JP2002253598A - Laser curing device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a laser curing device for giving laser irradiation to an affected part to be treated with less troublesome operation. SOLUTION: This laser curing device for curing the eye of a patient while guiding a laser beam thereto comprises a beam guide optical system having a reflecting mirror for reflecting the laser beam from a curing laser beam source toward the eye of the patient, a mirror driving means for driving the reflecting mirror to change the irradiation position of the laser beam, an observing means having an observation optical system for allowing an operator to observe the eye of the patient, a sight detecting means for detecting the position of a line of sight of the eye of the operator observing the affected part of the eye of the patient, and a drive control means for controlling the drive of the mirror driving means in accordance with the detection result of the sight detecting means.

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 treating a patient's eye.

[0002]

2. Description of the Related Art In a laser treatment apparatus used for ophthalmic treatment,
When the number of laser irradiations is large, as in panretinal photocoagulation, it is common to move the laser irradiation position on the fundus by driving a reflecting mirror that reflects the laser light toward the patient's eye by manipulating the manipulator. Was.

[0003]

However, since the surgeon holds the contact lens with one hand and operates the joystick or manipulator for moving the observation optical system with the other hand during the operation, the operation is complicated. there were. In order to change the laser irradiation conditions during the operation of the manipulator, it is necessary to once remove the hand from the manipulator to change the condition setting, and to put the hand on the manipulator again each time.

The present invention has been made in view of the above-mentioned problems of the prior art,
An object of the present invention is to provide a laser treatment apparatus capable of performing laser irradiation on a desired treatment site while reducing the complexity of operation.

[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 guiding a laser beam to a patient's eye to perform treatment, a light guide optical system having a reflecting mirror for reflecting a laser beam from a treatment laser light source toward the patient's eye, Mirror driving means for driving the reflection mirror to change the irradiation position of light, observation means having an observation optical system for the operator to observe the patient's eye, and gaze of the operator's eye observing the affected part of the patient's eye It is characterized by comprising: a line-of-sight detecting means for detecting a position; and a drive control means for controlling driving of the mirror driving means based on a detection result of the line-of-sight detecting means.

(2) In the laser treatment apparatus according to (1), furthermore, a judging means for judging the stability of the line of sight detected by the line of sight detecting means; And irradiation control means for enabling laser irradiation.

(3) In the laser treatment apparatus according to (1), the observation means is a microscope unit provided with an eyepiece for looking into the operator's eye, and the line-of-sight detection means is an operator's eye excluding the eyepiece. A light source for illuminating the device and a light receiving element for receiving reflected light from an operator's eye and performing photoelectric conversion, and detecting a line of sight of the operator based on a signal from the light receiving element. .

(4) The laser treatment apparatus according to (1), further comprising signal input means for inputting a treatment laser light irradiation instruction signal, wherein the drive control means receives the instruction signal and irradiates the treatment laser light. The driving unit is controlled so that the driving of the reflection mirror is stopped during a certain period.

(5) In the laser treatment apparatus of (1), further, a judgment means for judging whether or not the operator is in an observation state based on the detection result of the line-of-sight detection means, and the operator using the judgment means. Prohibiting means for prohibiting the irradiation of the treatment laser light guided by the light guiding optical system when it is determined that is not in the observation state.

[0011]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a view showing an external view of a laser treatment apparatus, and FIG. 2 is a view for explaining a schematic optical system of the apparatus.

Reference numeral 1 denotes a laser treatment apparatus main body, in which a laser light source for emitting a treatment laser beam, an aiming light source, and the like are incorporated. Reference numeral 2 denotes a control unit for setting and inputting laser irradiation output conditions, aiming light output, and the like. Reference numeral 3 denotes a slit lamp delivery including an illumination unit and a binocular microscope unit, to which an irradiation optical system unit 40 for irradiating a treatment laser beam to a patient's eye is attached. Reference numeral 5 denotes a foot switch for transmitting a trigger signal for laser irradiation. Reference numeral 6 denotes a joystick for moving the slit lamp delivery 3.

FIG. 2 is a diagram showing an optical system of the laser photocoagulation apparatus. 70 is a treatment laser light source. Reference numeral 71 denotes a beam splitter that transmits most of the laser light from the treatment laser light source 70 and partially reflects the treatment laser light. The treatment laser light reflected by the beam splitter 71 is output through a diffusion plate 72 to an output sensor 7.
3 is incident. The output sensor 73 detects the output of the laser light emitted from the treatment laser light source 70.

Reference numeral 74 denotes a first safety shutter. When the foot switch 5 is depressed and a command for irradiating the therapeutic laser beam is issued, the shutter is separated from the optical path by driving the shutter driving device 91 shown in FIG. It allows light to pass through, and is inserted into the optical path to block laser light in the event of an abnormality or the like. The opening and closing of the first safety shutter 74 is detected by a shutter sensor 74a.

Reference numeral 78 denotes a semiconductor laser for aiming. The laser light emitted from the semiconductor laser 78 passes through a collimator lens 79 and is made coaxial with the treatment laser light by a dichroic mirror 80.

Reference numeral 81 denotes a second safety shutter. Opening and closing of the second safety shutter 81 is detected by a shutter sensor 81a. Reference numeral 82 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 unit 40 of the slit lamp delivery 3.

The laser light guided to the irradiation optical system unit 40 includes a relay lens 41 and a zoom lens 4 movable in the optical axis direction for changing the spot size of the laser light.
2. After passing through the objective lens 43, the light is reflected by the reflection mirror 19 that is driven to swing, and is irradiated to the affected part of the patient's eye E through the contact lens 44. Reference numeral 50 denotes an illumination optical system for projecting slit light, and includes an illumination light source, a condenser lens, a slit, a projection lens, and the like.

Further, the reflection mirror 19 is moved (oscillated in the embodiment) to the irradiation optical system unit 40 to drive the reflection mirror for finely adjusting the irradiation position of the laser light guided by the fiber cable 4. An apparatus 90 is provided.

Reference numeral 60 denotes an observation optical system arranged in the binocular microscope unit 59. The observation optical system 60 includes an objective lens 61 shared by the left and right observation optical paths, a variable power lens 62 disposed in each of the left and right optical paths, an operator protection filter 67, an imaging lens 63, an erect prism 64, and a field stop 65. , And lenses 66a and 66b disposed on the eyepiece 66.

The eyepiece 66 is provided with a visual line detection device 100. The line-of-sight detection device 100 includes an infrared LED 10
1, a lens 102, a half mirror 103, a dichroic mirror 104, a lens 105, and a two-dimensional CCD 106. The infrared light from the infrared LED 101 passes through the lens 102, the half mirror 103, the dichroic mirror 104, and the lens 66b, and becomes a substantially parallel light beam to illuminate the operator's eyeball. The reflected light from the surgeon's eyeball is
A two-dimensional CCD 106 is formed by a lens 66b, a dichroic mirror 104, a half mirror 103, and a lens 105.
It is led to. The dichroic mirror 104 reflects infrared light and transmits visible light.

Of the light reflected from the operator's eyeball, the light reflected near the cornea is called a Purkinje image, and the Purkinje image is observed on the two-dimensional CCD 106. In addition, a dark pupil region is observed in the iris brightly illuminated by infrared light illumination. The center of the pupil is obtained from the pupil region observed on the two-dimensional CCD 106, and the positional relationship between the Purkinje image of the front surface of the cornea and the Purkinje image of the front surface of the crystalline lens is known, whereby the visual axis direction of the eyeball, that is, the visual line direction can be detected. An example of this gaze detection method is introduced in Japanese Patent Application Laid-Open No. 1-241511. In addition to this, various methods of gaze detection are known, and are not limited to the present embodiment.

FIG. 3 is a diagram for explaining the mechanism of the reflection mirror driving device 90. FIG. 3A is a front view as viewed from the patient side.
FIG. 3B is a side view of FIG. 3A viewed from the direction A. In FIG. 3B, a ring-shaped rotating member 21 is held at the lower end of the irradiation optical system unit 40 so as to be rotatable around the optical axis L of the objective lens 43. Pass through this rotating member 21.
The upper part of the rotating member 21 is an asymmetrical flange 21a.
b (gears formed with the same radius around the rotation center of the rotating member 21). The gear 21b is a motor 15 fixed to the frame of the irradiation optical system unit 40.
With the gear 16 fitted to the shaft. That is,
The driving of the motor 15 causes the rotating member 21 to rotate. As shown in FIG. 3A, a support member 22 extending rearward is attached to a side surface of the rotary member 21 so as to be rotatable in a vertical direction with a screw 22a as a fulcrum.
2, a mirror mount 20 for fixing and holding the reflection mirror 19 is fixed. The gear 13 is fixed to the support member 22. The gear 13 meshes with the gear 12 fitted on the shaft of the motor 11 fixed to the flange 21a. That is, the driving of the motor 11 causes the support member 22 to rotate about the screw 22a.

With such a configuration, the reflection mirror 19 swings left and right around the optical axis L by driving the motor 15 and swings back and forth around the screw 22a by the driving of the motor 11. This makes it possible to change the reflection direction of the laser light.

In the apparatus having the above configuration,
The operation will be described with reference to the control system block diagram of FIG.

The operator first sets the laser irradiation conditions such as the coagulation time and the laser power by using the switches 2a and 2a of the control unit 2.
Set with b. At this time, whether or not the laser irradiation position is moved by the line of sight detection is set by the switch 2c. When the gaze detection is not used, the reflection mirror 19 can be driven by operating the lever 6a provided above the joystick 6, but the following description will be made assuming that the gaze detection is used.

The aiming light is turned on by an aiming switch (not shown), and the fundus illuminated by the illumination light from the illumination optical system 50 is observed through the observation optical system 60. Then, the slit lamp delivery 3 is moved by the joystick 6 to perform positioning with the patient's eye.

In the initial state of the laser device, the aiming light is located at the center 111 of the observed image as shown in FIG. 5 according to an instruction from the control unit 110 to the reflection mirror driving device 90. When the surgeon brings his or her eyeball closer to the eyepiece 66 of the microscope unit 59, the gaze detection device 100 detects the gaze direction.
The control unit 110 drives the driving device 90 based on the detection information to move the reflection mirror 19. As a result, aiming light is applied to a portion where the operator's line of sight is directed. For example, if laser irradiation is to be performed on the portion 112,
Stare at 12. This operation of looking at the treatment site is an indispensable act in conventional treatment. Surgeon at site 11
Looking at 2, the visual line detection device 100 informs the control unit 110 that the observation position of the operator is the site 112. The control unit 110 operates the motors 15 and 21 of the reflection mirror driving device so that the aiming light is irradiated on the part 112 based on the information.

When aiming of aiming light at a desired portion is completed, the foot switch 5 is used to irradiate laser light. When the foot switch 5 is depressed, the control unit 110 determines whether the line of sight of the operator's eye is stable. The stability of the line of sight can be determined based on whether or not the line of sight movement is within an allowable range for a predetermined time (for example, 0.2 seconds) before or after the input of the trigger signal. If the control unit 110 determines that the line of sight is stable, the control unit 110 drives the shutter driving device 91 to release the first safety shutter 74 from the optical path to allow the passage of laser light, 70 is irradiated with laser light.

During the coagulation time during which the laser beam is irradiated after the trigger signal is inputted from the foot switch 5 (this is preset in the panel unit 2), the control unit 11
0 fixes the reflection mirror 19 without driving the motors 15 and 21 of the reflection mirror driving device. Thus, even if the direction of the operator's line of sight moves during laser irradiation, the treatment laser light is prevented from flowing in the direction in which the line of sight has moved, and the laser beam can be stably applied to the aiming position. After the laser irradiation is completed, the fixing of the reflection mirror 19 is released again, and the aiming position can be moved by the line of sight detection.

After the treatment of the site 112 is completed, the surgeon gazes at the next treatment site 113, confirms that the aiming light has moved to the site 113 as in the previous case, and then steps on the foot switch 5. By repeating such operations, the treatment of the entire treatment site on the retina is completed.

When performing a treatment with a large number of laser irradiations, such as pan-retinal photocoagulation, the treatment laser light is continuously irradiated at a constant period while the laser irradiation instruction signal is being input from the foot switch 5. Repeat mode is also used. This repeat mode is selected by the switch 2d of the control unit 2. In the repeat mode, an interval time (pause time) between irradiations is set by the interval switch 2e. Even in the repeat mode, it is possible to correspond to the movement of the aiming position by the line of sight detection. For example, if the interval time is 1 second, the surgeon changes the gaze position at 1-second intervals to perform treatment. At this time, the control unit 110 also monitors whether or not the line of sight of the operator's eye is stable for a predetermined time immediately before the elapse of the interval time, and permits the laser irradiation when the line of sight is stable.

The detection result of the visual axis detection device 100 can be used to determine whether or not the operator is observing the patient's eye and whether or not the operator is in a state where treatment is possible. It is. Below, STANDBY-READY using the gaze detection function
Automatic switching and switching of the power saving mode will be described.

After the preparation for laser irradiation is completed, the READY state in which laser irradiation is possible by pressing the switch 2f (the state in which laser irradiation is possible by pressing the foot switch 5) is set. When the operator's eyeball is positioned on the eyepiece 66, the gaze detection device 100 detects reflected light from the eyeball, and the control unit 110 determines that the operator is observing the patient's eye. When the operator removes the eyeball from the eyepiece 66, the reflected light from the eyeball is no longer detected, so that the operator is not in the observation state. In this case, the control unit 110 keeps the first safety shutter closed so that the treatment laser beam is not irradiated to the patient's eye even if a trigger signal is input from the foot switch 5. Thereby, laser irradiation when the operator is not in the observation state can be prevented.

Further, the controller 110 controls the line-of-sight
When the eyeball detection signal from 0 is not obtained continuously for one minute, the laser irradiation state mode itself is automatically switched from READY to STANDBY state. Thus, forgetting to press the STANDBY switch 2g for releasing the READY mode can be resolved.
Further, if the eyeball detection signal is not obtained even after 10 minutes, the control unit 110 turns off the main power supply of the laser device, turns off the laser light sources 70 and 78, the observation illumination light, and the like, and waits for power saving. Mode. This standby mode is released by pressing a switch of the control unit 2 or the like.

In the above embodiment, a slit lamp which is observed by an operator's eye while observing an eye is described as an example of an observation means, but an observation means using a monitor may be used. In the observation means having a monitor, an image pickup device such as a CCD camera is provided in the observation optical system, and the output is output to the monitor. In this case, the line-of-sight detection may be configured such that the reflected light of the operator's eyes is received by an illumination light source and a CCD camera placed near the monitor, or the line-of-sight detection device 100 may be provided in goggles or glasses. . Alternatively, a configuration in which the line-of-sight detection device 100 is provided in the head-up display is also possible.

[0036]

As described above, according to the present invention,
The laser irradiation can be performed on a target treatment site with less troublesome operation. In addition, unintended laser irradiation can be prevented.

[Brief description of the drawings]

FIG. 1 is a diagram showing an appearance of an apparatus.

FIG. 2 is a diagram illustrating an optical system.

FIG. 3 is a diagram illustrating a driving mechanism of a reflection mirror driving device.

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

FIG. 5 is a diagram showing an aiming light irradiation image in fundus observation.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Device main body 2 Control part 3 Slit lamp delivery 4 Fiber cable 5 Foot switch 19 Reflection mirror 60 Observation optical system 70 Treatment laser light source 74 First safety shutter 90 Reflection mirror driving device 100 Eye-gaze detecting device 101 Infrared LED 106 Two-dimensional CCD 110 Control unit

Claims (5)

[Claims] 1. A laser treatment apparatus for guiding a laser beam to a patient's eye to perform a treatment, comprising: a light guide optical system having a reflection mirror for reflecting a laser beam from a treatment laser light source toward the patient's eye; Mirror driving means for driving the reflection mirror to change the irradiation position of the eye, observation means having an observation optical system for the operator to observe the patient's eye, and gaze position of the operator's eye observing the affected part of the patient's eye Gaze detection means for detecting
And a drive control means for controlling the driving of the mirror drive means based on the detection result of the visual axis detection means. 2. The laser treatment apparatus according to claim 1, further comprising: a judging means for judging the stability of the line of sight detected by said line of sight detecting means, and when the line of sight position is judged to be stable by said judging means. A laser treatment apparatus, comprising: irradiation control means for enabling laser irradiation. 3. The laser treatment apparatus according to claim 1, wherein the observation means is a microscope unit provided with an eyepiece for peeking at an operator's eye, and the line of sight detection means removes the operator's eye excluding the eyepiece. A laser having a light source for illumination and a light receiving element for receiving reflected light from an operator's eye and photoelectrically converting the light, and for detecting a line of sight of the operator based on a signal from the light receiving element Treatment device. 4. The laser treatment apparatus according to claim 1, further comprising signal input means for inputting a treatment laser light irradiation instruction signal, wherein said drive control means receives the instruction signal and emits the treatment laser light. A laser treatment apparatus for controlling the driving means so as to stop driving the reflection mirror during a certain period. 5. The laser treatment apparatus according to claim 1, further comprising: a judging unit for judging whether or not the operator is in an observation state based on a detection result of the gaze detecting unit; Prohibiting means for prohibiting irradiation of the treatment laser light guided by the light guiding optical system when it is determined that the laser treatment apparatus is not in the observation state.