JP2017196273A - Ophthalmic laser treatment apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ophthalmic laser treatment apparatus capable of applying treatment laser light to a treatment side without causing an operator to hold a contact lens.SOLUTION: The ophthalmic laser treatment apparatus for applying laser light to a patient's eye to perform treatment includes: a jaw placement base for supporting the head of the patient; a contact lens part coming into contact with the patient's eye; a laser irradiation optical system including the contact lens part and applying the treatment laser light to the patient's eye; and a holding mechanism for constantly holding the contact lens part on an optical axis of the laser irradiation optical system. The holding mechanism holds the contact lens part so as to match an intermediate imaging position of the laser irradiation optical system with a front-side focal position of the contact lens part.SELECTED DRAWING: Figure 1

Description

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

  A laser treatment apparatus for coagulating the fundus of a patient's eye is known (see, for example, Patent Document 1). As a method of using such a laser treatment apparatus, there is known a method in which a contact lens (front lens) gripped by an operator is brought into contact with a patient's eye and treatment laser light is irradiated to the fundus of the patient's eye through the contact lens. It has been.

JP 2009-233303 A

  By the way, when performing treatment with a treatment laser beam using a contact lens, the surgeon needs to perform various operations of the laser treatment apparatus with the other hand while holding the contact lens with one hand. The degree of freedom is limited, and it is easy for the surgeon. Furthermore, since the contact lens is continuously held by the surgeon's hand during treatment, the contact state between the contact lens and the patient's eye may easily become unstable.

  An object of the present invention is to provide an ophthalmic laser treatment apparatus that can irradiate a treatment laser beam to a treatment site without an operator grasping a contact lens.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) An ophthalmic laser treatment apparatus that performs treatment by irradiating a patient's eye with laser light includes: a chin rest for supporting a patient's head; a contact lens unit that contacts the patient's eye; and the contact lens unit. A laser irradiation optical system for irradiating treatment laser light to the patient's eye, and a holding mechanism for constantly holding the contact lens unit on the optical axis of the laser irradiation optical system, the holding mechanism Holds the contact lens unit so as to match the intermediate imaging position of the laser irradiation optical system and the front focal position of the contact lens unit,
It is characterized by that.

  ADVANTAGE OF THE INVENTION According to this invention, the ophthalmic laser treatment apparatus which can irradiate a treatment laser beam to a treatment site | part, without an operator holding | grip a contact lens can be provided.

1 is a schematic view of an ophthalmic laser treatment apparatus. It is the schematic of a control part. It is a flowchart concerning control of a control part. It is a flowchart concerning control of a control part.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic view of an ophthalmic laser treatment apparatus 1 according to this embodiment. FIG. 2 is a schematic diagram of the control unit 80 of the ophthalmic laser treatment apparatus 1. The ophthalmic laser treatment apparatus 1 of this embodiment can be used for retinal photocoagulation as an example.

  An ophthalmic laser treatment apparatus 1 according to this embodiment includes a main body 2 for housing an optical system (laser irradiation optical system 10 and the like), a base 3 for supporting the main body 2, a main body 2 and a base 3. And a moving mechanism 4 (first moving means) for moving the main body 2 in the three-dimensional direction (vertical / horizontal / front-rear direction) on the base 3. The moving mechanism 4 of the present embodiment includes a motor (actuator) for moving the main body 2.

  The fixing unit 5 is used to fix (hold) the patient's head Ph. In this embodiment, the fixing unit 5 is connected to the base unit 3. The fixing portion 5 supports the chin rest 5a for suppressing the vertical movement of the head Ph, the forehead support 5b for suppressing the front / rear / left / right movement of the head Ph, and the chin rest 5a and the forehead support 5b. Including the supporting base 5c. The moving mechanism 4 described above can move the main body 2 relative to the head Ph fixed to the fixing portion 5 in a three-dimensional direction. In other words, the moving mechanism 4 can move the main body 2 relative to the chin rest 5a. In the present embodiment, the fixing unit 5 includes the chin rest 5a and the forehead support 5b. However, the fixing unit 5 is not limited to this, and the member of the fixing unit comes into contact with the patient's head and the patient's eye E It is only necessary to suppress unnecessary movement. For example, the fixing portion 5 may include only one of the chin rest 5a and the forehead rest 5b. The forehead support 5b may be provided with a band for further fixing the head Ph. In addition, the base part 3 and the fixing | fixed part 5 may be integrally molded. For example, the chin rest 5a and the forehead support 5b may be integrally formed. The chin rest 5a may be movable in the vertical direction or the horizontal direction with respect to the support base 5c (base part 3).

  The main body 2 of the present embodiment includes a laser irradiation optical system 10 for irradiating the patient's eye E with the treatment laser light, an illumination optical system 20 for projecting the observation illumination light to the patient's eye E, and the patient's eye E. An observation optical system 30 for observing and a fixation target optical system 40 for guiding a treatment site. In this embodiment, at least the optical axis L1 of the laser irradiation optical system 10, the optical axis of the illumination optical system 20, the optical axis of the observation optical system 30, and the optical axis of the fixation target optical system 40 are dichroic mirror 24. The optical system is coaxial on the patient eye E side, and these optical systems share the contact lens unit 100.

  The contact lens unit 100 of this embodiment is in contact with the patient's eye E. The contact lens unit 100 according to the present embodiment supports the lens 18a, the lens 18b that is in contact with the patient's eye E, and the lens 18a and the lens 18b at predetermined intervals so as to have a preset optical design. Group 51 is included. The support base 51 is a cylindrical member having a substantially conical shape that tapers toward the distal end. The distal end of the support base 51 is sized so as to come into contact with the cornea of the patient's eye together with the lens 18b. In the following description, the optical elements (the lens 18a and the lens 18b) included in the contact lens unit 100 may be collectively referred to as a contact lens 18. Note that the ophthalmic laser treatment apparatus 1 of the present embodiment can use (wear) a commercially available product (a general-purpose product such as an Area Centralis (registered trademark), Quadr Aspheric lens) as the contact lens unit 100.

  In the present embodiment, a display unit 95 that displays an observation image of the patient's eye E and the like is connected to the housing of the main body 2. The display means 95 of this embodiment includes a monitor 95a and a touch panel 95b. The monitor 95a displays an observation image of the patient's eye E, treatment laser light irradiation conditions, a setting screen of the ophthalmic laser treatment apparatus 1, and the like. The surgeon can operate the touch panel 95b attached to the monitor 95a to instruct treatment laser light irradiation conditions, various settings of the ophthalmic laser treatment apparatus 1, and the like. That is, the display means 95 of this embodiment has a function as an operation input means.

  A holding mechanism 55 (detachable mechanism for holding the contact lens portion 100 detachably on the optical axis L1 of the laser irradiation optical system 10 is provided on the patient-side surface (front surface) of the main body 2 of the present embodiment. Including holding means). In other words, the holding mechanism 55 of this embodiment always holds the contact lens unit 100 on the optical axis L1 of the laser irradiation optical system 10. The holding mechanism 55 is provided at a position designed in advance so that the optical axis of the attached contact lens unit 100 and the optical axis L1 of the laser irradiation optical system 10 are coaxial. In the present embodiment, the mounting position of the contact lens unit 100 with respect to the main body unit 2 is determined by the holding mechanism 55 so that the optical axis of the contact lens unit 100 and the optical axis of the laser irradiation optical system 10 are coaxial. However, it is not limited to this. In order to suppress disturbance of optical elements such as noise light caused by being coaxial, the axis is deliberately slightly shifted within a range that does not affect the laser light treatment, and the contact lens unit 100 and the laser irradiation optical system 10 The contact lens unit 100 may be mounted with the optical axes substantially matched. By such a holding mechanism 55, contact lens portions of different types (optical characteristics and the like) can be selectively attached to the main body portion 2. In addition, since the contact lens unit 100 can be easily removed, the contact lens unit 100 can be easily cleaned and cleaned after the treatment using the ophthalmic laser treatment apparatus 1.

  Further, the housing of the main body 2 and the holding mechanism 55 are connected via an elastic member 52. The main body 2 of the present embodiment includes a pressure sensor 53 (contact pressure detecting means) for detecting the contact pressure between the patient's eye E and the contact lens unit 100. Furthermore, the main body 2 of the present embodiment includes a moving mechanism 54 (second moving means) for moving the holding mechanism 55 itself in the front-rear direction along the optical axis L1 of the laser irradiation optical system 10. By driving the moving mechanism 54, the holding mechanism 55 can move a little back and forth in the optical axis direction, and the contact lens unit 100 attached to the holding mechanism 55 can also move in accordance with the back-and-forth movement of the holding mechanism 55. Note that the moving mechanism 54 of the present embodiment includes a motor for moving the contact lens unit 100.

  In the present embodiment, the contact lens unit 100 and the optical elements of the optical systems other than the laser light source 11 are assembled to the frame 6. The housing of the main body 2 and the frame 6 are connected via a moving mechanism 93 (third moving means). The moving mechanism 93 of this embodiment can move (displace) the frame 6 within the housing of the main body 2. Specifically, the moving mechanism 93 of the present embodiment can move the frame 6 in a two-dimensional direction (up / down / left / right direction) within the housing of the main body 2. The moving mechanism 93 of the present embodiment includes a motor for moving the frame.

<Laser irradiation optical system 10>
The laser irradiation optical system 10 will be described. The laser light source 11 emits treatment laser light. The treatment laser light emitted from the laser light source 11 is made coaxial with the aiming light (not shown), then converted into a parallel light beam by the collimating lens 16 via the optical fiber 12, the intermediate lens 13, and the zoom lens group 14, and further, a dichroic mirror. 24, the objective lens 17, the lens 18a, and the lens 18b are transmitted in this order. The dichroic mirror 24 has a property of transmitting light in the wavelength region of the treatment laser light and aiming light and reflecting light in other wavelength regions. Further, from the lens 18b, the treatment laser light is emitted as parallel light. In a state where the lens 18b and the cornea Ec of the patient's eye E are in contact, the treatment laser light emitted from the lens 18b is condensed on the fundus Er of the patient's eye E. Thereby, a spot of treatment laser light is formed on the fundus oculi Er (retina). In FIG. 1, the condensing position of the treatment laser beam is indicated by reference numeral Cr0. A coagulation spot is formed at the location of the retina irradiated with the treatment laser beam. As the gain medium of the laser light source 11, for example, a known medium such as Nd: YAG, Nd: YVO4, Nd: YLF, Ho: YAG, Er: YAG, Yb: YAG, Yb: YVO4 can be used.

  In the present embodiment, the distance between the objective lens 17 and the position of the intermediate image plane (see reference numeral Cr1 in FIG. 1) is 50 mm. Thereby, the optical path length (from the emission end of the optical fiber 12 to the lens 18b) of the laser irradiation optical system 10 is suppressed. Moreover, the diameter of the objective lens 17 is suppressed. As an example, when the distance between the objective lens 17 and the position of the intermediate imaging plane is 100 mm, the diameter of the objective lens is 20 mm, whereas the distance between the objective lens 17 and the position of the intermediate imaging plane is 50 mm. In this case, the diameter of the objective lens can be 10 mm. The distance between the objective lens 17 and the lens 18a is preferably in the range of 30 to 60 mm. If this distance is short, for example, the molding accuracy (or position accuracy) of the optical element tends to be severe. On the other hand, when this distance is long, for example, it is difficult for the operator to confirm the position of the patient's eye E from the side (in the direction orthogonal to the optical axis L1).

  In the present embodiment, the intermediate imaging surface of the laser irradiation optical system 10 and the front focal position of the contact lens unit 100 are configured to coincide (substantially coincide). Specifically, the position indicated by reference numeral Cr <b> 1 (see FIG. 1) is the position of the intermediate image plane of the laser irradiation optical system 10 and the front focal position of the contact lens unit 100. The treatment laser light once condensed on the intermediate imaging plane is emitted from the contact lens unit 100 as parallel light or substantially parallel light. Note that the position indicated by reference numeral Cr1 is in a conjugate relationship with the position of the output end face of the optical fiber 12 (reference numeral Cr2). Further, the position indicated by the reference symbol Cr1 is in an optically conjugate positional relationship with the fundus Er (location of the reference symbol Cr0).

  The zoom lens group 14 of the present embodiment is configured such that the spot size can be varied without changing the focal position of the treatment laser light. The zoom lens group 14 includes a lens 14a and a lens 14b. A moving mechanism 91 (fourth moving means) is connected to the zoom lens group 14 of the present embodiment. The moving mechanism 91 can move the zoom lens group 14 along the optical axis L <b> 1 of the laser irradiation optical system 10. The moving mechanism 91 of the present embodiment includes a motor. Each of the lens 14a and the lens 14b may be moved in different directions by the moving mechanism 91. A moving mechanism 92 (fifth moving means) is connected to the objective lens 17 of the present embodiment. The moving mechanism 92 can move the objective lens 17 along the optical axis L <b> 1 of the laser irradiation optical system 10. The moving mechanism 92 can further move the objective lens 17 in a direction perpendicular to the optical axis L1 (in this embodiment, up and down, left and right directions). The moving mechanism 92 of the present embodiment includes a motor. For example, by moving the objective lens 17 along the optical axis L1, individual differences (refractive errors) in the axial length of the patient's eye E can be easily absorbed. Further, for example, by moving the objective lens 17 in a direction orthogonal to the optical axis L1, the irradiation position of the observation site or treatment laser beam (the focal position of the spot) can be moved.

<Illumination optics>
The illumination optical system 20 will be described. The light source 21 emits illumination light (for example, visible light). The illumination light emitted from the light source 21 is transmitted in the order of the diaphragm 22, the lens 23, and the dichroic mirror 43, and then reflected in the order of the half mirror 34 and the dichroic mirror 24. The illumination light reflected by the dichroic mirror 24 passes through the objective lens 17, the lens 18a, and the lens 18b in this order. In a state where the lens 18b and the cornea Ec are in contact, the illumination light transmitted through the lens 18b is once condensed on the pupil Ep of the patient's eye E and then diffused to illuminate the fundus Er. The diaphragm 22 of the present embodiment is disposed at a position optically conjugate with the fundus Er. Note that the aperture shape of the diaphragm 22 may be deformable, and the fundus may be illuminated with slit light.

<Fixed target optical system>
The fixation target optical system 40 will be described. The target light emitted from the light source 41 (for example, visible light having a wavelength different from the wavelength of the illumination light) passes through the lens 42 and is then reflected in the order of the dichroic mirror 43, the half mirror 34, and the dichroic mirror 24. . The target light reflected by the dichroic mirror is transmitted in the order of the objective lens 17, the lens 18a, and the lens 18b. In a state where the lens 18b and the cornea Ec are in contact, the index light transmitted through the lens 18b is collected on the fundus Er. The light source 41 of this embodiment is disposed at a position optically conjugate with the fundus oculi Er. In addition, the control part 80 may be able to change the presentation position of the visual target. For example, the light source 41 may be assembled in the moving mechanism, and the light source 41 may be moved on a plane orthogonal to the optical axis of the fixation target optical system 40 under the control of the control unit 80.

<Observation optics>
The observation optical system 30 will be described. In order to simplify the description, the lens 18b and the cornea Ec will be described as being in contact with each other. Observation light (such as illumination light reflected from the fundus) emitted from the fundus Er is transmitted through the lens 18b, the lens 18a, and the objective lens 17 in this order, and then reflected by the dichroic mirror 24. The observation light reflected by the dichroic mirror 24 passes through the half mirror 34, the filter 33, and the imaging lens 32 in this order and is collected on the light receiving element 31. The filter 33 of this embodiment has a characteristic of transmitting light other than the wavelength of the treatment laser light. In the present embodiment, a two-dimensional image sensor (for example, a CCD image sensor) is used as the light receiving element 31. The method for acquiring a patient's eye image is not limited to the aspect of the present embodiment. In addition, the control part 80 of this embodiment can display the observation image of the patient's eye E on the monitor 95a using the output signal of the light receiving element 31. The surgeon observes the observation image displayed on the monitor 95a, and can perform alignment (with respect to the patient's eye E) for irradiating treatment laser light (laser irradiation optical system 10). In this embodiment, since it is not necessary to directly observe the patient's eye E with the operator's eye, the incidence of the treatment laser light on the operator's eye is suppressed.

<Control unit>
This will be described with reference to FIG. The control unit 80 of this embodiment includes a CPU 81 (processor), a ROM 82, a RAM 83, a nonvolatile memory 84, and the like. The CPU 81 controls each part of the ophthalmic laser treatment apparatus 1. The ROM 82 stores various programs, initial values, and the like. The RAM 83 temporarily stores various information. The nonvolatile memory 84 is a non-transitory storage medium that can retain stored contents even when power supply is interrupted. For example, a USB memory, a flash ROM, or the like that is detachably attached to the control unit 80 may be used as the nonvolatile memory 84. The control unit 80 of this embodiment includes a laser light source 11, a light source 21, a light receiving element 31, a light source 41, a moving mechanism 54, a moving mechanism 91, a moving mechanism 92, a moving mechanism 93, a display unit 95, a foot switch 96, and a joystick. 97 is connected. The control unit 80 of the present embodiment has a function of display control means for controlling the display content of the monitor (display means 95). Note that the control unit 80 of the present embodiment is housed in the casing of the base unit 3.

<How to use>
A method of using the ophthalmic laser treatment apparatus 1 of the present embodiment will be described using FIG. 3 and FIG. 4 together. After the patient is seated, the operator places (guides) the patient's head Ph on the chin rest 5a. The patient's forehead is brought into contact with the forehead 5b. The surgeon operates the touch panel 95b to set treatment laser light irradiation conditions (irradiation energy, irradiation time, etc.). Next, the surgeon operates the touch panel 95b to set an observation site. Upon receiving the observation site setting instruction, the control unit 80 drives the motor of the moving mechanism 92 to move the objective lens 17 in a direction orthogonal to the optical axis L1 with a direction and a movement amount corresponding to the setting instruction. (See step S101 and step S102 in FIG. 3).

  Next, the operator operates the joystick 97 while observing the observation image displayed on the monitor 95a, and moves the main body 2 so that the patient's eye E and the contact lens unit 100 are in contact with each other. The control unit 80 drives the motor of the moving mechanism 4 based on the output signal of the joystick 97 (see Step S103 and Step S104). The control unit 80 detects whether or not the patient eye E and the contact lens unit 100 are in contact with each other using the output signal of the pressure sensor 53 (step S105). The contact between the patient's eye E and the contact lens unit 100 may be detected while the main body unit 2 is moving. When the contact is detected, the movement of the main body 2 may be immediately decelerated (stopped).

  When the control unit 80 detects that the patient's eye E is in contact with the contact lens unit 100, the control unit 80 determines whether or not the contact pressure is within a predetermined range (see step S106). Data relating to the predetermined range is stored in advance in the nonvolatile memory 84. In addition, when the patient's eye E and the contact lens part 100 are not contacting, the flow of FIG. 3 is exited. Note that the control unit 80 of the present embodiment loops the flow shown in FIG. 3 at predetermined time intervals. When the contact pressure is outside the predetermined range, the control unit 80 drives the moving mechanism 54 so that the contact pressure falls within the predetermined range (see step S107).

  When the contact pressure between the patient's eye E and the contact lens unit 100 is insufficient, a gap is likely to be generated between the cornea Ec and the lens 18b. This gap may reduce the beam quality of the treatment laser beam. Specifically, for example, there are individual differences in the surface shape (for example, the radius of curvature) of the cornea Ec. Therefore, when the contact pressure is low, the cornea Ec is not deformed easily, and a gap is easily generated between the patient's eye E and the contact lens unit 100. This gap facilitates unnecessary refraction and reflection of the treatment laser beam. Further, when the contact pressure between the patient's eye E and the contact lens unit 100 is excessive, the cornea Ec may be damaged by the edge of the contact lens unit 100 or the like. In this embodiment, the part of the contact lens unit 100 that contacts the patient's eye E is formed of a material (glass material, resin) that is harder than the cornea Ec. Further, the shape of the contact surface of the contact lens unit 100 does not necessarily match the surface shape of the cornea Ec. By detecting the contact pressure between the contact lens unit 100 and the patient's eye E, the cornea Ec is hardly damaged, and the beam quality of the treatment laser light is hardly lowered.

  When the contact pressure is within the predetermined range, the control unit 80 determines whether or not the movement of the objective lens 17 (direction parallel to the optical axis L1) is necessary (see step S108). Whether the objective lens 17 needs to be moved is determined using the output signal of the pressure sensor 53 (that is, the contact pressure between the patient's eye E and the contact lens unit 100). In the present embodiment, the deformation amount of the elastic member 52 is detected from the output signal of the pressure sensor 53. The control unit 80 acquires the deformation amount of the elastic member 52 and moves the objective lens 17 along the optical axis L1 based on the acquired deformation amount (see step S109). When the elastic member 52 is deformed, the front focal position of the contact lens unit 100 is shifted, so that the objective lens 17 is moved so that the shifted front focal position and the intermediate imaging position of the laser irradiation optical system 10 are matched. The Note that a plurality of elastic members 52 are provided around the optical axis L1 so as to suppress a deviation in contact pressure between the contact surface of the contact lens unit 100 and the surface of the cornea Ec. The moving mechanism 54 of the present embodiment can apply different pressures to the plurality of elastic members provided around the optical axis L1 so as to suppress the bias of the contact pressure described above. In addition, if the control part 80 determines with the movement of the objective lens 17 not being required, it will escape from the loop of FIG. 3, without moving the objective lens 17 (refer step S108).

  The surgeon observes the observation image displayed on the monitor 95a, and changes the observation site as necessary. When the positioning of the main body 2 with respect to the patient's eye E is completed, the surgeon operates the foot switch 96 to start irradiation of the treatment laser light. When detecting that the foot switch 96 is pressed (in other words, inputting a trigger signal for starting irradiation), the control unit 80 determines whether or not the contact pressure between the patient's eye E and the contact lens unit 100 is within a predetermined range. (See step S201 and step S202 in FIG. 4). For this determination, an output signal of the pressure sensor 53 is used. In addition, it is determined whether or not the pressure value is within a predetermined range in the same determination mode as in step S106 described above.

  When the control unit 80 determines that the contact pressure is outside the predetermined range, the control unit 80 exits from the flow of FIG. 4 (see step S202). That is, the control unit 80 suppresses (prohibits) treatment laser light irradiation when the contact pressure is outside the predetermined range. On the other hand, if the control unit 80 determines that the contact pressure is within the predetermined range, the control unit 80 controls the laser light source 11 to start irradiation of the treatment eye with the patient eye E (step S203). Irradiation of the treatment laser light is performed based on irradiation conditions preset by the operator. The controller 80 intermittently repeats the treatment laser light irradiation until a preset irradiation condition is satisfied (the control from step S202 to step S204 is looped). Here, if the contact pressure between the patient's eye E and the contact lens unit 100 is out of a predetermined range while the treatment laser light is being irradiated, the treatment laser light is prohibited from being irradiated (see step S202). . As the treatment laser light irradiation prohibition, the irradiation may be temporarily stopped. Alternatively, it may be completed (exit from the flow of FIG. 4) even during irradiation (during continuation).

<Summary>
In the ophthalmic laser treatment apparatus 1 according to the present embodiment, the front focal point of the contact lens unit 100 coincides with the intermediate imaging plane of the laser irradiation optical system 10, and the rear focal position of the contact lens unit 100 and the patient eye E The contact lens unit 100 is arranged so that the entrance pupil position (pupil) substantially matches. Thereby, for example, the illumination light or the treatment laser light is not easily blocked by the iris of the patient's eye E. Therefore, it is easy to observe at a wide angle up to the fundus periphery of the patient's eye E. Moreover, it is easy to perform photocoagulation.

  In the present embodiment, the operator does not have to hold the contact lens unit 100. Specifically, the main body unit 2 holds the contact lens unit 100. Thereby, for example, the burden on the operator is reduced, and unintended irradiation of the treatment laser light is suppressed. In the contact lens unit 100 of the present embodiment, the patient eye E and the contact lens unit 100 are arranged with appropriate contact pressure using the pressure sensor 53, the elastic member 52 (spring or the like), or the moving mechanism 54. Adjusted as follows. Here, the chin rest 5a or the forehead 5b may be provided with a sensor for detecting the contact pressure with the patient's head Ph. Thereby, for example, deterioration of the beam quality of the treatment laser light is suppressed, and the cornea Ec is hardly damaged. In the present embodiment, after the contact lens unit 100 comes into contact with the patient's eye, the pressure sensor 53 and the moving mechanism 54 are used to maintain a good contact state with the patient's eye. However, the present invention is not limited to this. . For example, if the eye information of the patient's eye such as the axial length is obtained in advance, the eye information is input using the operation input means of the apparatus, and the moving mechanism 54 is operated based on the input eye information. The contact lens unit 100 can be moved in the front-rear direction (optical axis direction).

  In addition, the ophthalmic laser treatment apparatus 1 of the present embodiment can use a commercially available contact lens (general-purpose product) as the contact lens unit 100. The ophthalmic laser treatment apparatus 1 has a holding mechanism 55 and can be equipped with contact lenses of different magnifications, manufacturers, and the like. Thereby, for example, contact lenses can be easily sterilized and disinfected at the site of use. Moreover, it is easy to irradiate the patient's eye E with a treatment laser beam using a contact lens more suitable for the purpose of treatment.

  Note that there is a possibility that the intermediate imaging position of the laser irradiation optical system 10 and the front focal position of the contact lens unit 100 are shifted due to the deformation amount of the elastic member 52 or the refractive power of the patient's eye E. Thereby, for example, the spot quality of the treatment laser beam formed at the treatment site may be deteriorated. In the present embodiment, the objective lens 17 is moved in a direction parallel to the optical axis L1, so that deterioration in spot quality is suppressed. Note that the absorption of the shift between the intermediate imaging position and the front focal position is not limited to the movement of the objective lens 17. For example, the frame 6 may be moved in a direction parallel to the optical axis L1. Further, the optical elements constituting the zoom lens group 14 may be moved.

  Further, in the ophthalmic laser treatment apparatus 1 of the present embodiment, the operator operates the joystick 97 according to the fundus region to be observed, so that the objective lens 17 (the optical element supported by the frame 6) is vertically and horizontally. Moved. Thereby, for example, the observation site can be changed and the irradiation position of the treatment laser beam can be changed. In the ophthalmic laser treatment apparatus 1 according to the present embodiment, the surgeon can irradiate the treatment laser light by operating the foot switch 96 or the switch of the joystick 97 while observing the monitor 95a. Thereby, for example, an operator's burden is reduced with respect to a method of observing an observation site with the naked eye while looking through the eyepiece. Further, the ophthalmic laser treatment apparatus 1 of the present embodiment prohibits the irradiation of the treatment laser light when the patient's eye E and the contact lens unit 100 are not in contact with each other with an appropriate pressure. Thereby, for example, unintended treatment laser light irradiation is suppressed.

  Note that the ophthalmic laser treatment apparatus 1 may include an auto-tracking unit and can cope with unintended movement of the patient's eye E (for example, fine fixation movement). For example, the ophthalmic laser treatment apparatus 1 may include a motion detection unit that detects the motion of the patient's eye E, and the objective lens 17 may be moved in a three-dimensional direction according to the motion detection result. In the optical system of the present embodiment, the objective lens 17 can be easily downsized, and thus the objective lens 17 can be easily moved quickly. In this embodiment, since it is not necessary for the operator to hold the contact lens unit 100, the distance between the lens 18a (contact lens unit) and the objective lens 17 can be easily shortened. Therefore, it is easy to make the optical system (laser irradiation optical system 10 or the like) compact. Thereby, for example, the surgeon can easily raise the eyelid of the patient's eye E by hand.

  In the present embodiment, the patient's eye E can be observed from the observation image obtained using the light receiving element 31. Accordingly, for example, when the patient's eye E is observed with the naked eye of the surgeon, the treatment laser light reflected by the patient's eye E hardly enters the surgeon's eye. Moreover, in this embodiment, it is difficult to visually recognize the treatment laser light from the outside of the ophthalmic laser treatment apparatus 1 (direction intersecting the optical axis L1). Thereby, for example, light hazards such as the eyes of the surgeon and the eyes of the assistant are suppressed. In the present embodiment, the treatment laser light and the illumination light can be coaxially projected onto the patient's eye E. Thereby, for example, the optical system of the ophthalmic laser treatment apparatus 1 can be further simplified. In the present embodiment, the contact pressure of the contact lens unit 100 on the patient's eye E is adjusted. Thereby, for example, the burden on the patient (discomfort, etc.) is reduced.

  In the present embodiment, a plurality of different optical systems are accommodated in the housing of the main body 2. However, at least one of the optical systems may be detachable. For example, a mode in which a laser delivery (laser irradiation optical system) is assembled to a slit lamp microscope (observation apparatus) may be used. In this case, the contact lens portion may be included in at least one of the slit lamp microscope and the laser delivery. The burden on the operator who holds the contact lens portion may be reduced. In addition, the laser irradiation optical system 10 may include a scanning unit for displacing the optical axis of the treatment laser light (see, for example, Japanese Patent Application Laid-Open No. 2011-212349). Thereby, for example, it becomes easy to quickly form spots at a plurality of sites.

  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.

1: Ophthalmic laser treatment apparatus 5a: Jaw mount 10: Laser irradiation optical system 55: Holding mechanism 100: Contact lens part E: Patient eye

Claims (4)

A chin rest for supporting the patient's head;
A contact lens part in contact with the patient's eye;
A laser irradiation optical system for irradiating the patient's eye with treatment laser light, including the contact lens unit;
A holding mechanism for constantly holding the contact lens unit on the optical axis of the laser irradiation optical system;
With
The holding mechanism holds the contact lens unit so that an intermediate imaging position of the laser irradiation optical system and a front focal position of the contact lens unit coincide with each other.
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to claim 1,
A moving means for moving the intermediate imaging position in a direction parallel to the optical axis;
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to claim 1 or 2,
The holding mechanism includes an attachment / detachment mechanism for making the contact lens portion detachable.
An ophthalmic laser treatment apparatus characterized by the above. The ophthalmic laser treatment apparatus according to any one of claims 1 to 3,
Contact pressure detecting means for detecting contact pressure between the patient's eye and the contact lens unit,
An ophthalmic laser treatment apparatus characterized by the above.

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