EP3389543A1 - Système de diagnostic et/ou de traitement ophtalmologique mobile - Google Patents

Système de diagnostic et/ou de traitement ophtalmologique mobile

Info

Publication number
EP3389543A1
EP3389543A1 EP16815799.8A EP16815799A EP3389543A1 EP 3389543 A1 EP3389543 A1 EP 3389543A1 EP 16815799 A EP16815799 A EP 16815799A EP 3389543 A1 EP3389543 A1 EP 3389543A1
Authority
EP
European Patent Office
Prior art keywords
diagnostic
therapy system
therapy
diagnosis
ophthalmological
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Withdrawn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
EP16815799.8A
Other languages
German (de)
English (en)
Inventor
Delbert Peter Andrews
Walter Matuschek
Dietmar Steinmetz
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.)
Carl Zeiss Meditec AG
Original Assignee
Carl Zeiss Meditec AG
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 Carl Zeiss Meditec AG filed Critical Carl Zeiss Meditec AG
Publication of EP3389543A1 publication Critical patent/EP3389543A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0083—Apparatus for testing the eyes; Instruments for examining the eyes provided with means for patient positioning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/10—Furniture specially adapted for surgical or diagnostic appliances or instruments
    • A61B50/13—Trolleys, e.g. carts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • 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
    • A61F9/00825—Methods or devices for eye surgery using laser for photodisruption
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B2090/5025—Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism
    • A61B2090/504—Supports for surgical instruments, e.g. articulated arms with a counter-balancing mechanism with a counterweight
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/50—Supports for surgical instruments, e.g. articulated arms
    • A61B2090/506—Supports for surgical instruments, e.g. articulated arms using a parallelogram linkage, e.g. panthograph

Definitions

  • the present invention relates to an ophthalmological diagnosis and / or therapy system with a basic body, a the basic body
  • a diagnostic and / or therapeutic device a control device and a movement device.
  • eye diseases are first characterized by appropriate diagnostic methods and systems such as optical coherence tomography (OCT) or other ophthalmometric measurements, and then treated by laser-assisted surgical surgical systems.
  • OCT optical coherence tomography
  • laser-assisted surgical surgical systems ideally the previously collected measurement data are used and / or further data is determined.
  • IOL intraocular lens
  • the lens can be smashed by means of ultrasound, and an access cut through the cornea be made with the scalpel, through which the shattered lens is aspirated.
  • the lens can also be pre-cut by means of a therapy laser beam, which is generally a pulsed laser beam, femtosecond lasers being used, and the access section through the cornea can also be cut with the aid of the pulsed laser beam, but the ultrasound is then used smashed and then aspirated, in which case the effect of the ultrasound does not have to be as strong as in the case of a sole disintegration of the eye lens by means of ultrasound. Such a procedure is therefore gentler, but involves additional work steps.
  • a therapy laser beam which is generally a pulsed laser beam, femtosecond lasers being used
  • document PCT / EP2015 / 073390 describes an ophthalmic diagnostic and / or therapy system that is much more compact and portable.
  • the compact design of the system is also achieved in that the system comprises a base body and articulated arms, wherein the articulated arms in turn each contain a diagnostic and / or therapeutic device or at least a portion of such a device.
  • Such an ophthalmological diagnosis and / or therapy system which usually contains a number of joint arms and possibly also other protruding elements in addition to a compact body, must be protected so that when moving the system, for example by sliding past other objects or through door openings none of the sensitive parts of the system can be damaged by impact or collision.
  • such an ophthalmological diagnosis and / or therapy system must be able to be moved by different persons: For example, when transporting a person standing behind the system or while a patient is being treated by a doctor sitting in front of the system.
  • Object of the present invention is therefore an ophthalmological
  • Such an ophthalmological diagnosis and / or therapy system comprises first a main body and a the main body or a
  • the main body is advantageously covered by a housing.
  • Extension of the body can be realized for example by an axle or a holder.
  • the articulated arm which is usually movable, preferably adjoins the main body upwards.
  • the ophthalmic diagnostic and / or therapy system further comprises a diagnostic and / or therapeutic device. This can be made in one piece or contain several parts, possibly also spatially separated parts.
  • Examples of a diagnostic device are a surgical microscope, a
  • Scheimpflug camera an ultrasound device or an optical coherence tomography system (OCT).
  • OCT optical coherence tomography system
  • a laser system that uses laser radiation for therapeutic purposes, such as for cutting an eye tissue by means of photodisruption, or in turn an ultrasound system for smashing tissue by means of
  • the articulated arm comprises the diagnostic and / or therapeutic device or at least a part of the diagnostic and / or therapeutic device.
  • Therapy device can be used on the patient.
  • the ophthalmologic diagnosis and / or therapy system comprises a control device.
  • the control device can also be designed in one piece or in several parts.
  • the control device is set up to control the diagnosis and / or therapy device, but if necessary also to control further components of the ophthalmological diagnosis and / or therapy system, such as a beam deflecting device advantageously included in the ophthalmic diagnosis and / or therapy system or an adjustable one
  • Beam focusing optics For this purpose, appropriate supply and
  • the ophthalmic diagnostic and / or therapy system comprises a movement device.
  • the diagnostic and / or therapy system can be changed in its position, for example, moved in the operating room or even spent in another room. This is preferably done by a person who manually shifts the system.
  • an ophthalmic diagnostic and / or therapy system comprises an articulated arm also implies that it may comprise several articulated arms. In the presence of a plurality of articulated arms, these can be designed to be coupled together, for example by means of a coupling device.
  • one of the articulated arms may include a diagnostic device or a part of a diagnostic device and another of the articulated arms may contain a therapy device or a part of a therapy device.
  • the circumferential handle structure extends at a distance to the body around it.
  • the encircling handle structure for
  • Main body be variably spaced, the distance between the handle structure and body can therefore vary.
  • a handle structure revolving around the main body allows optimum operation when the ophthalmological diagnosis and / or therapy system is to be moved. It also forms an outer protective structure around the main body: Before it can strike against an obstacle during a movement, this is intercepted by the encircling handle structure.
  • the articulated arm can thus be placed in a transport and / or
  • Resting position can be spent that he is in a plan view of the diagnostic and / or therapy system within the area encompassed by the rotating handle structure surface.
  • the positions of the largest "protruding" of a spent in transport or rest position articulated arm also determine the respective distance of the rotating handle structure to the body.
  • the circumferential handle structure also provides appropriate protection for the articulated arm against collisions during transport, during which the
  • Articulated arm is in a transport position, or in a rest position of the articulated arm, that is, with the ophthalmological diagnosis and / or
  • the transport position preferably has an additional
  • the circumferential handle structure runs around the main body at different heights.
  • the height is a measure of the distance of the handle structure to a ground plane on which the ophthalmological diagnosis and / or therapy system is set up.
  • the height at which the encircling grip structure is arranged around the base body is adapted at different positions of the base body to the position of an operator of the ophthalmological diagnosis and / or therapy system who wants to grasp the system on the grip structure at this point.
  • the handle structure in places where the operator is in front of the device, at a greater height than at locations where the operator usually sits in front of the device. In this way, the ophthalmological diagnosis and / or therapy system can be optimally operated with regard to its movement.
  • the circumferential handle structure is formed by a closed handle ring which extends around the base body and is secured thereto. Such attachment can be done for example by at regular intervals extending from the handle ring to the main body or to a housing of the body transverse bars.
  • the handle ring does not necessarily have to have a symmetrical structure, but can also show a completely irregular shape in a plan view, and preferably also does not form a plane, but is thus the structure of
  • the movement device of a preferred ophthalmological diagnosis and / or therapy system comprises rollers and / or wheels.
  • these are designed so that they allow a change of direction.
  • they can be movable in all directions of a plane by means of a corresponding ball bearing or else be adjustable in their direction by a steering device.
  • the articulated arm of an ophthalmological diagnosis and / or therapy system has a plurality of rotatable or pivotable joints. This allows free movement of the articulated arm in three-dimensional space, i.e., a diagnostic and / or therapeutic device contained on the articulated arm can be positioned in any position of a three-dimensional diagnostic and / or therapy space.
  • Therapy system preferably a weight compensation device.
  • the main body of an ophthalmological diagnosis and / or therapy system preferably contains the control device or at least a part of the control device and / or a part of the diagnostic and / or
  • the diagnostic and / or therapy device contains a
  • At least one laser system ophthalmic diagnostic and / or therapeutic system.
  • a laser system of the therapy device of the ophthalmological diagnosis and / or therapy system which contains a laser source which generates a pulsed laser radiation.
  • a laser system is particularly preferred that generates a femtosecond laser radiation.
  • Such femtosecond laser radiation may be focused with a beam focusing optic at a desired position in the tissue and by means of a beam deflecting device, such as one or more scanners operate the different spatial directions x, y, and z, be distracted in the three-dimensional diagnostic and / or therapy room.
  • a beam deflecting device such as one or more scanners operate the different spatial directions x, y, and z, be distracted in the three-dimensional diagnostic and / or therapy room.
  • FIG. 1 shows a first embodiment of the invention
  • FIG. 3 shows a third embodiment of the invention
  • FIG. 4 shows a fourth embodiment of the invention
  • Fig. 1 is a first embodiment of the invention
  • This ophthalmologic diagnosis and / or therapy system 1 contains a basic body 2 which is mounted on a movement device 7 which has rollers. For this basic body 2 protrude out two axes 3-1, 3-2, on each of which an articulated arm 4-1, 4-2 is arranged.
  • the first articulated arm 4-1 contains a surgical microscope 5-1, while a laser applicator head 5-2 is arranged on the second articulated arm 4-2, from which in use a focused pulsed laser radiation, which is located in a base body 2 (here not shown) laser source - in this case a femtosecond laser - is generated and passed through a beam guiding system to the laser applicator head 5-2.
  • the first articulated arm 4-1 contains a surgical microscope 5-1, while a laser applicator head 5-2 is arranged on the second articulated arm 4-2, from which in use a focused pulsed laser radiation, which is located in a base body 2 (here not shown) laser source - in this case a femtosecond
  • Beam guiding system includes a beam deflecting device and a
  • Beam focusing optics The components of this ophthalmic diagnostic and / or therapy system 1 are controlled by a control device 6.
  • the ophthalmological diagnosis and / or therapy system further includes a handle structure 8 surrounding the base body 2, which is designed as a closed grip ring, which runs at a distance from the base body 2 and through a plurality Cross struts or mounting webs 15 is attached to a housing of the base body 2.
  • the two articulated arms 4-1, 4-2 are each in a rest position. They are thus at a movement of
  • the closed handle ring extends at different heights H-1, H-2 over a ground plane 14 around the base body 2 around.
  • the handle ring 8 is in a favorable for a standing person first height H-1 above the ground level 14, while the handle ring 8 at another location at which a second operator 13-2 of the ophthalmological diagnosis and / or therapy system 1 preferably operates while sitting, in a favorable for a seated person second height H-2 above the ground plane 14 is located.
  • the first height H1 is greater than the second height H-2. From both operators 13-1, 13-2, the ophthalmic diagnosis and / or therapy system 1 can thus be optimally operated.
  • Fig. 2 shows a second embodiment of the invention
  • ophthalmic diagnostic and / or therapy system 1 in a plan view.
  • this system 1 only one articulated arm 4-2 is shown, which contains the laser applicator head 5-2 and which is in a transport position.
  • the articulated arm 4-2 is detachably fixed on a storage structure 10 and a maximum "folded" over the base body 2, so that it does not substantially in the plan view of the
  • Base 2 protrudes.
  • the distance which the encircling grip ring 8 has to the base body 2 at the respective position is determined by a corresponding shaping of the
  • Diagnosis and / or therapy system 1 shows the Fig. 3 in a plan view.
  • the shape of the circumferential grip ring 8 is strongly related to the shape of the
  • Base body 2 adapted and makes it clear that the handle ring 8 does not necessarily have to have an annular or oval shape, but rather may form any self-contained structure.
  • the ophthalmological diagnosis and / or therapy system 1 according to the invention can be made even more compact without losing the protective function generated by the encircling grip ring 8, since the circumferential grip ring 8 has a greater distance to the base body 2 precisely where this is for protection of the articulated arm 4-2 and the articulated arms 4-1, 4-2 is really necessary.
  • FIG 4 shows a fourth exemplary embodiment of the ophthalmic diagnosis and / or therapy system 1 according to the invention in a side view.
  • This example corresponds to the first embodiment, however, the ophthalmologic diagnosis and / or therapy system 1 is in a working position.
  • Laser system comprises - namely the laser applicator head 5-2 as well as a part of a beam guidance system from a in the main body 2 of the ophthalmic diagnosis and / or therapy system 1 laser source (not shown) to the laser applicator head 5-2 -, are in positions where they are to
  • Therapy of an eye of a patient can be used on a couch (also not shown here) can be positioned next to the ophthalmic diagnostic and / or therapy system 1.
  • the articulated arms 4-1, 4-2 can of course be moved beyond the handle structure 8 which is encircled by the base body 2.
  • Turning or pivot axes 9-1, 9-2, 9-3, 9-4, 9-5, 9-6, 9-7, 9-8 are further shown in FIG first articulated arm 4-1 and the second
  • the two articulated arms 4-1, 4-2 can be connected to each other, that two parts of a coupling structure 12, the first part of the
  • Surgical microscope of the first articulated arm 4-1 is arranged and the second part of which is arranged on the laser applicator head 5-2 of the second articulated arm, are brought together.
  • the ophthalmological diagnosis and / or therapy system 1 retains its stability in every position of the articulated arms 4-1, 4-2 and does not tip over, the articulated arms 4-1, 4-2 have weight compensation structures 11.

Landscapes

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

Abstract

La présente invention concerne un système de diagnostic et/ou de traitement ophtalmologique (1) comprenant un corps de base (2), un bras articulé (4-1, 4-2) dans le prolongement du corps de base (2), un dispositif de diagnostic et/ou de traitement (5-1, 5-2), un dispositif de commande (6) et un dispositif de déplacement (7). Le but de l'invention est de décrire un système de diagnostic et/ou de traitement ophtalmologique permettant un mouvement aisé, tout en étant protégé de manière optimale, d'un tel système complexe (1) dans différentes situations habituelles du système. Pour ce faire, un système de diagnostic et/ou de traitement ophtalmologique (1) comporte une structure de préhension (8) qui entoure, à une certaine distance, le corps de base (2).
EP16815799.8A 2015-12-17 2016-12-14 Système de diagnostic et/ou de traitement ophtalmologique mobile Withdrawn EP3389543A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102015225551.4A DE102015225551A1 (de) 2015-12-17 2015-12-17 Bewegliches ophthalmologisches Diagnose- und/oder Therapiesystem
PCT/EP2016/080869 WO2017102772A1 (fr) 2015-12-17 2016-12-14 Système de diagnostic et/ou de traitement ophtalmologique mobile

Publications (1)

Publication Number Publication Date
EP3389543A1 true EP3389543A1 (fr) 2018-10-24

Family

ID=57589008

Family Applications (1)

Application Number Title Priority Date Filing Date
EP16815799.8A Withdrawn EP3389543A1 (fr) 2015-12-17 2016-12-14 Système de diagnostic et/ou de traitement ophtalmologique mobile

Country Status (4)

Country Link
EP (1) EP3389543A1 (fr)
CN (1) CN209611312U (fr)
DE (1) DE102015225551A1 (fr)
WO (1) WO2017102772A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111772921A (zh) * 2020-08-11 2020-10-16 曹志君 一种眼科白内障手术用多功能剥离钳

Family Cites Families (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ITMC20010027A1 (it) * 2001-03-13 2002-09-13 Carlo Maria Valazzi Sonda per la chirurgia endoscopica delle vie lacrimali.
MXPA04007576A (es) * 2002-02-11 2004-11-10 Visx Inc Sistema y metodo de ciclo cerrado para la ablacion de lentes con aberraciones.
EP1731120B1 (fr) * 2005-06-09 2008-05-07 SIE AG, Surgical Instrument Engineering Dispositif ophthalmologique destiné à l'ablation de tissus des yeux.
US20080004607A1 (en) * 2006-06-30 2008-01-03 Christopher Horvath Surgical laser system with remote control functionality
EP3381421B1 (fr) * 2011-05-12 2019-10-16 Carl Zeiss Meditec AG Instrument laser pour thérapie oculaire
DE102011116368A1 (de) * 2011-10-17 2013-04-18 Carl Zeiss Meditec Ag Vorrichtung und Verfahren zur extrakapsulären chirurgischen Kataraktbehandlung
US9730834B2 (en) * 2013-12-20 2017-08-15 Novartis Ag Variable stiffness cannula and methods for a surgical system
WO2016058931A2 (fr) 2014-10-17 2016-04-21 Carl Zeiss Meditec Ag Systèmes et procédés pour la chirurgie de l'œil au laser à impulsions courtes

Also Published As

Publication number Publication date
WO2017102772A1 (fr) 2017-06-22
DE102015225551A1 (de) 2017-06-22
CN209611312U (zh) 2019-11-12

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