JP2016193071A - Ophthalmic laser treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ophthalmic laser treatment device capable of appropriately treating an affected part of a patient's eye by appropriately observing the affected part of the patient's eye.SOLUTION: An ophthalmic laser treatment device includes an observation optical system for observing an affected part of a patient's eye, and a reflection surface provided in the observation optical system for reflecting a first wavelength laser beam and a second wavelength laser beam. A first reflection area for reflecting the first wavelength laser beam and a second reflection area for reflecting the second wavelength laser beam are formed on the reflection surface in a divided manner, and observation light of the observation optical system penetrates the reflection surface. The ophthalmic laser treatment device further includes a laser beam source for emitting the first wavelength laser beam and wavelength conversion means for converting the first wavelength laser beam emitted by the laser beam source to the second wavelength laser beam.SELECTED DRAWING: Figure 1

Description

  The present disclosure relates to an ophthalmic laser treatment apparatus that performs treatment by irradiating a patient's eye with laser light.

  Laser treatment apparatuses that perform treatment by irradiating a patient's eye with laser light are known. For example, the laser treatment apparatus of Patent Document 1 includes an observation optical system in which an operator observes an observation site of a patient's eye, and an irradiation optical system that emits treatment laser light for treating the tissue of the patient's eye. Moreover, the laser treatment apparatus of patent document 1 can convert the infrared laser beam (wavelength: 1064 nm) radiate | emitted by the laser light source into visible laser beam (wavelength: 532 nm) using a wavelength conversion element.

JP 2014-233469 A

  By the way, if a plurality of reflecting members that reflect light toward the patient's eyes are arranged at a plurality of positions of the observation optical system that observes the patient's eyes, the configuration of the observation optical system tends to be complicated. In addition, the optical path length of the observation optical system becomes long, which may make it difficult for the operator to observe the patient's eyes. On the other hand, when a plurality of types of light is reflected by a single reflecting member disposed in the observation optical system, a mode in which a coating process is performed in which light of a plurality of types of wavelengths is reflected by a single reflection region. However, in such an embodiment, the optical characteristics (spectral characteristics) of the coating process may be complicated.

  An object of the present disclosure is to provide an ophthalmic laser treatment apparatus that can appropriately observe an affected area of a patient's eye and appropriately treat the affected area of the patient's eye.

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

(1) An observation optical system for observing an affected area of a patient's eye, and a reflection surface that is provided in the observation optical system and reflects the first wavelength laser beam and the second wavelength laser beam. The first reflection region that reflects the one-wavelength laser light and the second reflection region that reflects the second-wavelength laser light are formed separately, and the observation light of the observation optical system is transmitted through the reflection surface.

  According to the present disclosure, it is possible to provide an ophthalmic laser treatment apparatus that can appropriately observe an affected area of a patient's eye and appropriately treat the affected area of the patient's eye.

It is an external view of the ophthalmic laser treatment apparatus of this indication. It is the figure which looked at the optical system of the ophthalmic laser treatment apparatus of FIG. 1 from the side. It is the figure which looked at the optical system of the ophthalmic laser treatment apparatus of FIG. 1 from upper direction. It is a figure which shows the structure of the control system of the ophthalmic laser treatment apparatus of FIG. It is a figure of the (a) 1st reflective surface of the dichroic mirror used for the ophthalmic laser treatment apparatus of 1st Embodiment, (b) It is a figure of a 2nd reflective surface. FIGS. 6A and 6B are diagrams for explaining (a) spectral reflection characteristics of a first reflection region and (b) illustrating a spectral reflection characteristic of a second reflection region formed in the dichroic mirror of FIG. 5. It is the simplified view which looked at the dichroic mirror of the ophthalmic laser treatment apparatus of 1st Embodiment from (a) side, (b) It is the figure seen from the B direction of FIG. It is the simplified view which looked at the dichroic mirror of the ophthalmic laser treatment apparatus of 1st Embodiment from (a) side, (b) It is the figure seen from the C direction of FIG. It is a figure explaining the spectral transmission characteristic of a dichroic mirror in the direction which observation light permeate | transmits. It is a figure of the spectral reflection characteristic for a comparison. It is a figure of the synthetic | combination means for a comparison. It is a figure of the spectral transmission characteristic for a comparison. It is a figure of the example of a change of the synthetic | combination means of 1st Embodiment. It is a figure of (a) reflective surface (1st surface) and (b) optical surface (2nd surface) of the dichroic mirror used for the ophthalmic laser treatment apparatus of 2nd Embodiment. It is the simplified view which looked at the dichroic mirror of the ophthalmic laser treatment apparatus of 2nd Embodiment from (a) side, (b) It is the figure seen from the B direction of FIG.

  Hereinafter, exemplary embodiments of the present disclosure will be described with reference to the drawings.

<First Embodiment>
FIG. 1 is an external view of an ophthalmic laser treatment apparatus 1A according to the first embodiment. 2 is a view of the optical system of the ophthalmic laser treatment apparatus 1A of FIG. 1 as viewed from the side (left side in FIG. 1). FIG. 3 is a view of the optical system of the ophthalmic laser treatment apparatus 1A of FIG. 1 as viewed from above. FIG. 4 is a diagram for explaining the configuration of the control system of the ophthalmic laser treatment apparatus 1A shown in FIG.

<Overall configuration>
The ophthalmic laser treatment apparatus 1A of the first embodiment includes a slit delivery unit 2 and a table unit 3 as an example. The slit delivery part 2 irradiates treatment laser light for treating the affected part of the patient's eye Ep. The ophthalmic laser treatment apparatus 1A of the first embodiment emits a first wavelength laser beam and a second wavelength laser beam as the treatment laser beam. In addition, the ophthalmic laser treatment apparatus 1 </ b> A of the first embodiment includes an irradiation optical system 10, an observation optical system 30, an illumination optical system 40, and a control unit 110 as an example. Various optical systems and treatment laser light included in the ophthalmic laser treatment apparatus 1A of the first embodiment will be described in detail later.

  The table unit 3 of the first embodiment mounts the slit delivery unit 2. The slit delivery part 2 of 1st Embodiment is provided with the main-body part 101, the illumination part 102, the microscope part 103, the eyepiece part 104, the displacement part 107, the operation panel part 105, the joystick part 106, and the headrest part 108 as an example. . The main body 101 of the first embodiment generates a first wavelength laser beam and a second wavelength laser beam. The illumination unit 102 of the first embodiment emits illumination light for observing the observation site of the patient's eye Ep. The microscope unit 103 of the first embodiment obtains an observation image of the observation site of the patient's eye Ep. The microscope unit 103 according to the first embodiment includes an eyepiece unit 104 that provides an operator with an observation image. It should be noted that at least one of the first wavelength laser light generating means and the second wavelength laser light generating means may be disposed outside the slit delivery section 2. In this case, for example, a laser beam may be connected to the optical system of the slit delivery unit 2 using an optical fiber cable.

  The displacement part 107 of 1st Embodiment moves the optical system with which the ophthalmic laser treatment apparatus 1A is provided in the up-down / left-right / front-back direction. Moreover, the displacement part 107 of 1st Embodiment rotates the irradiation optical system 10 and the observation optical system 30 in the left-right direction. The operation panel unit 105 of the first embodiment is used by an operator to set various operating conditions of the ophthalmic laser treatment apparatus 1A. The joystick unit 106 according to the first embodiment is used by an operator to align various optical systems with respect to the patient's eye Ep. The headrest part 108 of 1st Embodiment is used in order to fix a patient's face.

<Illumination optics>
The illumination optical system 40 of the first embodiment will be described with reference to FIGS. The illumination optical system 40 illuminates observation light on the observation site of the patient's eye Ep. In the first embodiment, visible light is illuminated on the observation site of the patient's eye Ep. The illumination optical system 40 includes, as an example, a lamp 41, a lens 42, a diaphragm 43, a lens group 44, and a prism 45. For example, the lamp 41 may be an incandescent bulb, a light emitting diode, or the like. The illumination optical system 40 may include a slit plate or the like for illuminating the observation site with slit light.

<Observation optics>
The observation optical system 30 of the first embodiment is used by an operator to observe the observation site of the patient's eye Ep. In the first embodiment, the observation site of the patient's eye Ep is observed from two directions (a plurality of directions). Thereby, for example, the surgeon can stereoscopically view the observation site. The observation optical system 30 of the first embodiment has an optical axis L3R that provides an observation image to the operator's right eye and an optical axis L3L that provides an observation image to the operator's left eye. That is, the observation optical system 30 of the first embodiment includes two observation light beams that are separated from each other. In the following description, the optical axis L3R and the optical axis L3L may be collectively referred to as the optical axis L3. Note that the observation optical system 30 may be only one of the optical axis L3R and the optical axis L3L (that is, a monocular observation optical system).

  In the present disclosure, the light that forms the observation image provided to the operator may be referred to as observation light. In addition, light used for generating an observation image, that is, light passing through the field stop 35 (35R, 35L) in the first embodiment is referred to as observation light. For example, when an observation image is provided to the surgeon using an output signal of the image sensor, light received by the image sensor is referred to as observation light.

  The observation optical system 30 of the first embodiment includes an objective lens 23, a dichroic mirror 22, a variable magnification optical system 31 (31R, 31L), an operator protection filter 32 (32R, 32L), and an imaging lens 33 (33R, 33L). And an erecting prism group 34 (34R, 34L), a field stop 35 (35R, 35L), and an eyepiece 36 (36R, 36L).

  In the first embodiment, the objective lens 23 and the dichroic mirror 22 are shared by the observation optical system 30 and the irradiation optical system 10. That is, the dichroic mirror 22 of the first embodiment is a combining unit 29A that combines the observation optical system 30 and the irradiation optical system 10. The dichroic mirror 22 of the first embodiment transmits observation light (visible light) from the patient's eye Ep, and transmits first wavelength laser light (infrared light) and second wavelength laser light (visible light) to the patient's eye. Reflects towards Ep. A detailed description of the dichroic mirror 22 will be given later.

  The variable magnification optical system 31 is used to change the observation magnification. For example, a rotating drum or the like in which a plurality of lenses having different refractive powers are combined can be used for the variable magnification optical system 31. The surgeon protection filter 32 suppresses the treatment laser light reflected by the patient's eye Ep or the like from reaching the surgeon's eye Eo. The operator protection filter 32 of the first embodiment has a characteristic of attenuating the wavelength of the treatment laser light. In the first embodiment, the operator looks through the eyepiece 104 to observe the observation site, but the operator's observation method is not limited to this. For example, an imaging element may be arranged in the observation optical system 30 and an observation image captured by the imaging element may be displayed on the display screen 115 (display unit) or the like. In addition, infrared light observation light may be imaged by an imaging device or the like to provide the operator with an observation image. Note that the observation optical system 30 of the present disclosure is a simple observation optical system 30 by the combining unit 29 </ b> A, and thus the above-described imaging element or the like is easily arranged in the observation optical system 30.

<Irradiation optics>
The irradiation optical system 10 of the first embodiment is used for irradiating a treatment laser beam to the patient's eye Ep. The ophthalmic laser treatment apparatus 1A of the first embodiment irradiates a plurality of types of treatment laser beams. Specifically, the ophthalmic laser treatment apparatus 1A of the first embodiment uses a first wavelength laser beam in the infrared wavelength band and a second wavelength laser beam in the visible wavelength band as a plurality of types of treatment laser lights having different wavelengths. Irradiate. The first wavelength laser beam is used, for example, for the treatment of secondary cataract. The tissue of the patient's eye Ep can be photodestructed or photoruptured using the first wavelength laser beam. The first wavelength laser light of this embodiment generates plasma in the vicinity of the condensing position of the first wavelength laser light. The second wavelength laser beam is used in, for example, selective laser trabeculoplasty (SLT). The tissue of the patient's eye Ep can be photoheated using the second wavelength laser light. In the first embodiment, 1064 nm light is irradiated as the first wavelength laser light, and 532 nm light is irradiated as the second wavelength laser light. The wavelength and type of treatment laser light are not limited to this. For example, both the first wavelength laser beam and the second wavelength laser beam may be able to photocoagulate the tissue of the patient's eye Ep.

  The irradiation optical system 10 of the first embodiment includes a first irradiation optical system 10A and a second irradiation optical system 10B. The first irradiation optical system 10A is used for irradiating the patient's eye Ep with the first wavelength laser beam. The first irradiation optical system 10A includes an optical axis L1. The second irradiation optical system 10B is used for irradiating the patient's eye Ep with the second wavelength laser light. The second irradiation optical system 10B includes the optical axis L2. Note that an optical path at least partially shared by the first irradiation optical system 10A and the second irradiation optical system 10B may be called a shared optical path. Further, an optical path used only in the first irradiation optical system 10A or an optical path used only in the second irradiation optical system 10B may be referred to as a dedicated optical path.

<First irradiation optical system>
The first irradiation optical system 10A of the first embodiment includes a laser light source 11, a first energy adjustment unit 12, a beam splitter 14, a mirror 15, a safety shutter 16, a focus shift lens group 17, a dichroic mirror 18, a safety shutter 19, and an extract. A panda lens group 21, a dichroic mirror 22, and an objective lens 23 are provided. The irradiation optical system 10 of the first embodiment shares the objective lens 23 and the dichroic mirror 22 with the observation optical system 30. In the first embodiment, the members from the laser light source 11 to the beam splitter 14 and the members from the safety shutter 19 to the objective lens 23 are shared by the first irradiation optical system 10A and the second irradiation optical system 10B. That is, in the ophthalmic laser treatment apparatus 1A of the first embodiment, the first wavelength laser beam and the second wavelength laser beam are coaxial (or substantially coaxial) and proceed to the dichroic mirror 22 (combining means 29A). A detailed description of the second irradiation optical system 10B will be described later. The first irradiation optical system 10 </ b> A according to the first embodiment includes a first aiming light source 71, a collimator lens 72, and a diaphragm 73 in the branch optical path branched by the dichroic mirror 18.

  The laser light source 11 emits a first wavelength laser beam. In the laser light source 11 of the first embodiment, YAG (yttrium, aluminum, garnet) crystal (Nd: YAG) doped with neodymium is used as a laser rod. The laser light source 11 of the first embodiment can emit a pulse laser. The laser light source 11 of the first embodiment can emit a giant pulse (high energy laser light). The laser light source 11 of the first embodiment is a Q switch YAG laser. The laser light source 11 of the first embodiment is a laser light source including a Q switch element. That is, a high output pulse can be emitted from the laser light source 11 using the Q switch method. The first aiming light source 71 emits aiming light indicating the position (namely, the position of the treatment spot) irradiated with the first wavelength laser light. In the first embodiment, a light source that emits visible laser light having a wavelength of 635 nm (red) is used as the first aiming light source 71. However, it goes without saying that the wavelength of the aiming light can be changed as appropriate.

  The 1st energy adjustment part 12 adjusts the energy amount of the treatment laser beam (1st wavelength laser beam or 2nd wavelength laser beam in 1st Embodiment) irradiated to the structure | tissue of the patient eye Ep. That is, the first energy adjusting unit 12 is an adjusting unit (first adjusting unit) that adjusts the energy of the first wavelength laser beam. In 1st Embodiment, the 1st energy adjustment part 12 is used as a light reduction means (1st light reduction means) which attenuates the light quantity of a 1st wavelength laser beam. The first energy adjustment unit 12 of the first embodiment includes a half-wave plate 12A and a polarizing plate 12B. The half-wave plate 12A is rotated by a motor 81 around the emission optical axis of the laser light source 11 (in other words, the optical axis L1 of the first irradiation optical system 10A or the optical axis L2 of the second irradiation optical system 10B). To do. The polarizing plate 12B is arranged at a Brewster angle. In the first embodiment, the energy of the first wavelength laser light is adjusted by the combination of the half-wave plate 12A and the polarizing plate 12B. Specifically, the control unit 110 can adjust the energy of the first wavelength laser light output from the first energy adjustment unit 12 to an arbitrary value by rotating the half-wave plate 12A to an arbitrary angle. .

  The beam splitter 14 reflects a part of the first wavelength laser light toward the photodetector 82. The photodetector 82 detects the amount of energy of the first wavelength laser light by receiving the first wavelength laser light reflected by the beam splitter 14. The safety shutter 16 is moved between the optical axis L1 and the outside of the optical axis L1 by a shutter driving unit 83 (for example, a solenoid). The safety shutter 16 is disposed on the optical axis L1 to block the irradiation of the first wavelength laser light to the patient's eye Ep.

  The focus shift lens group 17 displaces (shifts) the focus position of the first wavelength laser light emitted from the laser light source 11 with respect to the focus position (condensing position) of the first aiming light emitted from the first aiming light source 71. Let In the first embodiment, the focus position of the first wavelength laser light emitted from the laser light source 11 can be displaced either far or near with respect to the focus position of the first aiming light. The focus position of the treatment laser beam with respect to the focus position of the aiming light may be referred to as a focus shift position. That is, the first irradiation optical system 10A of the first embodiment includes a focus shift unit. The focus shift lens group 17 includes a concave lens and a convex lens. The focus shift lens group 17 uses a motor 84 (drive means) that drives the shift of the focus shift position. In the first embodiment, a motor 84 is connected to the convex lens. The control unit 110 described later can adjust the focus shift position. In the first embodiment, the control unit 110 can adjust the focus shift position in the range of −500 μm to +500 μm by moving the convex lens in the optical axis direction.

  The collimator lens 72 converts the first aiming light emitted from the first aiming light source 71 into a parallel light flux. The aperture 73 is formed with two holes. The light beam passing through the collimator lens 72 is directed to the dichroic mirror 18 in a state where the light beam is separated into two by the diaphragm 73. The dichroic mirror 18 combines the first wavelength laser beam and the first aiming beam. The dichroic mirror 18 of the first embodiment multiplexes the first wavelength laser light and the first aiming light by reflecting the first wavelength laser light and transmitting the first aiming light. Note that the ophthalmic laser treatment apparatus 1A may irradiate the patient's eye Ep from different optical paths without combining the first wavelength laser light and the first aiming light.

  The safety shutter 19 is moved between the optical axis L1 and the outside of the optical axis L1 by a shutter driving unit 85 (for example, a solenoid). The safety shutter 19 is disposed on the optical axis L1, thereby allowing laser light to the patient's eye Ep (in the first embodiment, the first wavelength laser light, the second wavelength laser light, the first aiming light, or the second aiming light). Block irradiation of at least one of the aiming lights.

  The expander lens group 21 includes at least one of laser light multiplexed by the dichroic mirror 18 (in the first embodiment, first wavelength laser light, second wavelength laser light, first aiming light, or second aiming light). ). The laser light magnified by the expander lens group 21 is reflected by the dichroic mirror 22 and passes through the objective lens 23. In the first embodiment, the first wavelength laser light transmitted through the objective lens 23 is irradiated onto the tissue of the patient eye Ep through the contact lens 24 attached to the patient eye Ep. The dichroic mirror 22 substantially reflects the light having the wavelength of the reflected light so that the reflected light of the first wavelength laser light reflected by the patient's eye Ep does not easily enter the surgeon's eye Eo. The irradiation optical system 10 may be provided with a configuration for adjusting the spot size of the laser light irradiated to the tissue.

<Second irradiation optical system>
The second irradiation optical system 10B of the first embodiment includes a laser light source 11, a first energy adjustment unit 12, a beam splitter 14, a movable mirror 61, a wavelength converter 62, a second energy adjustment unit 68, a beam splitter 65, and a dichroic mirror. 66, a movable mirror 67, a safety shutter 19, an expander lens group 21, a dichroic mirror 22, and an objective lens 23. As described above, in the first embodiment, the members from the laser light source 11 to the beam splitter 14 and the members from the safety shutter 19 to the objective lens 23 are the first irradiation optical system 10A and the second irradiation optical system 10B. Sharing. Thereby, the configuration of the ophthalmic laser treatment apparatus 1A can be simplified.

  Further, since the optical axis L1 and the optical axis L2 are coaxial (or substantially coaxial) and proceed to the synthesizing unit 29A (dichroic mirror 22), the synthesizing unit 29A can be configured simply. For example, the total length (distance LBa: see FIG. 2 and the like) of the combining unit 29A can be suppressed. The second irradiation optical system 10 </ b> B of the first embodiment shares the objective lens 23 and the dichroic mirror 22 with the observation optical system 30. Therefore, the optical system of the ophthalmic laser treatment apparatus 1A can be configured simply. For example, the microscope unit 103 can be downsized. Hereinafter, description of the shared member is omitted. Note that the optical axis L1 and the optical axis L2 do not have to coincide completely. For example, the first wavelength laser beam and the second wavelength laser beam may be incident on the dichroic mirror 22 via a common optical member. In the first embodiment, the first wavelength laser beam and the second wavelength laser beam are incident on the dichroic mirror 22 via the expander lens group 21.

  The light flow of the second irradiation optical system 10B will be briefly described. The first wavelength laser light emitted from the laser light source 11 proceeds in the order of the first energy adjusting unit 12 and the beam splitter 14, and is reflected toward the wavelength converter 62 by the movable mirror 61 inserted on the optical axis L1. Is done. That is, the wavelength converter 62 is provided in the optical path branched from the optical path of the first irradiation optical system 10A. The first wavelength laser beam reflected by the movable mirror 61 is converted into the second wavelength laser beam by the wavelength converter 62. The second wavelength laser beam emitted from the wavelength converter 62 proceeds in the order of the second energy adjusting unit 68, the beam splitter 65, and the dichroic mirror 66, and is moved to the safety shutter 19 by the movable mirror 67 inserted on the optical axis L1. Reflected towards. The second wavelength laser light reflected by the movable mirror 67 proceeds in the order of the safety shutter 19 and the expander lens group 21, and is reflected by the dichroic mirror 22 toward the objective lens 23. The second wavelength laser light reflected by the dichroic mirror 22 and transmitted through the objective lens 23 is irradiated onto the tissue of the patient eye Ep through a contact lens attached to the patient eye Ep.

  The movable mirror 61 is moved between the optical axis L1 and the outside of the optical axis L1 by a mirror driving unit 91 (for example, a solenoid). The mirror driving unit 91 is connected to the control unit 110. In the first embodiment, when irradiating the patient's eye Ep with the first wavelength laser light, the control unit 110 retracts the movable mirror 61 from the optical axis L1. When irradiating the patient's eye Ep with the second wavelength laser light, the control unit 110 moves the movable mirror 61 on the optical axis L1. The first wavelength laser beam reflected by the movable mirror 61 enters the wavelength converter 62. The control unit 110 retracts the movable mirror 61 and the movable mirror 67 from the optical axis L1 when irradiating the patient's eye Ep with the first wavelength laser light.

  The wavelength converter 62 of the first embodiment converts the first wavelength laser light (wavelength: 1064 nm) emitted from the laser light source 11 into the second wavelength laser light (wavelength: 532 nm). That is, the wavelength converter 62 of the first embodiment is a wavelength conversion unit. The second energy adjusting unit 68 adjusts the amount of energy of the second wavelength laser light irradiated to the tissue of the patient's eye Ep. That is, the second energy adjusting unit 68 is an adjusting unit (second adjusting unit) that adjusts the energy of the second wavelength laser beam. In the first embodiment, the second energy adjusting unit 68 is used as a dimming means (second dimming means) for dimming the light amount of the second wavelength laser light. In the first embodiment, the energy of the second wavelength laser light is adjusted using at least one of the first energy adjustment unit 12 and the second energy adjustment unit 68.

  The second energy adjustment unit 68 of the first embodiment includes a half-wave plate 63 </ b> A and a polarizing plate 64. The half-wave plate 63A of the first embodiment is moved between the optical axis L2 of the second irradiation optical system 10B and the outside of the optical axis L2 by a motor 92 (a light-reducing member driving unit), or Rotate around the optical axis L2. As a result, the polarization direction of the second wavelength laser light incident on the half-wave plate 63A is rotated. The combination of the half-wave plate 63A and the polarizing plate 64 reduces (attenuates) the energy of the second wavelength laser beam. In other words, the energy of the second wavelength laser light is adjusted by the combination of the half-wave plate 63A and the polarizing plate 64.

  The beam splitter 65 reflects part of the second wavelength laser light toward the photodetector 93. The photodetector 93 detects the amount of energy of the second wavelength laser light by receiving the second wavelength laser light reflected by the beam splitter 65. The second aiming light source 94 is used as a light source for alignment for irradiating the affected part of the patient's eye Ep with the second wavelength laser light. In the first embodiment, a light source that emits visible laser light having a wavelength of 635 nm (red) is used as the second aiming light source 94. However, it goes without saying that the wavelength of the aiming light can be changed as appropriate. The second aiming light emitted from the second aiming light source 94 goes to the dichroic mirror 66.

  The dichroic mirror 66 combines the second wavelength laser light and the second aiming light. The dichroic mirror 66 according to the first embodiment combines the second wavelength laser light and the second aiming light by reflecting the second aiming light and transmitting the second wavelength laser light. Note that the ophthalmic laser treatment apparatus 1A may irradiate the patient's eye Ep from different optical paths without combining the second wavelength laser light and the second aiming light.

  The movable mirror 67 is moved between the optical axis L1 and the outside of the optical axis L1 by a mirror driving unit 95 (for example, a solenoid). The mirror driving unit 95 is connected to the control unit 110. When irradiating the patient's eye Ep with the first wavelength laser light, the control unit 110 retracts the movable mirror 67 from the optical axis L1. When irradiating the patient's eye Ep with the second wavelength laser light, the control unit 110 moves the movable mirror 67 on the optical axis L1. The second wavelength laser light reflected by the movable mirror 67 goes to the safety shutter 19. After the safety shutter 19, the light path travels in common with the first irradiation optical system 10 </ b> A, so the description is omitted. In the first embodiment, the beam diameter of the second wavelength laser beam incident on the dichroic mirror 22 is smaller than the beam diameter of the first wavelength laser beam (see FIGS. 7 and 8). This is because in the first embodiment, the treatment method is different between the case where the first wavelength laser light is used and the case where the second wavelength laser light is used. Specifically, the ophthalmic laser treatment apparatus 1A of the first embodiment generates plasma in the affected area by irradiating the first wavelength laser beam, but generates plasma in the affected area when irradiating the second wavelength laser light. I won't let you.

  Here, as an example of treatment using the second wavelength laser light of the first embodiment, a case where selective laser trabeculoplasty (SLT) is performed will be described. SLT is a treatment method in which treatment laser light is irradiated to the trabecular meshwork at the corner of the patient's eye Ep in order to increase the amount of aqueous humor discharged from the patient's eye Ep. In SLT, treatment laser light is irradiated a plurality of times over the entire circumference or part of an annular trabecular meshwork. In SLT, a contact lens is attached to the cornea of the patient's eye Ep. As an example of the contact lens, a corner mirror (gonioscope) for observing the corner angle of the patient's eye Ep, or a Goldman trihedral mirror can be used. The corner angle is observed through a reflection mirror provided in the contact lens. The operator adjusts the irradiation position of the aiming light emitted from the second aiming light source 94 to the spot to be treated while adjusting the position of the contact lens. The surgeon operates the trigger switch 116 in a state where the alignment is completed, thereby irradiating the spot with the second wavelength laser light.

<Synthesis means>
The synthesizing means 29A (dichroic mirror 22) of the first embodiment will be described in detail with reference to FIGS. The synthesizing unit 29A of the first embodiment has a plurality of optical surfaces. The synthesizing means 29A of the first embodiment is a plate-type optical member having optical surfaces formed on both sides. The material (base material) of the dichroic mirror 22 may be glass. In the first embodiment, among the optical surfaces arranged on both surfaces of the plate-like optical member, one optical surface is the first reflecting surface 22A, and the other optical surface is the second reflecting surface 22B. In the first embodiment, the first reflecting surface 22A and the second reflecting surface 22B are flat surfaces, but at least one of the first reflecting surface 22A and the second reflecting surface 22B may be a curved surface. In the first embodiment, the first wavelength laser light is reflected by the first reflecting surface 22A, and the second wavelength laser light is reflected by the second reflecting surface 22B.

  The first reflecting surface 22A and the second reflecting surface 22B of the first embodiment are inclined in the same direction (the patient eye Ep side in the first embodiment) with respect to the optical axis L3R (optical axis L3L) of the observation optical system 30. ing. Specifically, the first reflecting surface A and the second reflecting surface 22B of the first embodiment are configured such that the optical axis L3 (optical axis L3R) is viewed from the side (X direction in FIG. 2) of the optical axis L3 of the observation optical system 30. , Tilted 45 ° toward the patient's eye with respect to the optical axis L3L). That is, the first reflecting surface 22A and the second reflecting surface 22B are parallel. In the first embodiment, when viewed from the patient's eye Ep side, the first reflecting surface 22A is closer to the patient's eye Ep than the second reflecting surface 22B. In the first embodiment, the observation light of the observation optical system 30 is transmitted through the first reflection surface 22A and the second reflection surface 22B (see FIGS. 2, 3 and the like).

<First reflective surface of the combining means>
In the first reflecting surface 22A of the first embodiment, a first reflecting region P1 that reflects the first aiming light, the second aiming light, and the first wavelength laser light is formed (see FIG. 5A). . In the first embodiment, the first reflection region P1 is formed on the entire first reflection surface 22A. In the first embodiment, a coating process is performed on the surface of the optical surface to form the first reflection region P1. In the first embodiment, a dichroic mirror coat is formed on the surface of the optical surface. In the first embodiment, the observation light is transmitted through the first reflection region P1 (see FIG. 7B). In FIG. 7B, the light beam of the observation light passing through the field stop 35 is indicated by a light beam OBS (OBSr, OBSl), and the light beam of the first wavelength laser light is indicated by a region LSR1. In the first embodiment, the second wavelength laser light is transmitted through the first reflection region P1 (see FIG. 7B). That is, the second wavelength laser light is reflected by the second reflection region after passing through the first reflection region P1. Note that the first reflective region P1 may be formed in a partial region of the first reflective surface 22A. In FIG. 2, when the reflection surface 22A is viewed from the A direction, the area of the first reflection region P1 is preferably equal to or larger than the beam diameter of the first wavelength laser light incident on the first reflection surface 22A. As a result, an event in which the energy of the first wavelength laser light incident on the combining unit 29A is attenuated by the combining unit 29A can be suppressed.

  The first reflection region P1 of the first embodiment has a reflection characteristic of reflecting the first aiming light, the second aiming light, and the first wavelength laser light and transmitting other wavelengths (wavelength bands). FIG. 6A is a diagram showing the spectral reflection characteristics of the first reflecting surface 22A of the first embodiment. FIG. 6A shows the reflection characteristics of light incident at 45 ° with respect to the first reflecting surface 22A. The first reflection region P1 of the first embodiment installed in the mode of FIG. 2 reflects 98% or more of the incident first wavelength laser light and reflects 30% of the incident aiming light. Specifically, in FIG. 6A, the first wavelength laser beam (wavelength 1064 nm) is reflected at the reflection characteristic portion indicated by the portion R1. Further, the aiming light (wavelength 635 nm) is reflected at the reflection characteristic portion indicated by the portion R3 in FIG.

  The reason why the reflectance of the aiming light is lower than the reflectance of the first wavelength laser light is that the surgeon observes the aiming light irradiated to the observation site. That is, the surgeon can observe the aiming light that has been reflected by the observation site of the patient's eye Ep and then transmitted through the combining means 29A, using the observation optical system 30. The reflection characteristic of the first reflection region P1 of this embodiment has a low reflectance at a wavelength corresponding to the wavelength of the aiming light. Specifically, the first reflection region P1 of the first embodiment transmits 70% of aiming light. The combining unit 29A may not reflect the aiming light. For example, you may irradiate the observation part of the patient's eye Ep not through the dichroic mirror 22 with aiming light.

<Second reflecting surface of the combining means>
On the second reflecting surface 22B of the first embodiment, a second reflecting region P2 that reflects the second wavelength laser beam is formed (see FIG. 5B). In the first embodiment, the second reflective region P2 is formed in a partial region of the second reflective surface 22B. Specifically, a band-shaped second reflection region P2 passing through the center of the second reflection surface 22B is formed on the second reflection surface 22B. When viewed from the C direction in FIG. 2, the belt-like second reflection region P <b> 2 extends in the Y direction. The second reflection region P2 is formed in a shape that reduces the overlap with the observation light (described later with reference to FIG. 8B).

  The second reflection region P2 of the first embodiment has a reflection characteristic that reflects the second wavelength laser light and transmits light of other wavelengths (wavelength bands). FIG. 6B is a diagram showing the spectral reflection characteristics of the second reflecting surface 22B of the first embodiment. FIG. 6B shows the reflection characteristics of light incident at 45 ° with respect to the second reflecting surface 22B. The second reflection region P2 of the first embodiment installed in the mode of FIG. 2 reflects 95% or more of the incident second wavelength laser light. Specifically, in FIG. 6B, the second wavelength laser light (wavelength 532 nm) is reflected at the reflection characteristic portion indicated by the portion R2. The region of the second reflecting surface 22B where the second reflecting region P2 is not formed preferably has spectral transmission characteristics that suppress the attenuation of visible light. Thereby, for example, an event that the observation image becomes dark, an event that the observation image is colored, and the like can be suppressed. In the first embodiment, the observation light is transmitted through the region of the second reflection surface 22B where the second reflection region P2 is not formed (see FIG. 8B). In FIG. 8B, the superposition of the light beam OBS (OBSl, OBSr) and the second reflection region P2 is suppressed. In addition, the region LSR2 corresponding to the light beam of the second wavelength laser light is reflected within the region (hatched portion) of the second reflection region.

<Control unit>
Next, the control unit 110 according to the first embodiment will be described with reference to FIG. The controller 110 controls the operation of the ophthalmic laser treatment apparatus 1A. The control unit 110 of the first embodiment includes a CPU 111 (processor), a ROM 112, a RAM 113, and a nonvolatile memory 114. The CPU 111 controls each unit in the ophthalmic laser treatment apparatus 1A. The ROM 112 stores various programs, initial values, and the like. The RAM 113 temporarily stores various information. The nonvolatile memory 114 is a non-transitory storage medium that can retain stored contents even when power supply is interrupted. For example, a USB memory detachably attached to the control unit 110, a flash ROM incorporated in the control unit 110, or the like may be used as the nonvolatile memory 114.

  In the first embodiment, the control unit 110 includes the laser light source 11, the motor 81, the photodetector 82, the shutter drive unit 83, the motor 84, the first aiming light source 71, the shutter drive unit 85, the lamp 41, and the mirror drive unit 91. , A motor 92, a photodetector 93, a second aiming light source 94, a mirror driving unit 95, an operation panel unit 105, a joystick unit 106, a trigger switch 116, a display screen 115, and the like are connected. The display screen 115 of the first embodiment displays various setting states of the ophthalmic laser treatment apparatus 1A. The trigger switch 116 is operated by the operator to transmit a trigger signal for the treatment laser beam. The trigger switch 116 of the first embodiment is a foot switch. The mode of the trigger switch 116 is not limited to the foot switch. For example, a trigger switch may be provided at the apex of the joystick unit 106.

<How to use the first embodiment>
Next, irradiation of the first wavelength laser beam or the second wavelength laser beam to the affected area using the ophthalmic laser treatment apparatus 1A of the first embodiment will be described. Note that the affected part irradiated with the first wavelength laser light may be different from the affected part irradiated with the second wavelength laser light. The method of using the ophthalmic laser treatment apparatus 1A is not limited to the description described later.

  First, a treatment operation using the first wavelength laser light using the ophthalmic laser treatment apparatus 1A of the first embodiment will be described. The surgeon performs the following operation. First, the operation panel unit 105 is operated to select the first wavelength laser light irradiation mode. Subsequently, various settings of the ophthalmic laser treatment apparatus 1A are performed. Subsequently, the patient's face is fixed to the headrest portion 108, and the contact lens is applied to the patient's eye Ep. Subsequently, the eyepiece 104 is viewed and observed. Subsequently, the joystick unit 106 is operated while observing the observation image to aim the first aiming light at the affected part of the patient's eye Ep. Subsequently, the trigger switch 116 is pressed to irradiate the affected area of the patient's eye Ep with the first wavelength laser beam (pulse laser beam). When detecting that the trigger switch 116 has been pressed, the control unit 110 controls the laser light source 11 to emit pulsed laser light from the laser light source 11. The ophthalmic laser treatment apparatus 1A irradiates a patient's eye Ep with a first wavelength laser beam (pulse laser beam) emitted from a laser light source 11 (Q-switched YAG laser).

  Next, a treatment operation using the second wavelength laser light using the ophthalmic laser treatment apparatus 1A of the first embodiment will be described. The surgeon performs the following operation. First, the operation panel unit 105 is operated to select the second wavelength laser light irradiation mode. Subsequently, various settings of the ophthalmic laser treatment apparatus 1A are performed. Subsequently, the patient's face is fixed to the headrest portion 108, and the contact lens is applied to the patient's eye Ep. Subsequently, the eyepiece 104 is viewed and observed. Subsequently, the joystick unit 106 is operated while observing the observation image to aim the second aiming light at the affected part of the patient's eye Ep. Subsequently, the trigger switch 116 is pressed to irradiate the second wavelength laser beam (pulse laser beam). When detecting that the trigger switch 116 has been pressed, the control unit 110 controls the laser light source 11 to emit pulsed laser light from the laser light source 11. The ophthalmic laser treatment apparatus 1A converts the wavelength of the first wavelength laser beam (pulse laser beam) emitted from the laser light source 11 (Q switch YAG laser) into the second wavelength laser beam, and then converts the second wavelength laser beam. Is applied to the patient's eye Ep.

<Operation and effect of synthesis means>
The optical path length of the observation optical system 30 of the first embodiment will be described. For comparison with the first embodiment, an optical system having the configuration of FIG. 11 is illustrated. FIG. 11 corresponds to a schematic view centered on the dichroic mirror 22 in the first embodiment. The optical system shown in FIG. 11 includes two reflecting members (a member 222 and a member 223) in the observation optical system 30 as a combining unit 29C for combining the observation wavelength optical system 30 with the first wavelength laser beam and the second wavelength laser beam. Is arranged. The member 222 has a first reflecting surface 22A, and the member 223 has a second reflecting surface 22B. When the optical system for comparison shown in FIG. 11 is viewed from a direction (A direction in FIG. 11) orthogonal to the optical axis (L3R, L3L) of the observation optical system, the first reflecting surface 22A and the second reflecting surface 22B are Do not overlap. The combining unit 29C requires a distance LBb. When the distance LBa (see FIGS. 2 and 3) of the synthesizing unit 29A of the first embodiment is compared with the distance LBb of the synthesizing unit 29C for comparison, the relationship of distance LBa <distance LBb is established. That is, in the ophthalmic laser treatment apparatus 1A of the first embodiment, an increase in the optical path length of the observation optical system 30 is suitably suppressed. Thereby, for example, the operator can easily support the contact lens during observation.

  Next, the relationship between the laser light and the observation light in the combining unit 29A will be described in detail with reference to FIGS. FIG. 7B is a view of the dichroic mirror 22 as viewed from the B direction (see FIGS. 2 and 3). The vertical direction of the drawing in FIG. 7B is the Y direction in FIG. In FIG. 7B, the light beam of the observation light is transmitted through the region inside the dotted line indicated by the region OBSr and the region OBSl. FIG. 8B is a view of the dichroic mirror 22 viewed from the C direction (see FIGS. 2 and 3). The vertical direction of the drawing in FIG. 8B is the Y direction in FIG. In FIG. 8B, the light beam of the observation light is transmitted through the region inside the dotted line indicated by the region OBSr and the region OBSl. That is, the observation light is transmitted through the region (first reflection region P1) where the first wavelength laser beam is reflected. In addition, the light beam of the first wavelength laser light is irradiated to the region inside the solid line indicated by the region LSR1 in FIG. The first wavelength laser light is reflected toward the objective lens 23. In FIG. 8B, the second wavelength laser light transmitted through the first reflection region P1 is irradiated to the region inside the solid line indicated by the region LSR2. Then, the second wavelength laser light is reflected toward the objective lens 23 (the reflected second wavelength laser light is transmitted through the first reflection region P1 again). The observation light from the ophthalmic laser treatment apparatus 1A of the first embodiment is transmitted through the first reflection region P1 when passing through the combining unit 29A (dichroic mirror 22), but avoids the second reflection region P2. Thereby, attenuation of observation light is suppressed. Therefore, for example, the operator can observe an observation image with favorable brightness. In addition, the surgeon can observe an observation image in which coloring is suppressed.

  FIG. 9 is a diagram showing the spectral transmission characteristics of the synthesizing unit 29A. FIG. 9 is a diagram of the spectral transmission characteristics of the combining unit 29A with respect to the light beam that passes through the first reflection region P1 and does not pass through the second reflection region P2. In the characteristic diagram shown in FIG. 9, as an example, a wavelength band of 400 to 700 nm, which is generally called a visible wavelength band, is indicated by a solid line. The transmittance in the visible wavelength band is indicated by hatching. Here, FIG. 12 is illustrated for comparison. FIG. 12 is a diagram of spectral transmission characteristics of the combining unit 29A with respect to light rays that pass through the first reflection region P1 and the second reflection region P2. In FIG. 12, similarly to FIG. 9 described above, as an example, a wavelength band of 400 to 700 nm, which is generally called a visible wavelength band, is indicated by a solid line, and the transmittance in the visible wavelength band is indicated by hatching.

  As is apparent from FIG. 12, the light transmitted through the first reflection region P1 and the second reflection region P2 is greatly attenuated by the influence of the second reflection region P2 (for example, the location R2 in FIG. 12). '). As a result, the observation image tends to be dark. Further, since light of a specific wavelength (wavelength band) is greatly attenuated, the observation image is likely to be colored. In the case of the transmission characteristics shown in FIG. 12, since the green wavelength component is attenuated, the observed image is easily colored with a magenta tone. That is, the color reproducibility of the observation image is likely to deteriorate. On the other hand, in the ophthalmic laser treatment apparatus 1A of the first embodiment, since the observation light avoids the second reflection region P2, attenuation of the observation light is suppressed (see FIG. 9). Note that the observation light may not strictly avoid the second reflection region P2. It is only necessary that the overlapping area where the observation light and the first reflection region P1 overlap is larger than the overlapping area where the observation light and the second reflection region P2 overlap. Or the 2nd reflective area | region P2 should just be formed in consideration of the permeation | transmission area | region of observation light.

  FIG. 10 is a diagram of spectral reflection characteristics exemplified for comparison. In order to form the reflective region having the reflective characteristics illustrated in FIG. 10 on the reflective surface used as the combining means, for example, precise coating management may be required. This can make the ophthalmic laser treatment device expensive. In addition, in the case of rough coating management, there is a possibility that the laser beam cannot be reflected with a suitable light amount. On the other hand, the reflection characteristic of the reflection region formed in the combining unit 29A of the first embodiment is simplified more than the spectral reflection characteristic illustrated in FIG. 10 (see FIG. 6). Therefore, it is easy to form the first reflection region P1 and the second reflection region P2. In addition, for example, the first reflection region P1 and the second reflection region P2 can be easily formed with more precise wavelength characteristics. In addition, for example, the composition means 29A of the first embodiment is unlikely to cause individual differences. In the present embodiment, the first wavelength laser beam and the second wavelength laser beam are incident on the combining unit 29A through the same or substantially the same optical path, and are reflected by the combining unit 29A. That is, the optical path of the first wavelength laser beam is close to the optical path of the second wavelength laser beam. Therefore, the optical system of the ophthalmic laser treatment apparatus 1A can be configured simply (see FIG. 11 for comparison). For example, the first wavelength laser beam and the second wavelength laser beam can be coaxially (or substantially coaxially) incident on the combining unit 29A. For example, it is possible to irradiate the patient's eye Ep with a treatment laser beam with good light collection accuracy. A case where the first wavelength laser beam is reflected by the second reflecting surface 22B is considered as a comparative example. In this comparative example, the first wavelength laser light may be affected by the coating boundary surface when passing through the first reflecting surface 22A, resulting in a decrease in beam quality, a decrease in transmittance, and the like. Further, it is conceivable that the beam quality of the first wavelength laser beam is lowered by passing through the twice refracting surface (twice the first reflecting surface 22A). Due to the deterioration of the beam quality, there is a possibility that plasma is hardly generated in the affected area when the first-wavelength laser light is irradiated to the patient's eye Ep.

<Example of transformation of synthesis means>
Next, a modification example of the combining unit 29A (dichroic mirror 22) exemplified as the first embodiment will be described. FIG. 13 is a diagram in which two mirrors (mirror 26 and mirror 27) are provided instead of the dichroic mirror 22 of the first embodiment. In other words, the composition unit 29 </ b> A of the modification example includes the mirror 26 and the mirror 27. The mirror 26 includes a reflective surface 26A and an optical surface 26B, and the mirror 27 includes a reflective surface 27A and an optical surface 27B. The mirror 26 and the mirror 27 in the modification example are plate-like optical members.

  The mirror 26 and the mirror 27 are arranged to be inclined in the same direction (patient eye Ep side) with respect to the optical axis L3R (optical axis L3L) of the observation optical system 30. The mirror 26 and the mirror 27 are separated from each other. The reflecting surfaces 26A and 27A have parallel optical surfaces. The area of the reflective surface 26A in the modification example is the same as the area of the first reflective surface 22A in the first embodiment. The reflective surface 27A of the modification example has the same area as the second reflective surface 22B of the first embodiment. As with the first reflection surface 22A of the dichroic mirror 22, a first reflection region P1 is formed on the reflection surface 26A. Similar to the second reflection surface 22B of the dichroic mirror 22, a second reflection region P2 is formed on the reflection surface 27A.

  In the modification example, the first wavelength laser beam is reflected by the reflecting surface 26A, and the second wavelength laser beam is reflected by the reflecting surface 27A. Further, the observation light is transmitted through the reflecting surface 26A and the reflecting surface 27A. As the combining means 29A, it is only necessary to provide the observation optical system 30 with the approximate distance LBa. Therefore, an increase in the optical path length (see the distance LA in FIGS. 1 to 3) of the observation optical system 30 of the ophthalmic laser treatment apparatus 1A can be suppressed. In addition, although the case where two plate-shaped optical members were used was illustrated as a modification example, the formation mode of the first reflection surface 22A and the second reflection surface 22B is not limited to this. For example, a solid or liquid may be interposed between the first reflecting surface 22A and the second reflecting surface 22B.

<Operation and Effect of First Embodiment>
An ophthalmic laser treatment apparatus 1A according to the first embodiment includes an observation optical system 30 that observes an affected area of a patient's eye Ep, and a first reflection region P1 that is provided in the observation optical system 30 and reflects a first wavelength laser beam. The first reflection surface 22A and the second reflection surface 22B having the second reflection region P2 provided in the observation optical system 30 and reflecting the second wavelength laser light are provided. In addition, when viewed from a direction orthogonal to the observation optical axis (optical axis L3R, optical axis L3L) of the observation optical system 30 (for example, the A direction in FIG. 2), at least the first reflection surface 22A and the second reflection surface 22B Part of them overlaps, and the observation light of the observation optical system 30 passes through the first reflection surface 22A and the second reflection surface 22B.

  Thereby, for example, an increase in the optical path length of the observation optical system 30 (see the distance LA in FIGS. 1 to 3) can be suppressed. Since an increase in the distance between the operator's face and the patient's eye Ep can be suppressed, the operator can preferably observe the patient's eye Ep. For example, the operator can easily support the contact lens 24 while observing the patient's eye Ep. Moreover, in 1st Embodiment, although the structure of the observation optical system 30 is simple, it can irradiate the patient eye Ep with the multiple types of treatment laser light from which a wavelength differs. Since the configuration of the observation optical system 30 is simple, for example, it is easy to manufacture the ophthalmic laser treatment apparatus 1A. In addition, when viewed from the direction orthogonal to the observation optical axis of the observation optical system 30, at least a part of the first reflection surface 22A and the second reflection surface 22B overlap, for example, a plurality of types having different wavelengths. The treatment laser light can be merged at one place on the optical path of the observation optical system 30 (the position of the dichroic mirror 22 in the first embodiment). Further, in the synthesizing unit 29A (dichroic mirror 22), the first reflection region P1 that reflects the first wavelength laser beam and the second reflection region P2 that reflects the second wavelength laser beam are formed on different surfaces. Thereby, the combining means 29A that reflects the first wavelength laser beam and the second wavelength laser beam can be easily manufactured.

  Further, the ophthalmic laser treatment apparatus 1A of the first embodiment has a laser light source 11 that emits a first wavelength laser beam, and a wavelength that converts the first wavelength laser beam emitted by the laser light source 11 into a second wavelength laser beam. Conversion means (wavelength converter 62) is provided. Accordingly, the ophthalmic laser treatment apparatus 1A can irradiate a plurality of types of treatment laser beams having different wavelengths with a simple configuration. For example, an increase in the number of laser light sources provided in the ophthalmic laser treatment apparatus can be suppressed. Therefore, for example, the ophthalmic laser treatment apparatus 1A can be provided at a low cost. In addition, the manufacture or installation of the ophthalmic laser treatment apparatus 1A is facilitated. Moreover, the enlargement of the ophthalmic laser treatment apparatus 1A can be suppressed.

  In addition, the second wavelength laser light of the ophthalmic laser treatment apparatus 1A of the first embodiment is reflected by the second reflection region P2 after passing through the first reflection region P1. Accordingly, for example, the first wavelength laser beam can be efficiently reflected by the first reflection region P1 while the second wavelength laser beam is reflected by the second reflection region P2. For example, the number of times that the first wavelength laser light passes through the surface or bonding surface of the optical member can be reduced. Therefore, unnecessary internal reflection can be suppressed. The first wavelength laser beam having a larger beam diameter than the second wavelength laser beam can be suitably focused on the affected part of the patient's eye Ep. For example, high-quality plasma can be generated in the affected area using the first wavelength laser beam. In other words, the first wavelength laser beam and the second wavelength laser beam are preferably condensed by transmitting the second wavelength laser beam having a smaller incident angle to the affected part than the first wavelength laser beam through the first reflection region P1. It can be focused on the patient's eye Ep due to its characteristics.

  Further, the first reflecting surface 22A and the second reflecting surface 22B of the first embodiment are inclined in the same direction with respect to the optical axis L3 (optical axis L3R, optical axis L3L) of the observation optical system 30. . Thereby, for example, a plurality of types of different treatment laser beams are easily incident on the first reflecting surface 22A or the second reflecting surface 22B in a coaxial manner. In addition, the observation optical system 30 can be easily manufactured.

  Moreover, the ophthalmic laser treatment apparatus 1A of the first embodiment includes a plate-type optical member having optical surfaces formed on both sides. The first reflecting surface 22A is provided on one surface of the optical member, and the second reflecting surface is provided on the other surface. Accordingly, for example, the ophthalmic laser treatment apparatus 1A can include the first reflecting surface 22A and the second reflecting surface 22B with a simple configuration. The first reflecting surface 22A and the second reflecting surface 22B can be manufactured at low cost. Assembly of the ophthalmic laser treatment apparatus 1A is facilitated.

  In the ophthalmic laser treatment apparatus 1A of the first embodiment, the first wavelength laser light is infrared light, and the second wavelength laser light is visible light. The overlapping area where the observation light and the first reflection region P1 overlap is larger than the overlapping area where the observation light and the second reflection region P2 overlap. Thereby, for example, the phenomenon that the observation light is dimmed in the observation optical system 30 can be suppressed. Therefore, the surgeon can confirm an observation image with suitable brightness. In addition, the observation optical system 30 can suppress the phenomenon that the observation image is colored. In other words, an event in which the color reproducibility or color rendering performance is lowered in the observation optical system 30 can be suppressed. Therefore, the surgeon can observe an observation image having a favorable color tone. In this disclosure, it will be easily understood by those skilled in the art that the observation light and the second reflection region P2 do not necessarily overlap (that is, the overlapping area may be zero).

  In the ophthalmic laser treatment apparatus 1A of the first embodiment, the area of the first reflection region P1 formed on the first reflection surface 22A is larger than the area of the second reflection region P2 formed on the second reflection surface 22B. Is also big. Thus, for example, the operator can observe an observation image with favorable image quality while reflecting the first wavelength laser beam having a large light beam diameter by the first reflecting surface 22A. For example, it is easy to irradiate the affected part of the patient's eye Ep with a treatment laser beam having a large incident angle. As an example, it is easy to treat the affected part of the patient's eye Ep with plasma.

  In addition, the ophthalmic laser treatment apparatus 1A of the first embodiment transmits a plurality of separated observation lights through the second reflecting surface 22B (the reflecting surface 25a in the second embodiment), and the optical paths of the separated plurality of observation lights. A second reflection region P2 is formed between (transmission regions). Accordingly, for example, the second reflecting surface 22B can be easily installed on the observation optical system 30. Further, an increase in the area of the ophthalmic laser treatment apparatus 1A in the direction intersecting the optical axis L3 of the observation light can be suppressed. In addition, the provision of the second reflecting surface 22B in the observation optical system 30 can suppress an event that the image quality of the observation image is degraded.

  In addition, the ophthalmic laser treatment apparatus 1A of the first embodiment causes the first wavelength laser beam and the second wavelength laser beam to be coaxially incident on the first reflecting surface 22A or the second reflecting surface 22B, thereby performing the second embodiment. In the form of the ophthalmic laser treatment apparatus 1A, the first wavelength laser beam and the second wavelength laser beam are coaxially incident on the reflection surface 25a. Thereby, for example, the first reflecting surface 22A and the second reflecting surface 22B (the reflecting surface 25a in the second embodiment) can be installed in the observation optical system 30 with a simple configuration. Further, the observation optical system 30 and the irradiation optical system 10 can be easily connected. As an example, the manufacture of the ophthalmic laser treatment apparatus 1A is facilitated.

  In the ophthalmic laser treatment apparatus 1A of the first embodiment, the observation optical system 30 includes the objective lens 23, and the observation optical system 30 includes the first reflection surface 22A and the second reflection surface 22B (second embodiment). In the form, the objective lens 23 is arranged closer to the patient's eye Ep than the reflecting surface 25a). Thereby, for example, the front of the patient's eye Ep can be simplified. Moreover, it is easy to irradiate the affected part of the patient's eye Ep with a treatment laser beam having a large incident angle while making the front of the patient's eye Ep simple.

  Further, the ophthalmic laser treatment apparatus 1A used in the first embodiment uses the first wavelength laser light to photodisrupt or rupture the tissue of the patient eye Ep, and uses the second wavelength laser light to the patient eye Ep. Lightly heat the tissue. Accordingly, for example, the ophthalmic laser treatment apparatus 1A has a simple configuration, but the operator can preferably observe the observation site, and can easily treat a plurality of types of affected areas.

Second Embodiment
Next, an ophthalmic laser treatment apparatus 1B according to the second embodiment will be described with reference to FIGS. FIG. 14 is a diagram of the optical surface of the combining means 29B provided in the ophthalmic laser treatment apparatus 1B (see FIGS. 1 to 3) of the second embodiment. The configuration of the ophthalmic laser treatment apparatus 1B may be simply changed from the configuration of the synthesizing unit 29A to the synthesizing unit 29B with respect to the configuration of the ophthalmic laser therapy apparatus 1A of the first embodiment. Moreover, the usage method of the ophthalmic laser treatment apparatus 1B of the second embodiment and the usage method of the ophthalmic laser treatment apparatus 1A of the first embodiment may be the same. Hereinafter, only the difference will be described on the assumption that the place of the combining unit 29A of the ophthalmic laser treatment apparatus 1A of the first embodiment is replaced with the combining unit 29B. In FIGS. 1 to 3, the differences between the first embodiment and the second embodiment are indicated by reference numerals with parentheses.

<Synthesis means>
The synthesizing means 29B (dichroic mirror 25) of the second embodiment will be described in detail with reference to FIGS. Note that description of the same reference numerals as in the first embodiment may be omitted. The synthesizing means 29B of the second embodiment has a plurality of optical surfaces. The synthesizing means 29B of the second embodiment is a plate-type optical member having optical surfaces formed on both sides. Of the optical surfaces arranged on both surfaces of the plate-like optical member, one optical surface is the reflecting surface 25A, and the other optical surface is the optical surface 25B. In the second embodiment, the first wavelength laser beam and the second wavelength laser beam are reflected by the reflecting surface 25A. The dimensions (vertical / horizontal / thickness) of the dichroic mirror 25 of the second embodiment are the same as the dimensions of the dichroic mirror 22 of the first embodiment.

  The reflection surface 25A of the second embodiment is disposed to be inclined with respect to the optical axis L3R (optical axis L3L) of the observation optical system 30. Similar to the first embodiment, the reflecting surface 25A is inclined toward the patient's eye Ep side. The reflecting surface 25A and the optical surface 25B of the second embodiment are parallel to each other. In the second embodiment, the observation light of the observation optical system 30 is transmitted through the reflection surface 25A and the optical surface 25B (see FIGS. 2 and 3). In the second embodiment, as viewed from the patient's eye Ep side, the reflective surface 25A is disposed on the front side, and the optical surface 25B is disposed on the back side (see FIG. 2).

  The reflection surface 25A of the second embodiment includes a first reflection region P1 that reflects the first aiming light, the second aiming light, and the first wavelength laser light, and a second reflection region P2 that reflects the second wavelength laser light. Are divided (see FIG. 14A). That is, a plurality of reflection regions having different reflection characteristics are formed on the reflection surface 25A of the second embodiment. In the second embodiment, different coating processes are performed on the surface of the optical surface to form the first reflection region P1 and the second reflection region P2. Thereby, a dichroic mirror coat is formed on the surface of the optical surface. In the second embodiment, the first reflection region P1 is formed around the second reflection region P2. In the second embodiment, the first reflection region P1 is formed in a region where the second reflection region P2 of the optical surface is not formed.

  The first reflection region P1 of the second embodiment has the same reflection characteristics as the first reflection region P1 of the first embodiment. The second reflection region P2 of the second embodiment has the same reflection characteristics as the second reflection region P2 of the first embodiment. The second reflection region P2 may have reflection characteristics that can also reflect the first wavelength laser beam. As an example, the reflection characteristic of the second reflection region P2 may be the reflection characteristic shown in FIG. That is, the first wavelength laser beam and the second wavelength laser beam are reflected by the second reflecting surface. Also in this case, the first reflection region P1 is formed around the second reflection region P2. By forming in this way, the first wavelength laser beam and the second wavelength laser beam incident on the reflecting surface 25A are prevented from being damaged by the reflecting surface 25A, and the first wavelength laser beam and The second wavelength laser light can be reflected. In the second embodiment, an elliptical second reflection region P2 is formed at the center of the reflection surface 25A. In other words, the second reflection region P2 is formed on a line segment connecting the optical axis L3R of the observation light and the optical axis L3L (see FIG. 15B).

  In the second embodiment, the area of the first reflection region P1 formed on the reflection surface 25A is larger than the area of the second reflection region P2. Further, as in the first embodiment, the second reflection region P2 is formed in a shape that reduces the overlap with the observation light (see FIG. 15B). In addition, the shape or area of the 1st reflection area | region P1 and the 2nd reflection area | region P2 is not restricted to the aspect of FIG. As an example, the area of the first reflection region P1 may be smaller than the area of the second reflection region P2. Further, the first reflection region P1 (or the second reflection region P2) formed on the reflection surface may be separated. The optical surface 25B preferably has a spectral transmission characteristic that suppresses attenuation of visible light. For example, an antireflection film (coat) that prevents unnecessary internal reflection may be formed on the optical surface 25B. .

<Operation and effect of synthesis means>
Similarly to the ophthalmic laser treatment apparatus 1A of the first embodiment, the optical path length of the observation optical system 30 is suitably suppressed in the ophthalmic laser treatment apparatus 1B of the second embodiment (for details, see the first embodiment). Please refer to the explanation). The relationship between the laser light and the observation light in the combining unit 29B (dichroic mirror 25) will be described with reference to FIG. FIG. 15 is a view of the dichroic mirror 25 as seen from the B direction (see FIGS. 2 and 3). The reference numerals in FIG. 15 are the same as those in FIGS. Further, in FIG. 15, a view of the dichroic mirror 25 viewed from the C direction is omitted.

  Similarly to the first embodiment, in the second embodiment, the observation light is transmitted through the region (first reflection region P1) where the first wavelength laser light is reflected. The second wavelength laser light of the first embodiment is reflected by the second reflecting surface 22B after passing through the first reflecting surface 22A where the first reflecting region P1 is formed. On the other hand, the 2nd wavelength laser beam of 2nd Embodiment is reflected on the surface, without permeate | transmitting the surface of the synthetic | combination means 29B. Thereby, for example, the optical path of the first wavelength laser beam and the optical path of the second wavelength laser beam can be made closer. In addition, since the laser light is reflected on the surface of the combining unit 29B, unnecessary reflection or the like hardly occurs. For example, unnecessary reflection occurring inside the optical member can be suppressed. Therefore, for example, it is possible to suppress deterioration in the quality of the treatment laser beam.

  Similar to the first embodiment, the observation light of the ophthalmic laser treatment apparatus 1B of the second embodiment avoids the second reflection region P2 when passing through the combining means 29B (dichroic mirror 25). This suppresses the attenuation of the observation light used by the operator for observation (see the description of the first embodiment). Therefore, for example, the operator can observe an observation image with favorable brightness. In addition, the surgeon can observe a colored observation image.

<Operation and Effect of Second Embodiment>
That is, the ophthalmic laser treatment apparatus 1B using the synthesizing unit 29B (reflection surface 25a) of the second embodiment is provided in the observation optical system 30 for observing the affected part of the patient eye Ep and the observation optical system 30, and A reflecting surface 25a that reflects the one-wavelength laser light and the second-wavelength laser light. On the reflection surface 25a, a first reflection region P1 that reflects the first wavelength laser light and a second reflection region P2 that reflects the second wavelength laser light are separately formed, and the reflection surface 25a is observed with the observation optical system. 30 observation lights are transmitted.

  Thereby, as an example, an increase in the optical path length of the observation optical system 30 can be suppressed. Since an increase in the distance between the operator's face and the patient's eye Ep can be suppressed, the operator can preferably observe the patient's eye Ep. The operator can easily support the contact lens 24 brought into contact with the patient's eye Ep with his / her hand while observing the patient's eye Ep. In addition, a simple configuration of the observation optical system 30 can favorably reflect a plurality of types of treatment laser beams having different wavelengths. Therefore, manufacture or installation of the ophthalmic laser treatment apparatus 1B is facilitated. For example, a plurality of types of treatment laser beams having different wavelengths can be merged into the observation optical system 30 at one place.

  The ophthalmic laser treatment apparatus 1B according to the second embodiment includes a laser light source 11 that emits a first wavelength laser beam, and a wavelength that converts the first wavelength laser beam emitted by the laser light source 11 into a second wavelength laser beam. Conversion means (wavelength converter 62) is provided. Accordingly, the ophthalmic laser treatment apparatus 1A can irradiate a plurality of types of treatment laser beams having different wavelengths with a simple configuration. For example, an increase in the number of laser light sources provided in the ophthalmic laser treatment apparatus can be suppressed. Therefore, for example, the ophthalmic laser treatment apparatus 1A can be provided at a low cost. Manufacture or installation of the ophthalmic laser treatment apparatus 1A is facilitated. Moreover, the enlargement of the ophthalmic laser treatment apparatus 1A can be suppressed.

  Further, in the ophthalmic laser treatment apparatus 1B of the second embodiment, the first reflection region P1 is formed around the second reflection region P2. Thereby, for example, it is easy to irradiate the affected part of the patient's eye Ep from the same direction with a plurality of types of treatment laser beams having different wavelengths. Moreover, in the irradiation optical system 10, it is easy to share (coaxial) the optical paths of a plurality of types of treatment laser beams having different wavelengths. For example, the members of the irradiation optical system 10 can be shared in the optical paths of a plurality of types of treatment laser beams having different wavelengths. Therefore, the ophthalmic laser treatment apparatus 1B can be provided at low cost.

  In the ophthalmic laser treatment apparatus 1A of the first embodiment and the ophthalmic laser treatment apparatus 1B of the second embodiment, the first wavelength laser light is infrared light, and the second wavelength laser light is visible light. . The overlapping area where the observation light and the first reflection region P1 overlap is larger than the overlapping area where the observation light and the second reflection region P2 overlap. Thereby, for example, the phenomenon that the observation light is dimmed in the observation optical system 30 can be suppressed. Therefore, the surgeon can confirm an observation image with suitable brightness. In addition, the observation optical system 30 can suppress the phenomenon that the observation image is colored. In other words, an event in which the color reproducibility or color rendering performance is lowered in the observation optical system 30 can be suppressed. Therefore, the surgeon can observe an observation image having a favorable color tone. In this disclosure, it will be easily understood by those skilled in the art that the observation light and the second reflection region P2 do not necessarily overlap (that is, the overlapping area may be zero).

  Further, in the ophthalmic laser treatment apparatus 1A of the first embodiment and the ophthalmic laser treatment apparatus 1B of the second embodiment, the area of the first reflection region P1 formed on the first reflection surface 22A is the second reflection surface. It is larger than the area of the second reflection region P2 formed in 22B. Thus, for example, the operator can observe an observation image with favorable image quality while reflecting the first wavelength laser beam having a large light beam diameter by the first reflecting surface 22A. For example, it is easy to irradiate the affected part of the patient's eye Ep with a treatment laser beam having a large incident angle. As an example, it is easy to treat the affected part of the patient's eye Ep with plasma.

  In the ophthalmic laser treatment apparatus 1A of the first embodiment and the ophthalmic laser treatment apparatus 1B of the second embodiment, the plurality of separated observation lights are reflected on the second reflection surface 22B (the reflection surface 25a in the second embodiment). The second reflection region P2 is formed between the optical paths (transmission regions) of the plurality of observation lights that are transmitted through and separated. Accordingly, for example, the second reflecting surface 22B can be easily installed on the observation optical system 30. Moreover, the increase in the area of the ophthalmic laser treatment apparatus (1A, 1B) in the direction intersecting the optical axis L3 of the observation light can be suppressed. In addition, the provision of the second reflecting surface 22B in the observation optical system 30 can suppress an event that the image quality of the observation image is degraded.

  In addition, the ophthalmic laser treatment apparatus 1A of the first embodiment causes the first wavelength laser beam and the second wavelength laser beam to be coaxially incident on the first reflecting surface 22A or the second reflecting surface 22B, thereby performing the second embodiment. In the form of the ophthalmic laser treatment apparatus 1B, the first wavelength laser beam and the second wavelength laser beam are coaxially incident on the reflection surface 25a. Thereby, for example, the first reflecting surface 22A and the second reflecting surface 22B (the reflecting surface 25a in the second embodiment) can be installed in the observation optical system 30 with a simple configuration. Further, the observation optical system 30 and the irradiation optical system 10 can be easily connected. As an example, manufacture of the ophthalmic laser treatment apparatus (1A, 1B) is facilitated.

  In the ophthalmic laser treatment apparatus 1A of the first embodiment and the ophthalmic laser treatment apparatus 1B of the second embodiment, the observation optical system 30 includes the objective lens 23, and the observation optical system 30 includes the first The objective lens 23 is disposed closer to the patient's eye Ep side than the reflecting surface 22A and the second reflecting surface 22B (the reflecting surface 25a in the second embodiment). Thereby, for example, the front of the patient's eye Ep can be simplified. Moreover, it is easy to irradiate the affected part of the patient's eye Ep with a treatment laser beam having a large incident angle while making the front of the patient's eye Ep simple.

  Further, the ophthalmic laser treatment apparatus 1A used in the first embodiment and the ophthalmic laser treatment apparatus 1B used in the second embodiment use the first wavelength laser light to photodisrupt or light the tissue of the patient's eye Ep. The tissue of the patient eye Ep is optically heated using the second wavelength laser light. Thus, for example, the ophthalmic laser treatment apparatus (1A, 1B) has a simple configuration, but the operator can preferably observe the observation site and can easily treat a plurality of types of affected areas.

<Others>
In the first embodiment and the second embodiment, the observation light is transmitted while avoiding the second reflection region P2, but the observation light and the second reflection region P2 may overlap. As an example, the illumination optical system 40 may be provided with a color tone changing means (for example, a coating process on the optical surface) that changes the spectral wavelength characteristic of the illumination light. Alternatively, separately from the second reflection region P2, the observation optical system 30 may be provided with a color tone changing means (for example, a coating process on the optical surface) that changes the spectral wavelength characteristic of the observation light. That is, the wavelength balance of the observation light that changes in the second reflection region P2 may be compensated (cancelled) by the color tone conversion means provided in the ophthalmic laser treatment apparatus. However, by using the color tone changing means, it is necessary to increase the light amount of the observation light source, or the observation image may become dark. Therefore, the smaller the overlapping area between the observation light and the second reflection region P2, the better.

  In the first embodiment and the second embodiment, the irradiation optical system 10 is housed in the housing of the ophthalmic laser treatment apparatus (1A, 1B), but the aspect of the irradiation optical system 10 is not limited to this. No. For example, the irradiation optical system 10 may be formed as a separate unit (delivery unit). Specifically, another unit including the irradiation optical system 10 may be detachable from an apparatus having observation means for the patient's eye Ep.

  In the first embodiment and the second embodiment, the synthesizing unit 29 (29A, 29B) is configured by a plate-like optical member, but the mode of the synthesizing unit 29 is not limited to this. For example, the combining means may be formed using a prism-shaped member.

  It should be thought that embodiment disclosed this time is an illustration and restrictive at no points. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.

1A: Laser treatment apparatus for ophthalmology 11: Laser light source 22: Dichroic mirror 22A: First reflection surface 22B: First reflection surface 25: Dichroic mirror 25A: Reflection surface 30: Observation optical system 62: Wavelength converter Ep: Patient eye P1 : First reflection area P2: Second reflection area

Claims (9)

An observation optical system for observing the affected area of the patient's eye;
A reflection surface provided in the observation optical system and reflecting the first wavelength laser beam and the second wavelength laser beam;
With
The reflection surface is formed by dividing a first reflection region that reflects the first wavelength laser beam and a second reflection region that reflects the second wavelength laser beam,
Observation light of the observation optical system is transmitted through the reflection surface.
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment device according to claim 1,
A laser light source for emitting the first wavelength laser light;
Wavelength converting means for converting the first wavelength laser light emitted by the laser light source into the second wavelength laser light;
An ophthalmic laser treatment apparatus, further comprising: The ophthalmic laser treatment apparatus according to claim 1 or 2,
The first reflective region is formed around the second reflective region;
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to any one of claims 1 to 3,
The first wavelength laser light is infrared light,
The second wavelength laser light is visible light,
The overlapping area where the observation light and the first reflection region overlap is larger than the overlapping area where the observation light and the second reflection region overlap.
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to claim 4,
The area of the first reflection region formed on the reflection surface is larger than the area of the second reflection region formed on the reflection surface,
An ophthalmic laser treatment apparatus characterized by the above. An ophthalmic laser treatment apparatus according to any one of claims 1 to 5,
A plurality of separated observation lights are transmitted through the reflecting surface,
The second reflection region is formed between the plurality of separated observation lights,
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to any one of claims 1 to 6,
The first wavelength laser beam and the second wavelength laser beam are coaxially incident on the reflecting surface;
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to any one of claims 1 to 7,
The observation optical system includes an objective lens,
In the observation optical system, the objective lens is disposed closer to the patient's eye than the reflecting surface.
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to any one of claims 1 to 8,
Photodisrupting or rupturing the tissue of the patient's eye using the first wavelength laser light,
Optically heating the tissue of the patient's eye using the second wavelength laser light,
An ophthalmic laser treatment apparatus characterized by the above.

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