JP2016193027A - Ophthalmic laser surgery device and ophthalmic surgery control program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ophthalmic laser surgery device and an ophthalmic surgery control program capable of suppressing an impact of inertia force that acts on a Z scan unit and appropriately scanning spots of a pulse laser beam.SOLUTION: An ophthalmic laser surgery device includes an XY scan unit, a first Z scan unit, a second Z scan unit, and a control unit. The XY scan unit scans a spot of a pulse laser beam in an XY direction. The first Z scan unit can perform +Z drive for moving the spot in a +Z direction, and -Z drive for moving the spot in a -Z direction. The second Z scan unit can perform the +Z drive and the -Z drive independently of the first Z scan unit. The control unit can cause the spot to be scanned in a plurality of target positions by controlling the drive of the second Z scan unit and the XY scan unit while causing the first Z scan unit to perform the +Z drive or the -Z drive continuously.SELECTED DRAWING: Figure 4

Description

  The present disclosure relates to an ophthalmic laser surgical apparatus for condensing pulsed laser light on a tissue of a patient's eye and treating the patient's eye, and an ophthalmic surgery control program.

  2. Description of the Related Art Conventionally, a technique for treating (for example, cutting or destroying) a tissue of a patient's eye by condensing pulse laser light at each of a plurality of target positions in the patient's eye is known. For example, an ophthalmic laser system disclosed in Patent Document 1 includes an incremental Z scanner and a continuous Z scanner. The incremental Z scanner incrementally Z-scans the depth of focus of the ophthalmic laser system by Z steps. The continuous Z scanner continuously Z-scans the depth of focus within a range corresponding to the Z step.

Special table 2013-510657 gazette

  The incremental Z scanner described in Patent Literature 1 needs to perform acceleration and deceleration each time an incremental Z scan is performed. An inertial force acts on the Z scanner. Therefore, for example, it may take time to start the acceleration or deceleration of the Z scanner and reach the required driving speed, and the operation time may be prolonged. In addition, the load on the Z scanner may increase and the life of the scanner may be shortened.

  The present disclosure typically provides an ophthalmic laser surgical apparatus and an ophthalmic surgical control program capable of suppressing the influence of inertial force acting on a Z scanning unit and appropriately scanning a spot of pulsed laser light. With a purpose.

  An ophthalmic laser surgical apparatus provided by an exemplary embodiment of the present disclosure is an ophthalmic laser surgical apparatus that treats a patient's eye by focusing pulsed laser light in a tissue of the patient's eye, the laser light source An XY scanning unit that scans a spot in which the pulse laser beam emitted from the tissue is condensed in the tissue in an XY direction intersecting the optical axis of the pulse laser beam, and the spot along the optical axis of the pulse laser beam A Z scanning unit that scans in the Z direction; and a control unit that controls the operation of the ophthalmic laser surgical apparatus. The Z scanning unit moves the spot in the + Z direction. A first Z scanning unit capable of performing −Z driving to move in the −Z direction; and a second Z scanning unit capable of performing the + Z driving and the −Z driving independently of the first Z scanning unit, Control Is configured to control the driving of the second Z scanning unit and the XY scanning unit while continuously causing the first Z scanning unit to execute one of the + Z driving and the −Z driving. The spot can be scanned at a target position.

  An ophthalmic surgical control program provided by an exemplary embodiment of the present disclosure is an ophthalmic surgical control program for controlling an ophthalmic laser surgical apparatus for treating a tissue of a patient's eye, and the ophthalmic laser surgical apparatus includes: An XY scanning unit that scans a spot where pulsed laser light emitted from a laser light source is condensed in the tissue in an XY direction intersecting the optical axis of the pulsed laser light; and the spot is an optical axis of the pulsed laser light. A Z-scanning unit that scans in the Z-direction along the Z-axis, and the Z-scanning unit can execute + Z driving for moving the spot in the + Z direction and -Z driving for moving the spot in the -Z direction. A first Z scanning unit; and a second Z scanning unit capable of executing the + Z driving and the −Z driving independently of the first Z scanning unit, wherein the ophthalmic surgery control program is a processor. By controlling the driving of the second Z scanning unit and the XY scanning unit while causing the first Z scanning unit to continuously execute one of the + Z driving and the −Z driving, It is possible to cause the ophthalmic laser surgical apparatus to execute a control step of scanning the spot at a plurality of target positions in the tissue.

  According to the ophthalmic laser surgical apparatus and the ophthalmic surgery control program according to the present disclosure, the influence of the inertial force acting on the Z scanning unit is suppressed, and the pulse laser beam spot is appropriately scanned.

1 is a diagram illustrating an overall configuration of an ophthalmic laser surgical apparatus 1. FIG. It is a figure showing typically the example of the 1st operation process. It is a figure which shows typically the treatment shape 80 formed by the 1st example of a surgical process shown in FIG. It is a graph which shows typically operation of each composition at the time of performing the example of the 1st operation process, and the Z coordinate of a spot. It is a figure which shows typically the reference plane 60 set by the 2nd surgery process example. It is a graph which shows typically the operation of each composition at the time of performing the example of the 2nd operation process, and the Z coordinate of a spot. It is a figure which shows typically the reference plane 60 set by the 3rd example of a surgical process. It is a graph which shows typically the operation of each composition at the time of performing the example of the 3rd operation process, and the Z coordinate of a spot. It is a flowchart of the ophthalmic surgery control process which the ophthalmic laser surgery apparatus 1 performs. It is a flowchart of the control data creation process performed in an ophthalmic surgery control process.

  Hereinafter, exemplary embodiments of the present disclosure will be described. In this embodiment, an ophthalmic laser surgical apparatus 1 capable of treating both the cornea and the lens of the patient's eye E is illustrated. “Treatment” indicates that the tissue of the patient's eye E is cut or broken.

<Overall configuration>
Hereinafter, with reference to FIG. 1, about the whole structure of the ophthalmic laser surgical apparatus 1 of this embodiment, from the laser light source 2 side (that is, the upstream side of the optical path of the pulse laser beam) to the patient eye E side (that is, the pulse). Description will be made in order on the downstream side of the optical path of the laser beam.

  The laser light source 2 emits pulsed laser light. In the present embodiment, when the pulsed laser light emitted from the laser light source 2 is condensed in the tissue of the patient's eye E, plasma is generated at the condensing position (spot), and the tissue is cut and fractured. . The above phenomenon is sometimes referred to as photodisruption. For the laser light source 2, for example, a device that emits pulsed laser light having a pulse width on the order of femtoseconds to picoseconds can be used. Hereinafter, the direction along the optical axis of the pulsed laser light emitted from the laser light source 2 is defined as the Z direction. One of the directions intersecting the Z direction (vertically intersecting in the present embodiment) is defined as the X direction. A direction that intersects both the Z direction and the X direction (vertically intersects in this embodiment) is defined as a Y direction.

  The aiming light source 3 emits aiming light indicating a position to which the pulse laser light is irradiated. In the present embodiment, a light source that emits visible laser light is used as the aiming light source 3. The aiming light source 3 may be omitted.

  The dichroic mirror 4 is provided in the optical path of pulsed laser light (hereinafter sometimes simply referred to as “optical path”). The dichroic mirror 4 combines the laser light emitted from the laser light source 2 and the aiming light emitted from the aiming light source 3.

  In this embodiment, the pulse pick unit 5 is used for switching whether or not to irradiate the tissue of the patient's eye E with the pulsed laser light. As an example, an acousto-optic device (AOM) that changes the optical path of the selected pulse laser beam is used for the pulse pick unit 5 of the present embodiment. The pulse laser beam whose optical path has been changed by the pulse pick unit 5 reaches a beam dump (not shown) that absorbs the laser and does not reach the patient's eye E. That is, the ophthalmic laser surgical apparatus 1 according to the present embodiment selectively changes a part of the optical path of the pulsed laser light emitted from the laser light source 2 by the pulse pick unit 5 (that is, picking). To do). As a result, whether or not the patient's eye E is irradiated with pulsed laser light is controlled.

  Note that devices other than the acoustooptic device (for example, MEMS, galvanometer mirror, polygon mirror, Pockels cell, etc.) may be used for the pulse pick unit 5. Further, the ophthalmic laser surgical apparatus 1 may switch whether or not to emit the pulsed laser light to the patient's eye E by switching between emission and stop of emission of the pulsed laser light by the laser light source 2. Further, the ophthalmic laser surgical apparatus 1 prohibits the patient eye E from being irradiated with the pulsed laser light for cutting or crushing the tissue by weakening the energy of the pulsed laser light applied to the patient eye E. May be.

  The zoom expander 13 is provided between the laser light source 2 and the XY scanning unit 25 (described later) in the optical path (specifically, between the pulse pick unit 5 and the second Z scanning unit 15 (described later) in the present embodiment). It has been. The zoom expander 13 can change the beam diameter of the pulsed laser light emitted from the laser light source 2. The control unit 47 (described later) drives the zoom expander 13 to change the beam diameter of the pulsed laser light, whereby the pulsed laser light emitted from the objective lens 35 (described later) toward the patient eye E is changed. The numerical aperture NA can be adjusted. The numerical aperture NA increases as the beam diameter increases, and the numerical aperture NA decreases as the beam diameter decreases.

  The second Z scanning unit 15 is a part of the Z scanning unit that scans a spot on which the pulse laser beam is condensed in the Z direction. In the present embodiment, the second Z scanning unit 15 is provided between the laser light source 2 and the XY scanning unit 25 in the optical path (specifically, between the zoom expander 13 and the XY scanning unit 25 in the present embodiment). . As an example, the second Z scanning unit 15 of the present embodiment includes a moving optical element 16 having negative refractive power and a second Z scanning driving unit 17 that moves the moving optical element 16 along the optical axis. For example, a galvano motor or the like that can move the moving optical element 16 at a high speed may be used for the second Z scanning drive unit 17. A lens 21 is provided between the moving optical element 16 and the XY scanning unit 25. The lens 21 guides the laser light that has passed through the second Z scanning unit 15 to the XY scanning unit 25.

  When the moving optical element 16 moves in the optical axis direction, the spot of the pulsed laser light on the patient's eye E moves in the Z direction. Specifically, in this embodiment, when the moving optical element 16 moves to the XY scanning unit 25 side (downstream side), the spot moves to the downstream side (+ Z side). The driving of the second Z scanning unit 15 in this case is referred to as + Z driving. Further, when the moving optical element 16 moves to the laser light source 2 side (upstream side), the spot moves to the upstream side (−Z side). The driving of the second Z scanning unit 15 in this case is referred to as -Z driving.

  The second Z scanning unit 15 of the present embodiment is provided on the upstream side of the optical path from the XY scanning unit 25. In this case, laser light that has not been scanned in the XY directions is incident on the movable optical element 16. Therefore, the moving optical element 16 can be easily reduced in size.

  Actually, in the present embodiment, the mass of the member (including the moving optical element 16) moved by the second Z scan drive unit 17 is smaller than the mass of the member moved by the first Z scan drive unit 46 (described later). That is, the inertial force acting on the second Z scanning unit 15 is smaller than the inertial force acting on the first Z scanning unit 44. Further, the maximum acceleration when the second Z scanning unit 15 changes the driving speed of the moving optical element 16 is larger than the maximum acceleration when the first Z scanning unit 44 changes the driving speed. Therefore, the second Z scanning unit 15 of the present embodiment can change the moving speed of the spot more quickly than the first Z scanning unit 44. The maximum acceleration refers to an acceleration (limit acceleration) when each of the first Z scanning unit 45 and the second Z scanning unit 15 changes the driving speed of the moving optical element with the maximum output. In the present embodiment, not only the maximum acceleration of the moving optical element, but also the maximum acceleration of the spot (image) scanned by moving the moving optical element, the second Z scanning unit 15 uses the first Z scanning unit 44. Bigger than.

  The XY scanning unit 25 scans the pulse laser beam in the XY direction intersecting the optical axis. In the present embodiment, the XY scanning unit 25 includes an X deflection device 26 and a Y deflection device 27. The X deflection device 26 scans the pulse laser beam emitted from the laser light source in the X direction. The Y deflection device 27 further scans the pulse laser beam scanned in the X direction by the X deflection device 26 in the Y direction. In this embodiment, galvanometer mirrors are employed for both the X deflection device 26 and the Y deflection device 27. However, another device that scans light (for example, a scanner such as a polygon mirror or an acousto-optic device) may be employed in at least one of the X deflection device 26 and the Y deflection device 27. Further, at least one of the X deflection device 26 and the Y deflection device 27 may include a plurality of scanners. As an example, the ophthalmic laser surgical apparatus 1 according to the present embodiment is configured so that the X-deflection device 26 is configured by two galvanometer mirrors, so that the principal ray of the pulsed laser beam can be used regardless of the scanning amount in the X direction. It is made incident on 27 predetermined places. As a result, the predetermined portion of the Y deflection device 27 becomes a pivot point through which the chief rays of all the pulsed laser beams scanned by the XY scanning unit 25 pass.

  The relay unit 30 is provided between the XY scanning unit 25 and the objective lens 35. The relay unit 30 of this embodiment is a Keplerian relay optical system. Even when the Kepler-type relay optical system is constituted by three or more optical members, the function can be expressed by two lenses. Therefore, in FIG. 1, the relay part 30 is shown by two lenses. Note that other optical elements other than the relay unit 30 may also be configured by a number of optical elements different from the number of optical elements illustrated. The relay unit 30 includes a pivot point in the XY scanning unit 25 (in this embodiment, a predetermined position on the scanning surface in the Y deflection device 27) and an objective lens 35 by an upstream relay optical element 31 and a downstream relay optical element 32. The object side focal point is connected in a conjugate relationship. Further, the positional relationship between the upstream relay optical element 31 and the XY scanning unit 25 is maintained so that the object side focal point of the upstream relay optical element 31 coincides with the pivot point in the XY scanning unit 25. Therefore, the telecentric performance of the pulse laser beam emitted from the upstream relay optical element 31 is maintained.

  The objective lens 35 is disposed on the downstream side of the optical path from the downstream relay optical element 32 of the relay unit 30. The pulsed laser light that has passed through the objective lens 35 is focused on the tissue of the patient's eye E through the eyeball interface 37.

  The eyeball interface 37 fixes the patient eye E by being connected to the patient eye E. Various configurations (for example, an immersion interface and a contact lens) can be adopted as the configuration of the eyeball interface 37.

  The dichroic mirror 38 is provided between the objective lens 35 and the downstream relay optical element 32 in the optical path. The dichroic mirror 38 of the present embodiment reflects most of the pulsed laser light from the laser light source 2 and most of the aiming light from the aiming light source 3, and light from the observation unit 40 and the OCT unit 41 described later. Most of it. As a result, the optical axes of the plurality of lights are coaxial.

  The observation unit 40 acquires a front image of the patient's eye E and the eyeball interface 37 connected to the patient's eye E. The observation unit 40 of the present embodiment can capture the patient's eye E illuminated by visible light or infrared light and display it on a monitor (not shown). An operator or the like can observe the patient's eye E from the front by looking at the monitor.

  The OCT unit 41 acquires a tissue of the patient's eye E and a tomographic image of the eyeball interface 37. As an example, the OCT unit 41 of the present embodiment includes a light source, a light splitter, a reference optical system, a scanning unit, and a detector. The light source emits light for acquiring a tomographic image. The light splitter divides the light emitted from the light source into reference light and measurement light. The reference light enters the reference optical system, and the measurement light enters the scanning unit. The reference optical system has a configuration that changes the optical path length difference between the measurement light and the reference light. The scanning unit scans the measurement light in a two-dimensional direction on the tissue. The detector detects an interference state between the measurement light reflected by the tissue and the reference light that has passed through the reference optical system. The ophthalmic laser surgical apparatus 1 scans the measurement light and detects the interference state between the reflected measurement light and the reference light, thereby acquiring information in the tissue depth direction. Based on the acquired information in the depth direction, a tomographic image of a subject to be imaged (a tissue of the patient's eye E) is acquired.

  Various configurations can be used for the OCT unit 41. For example, any of SS-OCT, SD-OCT, TD-OCT, etc. may be adopted as the OCT unit 41. The ophthalmic laser surgical apparatus may capture a tomographic image using a technique other than optical interference.

  In the present embodiment, the control unit 47 (described later) can acquire information on the tilt of the patient's eye E based on the tomographic image acquired by the OCT unit 41. As an example, in the present embodiment, the tilt of the patient's eye E with respect to the optical axis of the pulsed laser light (for example, the tilt of the visual axis, the tilt of the crystalline lens, etc.) is acquired as the tilt information of the patient's eye E. Note that the ophthalmic laser surgical apparatus 1 may acquire information on the tilt of the patient's eye E by a different method. For example, the ophthalmic laser surgical apparatus 1 may detect the tilt of the patient's eye E using at least one of a Shine peak image, an SLO image, a front image taken by the observation unit 40, and the like.

  In addition, the ophthalmic laser surgical apparatus 1 according to the present embodiment performs a treatment performed on the patient's eye E with pulsed laser light (for example, crushing of the lens, formation of a cut in the lens, incision of the anterior lens capsule, and formation of a corneal port Etc.) can be associated with a tomographic image of the patient's eye E. Furthermore, the ophthalmic laser surgical apparatus 1 according to the present embodiment can also associate a target position on which pulsed laser light is focused with a tomographic image of the patient's eye E. Therefore, the ophthalmic laser surgical apparatus 1 can control the operation of irradiating and scanning the pulsed laser beam using the tomographic image.

  The dichroic mirror 42 is coaxial with the optical axis of the observation unit 40 and the optical axis of the OCT unit 41. The light that has passed through the dichroic mirror 42 is made coaxial with the pulse laser beam emitted from the laser light source 2 by the dichroic mirror 38 described above.

  The first Z scanning unit 44 is a part of a Z scanning unit that scans a spot in the Z direction. That is, the Z scanning unit of the present embodiment includes the first Z scanning unit 44 and the second Z scanning unit 15. In addition to the first Z scanning unit 44 and the second Z scanning unit 15, the ophthalmic laser surgical apparatus 1 may further include a mechanism for scanning the spot in the Z direction. As an example, the first Z scanning unit 44 of the present embodiment moves the optical unit including the XY scanning unit 25 and the upstream relay optical element 31 along the optical axis (that is, in the Z direction), so that the upstream side The optical path length between the relay optical element 31 and the objective lens 35 is changed. As a result, the spot is scanned in the Z direction.

  Specifically, the first Z scanning unit 44 of this embodiment includes a moving stage 45 and a first Z scanning drive unit 46. The moving stage 45 can move the moving optical elements (in the present embodiment, the second Z scanning unit 15, the lens 21, the XY scanning unit 25, and the upstream relay optical element 31) while maintaining their positional relationships. To support. The first Z scanning drive unit 46 moves the moving stage 45 along the optical axis. In the present embodiment, when the moving stage 45 moves to the patient's eye E side (downstream side), the spot moves to the downstream side (+ Z side). The driving of the first Z scanning unit 44 in this case is referred to as + Z driving. When the moving stage 45 moves to the laser light source 2 side (upstream side), the spot moves to the upstream side (−Z side). The driving of the first Z scanning unit 44 in this case is referred to as -Z driving.

  Needless to say, the Z coordinate of the spot collected in the tissue is determined by the optical element on the optical path. In the present embodiment, the Z coordinate of the spot varies depending on the optical elements of the first Z scanning unit 44 and the second Z scanning unit 15 (specifically, the position of the optical element in the Z direction). In addition, the first Z scanning unit 44 and the second Z scanning unit 15 can perform + Z driving and −Z driving independently of each other. Therefore, for example, the ophthalmic laser surgical apparatus 1 maintains the Z coordinate of the spot at a constant value by causing the second Z scanning unit 15 to perform −Z driving while causing the first Z scanning unit 44 to perform + Z driving. It is also possible to do. The ophthalmic laser surgical apparatus 1 can also finely adjust the Z coordinate of the spot by the second Z scanning unit 15 while roughly scanning the spot by the first Z scanning unit 44.

  The range in which each of the first Z scanning unit 44 and the second Z scanning unit 15 can independently scan the spot in the Z direction is limited. In the present embodiment, the scanning range in which the first Z scanning unit 44 can independently scan the spot in the Z direction is more than the scanning range in which the second Z scanning unit 15 can independently scan the spot in the Z direction. Is also big. Further, in the present embodiment, the mass of the member (the moving stage 45 and the upstream relay optical element 31 and the like) that the first Z scan driving unit 46 moves is the mass of the moving optical element 16 and the like that the second Z scan driving unit 17 moves. Bigger than.

  The configurations of the first Z scanning unit 44 and the second Z scanning unit 15 can be changed as appropriate. For example, the ophthalmic laser surgical apparatus 1 includes at least one of optical elements (for example, the upstream relay optical element 31, the downstream relay optical element 32, and the objective lens 35) located on the downstream side of the XY scanning unit 25. The spot may be scanned in the Z direction by moving in the optical axis direction. The position of the second Z scanning unit 15 may be changed.

  The control unit 47 includes a CPU 48, a ROM 49, a RAM 50, a nonvolatile memory (not shown), and the like. The CPU 48 controls various controls of the ophthalmic laser surgical apparatus 1 (for example, control of the laser light source 2, operation control of the pulse pick unit 5, operation control of the scanning units 15, 25, and 44). The ROM 49 stores various programs for controlling the operation of the ophthalmic laser surgical apparatus 1 (for example, an ophthalmic surgery control program for executing an ophthalmic surgery control process described later), initial values, and the like. The RAM 50 temporarily stores various information. A nonvolatile memory is a non-transitory storage medium that can retain stored contents even when power supply is interrupted. The ophthalmic surgery control program or the like may be stored in a nonvolatile memory.

<Example of first surgical process>
With reference to FIG. 2 to FIG. 4, a first surgical process example that can be executed by the ophthalmic laser surgical apparatus 1 of the present embodiment will be described. The ophthalmic laser surgical apparatus 1 (control unit 47) of the present embodiment causes the first Z scanning unit 44 to continuously perform + Z driving or −Z driving after starting a series of treatments and completing it. However, the second Z scanning unit 15 and the XY scanning unit 25 are driven. As a result, the spot 70 is scanned at each of the plurality of target positions. Therefore, the ophthalmic laser surgical apparatus 1 suppresses the influence of the inertial force acting on the first Z scanning unit 44 compared to the case where the drive direction of the first Z scanning unit 44 is changed or stopped during the treatment. Can do. Note that a series of treatments indicates, for example, from the start to the completion of treatment with a two-dimensional or three-dimensional pulse laser beam extending in the Z direction. When a treatment start instruction is input, the control unit 47 automatically starts and completes a series of treatments.

  In particular, the ophthalmic laser surgical apparatus 1 of the present embodiment can scan one or a plurality of spots on a virtual reference plane. The operation (step) for maintaining the spot scanned by the XY scanning unit 25 on one reference plane is referred to as a maintenance operation (maintenance step). Further, when the scanning of the spot on one reference plane is completed, the reference plane can be changed and the spot can be scanned on the changed reference plane. The operation (step) for changing the reference plane is referred to as a change operation (change step). The ophthalmic laser surgical apparatus 1 according to the present embodiment can perform a treatment of a two-dimensional shape or a three-dimensional shape extending in the Z direction by alternately and continuously executing the maintenance step and the change step.

  As shown in FIG. 2, the ophthalmic laser surgical apparatus 1 (control unit 47) of the present embodiment virtually sets a plurality of reference planes 60 that intersect the optical axis (that is, the Z axis) of the pulse laser beam. In the example shown in FIG. 2, four reference planes 60 having Z coordinates of 0, 1, 2, and 3 are set. The ophthalmic laser surgical apparatus 1 first scans the spot 70 by the XY scanning unit 25 so that a “+” shape is drawn by the plurality of spots 70 on the reference plane 60 with Z = 0. During this time, the first Z scanning unit 44 and the second Z scanning unit 15 are driven so that the spot 70 scanned in the XY direction is maintained on the reference plane 60 with Z = 0. At each spot 70, photodisruption occurs in the tissue. By adjusting the distance between the plurality of spots 70 to an appropriate distance, an incision having a “+” shape is formed in the tissue along the reference plane 60.

  When scanning on the reference plane 60 with Z = 0 is completed, the reference plane 60 is changed to Z = 1. The interval between the reference surface 60 (Z = 0) before the change and the reference surface 60 (Z = 1) after the change is appropriately determined based on the type of treatment, the output of the pulse laser beam, the influence of aberration, and the like. Next, a plurality of spots 70 are scanned on the reference plane 60 with Z = 1 in the same manner as scanning on the reference plane 60 with Z = 0. When these operations (maintenance operation and change operation) are repeated up to the reference surface 60 with Z = 3, a treatment shape 80 extending in the Z direction is formed as shown in FIG. The treatment shape 80 illustrated in FIG. 3 is a shape constituted by an XZ cut surface 81 extending on the XZ plane and a YZ cut surface 82 extending on the YZ plane.

  Needless to say, the treatment shape 80 that can be formed is not limited to the shape illustrated in FIG. 3. For example, when a plurality of spots 70 are arranged in a circle on each reference surface 60, the treatment shape is cylindrical. Further, the size and number of the reference plane 60 and the spot 70 shown in the figure are different from the actual size and number in order to facilitate understanding of the description. Moreover, in this embodiment, the process of changing the reference plane 60 in order toward + Z direction is illustrated. However, it goes without saying that the order of changing the reference plane 60 can be set as appropriate. For example, the reference plane 60 may be changed in order toward the −Z direction.

  Aberration compensation will be described. In the ophthalmic laser surgical apparatus 1, various aberrations may be generated by scanning the spot 70 by the XY scanning unit 25. For example, there may be a case where the magnitude of the aberration increases as the spot 70 is separated from the optical axis. The ophthalmic laser surgical apparatus 1 according to the present embodiment can compensate for the aberration by driving the second Z scanning unit 15 based on the aberration generated in accordance with the scanning of the spot 70 by the XY scanning unit 25. As an example, in the first surgical process example shown in FIG. 2, the field curvature that occurs in response to scanning by the XY scanning unit 25 is compensated by the second Z scanning unit 15. As a result, the distortion of the reference surface 60 caused by the curvature of field is compensated, and the shape of the reference surface 60 approaches a plane. Therefore, according to the first surgical process example, an accurate and precise treatment shape 80 is formed by performing the treatment along the flat reference surface 60. The ophthalmic laser surgical apparatus 1 can also compensate for aberrations other than curvature of field (for example, astigmatism) by driving the second Z scanning unit 15.

  With reference to FIG. 4, operation | movement of each structure at the time of performing the 1st example of a surgical process is demonstrated. As described above, the control unit 47 of the present embodiment drives the second Z scanning unit 15 and the XY scanning unit 25 while causing the first Z scanning unit 44 to continuously perform + Z driving or −Z driving. That is, the ophthalmic laser surgical apparatus 1 according to the present embodiment continues to drive the first Z scanning unit 44 in the same direction during a series of operations from the start of the formation of one treatment shape to the completion thereof.

  Specifically, the control unit 47 of the present embodiment drives the first Z scanning unit 44 at a constant driving speed during the maintenance operation. More specifically, the control unit 47 of the present embodiment drives the first Z scanning unit 44 at a constant drive speed through the maintenance operation and the change operation. Therefore, the influence of the inertial force acting on the first Z scanning unit 44 is further suppressed as compared with the case where the driving speed is frequently changed.

  The control unit 47 of the present embodiment causes the first Z scanning unit 44 to perform an acceleration operation before the driving speed and driving position of the first Z scanning unit 44 reach the driving speed and driving position at the start of treatment. Can do. During the acceleration operation, the first Z scanning unit 44 moves toward the position preset as the driving position at the start of the treatment in the same direction as the driving direction after the start of the treatment in the + Z driving or the −Z driving (see FIG. 4). In the example, + Z drive) is started. Therefore, the influence of the inertial force acting on the first Z scanning unit 44 is suppressed as compared with the case where the driving of the first Z scanning unit 44 is started simultaneously with the start of the treatment. Note that irradiation of the pulsed laser light to the patient's eye E is prohibited during the acceleration operation. In this embodiment, irradiation of the pulsed laser light to the patient's eye E is prohibited by operating the pulse big unit during the acceleration operation. However, the ophthalmic laser surgical apparatus 1 may prohibit the irradiation of the patient's eye E with the pulsed laser light by stopping the driving of the laser light source 2 during the acceleration operation.

  When the acceleration operation ends, the maintenance operation is performed. In the maintenance operation, the operation of the pulse pick unit 5 is stopped, and the driving of the second Z scanning unit 15 and the XY scanning unit 25 is controlled to scan the spot 70 on the reference plane 60. In the maintenance operation in the first surgical process example, the control unit 47 drives in the direction opposite to the drive (+ Z drive in the example shown in FIG. 4) executed by the first Z scanning unit 44 (− in the example shown in FIG. 4). Z drive) is executed by the second Z scanning unit 15. In this case, the ophthalmic laser surgical apparatus 1 can make the angle of the reference surface 60 with respect to the optical axis (Z direction) closer to vertical. Accordingly, in the first surgical process example, the control unit 47 can easily calculate control data for forming a desired treatment shape on the basis of the optical axis.

  In the maintenance operation in the first surgical process example, the control unit 47 drives the second Z scanning unit 15 based on the angle of the reference surface 60 with respect to the optical axis (Z direction) and the driving speed of the first Z scanning unit 44. Is controlled to maintain the spot 70 on one reference plane 60. In this case, the ophthalmic laser surgical apparatus 1 can easily adjust the angle of the reference surface 60 with respect to the optical axis by the second Z scanning unit 15 while suppressing the influence of the inertial force acting on the first Z scanning unit 44. .

  Specifically, in the first surgical process example shown in FIG. 4, the second Z scanning unit 15 is based on the driving speed of the first Z scanning unit 44 so that the Z coordinate of the spot 70 is maintained during each maintenance operation. The average drive speed (that is, the drive speed when ignoring the operation for compensating the aberration) is controlled. As a result, in the first surgical process example, the angle of the reference surface 60 is perpendicular to the optical axis. The angle of the reference surface 60 with respect to the optical axis is adjusted by appropriately adjusting the driving speed of the second Z scanning unit 15 with respect to the driving speed of the first Z scanning unit 44. Therefore, for example, the ophthalmic laser surgical apparatus 1 can perform various treatments by adjusting the angle of the reference plane 60 in order to compensate for the inclination of the patient's eye E with respect to the optical axis.

  In addition, as described above, in the maintenance operation in the first surgical process example, the XY scanning unit compensates for aberrations (field curvature in the example shown in FIG. 4) that occur in response to scanning by the XY scanning unit 25. The second Z scanning unit 15 is driven in accordance with the operation 25. That is, in the example shown in FIG. 4, the driving speed of the second Z scanning unit 15 during the maintaining operation is not constant, and varies finely to compensate for aberrations. As a result, the Z coordinate of the spot 70 illustrated in the lower part of FIG. 4 is substantially constant throughout the maintenance operation, regardless of the variation in field curvature. In this case, as shown in FIG. 2, the curvature of field is compensated, and the reference surface 60 approaches a flat surface. Therefore, in the first surgical process example, the spot 70 is scanned more precisely. The aberration compensation includes not only the case where the influence of the aberration is completely removed but also the case where the influence of the aberration is reduced.

  When one maintenance operation (that is, scanning of the spot 70 on one reference surface 60) is completed, the changing operation is performed to change the reference surface 60. In the changing operation, the control unit 47 prohibits the tissue from being irradiated with pulsed laser light for cutting or crushing the tissue. Therefore, the ophthalmic laser surgical apparatus 1 according to the present embodiment can prevent the tissue from being irradiated with unnecessary pulsed laser light while the reference plane 60 is changed. As described above, in this embodiment, the pulse laser beam is picked by the pulse pick unit 5, so that irradiation of the pulse laser beam to the patient's eye E is prohibited.

  As shown in FIG. 4, in the changing operation in the first surgical process example, the reference plane 60 is changed by changing the driving speed of the second Z scanning unit 15 to a speed different from the driving speed in the maintaining process. Therefore, the ophthalmic laser surgical apparatus 1 can change the reference plane 60 while maintaining the driving direction of the first Z scanning unit 44 in the same direction while alternately performing the maintenance operation and the changing operation. Note that “changing the driving speed” in this case includes both a case where only the magnitude of the speed is changed without changing the direction, and a case where the direction is changed along with the magnitude of the speed.

  In the first surgical process example, the controller 47 drives the driving speed of the first Z scanning unit 44 during the changing operation and the distance in the Z direction between the reference surface 60 before the change and the reference surface 60 after the change (that is, Z The driving speed of the second Z scanning unit 15 during the changing operation is controlled based at least on the pitch). Therefore, the ophthalmic laser surgical apparatus 1 can appropriately change the reference surface 60 according to the distance between the reference surfaces 60. Further, the ophthalmic laser surgical apparatus 1 can appropriately change the reference plane 60 regardless of whether or not the plurality of Z pitches are constant.

  Specifically, as shown in FIG. 4, in the first surgical process example, the driving direction of the first Z scanning unit 44 and the driving direction of the second Z scanning unit 15 during the changing operation are the same. Therefore, the reference plane 60 can be moved in a shorter time than when the second Z scanning unit 15 is driven in the direction opposite to the driving direction of the first Z scanning unit 44 during the changing operation or when the second Z scanning unit 15 is stopped. Be changed. However, even when the second Z scanning unit 15 is driven in a direction opposite to the driving direction of the first Z scanning unit 44, the reference plane 60 can be changed. In the example shown in FIG. 4, the driving speed of the second Z scanning unit 15 during the changing operation is constant. However, the driving speed of the second Z scanning unit 15 may change during the changing operation.

  In the first surgical process example, the driving amount of the second Z scanning unit 15 during one maintenance operation and the driving amount of the second Z scanning unit 15 during one change operation are the same and opposite. This is the driving amount in the direction. In this case, even when the drive range of the second Z scanning unit 15 is limited, the drive amount is unlikely to reach the limit value.

<Second surgical process example>
With reference to FIG. 5 and FIG. 6, the 2nd example of a surgical process which can be performed by the ophthalmic laser surgical apparatus 1 of this embodiment is demonstrated. The second surgical process example is different from the first surgical process example described above in that the second Z scanning unit 15 does not compensate for aberrations generated in response to scanning by the XY scanning unit 25. About the operation | movement of each other structure, you may employ | adopt the same operation | movement as the 1st surgery process mentioned above. Therefore, in the following description, when the same operation | movement as the operation | movement in a 1st surgical process example can be employ | adopted, the description is abbreviate | omitted or simplified.

  In the second surgical process example shown in FIG. 5, as in the first surgical process example shown in FIG. 3, a plurality of spots 70 are formed on the four reference planes 60 whose Z coordinates are 0, 1, 2, and 3. Scanning (spot 70 is omitted in FIG. 5). However, in the second surgical process example, aberration (for example, curvature of field) is not compensated for during the maintenance process. As a result, in the example shown in FIG. 5, each reference surface 60 is not a perfect plane and is slightly curved due to the influence of aberration.

  In the maintenance operation of the second surgical process example shown in FIG. 6, the driving speed of the first Z scanning unit 44 is constant, and the driving speed of the second Z scanning unit 15 is also constant. In this case, the aberration generated according to the scanning by the XY scanning unit 25 is not compensated by the second Z scanning unit 15. As a result, the Z coordinate of the spot 70 illustrated in the lower part of FIG. 6 slightly varies under the influence of aberration during the maintenance operation. However, the control of the second Z scanning unit 15 is simpler than the first surgical process example. Therefore, the ophthalmic laser surgical apparatus 1 can perform treatment with simple control by performing treatment according to the second surgical process example when the influence of aberration can be ignored.

<Third surgical operation example>
With reference to FIG. 7 and FIG. 8, the 3rd example of a surgical process which can be performed by the ophthalmic laser surgical apparatus 1 of this embodiment is demonstrated. As shown in FIG. 7, the third surgical process example is different from the first surgical process example described above in that the angle of the reference surface 60 with respect to the optical axis (Z direction) is not perpendicular (FIG. 7 also shows a spot). 70 is omitted).

  In particular, during the maintenance operation in the third surgical process example, as shown in FIG. 8, the average driving speed of the second Z scanning unit 15 is set to zero. That is, during the maintenance operation in the third surgical process example, the second Z scanning unit 15 is driven for the purpose of compensating for aberrations generated in accordance with scanning by the XY scanning unit 25, but the reference plane 60 with respect to the optical axis. It is not driven for the purpose of adjusting the angle. Accordingly, in the third surgical process example, the Z coordinate of the spot 70 illustrated in the lower part of FIG. 8 is gradually changed by the first Z scanning unit 44 that continues to be driven in the same direction. As a result, as shown in FIG. 7, the angle of the reference surface 60 with respect to the optical axis is not vertical, but an inclination occurs. The control unit 47 controls the driving of the XY scanning unit 25 during the maintenance operation according to the inclination of the reference surface 60.

  During the changing operation in the third surgical process example, the driving speed of the second Z scanning unit 15 is controlled based on the driving speed and the Z pitch of the first Z scanning unit 44 as in the first surgical process example. However, in the third example of the surgical process shown in FIG. 8, the three-dimensional position where the scanning by the XY scanning unit 25 is completed on the reference surface 60 before the change and the XY scanning unit 25 on the reference surface 60 after the change. The difference in the Z direction from the three-dimensional position at which scanning by is started is considered as the Z pitch. In the third example of the surgical process shown in FIG. 8, the position where the scanning in the XY direction is completed on the reference surface 60 before the change is + Z direction from the position where the scanning in the XY direction is started on the reference surface 60 after the change. Is located. Therefore, in the example shown in FIG. 8, the driving direction of the second Z scanning unit 15 is adjusted so that the Z coordinate moves in the −Z direction in the changing operation.

  In the second surgical process example, the driving of the second Z scanning unit 15 during the changing operation may be controlled in the same manner as in the third surgical process example. That is, when controlling the driving of the second Z scanning unit 15 during the changing operation, the control unit 47 refers to only the simple distance between the reference surface 60 before the change and the reference surface 60 after the change as the “Z pitch”. Alternatively, the position in the XY direction as well as the distance between the reference surfaces 60 described above may be referred to as “Z pitch”. Further, as described above, the driving speed of the second Z scanning unit 15 in the maintenance operation may be adjusted so that the angle of the reference surface 60 with respect to the optical axis becomes a desired angle.

  The first to third surgical process examples described above are only a part of many surgical processes that can be performed by the ophthalmic laser surgical apparatus 1. Therefore, the ophthalmic laser surgical apparatus 1 may be executed by changing a part of the operations shown in the first to third surgical process examples, or a plurality of the surgical procedure examples shown in the first to third surgical process examples. These operations may be executed in combination as appropriate.

<Ophthalmic surgery control processing>
With reference to FIG. 9 and FIG. 10, the ophthalmic surgery control process which the ophthalmic laser surgery apparatus 1 of this embodiment performs is demonstrated. The ophthalmic surgery control process described below includes a process of creating control data and a process of controlling the driving of the scanning units 15, 25, 44, etc. according to the created control data. The control data is data that is referred to when the control unit 47 controls the driving of the scanning units 15, 25, 44, etc. to execute a series of treatments. In the present embodiment, the process of creating control data and the process of controlling the driving of the scanning units 15, 25, 44 and the like are both executed by the control unit 47 of the ophthalmic laser surgical apparatus 1. However, the entire ophthalmic surgery control process need not be executed by the control unit 47 of the ophthalmic laser surgical apparatus 1. For example, the process of creating control data may be executed by a device (for example, a PC) other than the ophthalmic laser surgical apparatus 1. In this case, each of a program executed by a processor such as a PC and a program executed by the processor of the ophthalmic laser surgical apparatus 1 is an ophthalmic surgery control program.

  The ophthalmic surgery control process shown in FIG. 9 is executed by a CPU (processor) 48 of the control unit 47 when an instruction to perform ophthalmic surgery (treatment of the patient's eye E with a pulse laser) is input via the operation unit or the like. Is done. The CPU 48 executes the ophthalmic surgery control process shown in FIG. 9 according to a program stored in the ROM 49 or the nonvolatile memory.

  First, the control unit 47 accepts selection of the type of treatment to be executed (S1). Examples of the type of treatment include at least one of crushing of the lens during cataract surgery, formation of a corneal port, incision of the anterior lens capsule, and formation of an incision in the lens during correction of presbyopia. Next, a control data creation process is executed (S2).

  As shown in FIG. 10, when the control data creation process is started, the treatment shape formed by the pulse laser beam is determined according to the type of treatment selected in S1 (see FIG. 9) (S21). . For example, the control unit 47 may determine the treatment shape by associating the treatment shape to be formed with the image photographed by the photographing means (the OCT unit 41 in the present embodiment). In this case, the control unit 47 may automatically associate the treatment shape with the image, or may associate the treatment shape with the image according to a user operation.

  Next, the control unit 47 determines the angle, shape, and interval (Z pitch) of the reference surface 60 (S22). For example, the control unit 47 may determine an angle that is perpendicular to the optical axis (Z direction) as the angle of the default reference plane 60 determined in S22. Conversely, the control unit 47 may set an angle that is not perpendicular to the optical axis as the angle of the default reference plane 60. Further, the control unit 47 may determine whether or not the shape of the reference surface 60 is a plane according to the treatment shape to be formed. Further, the control unit 47 may determine the interval between two adjacent reference planes 60 based on the size of bubbles generated in the spot 70. Note that the interval between the reference surfaces 60 may be determined in advance.

  Next, the control unit 47 determines whether or not to correct the inclination of the patient's eye E (S23). For example, the control unit 47 may determine whether or not to correct the inclination according to an operation by the user. Further, the control unit 47 detects the inclination of the axis of the patient's eye E (for example, the visual axis or the axis of the crystalline lens) with respect to the optical axis of the pulsed laser light based on the photographed image, and determines the inclination based on the detected inclination. It may be determined whether or not to correct. As described above, a tomographic image captured by the OCT unit 41, a front image captured by the observation unit 40, or the like can be used as the captured image for detecting the tilt of the patient's eye E. When the inclination is not corrected (S23: NO), the process proceeds to S26.

  When correcting the tilt of the patient's eye E (S23: YES), the control unit 47 acquires information on the tilt of the patient's eye E and corrects the angle of the reference plane 60 determined in S22 (S24). For example, as a method for acquiring information about the tilt of the patient's eye E, a method for calculating the tilt of the axis of the patient's eye E with respect to the optical axis from a captured image, a method for causing the user to input the tilt, and the like can be employed. As a method for correcting the angle of the reference surface 60, for example, a method of correcting the angle of the reference surface 60 so that the reference surface 60 is perpendicular to the axis of the patient's eye E can be employed.

  Next, the control unit 47 sets the driving speed S1 of the first Z scanning unit 44 (S26). As an example, in the present embodiment, the driving speed S1 of the first Z scanning unit 44 is constant throughout the maintaining operation and the changing operation.

  Next, the control unit 47 acquires the angle D of the reference surface 60 with respect to the optical axis (that is, the Z axis) of the pulsed laser light (S27). The controller 47 sets the driving speed kS2 of the second Z scanning unit 15 during each maintenance operation based on the driving speed S1 of the first Z scanning unit 44 and the angle D of the reference surface 60 (S28).

  Next, the control unit 47 determines whether or not to compensate for the aberration generated in response to the scanning by the XY scanning unit 25 (S30). For example, the control unit 47 may determine whether or not to compensate the aberration according to the operation by the user, or may determine according to the type of treatment. If the aberration is not compensated (S30: NO), the process proceeds to S34.

  When the aberration is compensated (S30: YES), the control unit 47 acquires information on the aberration that occurs in response to the scanning by the XY scanning unit 25 (S31). For example, table data or the like that associates the amount of scanning by the XY scanning unit 25 with the amount of aberration may be created and stored in advance through experiments or the like. In this case, the control unit 47 may acquire the stored data as aberration information. Further, the control unit 47 may obtain the aberration caused by the scanning in the XY directions by calculation. Next, the control unit 47 adjusts the driving speed of the second Z scanning unit 15 during the maintenance operation based on the aberration information acquired in S31 (S32). Specifically, the control unit 47 of the present embodiment drives the second Z scanning unit 15 according to the operation of the XY scanning unit 25 during the maintenance operation so that the amount of aberration acquired in S31 is compensated (reduced). Adjust the speed.

  Next, the control unit 47 sets the driving speed cS2 of the second Z scanning unit 15 during each changing operation based on at least the driving speed S1 of the first Z scanning unit 44 and the Z pitch (S34). The control unit 47 sets the intersection of each reference surface 60 and the treatment shape as a target position for condensing the pulse laser beam (S35). Control data is created by the above processing. The process returns to the ophthalmic surgery control process.

  Returning to the description of FIG. When the control data creation process (S2) ends, it is determined whether or not there is an instruction to start treatment (S4). When the user scans the operation unit and inputs a treatment start instruction (S4: YES), the control unit 47 starts the acceleration operation of the first Z scanning unit 44 (S5). When the drive position and drive speed of the first Z scanning unit 44 reach the set values (S7: YES), the maintenance operation is started. In the maintenance operation, the control unit 47 drives the second Z scanning unit 15 at the set drive speed kS2 (S9). Further, the control unit 47 drives the XY scanning unit 25 according to the control data and stops the picking of the pulsed laser light by the pulse pick unit 5 (S10). When the scanning of the spot 70 on one reference plane 60 is completed (S11: YES), one maintenance operation is completed.

  Next, it is determined whether or not the formation of a series of treatment shapes has been completed (S13). If it is not completed (S13: NO), the changing operation is performed. In the changing operation, the control unit 47 starts the operation of the pulse pick unit 5 and picks the pulse laser beam (S15). Further, the control unit 47 drives the second Z scanning unit 15 at the set driving speed cS2, and changes the reference surface 60 to the next reference surface (S16). When the Z coordinate reaches the next reference plane (S17: YES), the process returns to S9, and the maintenance operation is performed again. When the formation of a series of treatment shapes is completed (S13: YES), the driving of the laser light source 2 and the scanning units 15, 25, 44 is stopped (S19), and the ophthalmic surgery control process is ended.

  As described above, the ophthalmic laser surgical apparatus 1 according to this embodiment controls the driving of the second Z scanning unit 15 and the XY scanning unit 25 while causing the first Z scanning unit 44 to perform + Z driving or −Z driving. Thus, the spot 70 can be scanned at a plurality of target positions in the tissue. For example, the ophthalmic laser surgical apparatus 1 is completed after starting one of two-dimensional shape or three-dimensional shape treatment (for example, crushing of the lens, incision of the lens, and formation of a corneal port) extending in the Z direction. It is also possible to continue driving the first Z-scanning unit 44 in the same direction during a series of operations until it is performed. In other words, the ophthalmic laser surgical apparatus 1 can continue to drive without stopping the first Z scanning unit 44 even when the spot 70 is scanned at a plurality of target positions located on the same XY plane. Therefore, the ophthalmic laser surgical apparatus 1 according to the present embodiment is compared with the case where the driving direction of the first Z scanning unit 44 is changed to the opposite direction during the treatment and the case where the driving of the first Z scanning unit 44 is temporarily stopped. Thus, the influence of inertial force acting on the first Z scanning unit 44 can be suppressed.

  In the present embodiment, the maximum acceleration of the second Z scanning unit 15 is larger than the maximum acceleration of the first Z scanning unit 44. In this case, the ophthalmic laser surgical apparatus 1 maintains a driving direction of the first Z scanning unit 44 with a small maximum acceleration (that is, the influence of inertial force is large) and has a large maximum acceleration (that is, the influence of the inertial force is large). Various appropriate spot scans can be performed by changing the driving speed of the second Z scanning unit 15. Therefore, the first Z-scanning unit 44 having a large influence of inertial force is suitably driven, and the entire series of operations is appropriately performed.

  Specifically, in the present embodiment, the mass of the member moved by the second Z scan drive unit 17 is smaller than the mass of the member moved by the first Z scan drive unit 46. Accordingly, the first Z scanning unit 44 to which a larger inertia force acts is suitably driven, and the entire series of operations is appropriately performed.

  In the present embodiment, the scanning range in which the first Z scanning unit 44 can scan the spot 70 is larger than the scanning range in which the second Z scanning unit 15 can scan the spot 70. In this case, the ophthalmic laser surgical apparatus 1 can treat a wide area in the Z direction by performing the treatment while continuously driving the first Z scanning unit 44 in the same direction.

  The control unit 47 of the present embodiment can compensate for the aberration by driving the second Z scanning unit 15 based on the aberration generated in response to the scanning by the XY scanning unit 25. Therefore, the ophthalmic laser surgical apparatus 1 of the present embodiment can condense the pulsed laser beam on the target position while suppressing the influence of aberration. In particular, in the present embodiment, the aberration can be appropriately finely compensated by adjusting the speed of the second Z scanning unit 15 that is less influenced by the inertial force than the first Z scanning unit 44.

  The ophthalmic laser surgical apparatus 1 of the present embodiment can execute a maintenance operation (a maintenance step) and a change operation (a change step). In the maintenance operation, the ophthalmic laser surgical apparatus 1 drives the second Z scanning unit 15 and the XY scanning unit 25 while causing the first Z scanning unit 44 to perform + Z driving or −Z driving. The focusing position (spot 70) of one or a plurality of pulsed laser beams is maintained on one reference plane 60 by the maintaining operation. The ophthalmic laser surgical apparatus 1 can also change the reference plane 60 by driving the first Z scanning unit 44 in the same direction as the driving in the maintenance operation in the changing operation. The maintenance operation and the change operation are executed alternately and continuously. In this case, the ophthalmic laser surgical apparatus 1 can continue the treatment of the two-dimensional shape or the three-dimensional shape spreading in the Z direction while keeping the driving direction of the first Z scanning unit 44 in the same direction. Therefore, the ophthalmic laser surgical apparatus 1 according to the present embodiment changes the driving direction of the first Z scanning unit 44 in the opposite direction during the treatment (for example, when the maintenance operation and the change operation are switched), and Compared with the case where the driving of the first Z scanning unit 44 is temporarily stopped, the influence of the inertial force acting on the first Z scanning unit 44 can be suppressed.

  The control unit 47 according to the present embodiment can cause the second Z scanning unit 15 to perform driving in the opposite direction to the driving performed by the first Z scanning unit 44 in the maintenance operation. Further, the control unit 47 can change the driving speed of the second Z scanning unit 15 to a speed different from the driving speed in the maintenance step in the changing operation. In this case, the ophthalmic laser surgical apparatus 1 performs the maintenance operation and the change operation alternately while keeping the driving direction of the first Z scanning unit 44 in the same direction, and each reference plane with respect to the optical axis (Z axis). The angle of 60 can be close to vertical. Therefore, the ophthalmic laser surgical apparatus 1 can easily execute control for performing treatment of a desired shape with the optical axis as a reference.

  The control unit 47 of the present embodiment can drive the first Z scanning unit 44 at a constant driving speed through the maintenance operation and the change operation. When the driving speed of the first Z scanning unit 44 is constant, the influence of the inertial force acting on the first Z scanning unit 44 is further suppressed as compared with the case where the driving speed is changed.

  In the maintenance operation of the present embodiment, the control unit 47 controls the driving speed of the second Z scanning unit 15 based on the angle of the reference surface 60 with respect to the optical axis and the driving speed of the first Z scanning unit 44. In this case, the ophthalmic laser surgical apparatus 1 can easily adjust the angle of the reference surface 60 with respect to the optical axis by the second Z scanning unit 15 while suppressing the influence of the inertial force acting on the first Z scanning unit 44. . In particular, in the present embodiment, the angle of the reference surface 60 is appropriately adjusted by adjusting the speed of the second Z scanning unit 15 that is less affected by the inertial force than the first Z scanning unit 44.

  In the present embodiment, the control unit 47 can make the driving speeds of the first Z scanning unit 44 and the second Z scanning unit 15 constant in each sustain operation. In this case, the control unit 47 can execute a series of treatments while driving the first Z scanning unit 44 and the second Z scanning unit 15 with simple control.

  In the present embodiment, the control unit 47 uses at least the driving speed of the first Z scanning unit 44 during the changing operation and the distance in the Z direction between the reference surfaces 60 of the second Z scanning unit 15 during the changing operation. The driving speed can be controlled. In this case, the ophthalmic laser surgical apparatus 1 according to the present embodiment can appropriately change the reference surface 60 according to the distance between the reference surfaces 60.

  In the present embodiment, the control unit 47 can make the driving directions of the first Z scanning unit 44 and the second Z scanning unit 15 during the changing operation the same. In this case, the ophthalmologic laser surgical apparatus 1 drives the second Z scanning unit 15 in the direction opposite to the driving direction of the first Z scanning unit 44 during the changing operation, or moves the second Z scanning unit 15 during the changing operation. Compared to the case of stopping, the reference surface 60 can be changed in a short time.

  In the changing operation of this embodiment, the tissue is not irradiated with pulsed laser light for cutting or crushing the tissue. Therefore, the ophthalmic laser surgical apparatus 1 according to the present embodiment can prevent the tissue from being irradiated with unnecessary pulsed laser light while the reference plane 60 is changed.

  The content disclosed in the above embodiment is merely an example. Therefore, it is possible to change the contents disclosed in the above embodiment. For example, in the above embodiment, the spot 70 is scanned on each of the plurality of reference planes 60. However, the ophthalmic laser surgical apparatus 1 can perform treatment without using the virtual reference planes 60 as a reference.

  The second Z scanning unit 15 of the above-described embodiment is generated in accordance with an operation for adjusting the angle of the reference surface 60 with respect to the optical axis, a change operation for changing the reference surface 60, and scanning by the XY scanning unit 25. Perform two or three of the operations to compensate for aberrations. Moreover, in the operation process example illustrated in the above embodiment, in any case, the maintenance operation and the change operation are repeatedly performed alternately. However, the ophthalmic laser surgical apparatus 1 may cause the second Z scanning unit 15 to execute only one of the three operations. For example, the ophthalmic laser surgical apparatus 1 may perform only the operation of adjusting the angle of one reference plane 60 with respect to the optical axis while causing the first Z scanning unit 44 to continuously perform + Z driving or −Z driving. . Further, the ophthalmic laser surgical apparatus 1 performs only the operation of compensating for the aberration generated in accordance with the scanning by the XY scanning unit 25 while continuously causing the first Z scanning unit 44 to perform + Z driving or −Z driving. You may make 2Z scanning part 15 perform. Further, the second Z scanning unit 15 may perform the angle adjustment operation and the aberration compensation operation of the reference surface 60 without performing the changing operation. Even in this case, the influence of the inertial force acting on the first Z scanning unit 44 is suppressed.

  The first Z scanning unit 44 and the second Z scanning unit 15 of the above embodiment scan the spot in the Z direction by moving an optical element such as a lens in the optical axis direction. However, it is possible to change the configuration of at least one of the first Z scanning unit 44 and the second Z scanning unit 15. For example, a lens (liquid lens or the like) whose refractive power changes may be adopted for the Z scanning unit. Further, even when the ophthalmic laser surgical apparatus 1 includes three or more Z scanning units, one or more of the plurality of Z scanning units are driven as the first Z scanning unit, and one of the other Z scanning units is driven. The above can be driven as the second Z scanning unit.

  In the above embodiment, if the aberration due to scanning in the XY directions is compensated or ignored, the plurality of reference surfaces 60 are flat and parallel to each other. Further, the interval between the plurality of reference planes 60 is constant. However, the interval between the plurality of reference planes 60 may be changed. Two or more reference planes 60 may intersect each other. One reference plane 60 may be formed virtually by connecting a plurality of virtual planes having different angles. Further, the ophthalmic laser surgical apparatus 1 appropriately adjusts the driving speed of the second Z scanning unit 15 with respect to the driving speed of the first Z scanning unit 44 during the maintenance operation, so that the reference surface 60 is intentionally shaped other than a plane. (A curved surface or the like) is also possible.

  In the first surgical process example (see FIGS. 2 to 4) of the above-described embodiment, in the maintenance operation, the second Z scanning unit 15 is caused to perform driving in the direction opposite to the driving performed by the first Z scanning unit 44. Thus, the angle of the reference surface 60 with respect to the optical axis (Z-axis) is made closer to vertical. In the maintenance operation in this example, when correcting the aberration due to the XY scan, or when the shape of the reference surface 60 is intentionally set to a shape other than a plane, the first Z scan is performed in one maintenance operation. The driving directions of the unit 44 and the second Z scanning unit 15 may be temporarily the same. That is, in the first surgical process example, if the direction of the driving end position with respect to the driving start position of the second Z scanning unit 15 is opposite to the driving direction of the first Z scanning unit 44 in one maintenance operation, Even when the driving directions of the Z scanning units 44 and 15 are temporarily the same, the angle of the reference surface 60 with respect to the optical axis approaches vertical.

  In the above embodiment, when the acceleration operation ends, the driving speed of the first Z scanning unit 44 becomes constant until a series of treatments is completed. Accordingly, the influence of the inertial force acting on the first Z scanning unit 44 is further suppressed as compared with the case where the driving speed of the first Z scanning unit 44 is changed. However, even when the driving speed of the first Z scanning unit 44 is changed, if the driving direction is maintained, the influence of the inertial force is less than when the driving is stopped or when the driving direction is changed to the opposite direction. It is suppressed. Note that the control unit 44 controls the driving speed of the second Z scanning unit 15 based on the driving speed of the first Z scanning unit 44 even when the driving speed of the first Z scanning unit 44 is changed. A spot 70 can be scanned on the angular reference plane 60.

  In the above-described embodiment, it is prohibited during the changing operation that the tissue is irradiated with pulsed laser light for cutting or crushing. However, when no particular inconvenience occurs even when the tissue is irradiated with the pulsed laser light during the changing operation, the ophthalmic laser surgical apparatus 1 may irradiate the tissue with the pulsed laser light even during the changing operation. Good.

  In the above-described embodiment, the Z scanning units 44 and 15 determine the spot movement amount (hereinafter referred to as “unit movement amount”) when each of the first Z scanning unit 44 and the second Z scanning unit 15 is driven by a unit amount. Even when driven in position, it is substantially constant. Therefore, the control unit 47 of the above embodiment controls the driving speeds of the first Z scanning unit 44 and the second Z scanning unit 15 without considering the fluctuation of the unit movement amount. However, the ophthalmic laser surgical apparatus 1 may control the driving speed in consideration of the fluctuation of the unit movement amount. Further, the ophthalmic laser surgical apparatus 1 may control the driving speed of the scanning units 44 and 15 based on the actual scanning speed of the spot 70. As described above, the “driving speed of the Z scanning units 44 and 15” in the present disclosure may mean both the driving speed of the movable part of the Z scanning units 44 and 15 and the actual scanning speed of the spot 70. is there. The ophthalmic laser surgical apparatus 1 may compensate the fluctuation of the unit movement amount in the first Z scanning unit 44 by the first Z scanning unit 15.

DESCRIPTION OF SYMBOLS 1 Ophthalmic laser surgical apparatus 2 Laser light source 5 Pulse pick part 15 2Z scanning part 16 Moving optical element 17 2Z scanning drive part 25 XY scanning part 31 Upstream relay optical element 32 Downstream relay optical element 35 Objective lens 41 OCT unit 44 First Z Scanning Unit 45 Moving Stage 46 First Z Scanning Driving Unit 47 Control Unit 48 CPU
49 ROM
60 Reference plane 70 Spot

Claims (14)

An ophthalmic laser surgical apparatus for treating a patient's eye by condensing pulsed laser light in a tissue of the patient's eye,
An XY scanning unit that scans a spot where pulsed laser light emitted from a laser light source is collected in the tissue in an XY direction intersecting the optical axis of the pulsed laser light;
A Z scanning unit that scans the spot in the Z direction along the optical axis of the pulsed laser beam;
A control unit for controlling the operation of the ophthalmic laser surgical apparatus;
With
The Z scanning unit is
A first Z scanning unit capable of executing + Z driving for moving the spot in the + Z direction and -Z driving for moving the spot in the -Z direction;
A second Z scanning unit capable of executing the + Z driving and the -Z driving independently of the first Z scanning unit;
With
The controller is
A plurality of target positions in the tissue are controlled by controlling the driving of the second Z scanning unit and the XY scanning unit while causing the first Z scanning unit to continuously execute one of the + Z driving and the −Z driving. An ophthalmic laser surgical apparatus characterized by being capable of scanning the spot. The ophthalmic laser surgical apparatus according to claim 1,
An ophthalmic laser surgical apparatus, wherein a maximum acceleration when the second Z scanning unit changes the driving speed is larger than a maximum acceleration when the first Z scanning unit changes the driving speed. The ophthalmic laser surgical apparatus according to claim 1 or 2,
Each of the first Z scanning unit and the second Z scanning unit is
A movable optical element capable of moving at least in the optical axis direction of the pulsed laser beam;
A driving unit that moves the spot in the Z direction by moving the moving optical element in the optical axis direction;
With
An ophthalmic laser surgical apparatus, wherein a mass of a member moved by the driving unit of the second Z scanning unit is smaller than a mass of a member moved by the driving unit of the first Z scanning unit. An ophthalmic laser surgical apparatus according to any one of claims 1 to 3,
An ophthalmic laser surgical apparatus, wherein a scanning range in which the spot can be scanned by the first Z scanning unit is larger than a scanning range in which the spot can be scanned by the second Z scanning unit. An ophthalmic laser surgical apparatus according to any one of claims 1 to 4,
The controller is
An ophthalmic laser surgical apparatus that compensates for the aberration by driving the second Z-scanning unit based on an aberration generated in accordance with the scanning of the spot by the XY scanning unit. An ophthalmic laser surgical apparatus according to any one of claims 1 to 5,
The controller is
The spot is maintained on one reference plane intersecting the optical axis by controlling the driving of the second Z scanning unit while causing the first Z scanning unit to execute one of the + Z driving and the −Z driving. A maintenance step to
Changing the reference plane for focusing the pulsed laser light by driving the first Z scanning unit in the same direction as the driving in the maintaining step;
The ophthalmic laser surgical apparatus is characterized in that the ophthalmic laser surgical apparatus can be executed alternately and continuously. The ophthalmic laser surgical apparatus according to claim 6,
The controller is
In the maintaining step, the second Z scanning unit is caused to execute driving in a direction opposite to the driving performed by the first Z scanning unit;
The ophthalmic laser surgical apparatus, wherein in the changing step, the driving speed of the second Z scanning unit is changed to a speed different from the driving speed in the maintaining step. The ophthalmic laser surgical apparatus according to claim 6 or 7,
The controller is
An ophthalmic laser surgical apparatus, wherein the first Z scanning unit is driven at a constant driving speed through the maintaining step and the changing step. An ophthalmic laser surgical apparatus according to any one of claims 6 to 8,
The controller is
In the maintaining step, by controlling the driving speed of the second Z-scanning unit based on the angle of the reference surface with respect to the Z direction and the driving speed of the first Z-scanning unit, the spot is set to one reference surface. An ophthalmic laser surgical apparatus characterized in that the apparatus is maintained. An ophthalmic laser surgical apparatus according to any one of claims 6 to 9,
The controller is
In each of the maintaining steps, the driving speed of the first Z scanning unit is made constant, and the driving speed of the second Z scanning unit is made constant. The ophthalmic laser surgical apparatus according to any one of claims 6 to 10,
The controller is
Based on the driving speed of the first Z scanning unit during the changing step and the distance in the Z direction between the reference surface before the change and the reference surface after the change, the second Z scanning unit during the changing step An ophthalmic laser surgical apparatus characterized by controlling a driving speed. An ophthalmic laser surgical apparatus according to any one of claims 6 to 11,
The controller is
In the changing step, the second Z-scanning unit is driven in the same direction as the driving performed by the first Z-scanning unit. The ophthalmic laser surgical apparatus according to any one of claims 6 to 12,
The controller is
The ophthalmic laser surgical apparatus characterized in that, in the changing step, the tissue is prohibited from being irradiated with pulsed laser light for cutting or crushing the tissue from the laser light source. An ophthalmic surgical control program for controlling an ophthalmic laser surgical apparatus for treating tissue of a patient's eye,
The ophthalmic laser surgical apparatus is:
An XY scanning unit that scans a spot where pulsed laser light emitted from a laser light source is collected in the tissue in an XY direction intersecting the optical axis of the pulsed laser light;
A Z scanning unit that scans the spot in the Z direction along the optical axis of the pulsed laser beam;
With
The Z scanning unit is
A first Z scanning unit capable of executing + Z driving for moving the spot in the + Z direction and -Z driving for moving the spot in the -Z direction;
A second Z scanning unit capable of executing the + Z driving and the -Z driving independently of the first Z scanning unit;
With
The ophthalmic surgery control program is executed by a processor,
A plurality of target positions in the tissue are controlled by controlling the driving of the second Z scanning unit and the XY scanning unit while causing the first Z scanning unit to continuously execute one of the + Z driving and the −Z driving. The ophthalmic surgery control program can cause the ophthalmic laser surgical apparatus to execute a control step of scanning the spot.