EP1003452A1 - Dispositif medical de guidage laser - Google Patents

Dispositif medical de guidage laser

Info

Publication number
EP1003452A1
EP1003452A1 EP98935203A EP98935203A EP1003452A1 EP 1003452 A1 EP1003452 A1 EP 1003452A1 EP 98935203 A EP98935203 A EP 98935203A EP 98935203 A EP98935203 A EP 98935203A EP 1003452 A1 EP1003452 A1 EP 1003452A1
Authority
EP
European Patent Office
Prior art keywords
laser light
retina
light source
laser
positioning means
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP98935203A
Other languages
German (de)
English (en)
Inventor
Kenneth Oliver
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Wallac Oy
Original Assignee
Wallac Oy
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Wallac Oy filed Critical Wallac Oy
Publication of EP1003452A1 publication Critical patent/EP1003452A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves 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
    • A61F2009/00844—Feedback systems
    • A61F2009/00851—Optical coherence topography [OCT]
    • 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
    • A61F2009/00861—Methods or devices for eye surgery using laser adapted for treatment at a particular location
    • A61F2009/00863—Retina

Definitions

  • This invention relates to a medical laser guidance apparatus .
  • laser light has been used to assist in the treatment of a number of ailments.
  • One particular application of laser light has been in the treatment of eye disease by the application of laser light to the retina of an eye.
  • Such treatment has involved preliminary inspection of the eye using a fundus camera, slit lamp or similar optical viewing device followed by movement of the patient to a separate location for laser treatment of the eye.
  • the laser is often applied days or weeks after the initial inspection, in view of the need to develop photographs taken by the fundus camera and the time required to analyse such photographs.
  • a number of sessions may be required, as the treatment is time consuming and traumatic for the patient, due to the need to compare the retina to be treated with earlier photographs. This, in turn, leads to the operator and patient tiring, making lengthy treatment sessions difficult to tolerate.
  • the present invention is directed towards solving some of the above problems.
  • a laser guidance apparatus comprising: a laser light source; laser light directing means for directing light from the laser light source into the optical path of a retina viewing apparatus at its optical output; laser light positioning means for moving the position of laser light from the laser light source within said optical path; and, control means for controlling the laser light source and positioning means in order to apply, in use, laser light to specific points or areas in the retina of an eye.
  • existing retina viewing apparatus need not be replaced, as the apparatus can be attached externally to the viewing apparatus.
  • An operator can view the position of low level laser light emitted by the laser light source by viewing the retina through the eye piece of the fundus camera, slit lamp or similar viewing apparatus, and can apply a treatment level of laser light to a selected point or area of a patient's retina by appropriate application of commands to the control means.
  • a video camera may be attached to the eyepiece of the viewing apparatus.
  • the video camera output can be displayed on a video monitor for ease of viewing.
  • points on the retina may be selected for laser treatment by simple operation of a mouse, trackball or the like with an output connected to the control means.
  • semi-automated control of the laser is also possible by providing real time or near real time image recognition means which receives selected point or area data from an operator and then tracks the retina using video data from a camera and outputs treatment level laser light as required.
  • This semi-automated arrangement has the advantage that it can compensate for movements of the retina by the patient at a speed and accuracy that is not within the ability of a human operator.
  • a diffractive optical element may be placed within the optical path of the guidance apparatus in order to produce, from a single primary laser beam, an array of secondary treatment beams, which can thus be used to speed up treatment over a selected area, in order to reduce treatment time and patient discomfort.
  • the laser light source may be a tube laser, solid state laser or a diode laser, which has the advantages of reduced weight, size, and power consumption.
  • the laser light positioning means may be a galvanometer and mirror arrangement, or may include acousto-optical devices.
  • the laser light positioning means may be employed to modulate the light emitted by the laser light source by directing it away from the viewing apparatus optical path in a pulsed manner. Alternatively the laser light source may be pulsed.
  • FIG. 1 is a schematic diagram of a known fundus camera
  • Fig. 2 is a schematic diagram of a guidance apparatus according to the present invention.
  • Fig. 3 is a schematic block diagram of a computer control guidance apparatus according to the present invention.
  • Fig. 4 is a diagram showing the operation of a diffractive optical element that may be employed in the present invention
  • Fig. 5 is a diagram of a treatment template for an apparatus employing the diffractive optical element shown in Figure 4;
  • Fig. 6 is a schematic diagram showing an example image recognition technique that may be employed with the present invention.
  • Fig. 1 shows a known fundus camera 1 which is employed to inspect the retina of an eye 3 which is to be treated.
  • An illuminating light source 2 provides illuminating light to the eye 3, which light is then reflected back towards a viewing eyepiece 4 and camera 5.
  • a flash light 2 is activated and a photograph taken with a camera 5 attached to a further optical output 20.
  • a focusing system 7 is provided to focus the image of the retina for clear viewing by both the camera 5 and through the eyepiece 4.
  • Fig. 2 shows an example of the present invention being operated in conjunction with the known fundus camera 1 of Fig. 1. Corresponding components are identically numbered. It will be appreciated that this example could be adapted to operate in conjunction with a slit lamp or similar retina viewing apparatus.
  • Attached to the optical output 20 of the fundus camera 1 is an optical extension 9.
  • the optical extension 9 comprises a half-silvered mirror 10 and lenses 11.
  • the mirror 10 is arranged to direct light from a laser light source 12 into the optical path of the fundus camera 1 and on to the retina of the eye 3 and also to allow light from the fundus camera 1 to transmit through to the cameras attached to the optical extension 20.
  • the laser light source 12 comprises a target laser light source 12a and a main pulse laser light source 12b. It will be appreciated, however, that a single laser light source, operating at two different power levels could be employed.
  • the target laser light source may be a HeNe or red diode laser
  • the main pulse laser light source an argon or NdYg laser.
  • An optional power level meter 21 monitors laser light levels to ensure only safe light levels are applied to the eye 3.
  • Light from the laser light source 12 is directed via a dichroic mirror 13 to a laser light positioning means 14 which is under the control of a control means 15, in the example a computer, and comprises two X Y galvo mirrors 14a, 14b.
  • a control means 15 in the example a computer
  • the light positioning means 14 operates to position light from the laser light source 12 within the optical path of the fundus camera 1 and to control the light's position on the retina of the eye.
  • the laser light source 12 in this example comprises a treatment light source 12a and target light source 12b.
  • An optional diffractive element 16 is placed in the path of the light from the laser light source 12. The operation of this optional diffractive element 16 will be described later.
  • Light from the laser light source 12 passes, in use, via the optical extension 9, through the camera 1 on to the retina of the eye 3 and back into the fundus camera 1 via the objective lens 8.
  • the light is then passed out, via the eyepiece 4 or optical extension 9 , to a video camera 5.
  • the output of the video camera 5 is, in this case, connected to the control means 15 via a computer system, although it may alternatively simply be output to a display.
  • a monitor 18 is provided to receive outputs from the control means 15 and hence to display images received by the video camera 5.
  • User input means 19, 20 are provided, and may be components such as a keyboard 19 and/or mouse 20, a joystick or foot pedal.
  • the example shown in Fig. 3 provides a number of treatment options.
  • the first option is complete control of the treatment by the control means 15.
  • control means receives data about the treatment, and controls the output of the laser light source 12, together with the laser positioning means 14 to apply laser light to the retina of the eye 3.
  • the control means 15 is adapted, using appropriate real time image recognition software to monitor the position of light from the laser light source relative to features on the retina of the eye, and to track the retina's position accordingly.
  • This example also enables a semi-automated process, in which particular points or areas on the retina are selected for treatment by an operator selecting points or areas displayed on the monitor 18. Once selection has been completed, the control means 15 then proceeds to treat the selected points or areas by application of the required level of laser light from the laser light source 12.
  • This option provides for the individual point or area selection of the retina by an operator, followed by actual positioning of the laser light by direct control of the laser positioning means 14, and pulse application of the laser light source 12 as required.
  • Fig. 4 shows the optional diffractive optical element 16 shown in Fig. 2.
  • This light diffractive element 16 diffracts a single laser beam 30 into a laser beam array 31 which, in this case, is a three-by-three matrix. It will be appreciated that matrices of other sizes. could also be produced.
  • the provision of this diffractive optical element 16 enables the application of laser light to multiple points in a single application, speeding up the treatment process, and reducing discomfort to the patient.
  • Fig. 5 with a three-by-three diffractive optical element 16, the application of eight separate pulses, providing eight arrays of application points A to H, which can cover a large area of the retina 3 when the diffractive optical element 16 is provided.
  • the apparatus may incorporate a laser control algorithm which spatially and or temporarily randomises or disperses application of light to selected treatment parts.
  • Fig. 6 shows an example of one image recognition process that may be used in conjunction with the apparatus of the present invention.
  • This process performed by the control means 15, employs the outline of the optic nerve as a reference point on the retina (although an alternative reference may be employed by an operator) , and searches through the output of the video camera 17 until a match is produced.
  • the control means 15 can then track the position of the retina 3 through both voluntary and involuntary eye movements by locking into and following the optic nerve position, or another topographical feature of the retinal image such as a blood vessel, for example.
  • the process of this example employs a cross-correlation function of the type
  • This function is at a maximum when a portion of image F which is under template T as exactly the same as T. This can then form a simple goodness-fit measure, having a range from 0 to 1 by computing paragraph R ft (u,v)/R tt (u,v) .
  • R tt is computed once, before any matching has to be done.
  • the deviation of the current captured image from a reference image (and its corresponding template) yields a number in X and Y dimensions which is essentially an estimate of deviation. This number can then be employed to drive laser light deflecting means to correctly align the laser beam to a selected target.
  • This process is particularly useful if an automated or pre-stored treatment data course of treatment is required.
  • control means 15 which is any suitable computer or microprocessor base system.
  • a PC any suitable computer or microprocessor base system.
  • Apple Macintosh or other work station system with appropriate software and control interfaces. This means that control of the system can be realised with high reliability and at relatively low cost.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Ophthalmology & Optometry (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Optics & Photonics (AREA)
  • Vascular Medicine (AREA)
  • Electromagnetism (AREA)
  • Otolaryngology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Eye Examination Apparatus (AREA)
  • Laser Surgery Devices (AREA)

Abstract

L'invention traite d'un dispositif de guidage laser comportant une source de lumière laser et un organe destiné à diriger la lumière provenant de cette source dans un chemin optique d'un dispositif de visualisation de la rétine et ce, en direction de la sortie optique de ce dernier. Un organe de positionnement de la lumière laser provoque le déplacement de la lumière laser provenant de la source de lumière à l'intérieur dudit chemin optique. Un organe commande ladite source de lumière laser et ledit organe de positionnement de manière à permettre l'application, en cours d'utilisation, de la lumière laser à des points ou zones spécifiques de la rétine d'un oeil.
EP98935203A 1997-08-14 1998-07-23 Dispositif medical de guidage laser Withdrawn EP1003452A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GB9717282 1997-08-14
GBGB9717282.9A GB9717282D0 (en) 1997-08-14 1997-08-14 Medical laser guidance apparatus
PCT/GB1998/002204 WO1999008635A1 (fr) 1997-08-14 1998-07-23 Dispositif medical de guidage laser

Publications (1)

Publication Number Publication Date
EP1003452A1 true EP1003452A1 (fr) 2000-05-31

Family

ID=10817508

Family Applications (1)

Application Number Title Priority Date Filing Date
EP98935203A Withdrawn EP1003452A1 (fr) 1997-08-14 1998-07-23 Dispositif medical de guidage laser

Country Status (6)

Country Link
EP (1) EP1003452A1 (fr)
JP (1) JP2001514928A (fr)
KR (1) KR20010022813A (fr)
AU (1) AU8455298A (fr)
GB (1) GB9717282D0 (fr)
WO (1) WO1999008635A1 (fr)

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001299941A (ja) * 2000-04-27 2001-10-30 Hamamatsu Photonics Kk レーザ治療装置
WO2005079919A1 (fr) * 2004-02-19 2005-09-01 Keng Siang Richard Teo Systeme de laser medical et procede d'irradiation d'une zone a traiter
US10219947B2 (en) 2012-05-25 2019-03-05 Ojai Retinal Technology, Llc System and process for retina phototherapy

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998000078A1 (fr) * 1996-07-01 1998-01-08 Life Science Resources Limited Appareil medical de guidage au laser

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3769963A (en) * 1972-03-31 1973-11-06 L Goldman Instrument for performing laser micro-surgery and diagnostic transillumination of living human tissue
WO1987000748A1 (fr) * 1985-07-31 1987-02-12 Daniele Sylvie Aron Rosa Dispositif de chirurgie ophtalmologique par photoablation
US4901718A (en) * 1988-02-02 1990-02-20 Intelligent Surgical Lasers 3-Dimensional laser beam guidance system
GB8917569D0 (en) * 1989-08-01 1989-09-13 Scient Generics Ltd Photocoagulation apparatus
US5029220A (en) * 1990-07-31 1991-07-02 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Optical joint correlator for real-time image tracking and retinal surgery
EP0630205A4 (fr) * 1992-02-27 1995-06-14 Phoenix Laser Systems Inc Poste de travail automatise a laser pour interventions industrielles et chirurgicales de haute precision.
IL103290A (en) * 1992-09-25 1996-06-18 Ben Nun Joshua Ophthalmologic examination and/or treatment apparatus
US5376086A (en) * 1993-10-26 1994-12-27 Khoobehi; Bahram Laser surgical method of sculpting a patient's cornea and associated intermediate controlling mask

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998000078A1 (fr) * 1996-07-01 1998-01-08 Life Science Resources Limited Appareil medical de guidage au laser

Also Published As

Publication number Publication date
WO1999008635A1 (fr) 1999-02-25
AU8455298A (en) 1999-03-08
KR20010022813A (ko) 2001-03-26
JP2001514928A (ja) 2001-09-18
GB9717282D0 (en) 1997-10-22

Similar Documents

Publication Publication Date Title
AU718942B2 (en) Medical laser guidance apparatus
AU2015210430B2 (en) Retinal laser surgery
US7766903B2 (en) Patterned laser treatment of the retina
US6494878B1 (en) System and method for accurate optical treatment of an eye's fundus
US5049147A (en) Apparatus for computerized laser surgery
JP5066094B2 (ja) 虚像照準装置を使った光学医療治療システム及び方法
US20080015553A1 (en) Steering laser treatment system and method of use
US8771261B2 (en) Dynamic optical surgical system utilizing a fixed relationship between target tissue visualization and beam delivery
US20020133144A1 (en) Laser irradiation mapping system
US20130304046A1 (en) Semi-automated ophthalmic photocoagulation method and apparatus
EP1147753A2 (fr) Système d'émission de faisceau laser et de suivi de l'oeil
US6267756B1 (en) Apparatus for the observation and the treatment of the eye using a laser
WO1990009141A3 (fr) Procede et appareil de chirurgie de precision a laser
US8512323B2 (en) Devices and methods for computer-assisted surgery
CN108524097B (zh) 一种激光治疗成像装置
WO1999008635A1 (fr) Dispositif medical de guidage laser
Roduit et al. Eye-guided surgical microscope

Legal Events

Date Code Title Description
PUAI Public reference made under article 153(3) epc to a published international application that has entered the european phase

Free format text: ORIGINAL CODE: 0009012

17P Request for examination filed

Effective date: 20000221

AK Designated contracting states

Kind code of ref document: A1

Designated state(s): BE DE DK ES FI FR GB IT NL SE

17Q First examination report despatched

Effective date: 20030617

STAA Information on the status of an ep patent application or granted ep patent

Free format text: STATUS: THE APPLICATION IS DEEMED TO BE WITHDRAWN

18D Application deemed to be withdrawn

Effective date: 20040720