JP2001187082A - Laser medical treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a laser medical treatment device which allows an operator to recognize the strained state of a patient. SOLUTION: The laser medical treatment device which cures the eye of a patient by irradiating a laser beam upon the eye is provided with a sensor which detects a change in state of the patient and a notifying means which notifies the operator of the change in the state of the patient based on the detected results of the sensor.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a laser treatment apparatus for performing treatment by irradiating an affected part of a patient with laser light.

[0002]

2. Description of the Related Art Conventionally, a laser treatment apparatus for irradiating an affected part of a patient's eye with a laser beam to perform treatment has been known.
Such a laser treatment device fixes the patient's face in advance, and then suppresses the behavior of the patient's eye during laser irradiation by staring at the fixation lamp or giving instructions by the operator in words. I have to.

[0003]

By the way, when laser treatment is the first time for a patient or the like, the patient is often nervous during the treatment, but the surgeon observes the patient's eye with the observation optical system while performing the laser treatment. And it is difficult to grasp whether the patient's tension continues during treatment.
If such tension persists during treatment, for example, the patient may not be able to continue staring at the eye and may inadvertently move the eye. As a result, appropriate treatment cannot be performed, and the treatment time is rather lengthened, and both the operator and the patient are burdened.

The present invention has been made in view of the above-mentioned problems of the prior art,
It is an object of the present invention to provide a laser treatment apparatus that allows an operator to know a patient's tension state.

[0005]

Means for Solving the Problems In order to solve the above problems, the present invention is characterized by having the following configuration.

(1) In a laser treatment apparatus for performing treatment by irradiating a laser beam to a patient's eye, a sensor for detecting a change in the state of the patient and a change in the state of the patient based on the detection result by the sensor. And a notifying unit for notifying the user.

(2) In the laser treatment apparatus according to (1), the sensor detects a change in a patient's condition based on a pulse.

(3) In the laser treatment apparatus according to (2), the notifying means is a displaying means for making a notification based on a change in a display state, and the displaying state of the displaying means is changed in accordance with a pulse change amount detected by the sensor. And display control means for changing the value.

(4) The laser treatment apparatus of (3) is provided with an observation optical system for observing a patient's eye, and the display means performs display in an observation visual field through the observation optical system. And

(5) In the laser treatment apparatus according to any one of (1) to (4), a second notification for notifying whether or not a change in the patient's condition can be detected based on an output signal from the sensor. Means are provided.

[0011]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing an external view of a laser photocoagulation device.

Reference numeral 1 denotes a laser device main body. Reference numeral 2 denotes a control unit for setting and inputting a laser irradiation output condition, aiming light output, and the like. Reference numeral 3 denotes a slit lamp delivery including an irradiation optical system 30, an illumination optical system 40, and an observation optical system 50, which will be described later. The delivery 3 is mounted so as to be able to move on the upper surface of the gantry 9 back and forth and right and left. Reference numeral 4 denotes a fiber cable for guiding the treatment laser light or the aiming light from the laser device main body 1 to the slit lamp delivery 3. Reference numeral 5 denotes a foot switch for transmitting a trigger signal for laser irradiation. Reference numeral 6 denotes a face fixing member having a chin rest and a forehead rest, which is fixed to the gantry 9. In addition, a fixation lamp 7 for keeping the patient's eye staring is installed above the face fixing member 6.

Reference numeral 8 denotes a grip to be gripped by the patient, and two grips are fixed on the gantry 9 with the face fixing member 6 interposed therebetween. At the time of treatment, the patient keeps holding this grip 8,
The posture can be stabilized. A sensor 8a for capturing a patient's pulse is attached to the left or right side (or both sides) of the grip 8, and is held while the patient holds the grip 8 (the hand is in contact with the sensor 8a). In the meantime, it is possible to detect the patient's pulse. Reference numeral 3a denotes a joystick for moving the slit lamp delivery 3, and 3b denotes a manipulator for finely adjusting the irradiation position of the laser beam.

FIG. 2 is a diagram showing an optical system of the laser photocoagulation apparatus. Reference numeral 10 denotes a treatment laser light source. In this embodiment,
From a Nd: YAG laser that oscillates a fundamental wave of 1064 nm,
A device that obtains green light that is the second harmonic (532 nm continuous oscillation) is used. Reference numeral 11 denotes a beam splitter that transmits most of the laser light from the treatment laser light source 10 and reflects part of the laser light. The treatment laser light reflected by the beam splitter 11 enters the output sensor 13 via the diffusion plate 12. The output sensor 13 detects the output of the laser light emitted from the treatment laser light source 10.

Reference numeral 14 denotes a first safety shutter. When the foot switch 5 is depressed and a command to irradiate the treatment laser beam is issued, the first safety shutter is separated from the optical path to allow passage of the laser beam. In the case of occurrence or the like, it is inserted into the optical path to block the laser beam. The opening and closing of the first safety shutter 14 is detected by a shutter sensor 14a.

Reference numeral 15 denotes an aiming semiconductor laser which emits 630 nm red light. The laser light emitted from the semiconductor laser 15 passes through a collimator lens 16 and is made coaxial with the treatment laser light by a dichroic mirror 17.

Reference numeral 18 denotes a second safety shutter. The opening and closing of the second safety shutter 18 is detected by a shutter sensor 18a. Reference numeral 19 denotes a condensing lens, which condenses each laser beam on the incident end face 4a of the optical fiber 4 and makes it incident. Each laser beam guided by the optical fiber 4 is guided to the irradiation optical system 30 of the slit lamp delivery 3.

The irradiation optical system 30 includes a collimator lens 31,
The zoom lens includes a zoom lens group 32, an objective lens 33, and a drive mirror.

Reference numeral 40 denotes an illumination optical system. After a visible light beam emitted from an illumination light source 41 passes through a condenser lens 42, its height is determined by a variable circular aperture 43, and its width is determined by a variable slit plate 44. It is formed into a light beam. After that, the slit illumination light passing through the variable slit plate 44 passes through the filter 45 and the projection lens 46,
The light is reflected by the split mirrors 48 a and 48 b and illuminates the patient's eye E via the contact lens 49. 47 is a correction lens.

Reference numeral 50 denotes an observation optical system. Observation optical system 50
Is an objective lens 51 shared by the left and right observation optical paths, a variable power lens 52 disposed on each of the left and right optical paths, and an imaging lens 5.
3. Upright prism 54, field stop 55, eyepiece 5
6. An operator protection filter 57 is provided.

A reflection mirror 58 is provided between the surgeon protection filter 57 and the imaging lens 53 in the observation optical path for one eye. The reflection mirror 58 is sized so as not to block the observation optical path much. Above the reflecting mirror 58, two LEDs 60a, 6 for notifying the detection result of the collimator lens 59 and the sensor 8a by lighting display.
0b is provided. LED 60a
Lights green, and the LED 60b lights red. LE
D60a and D60b are arranged at positions substantially conjugate with the field stop 55, and when the LEDs are turned on, as shown in FIG.
0b 'appears.

In the apparatus having the above configuration,
The operation will be described with reference to a state diagram during treatment in FIG. 3 and a block diagram showing a control system in FIG.

The surgeon X instructs the patient Y to hold the left and right grips 8 and fix the face to the face fixing member 6. The patient Y makes the forehead and the chin abut on the forehead and the chin rest of the face fixing member 6 while holding the grip 8 and stabilizing the posture. When the grip 8 is grasped, the pulse of the patient Y is detected by the sensor 8a. The surgeon uses the storage switch 2a of the control unit 2, and stores the pulse rate per unit time (hereinafter simply referred to as pulse rate) obtained from the sensor 8a at this time in the memory 101 as a reference pulse rate. Sensor 8
The pulse rate obtained by detecting a is displayed on the display 2b.

The operator X instructs the patient Y to stare at the fixation lamp 7, and observes the fundus illuminated by the illumination light from the illumination optical system 40 through the observation optical system 50. The aiming light is turned on by a switch of the control unit 2. When the setting is made to irradiate the aiming light, the control unit 100 causes the second safety shutter 18 to leave the optical path. The surgeon operates the joystick 3a to adjust the position to the affected part while observing the aiming light emitted to the fundus.

The operator sets irradiation conditions such as irradiation output and irradiation time of the treatment laser beam by various switches of the control unit 2. When you're ready for therapeutic laser irradiation,
After the laser beam is brought into the ready state in which the treatment laser beam can be irradiated, the manipulator 3b is operated to finely adjust the aiming of the affected part. When the aiming is completed, the foot switch 5 is depressed to perform laser irradiation. When the control unit 100 receives the laser irradiation signal from the foot switch 5, it releases the first safety shutter 14 from the optical path and causes the laser light source 10 to emit therapeutic laser light. The treatment laser light is guided to the optical system of the apparatus main body 1, the optical fiber 4, and the irradiation optical system 30, and is irradiated to the affected part of the patient's eye.

When such laser irradiation is performed several times or several tens in succession, the patient Y may become nervous due to anxiety, pain, etc. due to the laser irradiation. In general, the pulse becomes faster as the tension increases. By detecting the change in the pulse, the patient's tension can be grasped to some extent. Sensor 8 attached to grip 8
“a” sequentially detects the pulse rate of the patient Y.
When there is an output signal from the sensor 8a, it is determined that the pulse of the patient is detectable, the green LED 60a is turned on, and the reference pulse rate stored in the memory 101 is compared with the detected pulse rate. When a change in the pulse rate that is a predetermined number or more (for example, 1.5 times the reference pulse rate) is detected, the red LED 60b is turned on.

FIG. 5 shows an example of the state of an observation image observed by the observation optical system 50. When the LEDs 60a and 60b are turned on, the illuminated images 60a 'and 60
b 'is displayed. The appearance of the lighting image 60b 'in the observation visual field allows the operator X to recognize that the patient's degree of tension is high even during laser irradiation. Thus, for example, it is possible to timely stop the treatment and ease the patient's tension, or take timely actions such as using words. Then, when the tension of the patient Y is released and the pulse rate falls below a predetermined multiple of the reference pulse rate, the control unit 100 turns off the LED 60b. Since the lighted image 60b 'in the observation visual field disappears by turning off the LED 60b, the operator X can confirm that the tension of the patient Y has decreased. As a result, the patient Y due to the continued high tension state
It is possible to continue laser irradiation while suppressing the psychological burden on the patient and careless behavior of the patient's eye.

When the lighting image 60a 'does not appear, the pulse rate cannot be detected because the sensor 8a is not in contact with the patient's hand.
To ensure that the pulse rate is detected by the sensor 8a.

In the above embodiment, the means for informing the change of the tension state is performed by turning on / off the lighting image 60a 'and the lighting image 60b' in the observation visual field. However, the present invention is not limited to this. For example, the sound may not be surprised by the surgeon or the patient, or may be lit and displayed outside the apparatus. Also,
When the degree of change in the tension is reported on a display such as a level meter, the operator can know the change in the tension in more detail.

The position at which the sensor 8a is provided is not limited to the grip 8, but may be a face fixing member 6 which abuts the patient's face.
May be provided on the chin rest or forehead rest. In this case, the suitability of the contact state of the patient's face with the face fixing member 6 can be simultaneously known. Alternatively, a mechanism for directly attaching the sensor 8a to a wrist, temple, or the like may be used.

Further, it is conceivable to detect a change in the patient's condition not by the pulse but by a change in blood pressure or body temperature.

[0032]

As described above, according to the present invention, a change in the patient's tension can be recognized to some extent. As a result, the surgeon can take appropriate measures in a timely manner, and the burden on the patient and the surgeon can be reduced.

[Brief description of the drawings]

FIG. 1 is a diagram illustrating an appearance of an apparatus main body.

FIG. 2 is a diagram showing an optical system inside the device.

FIG. 3 is a diagram showing a state when a treatment is performed using an apparatus using the present invention.

FIG. 4 is a block diagram showing a control system.

FIG. 5 is a diagram showing a state of an observation image observed by an observation optical system.

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 laser apparatus main body 2 control unit 3 slit lamp delivery 5 foot switch 6 face fixing member 7 fixation lamp 8 grip 8 a sensor 30 irradiation optical system 40 illumination optical system 50 observation optical system 60 a green LED 60 b red LED 100 control unit

Claims (5)

[Claims] In a laser treatment apparatus for performing treatment by irradiating a laser beam to a patient's eye, a sensor for detecting a change in the state of the patient, and a change in the state of the patient based on a detection result by the sensor. And a notifying means for notifying. 2. The laser treatment apparatus according to claim 1, wherein the sensor detects a change in the condition of the patient based on a pulse. 3. The laser treatment apparatus according to claim 2, wherein said notifying means changes a display state of said display means in accordance with a change amount of a pulse detected by said sensor. And a display control means for changing the display. 4. A laser treatment apparatus according to claim 3, further comprising an observation optical system for observing a patient's eye, wherein said display means performs display within an observation field through said observation optical system. Laser treatment device. 5. The laser treatment apparatus according to claim 1, further comprising a second notifying means for notifying whether or not a change in the patient's condition can be detected based on an output signal from said sensor. A laser treatment apparatus, characterized in that: