camera (9) which is set up to record a video sequence of the intraocular lens (3) moving in the injector (2) and leaving the injector (2), and a data processing unit (11) which is set up to carry out image processing of at least one image of the video sequence and to detect errors and/or imminent errors of the displacing intraocular lens (3) using the image processing, the data processing gunit (11), in the event that the error and/or the impending error is detected, is set up to stop the actuator (5) so that the piston (4) is no longer driven, and/or an operator of the operating device ( 1) to notify. Operating device according to claim 1 , wherein the injector (2) has a force-displacement measuring device (13) which is set up to measure a force-displacement characteristic (20b) of a force (21) acting on the piston (4) and of a force (4 ) to determine the path (22) covered during its longitudinal displacement, the data processing unit (11) being set up to also recognize the error and/or the imminent error using the force-displacement characteristic (20b). Operating device according to claim 2 , The data processing unit (11) being set up to form the first derivation of the force-displacement characteristic (20b) and to recognize the error and/or the impending error on the basis of the first derivation. Operating device according to claim 2 or 3 , wherein the data processing unit (11) has a memory in which a plurality of reference force-displacement characteristics (20a) is stored, with at least part of the reference force Displacement characteristics (20a) corresponds to intraocular lenses (3) with a different range of refractive power, the data processing unit (11) being set up to compare the force-displacement characteristic with the corresponding reference force-displacement characteristic (20a) in order to to recognize the errors and/or the upcoming errors. Operating device according to claim 4 , wherein at least part of the reference force-displacement characteristic curves (20a) - different liquids arranged in the injector (2), which each have a different viscosity, - intraocular lenses (3) with a different surface finish and/or - intraocular lenses (3 ) corresponds to another type of haptic (23) of the intraocular lens (3). Surgical device according to one of Claims 1 until 5 , wherein the surgical device (1) has a surgical microscope and the camera (9) is part of the surgical microscope or the surgical microscope. Surgical device according to one of Claims 1 until 6 , the faults - a pinched haptic (23) of the intraocular lens (3), - a twisting of the intraocular lens (3) about an injector axis (19), - a tilting of the intraocular lens (3) against an injector axis (19), - damage the intraocular lens (3) and/or - have an incompletely folded intraocular lens (3). Surgical device according to one of Claims 1 until 7 , wherein the camera (9) is set up to also record the video sequence from the end of the piston (4) facing the intraocular lens (3) while the piston (4) is displaced in the injector housing (8) and optionally while the intraocular lens (3 ) facing end of the piston (4) leaves the injector (2), wherein the errors have damage to the intraocular lens (3) facing end of the piston (4). Surgical device according to one of Claims 1 until 8th , wherein the data processing unit (11) is set up to communicate wirelessly with the injector (2). Surgical device according to one of Claims 1 until 9 , wherein the data processing unit (11) is set up to notify the operator by means of the injector (2) tactile.

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