JP2019048161A - Laser treatment device - Google Patents

Abstract

To improve operability in the ophthalmic laser treatment.SOLUTION: An illumination system of a laser treatment device illuminates a patient's eyes with a slit light generated by a slit diaphragm. A setting unit sets a pattern of a laser beam irradiated by the illumination system onto the eyes to be examined. A determination unit determines a direction of the slit light based on the set pattern. A control unit executes first control for controlling the illumination system based on the set pattern, and second control for controlling the slit diaphragm based on the determined direction. A storage unit stores related information in which slit width information is related to doctor identification information, beforehand. A reception unit receives the doctor identification information. The determination unit determines the width of the slit light based on the set pattern, the received doctor identification information, and the related information. The control unit controls the slit diaphragm so as to cause the illumination to be performed by the slit light with the determined direction and width in the second control.SELECTED DRAWING: Figure 9

Description

  The present invention relates to a laser treatment apparatus used in the ophthalmologic field.

  Laser therapy devices are used to treat various eye diseases. For example, in the treatment of certain types of glaucoma, there is a treatment that irradiates a laser at a corner (a region between the cornea and the iris, including the trabecular meshwork) to form an outflow channel of aqueous humor. In addition, retinal photocoagulation is used in retinal diseases such as diabetic retinopathy.

  In a laser treatment apparatus, after aiming at a treatment site using aiming light of a predetermined pattern (arrangement of a plurality of spots), one configured to irradiate the treatment area with a laser beam of a predetermined pattern is known. There is.

Japanese Patent Application Publication No. 2009-514564 Unexamined-Japanese-Patent No. 2014-44462 Patent No. 5166454 gazette

  In such pattern laser treatment, the direction of the pattern to be irradiated is not always constant. For example, in the pattern laser treatment of the corner, the direction of the linear or arc-like pattern gradually changes along the corner of a substantially circular (substantially elliptical) shape. At this time, in order to confirm the irradiation position of the pattern, the range including the aiming position is illuminated by the slit light. And the position of this slit illumination is sequentially moved with the irradiation position of a pattern. In the prior art, since the direction of the slit illumination was manually changed, the user had to perform complicated work.

  In laser treatment of the fundus, the slit width is adjusted so that only the irradiation position (aim position) of the pattern and the periphery thereof are illuminated, so that the patient does not feel discomfort due to glare. That is, it is common to perform laser treatment while observing the fundus in a substantially rectangular illumination field. Therefore, the user had to manually change the orientation of the slit illumination according to the orientation of the applied pattern.

  Patterned laser treatment can move the aiming position more quickly than other methods. Therefore, it is necessary to move the slit illumination quickly. However, it is difficult to quickly and manually move and change the orientation of the slit illumination. In addition, this manual operation may reduce the efficiency of the pattern laser treatment, which may lead to an increase in treatment time and a decrease in throughput.

  Moreover, the slit width has a preference for each doctor. For example, some doctors may want to observe a range slightly wider than the irradiation range of the aiming light, and some doctors may want to observe a much wider range. Similarly, there is a preference for each doctor as to the direction of slit illumination. For example, some physicians want to use vertically-long slit illumination regardless of the orientation of the laser light pattern, and some physicians want to match the orientation of the pattern and the slit illumination. In the conventional apparatus, the doctor himself has realized the desired observation mode manually.

  An object of the present invention is to improve the operability of ophthalmic laser treatment.

  The laser treatment apparatus according to the embodiment includes a slit diaphragm that generates slit light from illumination light output from a light source, and illuminates a patient's eye with the slit light, and an irradiation system that irradiates the patient's eye with laser light. A setting unit configured to set a pattern of laser light emitted to the patient's eye; a determination unit configured to determine the direction of the slit light based on the pattern set by the setting unit; Control of the irradiation system to irradiate the patient's eye with the laser beam of the pattern, and controlling the slit diaphragm to illuminate the patient's eye with slit light of the direction determined by the determination unit Control unit for executing the second control to be performed, a storage unit for storing in advance related information in which slit width information is associated with each of the plurality of doctor identification information, and doctor identification information And the determination unit determines the width of the slit light based on the pattern set by the setting unit, the doctor identification information received by the reception unit, and the related information. In the second control, the control unit controls the slit diaphragm so as to illuminate the patient's eye with the slit light of the direction and width determined by the determination unit.

  According to the embodiment, the operability of the ophthalmic laser treatment can be improved.

BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. It is a flowchart which shows the operation example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. It is a flowchart which shows the operation example of the laser treatment apparatus which concerns on embodiment. It is the schematic for demonstrating the operation example of the laser therapeutic apparatus which concerns on embodiment. It is the schematic for demonstrating the operation example of the laser therapeutic apparatus which concerns on embodiment. It is the schematic for demonstrating the operation example of the laser therapeutic apparatus which concerns on embodiment. It is the schematic for demonstrating the operation example of the laser therapeutic apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment. BRIEF DESCRIPTION OF THE DRAWINGS It is the schematic which shows the structural example of the laser treatment apparatus which concerns on embodiment.

  Examples of embodiments of the laser treatment device according to the present invention will be described in detail with reference to the drawings. In the following embodiments, the techniques described in the above patent documents can be used arbitrarily. In addition, some of the embodiments and modifications described below can be arbitrarily combined.

  Define the direction. The direction from the optical system to the patient is referred to as the forward direction, and the opposite direction is referred to as the backward direction. Further, the horizontal direction orthogonal to the front direction is taken as the left and right direction. Furthermore, the direction perpendicular to both the front-rear direction and the left-right direction is the vertical direction.

First Embodiment
[Constitution]
An example of a structure of the laser treatment apparatus 1 which concerns on this embodiment is shown in FIG. The laser treatment apparatus 1 is used to apply laser treatment to a patient's eye E. Laser treatment is applied to the fundus oculi Ef and corners. The corner is a portion where the cornea Ec and the iris Ei are in contact. The symbol El shown in FIG. 1 represents a crystalline lens.

  The laser treatment apparatus 1 includes a light source unit 2, a slit lamp microscope 3, an optical fiber 4, a processing unit 5, an operation unit 6, and a display unit 7. Note that, instead of the slit lamp microscope 3, a microscope for surgery, an ophthalmoscope, an observation device of an intraocular insertion type, or the like may be used.

  The light source unit 2 and the slit lamp microscope 3 are optically connected via an optical fiber 4. The optical fiber 4 has one or more light guide paths. The light source unit 2 and the processing unit 5 are connected to be able to transmit signals. The slit lamp microscope 3 and the processing unit 5 are connected to be able to transmit signals. The operation unit 6 and the processing unit 5 are connected to be able to transmit signals. The transmission mode of the signal may be wired or wireless.

  The processing unit 5 includes a computer that operates by cooperation of hardware and software. The processing executed by the processing unit 5 will be described later. The operation unit 6 includes various hardware keys and / or software keys (GUI). As an example of a hardware key, a button, a handle, a knob, and a keyboard pointing device (mouse, track ball, etc.) provided in a computer (processing unit 5 etc.) connected to the slit lamp microscope 3 Etc.), and a foot switch, operation panel, etc. provided separately. The software key is displayed, for example, on the slit lamp microscope 3 or a display device provided in the computer.

(Light source unit 2)
The light source unit 2 generates light to be irradiated to the patient's eye E. The light source unit 2 includes an aiming light source 2a, a treatment light source 2b, a galvano mirror 2c, and a light shielding plate 2d. In addition, members other than the members shown in FIG. 1 can be provided in the light source unit 2. For example, an optical element (such as a lens) may be provided just before the optical fiber 4 to cause the light generated by the light source unit 2 to enter the end face of the optical fiber 4.

(Aiming light source 2a)
The aiming light source 2a generates an aiming light LA for aiming at a site to be subjected to the laser treatment. An arbitrary light source is used as the aiming light source 2a. For example, if the configuration aiming while visually observing the patient's eye E is applied, a light source for emitting a recognizable visible light by the operator's eye E ₀ (a laser light source, light emitting diode, or the like) is used as an aiming light source 2a. Moreover, when the structure which aims at aiming while observing the imaging | photography image of patient eye E is applied, the light source (a laser light source, a light emitting diode, etc.) which emits the light of a wavelength range which an imaging device for acquiring a photography image has sensitivity. Is used as the aiming light source 2a. The aiming light LA is guided to the galvano mirror 2c. The operation of the aiming light source 2a is controlled by the processing unit 5.

(Treatment light source 2b)
The treatment light source 2b emits laser light for treatment (treatment light LT). The treatment light LT may be visible laser light or invisible laser light depending on the application. Also, the treatment light source 2b may be a single laser light source or a plurality of laser light sources that emit laser light of different wavelengths. The treatment light LT is guided to the galvano mirror 2c. The operation of the treatment light source 2 b is controlled by the processing unit 5.

(Galvano mirror 2c)
The galvano mirror 2c includes a mirror having a reflective surface, and an actuator that changes the orientation of the mirror (the orientation of the reflective surface). The sighting light LA and the treatment light LT reach the same position on the reflective surface of the galvano mirror 2c. The aiming light LA and the treatment light LT may be collectively referred to as “irradiation light”. The direction of (the reflection surface of) the Galvano mirror 2c is at least the direction of reflecting the irradiation light toward the optical fiber 4 (the direction of irradiation) and the direction of reflecting the irradiation light toward the light shielding plate 2d (the direction of stopping) And will be changed. The operation of the galvano mirror 2 c is controlled by the processing unit 5.

(Light shield 2d)
When the galvano mirror 2c is disposed in the stopping direction, the irradiation light reaches the light shielding plate 2d. The light shielding plate 2d is a member made of, for example, a material and / or a form that absorbs the irradiation light, and has a light shielding function.

  In the present embodiment, the aiming light source 2a and the treatment light source 2b respectively generate light continuously. Then, the irradiation light is irradiated to the patient's eye E by arranging the galvano mirror 2 c in the irradiation direction. In addition, the irradiation of the irradiation light to the patient's eye E is stopped by arranging the galvanometer mirror 2c in the stopping direction.

  In another embodiment, the aiming light source 2a and / or the treatment light source 2b may be configured to be capable of intermittently generating light. That is, the aiming light source 2a and / or the treatment light source 2b may be configured to be capable of generating pulsed light. Furthermore, the duty ratio of the aiming light source 2a and / or the treatment light source 2b may be changeable. The pulse control for that is performed by the processing unit 5. Alternatively, lighting and extinguishing of the aiming light source 2a and / or the treatment light source 2b may be configured to be controllable. When the configurations according to these examples are applied, it is not necessary to provide the galvano mirror 2c and the light shielding plate 2d.

(Slit lamp microscope 3)
The slit lamp microscope 3 is a device used to observe the anterior segment of the patient's eye E and the fundus oculi Ef. More specifically, the slit lamp microscope 3 is an ophthalmologic apparatus for illuminating the patient's eye E with slit light and observing the illumination field in an enlarged manner. Note that “observation” includes one or both of observation through an eyepiece and observation of a captured image by an imaging device. That is, "observation" also includes "shooting".

  The slit lamp microscope 3 includes an illumination unit 3a, an observation unit 3b, an eyepiece unit 3c, and a laser irradiation unit 3d. The illumination system 10 shown in FIG. 2 is stored in the illumination unit 3a. An observation system 30 is stored in the observation unit 3 b and the eyepiece unit 3 c. A photographing system 40 is further stored in the observation unit 30d. A laser irradiation system 50 is stored in the laser irradiation unit 3d.

  Although not shown, the slit lamp microscope 3 is provided with operation members such as a lever, a handle, a button, and a knob as in the conventional case. These operation members are functionally included in the operation unit 6. In the configuration shown in FIG. 1, the processing unit 5 that receives the signal from the operation unit 6 is configured to control the slit lamp microscope 3. However, only the mechanism that operates using such an electrical driving force Alternatively, a mechanism that operates using the driving force applied by the operator can be applied.

(Optical system of slit lamp microscope 3)
The optical system of the slit lamp microscope 3 will be described with reference to FIG. The patient's eye E is in contact with the fundus oculi Ef and a contact lens CL used for laser treatment of an angle. The slit lamp microscope 3 includes an illumination system 10, an observation system 30, an imaging system 40, and a laser irradiation system 50. The contact lens CL is an example of an auxiliary lens applied to the patient's eye E in laser treatment. Another example of the auxiliary lens is a front lens that is applied to the patient's eye E in a contact or non-contact manner.

(Lighting system 10)
The illumination system 10 outputs illumination light for observing the patient's eye E. The illumination unit 3a is configured to be capable of changing the direction of the optical axis (illumination optical axis) 10a of the illumination system 10 in the left-right direction and the up-down direction. Thereby, the illumination direction of the patient's eye E can be arbitrarily changed.

  The illumination system 10 includes a light source 11, a condenser lens 12, filters 13, 14 and 15, a slit diaphragm 16, imaging lenses 17, 18 and 19, and a deflection member 20.

  The light source 11 outputs illumination light. The illumination system 10 may be provided with a plurality of light sources. For example, both the light source (halogen lamp, LED, etc.) that outputs steady light and the light source (xenon lamp, LED, etc.) that outputs flash light can be provided as the light source 11. Also, the light source for anterior eye observation and the light source for fundus observation may be provided separately. The condenser lens 12 is a lens (system) that collects the light output from the light source 11. The operation of the light source 11 is controlled by the processing unit 5.

  Each of the filters 13 to 15 is an optical element having the function of removing or weakening a specific component of the illumination light. Examples of the filters 13 to 15 include blue filters, red non-red filters, neutral density filters, heat protection filters, corneal fluorescence filters, color temperature conversion filters, color rendering conversion filters, ultraviolet cut filters, infrared cut filters, and the like. Each of the filters 13 to 15 is insertable into and removable from the light path of the illumination light. Insertion and removal of the filters 13 to 15 are controlled by the processing unit 5.

  The slit diaphragm 16 forms a slit for generating slit light (slit light). The slit diaphragm 16 includes a pair of slit blades. The slit width is changed by changing the distance between the slit blades. In addition, the direction of the slit is changed by integrally rotating these slit blades. The rotation center at this time is the illumination optical axis 10a. A diaphragm member other than the slit diaphragm 16 can be provided in the illumination system 10. Examples of the diaphragm member include an illumination diaphragm for changing the light quantity of the illumination light and an illumination field diaphragm for changing the size of the illumination field. Moreover, it is possible to change the light quantity of illumination light, and the size of an illumination field using members other than these aperture members. A liquid crystal shutter is an example of such a member. The operations of the slit diaphragm 16, the illumination diaphragm, the illumination field diaphragm, and the liquid crystal shutter are controlled by the processing unit 5.

  The imaging lenses 17, 18 and 19 are lens systems for forming an image of illumination light. The deflection member 20 deflects the illumination light having passed through the imaging lenses 17, 18 and 19 to irradiate the patient's eye E. For example, a reflective mirror or a reflective prism is used as the deflection member 20.

  A member other than the above can be provided in the illumination system 10. For example, a diffusion plate can be provided at the rear stage of the deflection member 20 so as to be insertable and removable. The diffusion plate makes the brightness of the illumination field uniform by diffusing the illumination light. Also, a background light source can be provided to illuminate the background area of the illumination field by the illumination light.

(Observation system 30)
Observation system 30 is an optical system that guides the illumination light of the return light from the eye E to the operator's eye E _0. The observation system 30 includes a pair of left and right optical systems that enables observation with the left and right eyes. Since the left and right optical systems have substantially the same configuration, only one optical system is shown in FIG.

  The observation unit 3 b is configured to be capable of changing the direction of the optical axis (observation optical axis) 30 a of the observation system 30 in the left-right direction and the up-down direction. Thereby, the observation direction of the patient's eye E can be arbitrarily changed.

  The observation system 30 includes an objective lens 31, variable magnification lenses 32 and 33, a protection filter 34, an imaging lens 35, a deflection unit 36, a field stop 37, and an eyepiece lens 38.

  The objective lens 31 is disposed at a position facing the patient's eye E. The variable magnification lenses 32 and 33 constitute a variable magnification optical system (zoom lens system). The variable magnification lenses 32 and 33 are movable along the observation optical axis 30a. As another example of the variable magnification optical system, a plurality of variable magnification lens groups which can be selectively inserted into the optical path of the observation system 30 can be provided. These variable power lens groups are configured to provide different magnifications. The variable power lens group disposed in the optical path of the observation system 30 is used as the variable power lenses 32 and 33. With such a variable power optical system, the magnification (field angle) of the macroscopic observation image and the photographed image of the patient's eye E can be changed. The change of the magnification is performed, for example, by operating the observation magnification operation knob included in the operation unit 6. In addition, the processing unit 5 may control the magnification based on an operation by a switch or the like included in the operation unit 6.

The protection filter 34 is a filter that shields the treatment light LT. Thereby, the operator's eye E ₀ can be protected from the laser light. The protection filter 34 is inserted into the light path, for example, in response to the start trigger of the laser treatment (or laser output). During normal observation, the protection filter 34 is retracted from the light path. Insertion and removal of the protection filter 34 is controlled by the processing unit 5. It is also possible to use a multilayer film filter that reduces the apparent color change. This filter is for example always arranged in the light path.

  The imaging lens 35 is a lens (system) that forms an image of the patient's eye E. The deflecting unit 36 is an optical member that is translated to match the light traveling direction to the eye width of the operator, and includes prisms 36 a and 36 b. The eyepiece 37 moves integrally with the deflection unit 36. The deflection unit 36 and the eyepiece lens 37 are stored in the eyepiece unit 3c. The other members in the observation system 30 are stored in the observation unit 3b.

(Shooting system 40)
The imaging system 40 is an optical system for imaging a patient's eye E. The imaging system 40 includes a beam splitter 41, an imaging lens 42, and an image sensor 43. The imaging system 40 is branched from the observation system 30. The beam splitter 41 is disposed between the imaging lens 35 of the observation system 30 and the deflection unit 36. Beam splitter 41 is, for example, a half mirror. The imaging lens 41 is a lens (system) that brings the image of the patient's eye E onto the image sensor 43. The image sensor 43 is, for example, an area sensor including an imaging device such as a CCD or a CMOS. Signals (image signals, video signals) output from the image sensor 43 are sent to the processing unit 5.

  The imaging system 40 may be provided to both of the left and right optical systems in the observation system 30, or the imaging system 40 may be provided to only one of them. When the left and right imaging systems 40 are provided, it is possible to acquire a stereoscopic image (stereo image) of the patient's eye E. The stereoscopic image is a still image or a moving image.

(Laser irradiation system 50)
The laser irradiation system 50 is an optical system for guiding the irradiation light transmitted from the light source unit 2 to the slit lamp microscope 3 via the optical fiber 4 to the patient's eye E. The laser irradiation system 50 includes a collimator lens 51, an optical scanner 52, a mirror 53, relay lenses 54 and 55, a mirror 56, a collimator lens 57, and a deflection member 58.

  The collimator lens 51 converts the irradiation light output from the optical fiber 4 into a parallel light flux. The optical scanner 52 two-dimensionally deflects the irradiation light. The optical scanner 52 includes, for example, a pair of galvano scanners. The operation of the light scanner 52 is controlled by the processing unit 5.

  The mirror 53 reflects the irradiation light that has passed through the light scanner 52 and changes its traveling direction. The relay lenses 54 and 55 relay the irradiation light reflected by the mirror 53. The mirror 56 reflects the illumination light passing through the relay lenses 54 and 55 to change its traveling direction. The collimator lens 57 converts the illumination light passed through the relay lenses 54 and 55 into a parallel light flux. The deflection member 58 is disposed behind the objective lens 31 and deflects the irradiation light passed through the collimator lens 57 to irradiate the patient's eye E.

(Contact lens CL)
When performing laser treatment of the fundus oculi Ef and corner angles, the contact lens CL is abutted against the cornea Ec. In order to perform various laser treatments, a plurality of contact lenses having different magnifications and forms are prepared. The user selects the contact lens in accordance with the type of treatment, the treatment site, the state of the patient's eye E, and the like.

[Irradiation conditions]
In the present example, irradiation light of a preset pattern is applied to the patient's eye E. There are various conditions (irradiation conditions) in the pattern of the irradiation light. The projection image of the irradiation light is called a spot. As irradiation conditions, an array pattern of a plurality of spots (array condition), a size of array pattern (array size condition), a direction of array pattern (array direction condition), a size of each spot (spot size condition), a spot interval There are spot spacing conditions etc. The irradiation conditions include those relating to matters other than patterns and spots. For example, the irradiation conditions include the intensity (power) and the wavelength of the irradiation light. The control based on these irradiation conditions is performed in the same manner as the conventional pattern irradiation type laser treatment apparatus.

[Control system]
The control system of the laser treatment apparatus 1 will be described with reference to FIG. The control system of the laser treatment apparatus 1 is configured around a control unit 101 provided in the processing unit 5. In FIG. 3, some constituent parts are omitted.

(Control unit 101)
The control unit 101 controls each part of the laser treatment apparatus 1. For example, the control unit 101 controls the light source unit 2, the display unit 7, the illumination system 10, the observation system 30, the laser irradiation system 50, and the like. The control unit 101 controls at least each element shown in FIG. For example, the control unit 101 executes control based on the irradiation conditions described above.

  As control of the light source unit 2, the control unit 101 performs control of the aiming light source 2a, control of the treatment light source 2b, control of the galvano mirror 2c, and the like. The control of the aiming light source 2a and the treatment light source 2b includes turning on / off of the output of the irradiation light, control of the output intensity (output light amount) of the irradiation light, and the like. In addition, when a configuration in which a plurality of types of treatment light LT can be output by one or more treatment light sources 2b is applied, the control unit 101 controls the treatment light source 2b to selectively output the treatment light LT. The control of the galvano mirror 2c includes control for changing the direction of the reflective surface of the galvano mirror 2c.

  The display unit 7 receives control of the control unit 101 and displays various information. The display unit 7 includes a flat panel display such as an LCD. The display unit 7 is provided, for example, in the slit lamp microscope 3 or the processing unit 5 (computer).

  As control of the illumination system 10, the control unit 101 performs control of the light source 11, control of the filters 13 to 15, control of the slit diaphragm 16, control of the other diaphragm members, and the like. The control of the light source 11 includes on / off of the output of the illumination light, the control of the output intensity of the illumination light (output light amount), and the like. The control of the filters 13-15 includes control of inserting and removing the filters 13-15 with respect to the illumination light axis 10a. Control of the filters 13 to 15 is performed by controlling the filter driver 13A.

  The control of the slit diaphragm 16 includes control to change the distance between the pair of slit blades, and control to move and rotate the pair of slit blades integrally. Control to change the distance between the pair of slit blades corresponds to control to change the slit width. The control of moving the pair of slit blades integrally corresponds to the control of shifting the irradiation position of the illumination light (slit light) while keeping the slit width constant. The control of integrally rotating the pair of slit blades corresponds to control of changing the direction of the slit light while keeping the slit width constant. It is possible to arbitrarily combine these controls for a pair of slit blades.

  As described above, the other aperture members include an illumination aperture for changing the amount of illumination light and an illumination field aperture for changing the size of the illumination field. The control of the slit diaphragm 16, the illumination diaphragm, and the illumination field diaphragm is performed by controlling the diaphragm drive unit 16A.

  As control of the observation system 30, the control unit 101 performs control of the variable magnification lenses 32 and 33, control of the protective filter 34, and the like. The control of the variable magnification lenses 32 and 33 is to control the variable magnification drive unit 32A to move them along the observation optical axis 30a, or to arrange variable magnification lens groups of different magnifications in the optical path of the observation system 30. It is control. Thereby, the observation magnification (angle of view) is changed. The control of the protection filter 34 is to control the protection filter drive unit 34A to insert and remove the protection filter 34 with respect to the observation optical axis 30a.

  As control of the laser irradiation system 50, the control unit 101 performs control of the light scanner 52 and the like. The control unit 101 changes, for example, the directions of the two galvanometer mirrors included in the light scanner 52. Thereby, the irradiation light incident from the light source unit 2 through the optical fiber 4 is two-dimensionally deflected.

  The control unit 101 performs read processing of data stored in the storage unit 102 and write processing of data to the storage unit 102.

  The control unit 101 includes a microprocessor, a RAM, a ROM, a hard disk drive, and the like. A computer program such as a control program is stored in advance in the hard disk drive. The operation of the control unit 101 is realized by the cooperation of a computer program and the above hardware. Also, the control unit 101 may include a communication device for communicating with an external device.

(Storage unit 102)
The storage unit 102 stores various data and computer programs. Storage unit 102 includes, for example, a storage device such as a RAM, a ROM, and a hard disk drive.

  The storage unit 102 stores related information 102 a. The related information 102 a includes information in which the pattern of the irradiation light (the aiming light LA and / or the treatment light LT) and the direction of the slit formed by the slit diaphragm 16 (that is, the direction of the slit light) are associated. An outline of the related information 102a is shown in FIG. The related information 102a illustrated in FIG. 4 is table information in which a field of “irradiation pattern” representing a pattern of illumination light and a field of “direction of slit light” are provided. In the column of irradiation patterns, identification information (irradiation pattern identification information) Pi indicating n types of irradiation patterns is recorded (nn1, i = 1 to n). In the direction of the slit light, the direction Oi of the slit light associated with each of the n pieces of irradiation pattern identification information is recorded (i = 1 to n). Here, for a certain i, j, Oi = Oj may be satisfied (j = 1 to n, j) i). That is, the n orientations Oi do not have to be all different, and the same orientation may be included.

  The related information 102 a may be set as a default or may be set by the user. In addition, the user can arbitrarily change the default setting related information 102 a. Furthermore, it is possible to provide the related information 102 a for each user. In this case, user identification information (doctor ID etc.) is associated with each related information 102a (or each information recorded in a single related information 102a), and is related to the user identification information input at the time of laser treatment The related information 102a (or recorded information) is selectively applied. In addition, it is possible to associate an attribute other than the user identification information with the related information 102a (or recording information). This attribute may include, for example, any of an attribute regarding a user, an attribute regarding a medical institution, an attribute regarding a patient, and an attribute regarding a laser treatment apparatus.

  Common related information 102a may be applied to the aiming light LA and the treatment light LT, or separate related information 102a may be applied to each. The former is applicable, for example, when the aiming light LA and the treatment light LT are simultaneously irradiated, or when the pattern of the aiming light LA and the pattern of the treatment light LT are the same. The latter is applicable, for example, when the pattern of the aiming light LA and the pattern of the treatment light LT are different.

(Pattern setting unit 103)
The pattern setting unit 103 sets the pattern of the laser light (the aiming light LA, the treatment light LT) emitted to the patient's eye E. The setting of the laser beam pattern is performed manually or automatically.

  An example of manual setting will be described. The control unit 101 causes the display unit 7 to display information for setting a pattern. This information may include information indicating the pattern shape and options of the pattern, and may include an image of the patient's eye E and a schematic view of the eye. The user specifies a desired pattern by using the operation unit 6. The pattern setting unit 103 provides the control unit 101 with a program for controlling the light scanner 52 (as well as the aiming light source 2a and / or the treatment light source 2b) in order to realize the pattern specified by the user. For this process, the pattern setting unit 103 prestores, for example, a library including a plurality of programs corresponding to a plurality of patterns, selects a program corresponding to the pattern designated by the user from the library, and controls it. Send to section 101.

  An example of automatic setting will be described. The pattern setting unit 103 stores in advance a pattern and a library corresponding to attributes such as the disease name and the degree (range, severity, etc.) of the disease. Attributes are input manually or automatically. The automatic input is performed, for example, with reference to an electronic medical record, a surgical report, and the like. The pattern setting unit 103 specifies a pattern corresponding to the input attribute, and selects the specified program from the library. Furthermore, the pattern setting unit 103 sends the selected program to the control unit 101. The pattern applied to the patient's eye E may be applied again.

  The pattern setting unit 103 may be configured to set not only the shape (type) of the pattern but also other parameters related to the pattern. The parameters that can be set by the pattern setting unit 103 include the direction and size of the pattern, and the size and interval of spots included in the pattern. These parameters (conditions) are set using a dedicated GUI. For example, a GUI for setting the direction of the pattern may be a button indicating a plurality of directions of the pattern (upward button, downward button, leftward button, rightward button, etc.), a button for rotating the pattern stepwise or continuously ( Including a right rotation button, a left rotation button, etc.

  It is also possible to set these parameters automatically. For example, the pattern setting unit 103 specifies the image area of the characteristic portion of the patient's eye E by analyzing the image of the patient's eye E (for example, a moving image or a still image acquired in real time). It is possible to set one or more parameters based on that. As a specific example, the pattern setting unit 103 analyzes the image of the patient's eye E, and the site to be irradiated with the treatment light LT (the site to be treated) and / or the site to be excluded from the site to be treated (the treatment excluded site) Identify The site to be treated is, for example, a diseased part or a blood vessel. The treatment exclusion site is, for example, a specific site (such as macula) of the patient's eye or a blood vessel. Furthermore, the pattern setting unit 103 sets a pattern based on the arrangement, the shape, and the size of the treatment target site and / or the treatment exclusion site.

  The pattern setting unit 103 can set an arbitrary parameter based on data (plan data) created by preoperative planning. Preoperative planning is work to determine the implementation content of laser treatment (laser surgery) based on examination data and diagnostic data acquired in advance. The items to be determined in the preoperative planning include the site of the patient's eye E to be subjected to the laser treatment (target site for treatment), the type of laser light to be applied (treatment light LT), the type of contact lens to be applied, There are the number of implementation and the interval of implementation of the operation. In addition, results of laser treatment performed in the past, images of patient's eye E (frontal image, cross-sectional image by optical coherence tomography (OCT), etc.) and attributes of patient / patient's eye (sex, age, medical history, The intensity of the laser light (the treatment light LT) can be determined based on the treatment history and the like, standard data, statistical data, and the like. The intensity of the treatment light LT may be, for example, an intensity that is actually applied for the treatment, or an initial intensity that is used in a task (trial) to determine the applied intensity.

(Data processing unit 110)
The data processing unit 110 performs various data processing. The data processing unit 110 is provided with a slit information determination unit 111.

(Slit information determination unit 111)
The slit information determination unit 111 determines the direction of the slit light based on the pattern set by the pattern setting unit 103. In the present embodiment, the slit information determination unit 111 determines the direction of slit light with reference to the related information 102 a stored in the storage unit 102. Specifically, the slit information determination unit 111 selects the irradiation pattern identification information Pi corresponding to the pattern set by the pattern setting unit 103 from the related information 102a, and a slit associated with the selected irradiation pattern identification information Pi. Identify the light direction Oi. The identified orientation Oi is employed as the orientation of slit light in the process.

  As described above, a configuration capable of changing the direction of the pattern can be applied. In this case, the related information 102 a shown in FIG. 4 associates the direction Oi of slit light with the pattern Pi in the default direction. When the direction of the pattern is changed, the contents of the change (rotation direction and rotation angle of the pattern) are input to the slit information determination unit 111. The slit information determination unit 111 acquires the direction of the slit light corresponding to the pattern whose direction is changed by changing the direction of the slit light corresponding to the pattern according to the input rotation direction and the rotation angle. be able to.

(Operation unit 6, display unit 7)
The operation unit 6 includes various hardware keys and / or software keys. Display unit 7 includes, for example, a flat panel display. It is possible to integrally configure at least a part of the operation unit 6 and at least a part of the display unit 7. The touch panel display is one example.

[Operation]
The operation of the laser treatment apparatus 1 will be described. An example of the operation of the laser treatment apparatus 1 is shown in FIG. In this example, the designation of the irradiation pattern and the designation of the direction are manually performed, but the same operation can be performed when one or both of the designation of the irradiation pattern and the designation of the direction are automatically performed. is there. In addition, although the pattern of the aiming light LA and the pattern of the treatment light LT are the same in this example, the same operation can be performed when the patterns are different.

(S1: The user specifies the irradiation pattern)
The user uses the operation unit 6 to specify the pattern of the irradiation light.

(S2: The user specifies the direction of the pattern)
If necessary, the user designates the orientation of the pattern designated in step S1 using the operation unit 6.

(S3: Set the pattern and direction)
The pattern setting unit 103 performs setting for realizing these on the basis of the pattern designated in step S1 and the direction designated in step S2.

(S4: Determine the direction of slit light)
The slit information determination unit 111 determines the direction of the slit light (that is, the direction of the slit light 16) based on the pattern and the direction set in step S3 (that is, the pattern specified in step S1 and the direction specified in step S2). The direction of the slit formed by the slit diaphragm 16 is determined.

(S5: Change the direction of the slit)
The control unit 101 controls the slit diaphragm 16 based on the direction of the slit light determined in step S4. As a result, the direction of the slit light determined in step S4 can be realized.

(S6: The user performs aiming start operation)
The user performs a predetermined aiming start operation using the operation unit 6. The aiming start operation is an operation for starting irradiation of the aiming light LA.

(S7: irradiate aiming light and slit light)
In response to the aiming start operation of step S6 being performed, the control unit 101 controls the illumination system 10 to irradiate the patient's eye E with slit light, and based on the pattern and direction set in step S3. By controlling the light source unit 2 and the light scanner 52, the aiming light LA of the pattern and direction is irradiated to the patient's eye E.

  The irradiation start timing of the aiming light LA and the irradiation start timing of the slit light may be arbitrary. For example, the irradiation of the aiming light LA may be started after the irradiation of the slit light is started. Also, the irradiation of the slit light and the irradiation of the aiming light LA may be started simultaneously.

(S8: The user performs a treatment start operation)
The user adjusts the position of the aiming light LA so that the aiming light LA is irradiated to the treatment target site. The user performs a predetermined treatment start operation using the operation unit 6 in a state where the aiming light LA is irradiated to the treatment target site. The treatment start operation is an operation for starting irradiation of the treatment light LT.

(S9: Irradiate therapeutic light)
In response to the aiming start operation of step S8 being performed, the control unit 101 controls the light source unit 2 and the optical scanner 52 based on the pattern and the direction set in step S3 to treat the pattern and the direction. The light LT is emitted to the patient's eye E. At this time, slit light is also irradiated.

  The above is the flow of the process for irradiating the treatment light LT of a predetermined pattern once. In the case of performing a wide range of laser treatment, at least a part of the above-described processing is repeatedly performed while changing the site to which the laser light is applied. When treating a wide range of the fundus oculi Ef, for example, aiming and laser treatment are repeatedly performed while moving the irradiation field of slit light in a fixed direction (the direction set in step S4). In addition, in the case of treatment of a corner, aiming and laser treatment are sequentially performed while changing the direction of the slit light in accordance with the corner of a substantially circular (substantially elliptical) shape.

[effect]
The effects of the laser treatment apparatus according to the present embodiment will be described.

  The laser treatment apparatus (1) includes an illumination system (10), an irradiation system (the light source unit 2, the laser irradiation system 50, etc.), a setting unit (pattern setting unit 103), and a determination unit (slit information determination unit 111). , And a control unit (101). The illumination system illuminates the patient's eye (E) with slit light. The irradiation system irradiates the patient's eye with laser light (aim light LA, treatment light LT). The setting unit sets a pattern of laser light emitted to the patient's eye. The determination unit determines the direction of the slit light based on the pattern set by the setting unit. The control unit controls the irradiation system (first control) for irradiating the patient's eye with the laser light of the pattern set by the setting unit, and illuminates the patient's eye with the slit light of the direction determined by the determination unit. Control of the illumination system (second control).

  In the present embodiment, the control unit can synchronously execute the first control and the second control. "Performing synchronously" means that the execution timing of the first control and the execution timing of the second control are synchronized, that is, they are linked (that they are associated). means.

  It is also possible to execute the first control and the second control asynchronously. For example, it is possible to configure to start the first control (irradiation control of the aiming light LA) automatically or manually after automatically or manually starting the second control (slit light irradiation control) .

  As an example of such synchronous control, the control unit is determined by the determination unit and at least a part of a period (first period) in which the patient's eye is irradiated with the laser light of the pattern set by the setting unit. The first control and the second control can be performed such that at least a part of a period (second period) in which the patient's eye is illuminated by the slit light in the opposite direction coincides with the other.

  In the example shown in FIG. 5, the period (second period) in which the slit light is irradiated is a period (first period) in which the sighting light LA is irradiated and a period (first time) in which the treatment light LT is irradiated Period 1) and the like. On the other hand, performing synchronous control so that the first period and the second period coincide, or a part of the first period and a part of the second period coincide. It is also possible to perform synchronous control.

  In the present embodiment, the setting unit may be configured to be able to set the direction of the laser light pattern. In this case, the determination unit can determine the direction of the slit light based on the pattern set by the setting unit and the direction thereof.

  According to this embodiment, the direction of the illumination field of the slit light can be automatically changed according to the irradiation pattern of the laser light. Therefore, the operability of the ophthalmic laser treatment is improved as compared to the prior art in which the direction of the illumination field of the slit light had to be manually changed.

  According to the configuration in which the first control and the second control are performed synchronously, the illumination by the slit light and the irradiation of the laser beam (the aiming beam, the treatment beam) are performed automatically and synchronously. It is possible to reduce the number of operations and further improve the operability.

  The configuration in which the setting result of the direction of the laser light pattern is reflected on the direction of the slit light is particularly effective when an asymmetrically shaped pattern is applied. However, when the tissue around the irradiation range of the laser beam is also observed, the direction of the slit light may be changed depending on the surrounding condition (displacement or arrangement of blood vessels, etc.). Therefore, it is not necessary to determine the direction of the slit light based only on the type of pattern and its direction, and it is possible to determine the direction of the slit light in consideration of other factors (for example, the state of the surroundings) is there.

Second Embodiment
The laser treatment apparatus according to the present embodiment determines the direction of slit light based on the position, orientation, size, etc. of the tissue of the patient's eye in addition to the pattern of the laser light. This laser treatment apparatus may have the same general configuration and optical system as the first embodiment (see FIGS. 1 and 2).

  The control system is also similar to that of the first embodiment (see FIG. 3). However, in the present embodiment, the related information 102 a does not have to be stored in the storage unit 102. Other components may be similar to those of the first embodiment. Hereinafter, the codes used in the first embodiment are applied mutatis mutandis.

  The laser treatment apparatus of the present embodiment includes an imaging system. The imaging system has a function of imaging the patient's eye E. In the configuration shown in FIGS. 1 to 3, an optical system for guiding light from the patient's eye E to the image sensor 43 is included in the imaging system. Note that the imaging system is not limited to such a configuration, and may be any ophthalmic imaging modality such as a scanning laser ophthalmoscope (SLO) or OCT. The pattern setting unit 103 may be able to execute the same process as that of the first embodiment.

  The slit information determination unit 111 identifies the image area of the characteristic portion of the patient's eye E by analyzing the image acquired by the imaging system (image signal (image data) output from the image sensor 43). The image to be analyzed is, for example, a moving image or a still image acquired in real time. The characteristic site of the patient's eye E may be a predetermined site or any site identified by image analysis. The default site includes the macula and optic papilla. The optional site includes a blood vessel and a diseased part. Image analysis for specifying such an image area may include an arbitrary area extraction process. The region extraction processing may include, for example, threshold processing, histogram analysis, edge detection, statistical classification, feature extraction, pattern recognition, arbitrary filtering, and the like.

  Furthermore, the slit information determination unit 111 determines the direction of the slit light based on the image area specified from the image acquired by the imaging system. An example of this determination process will be described. The image area specified from the image acquired by the imaging system includes a site to be irradiated with the treatment light LT (a site to be treated) and / or a site to be excluded from a site to be treated (a treatment excluded site). The site to be treated is, for example, a diseased part or a blood vessel. The treatment exclusion site is, for example, a specific site (such as macula) of the patient's eye or a blood vessel.

  The slit information determination unit 111 determines the direction of the slit light based on the arrangement, the shape, and the size of the treatment target site and / or the treatment exclusion site. Specifically, the direction of the slit light can be determined so that at least a part of the treatment target site is included, and in particular, the entire treatment target site is illuminated with the slit light, or the treatment target site The direction of the slit light can be determined such that the widest possible range is illuminated by the slit light. Therefore, for example, the direction of the maximum diameter of the treatment target site can be determined, and the direction of the slit light can be determined so that the longitudinal direction of the slit light matches the direction of the maximum diameter.

  In addition, when the treatment target site is sufficiently wide as compared with the single slit light irradiation field, the slit information determination unit 111 can obtain an array of a plurality of irradiation fields covering the entire treatment target site. At this time, the arrangement of a plurality of irradiation fields that efficiently cover the entire treatment target site, that is, the arrangement of a plurality of irradiation fields that reduce the area irradiated to a site other than the treatment target site is obtained. Can. In addition, a part of the arrangement of a plurality of irradiation fields may overlap. By providing such an overlapping area, the periphery of a single pattern irradiation area can be observed. In addition, when photographing a plurality of irradiation fields, it is possible to easily execute image synthesis for obtaining a panoramic image (wide area image) by using the overlapping area as a margin.

  According to the laser treatment apparatus of the present embodiment configured as described above, the operability of the ophthalmic laser treatment can be improved as in the first embodiment, and a suitable direction according to the state of the patient's eye E It is possible to realize a slit illumination of

Third Embodiment
The laser treatment apparatus according to the present embodiment determines the direction of slit light based on the position, orientation, size, etc. of the tissue of the patient's eye in addition to the pattern of the laser light. This laser treatment apparatus may have the same general configuration and optical system as the first embodiment (see FIGS. 1 and 2).

  The structural example of the laser treatment apparatus which concerns on this embodiment is shown in FIG. The present example differs from the first embodiment in that the holder 61 and the moving mechanism 62 are provided. Other components may be similar to those of the first embodiment. The related information 102a may be stored in the storage unit 102 (for example, similar to the first embodiment) or may not be stored (for example, similar to the second embodiment). Hereinafter, the codes used in the first embodiment are applied mutatis mutandis.

  The holding unit 61 holds the contact lens CL (or a front lens). Although not shown, the holder 61 includes an arm whose proximal end is connected to the slit lamp microscope 3 and a contact lens holder provided at the tip of the arm. The arm includes, for example, one or more joints, and is configured to be deformable. The contact lens holder is connected to the arm via a movable mechanism. The movable mechanism is configured to be capable of rotational movement, tilt and axial movement of the contact lens CL. The rotational movement is an operation of moving the contact lens CL around its axis. The rotational movement is performed to change the reflection direction of the irradiation light or the illumination light when a contact lens having a reflection surface in the inside, which is used for laser treatment of a corner or the periphery of the fundus is applied. The tilt is an operation to change the direction of the axis, and is performed to change the traveling direction of the irradiation light or the illumination light. Axial movement is performed to adjust the focus on the treatment site or the observation site. The movable mechanism may be configured to be able to execute at least one of rotational movement, tilt, and movement in the axial direction, and may be configured to be able to execute movement modes other than these.

  The moving mechanism 62 includes such a movable mechanism and one or more actuators for operating the movable mechanism. The operation of the moving mechanism 62 is executed by the control unit 101. In the present embodiment, the control unit 101 executes control of rotational movement, tilt, and movement in the axial direction of the contact lens CL held by the holding unit 61.

  The usage form of the present embodiment will be described. FIG. 7 shows an example of usage of this embodiment. Unless otherwise stated, the processes included in this example conform to the first embodiment.

(S11: preoperative planning)
Preoperative planning is performed as a preliminary step of laser treatment. In preoperative planning, a computer not shown is used. This computer is used, for example, for viewing a patient's electronic medical chart and images, and for creating plan data. The doctor creates plan data with reference to examination data and diagnosis data of the patient's eye E. The plan data includes at least data representing a treatment target site of the patient's eye E. In addition, the type and intensity of the treatment light, the type of the contact lens, the number of times of performing the surgery, the execution interval, and the like may be included in the plan data. The created plan data is sent to the laser treatment apparatus 1 via a filing system such as an electronic medical chart system or a recording medium, and stored in the storage unit 102 (not shown). After such preparation, the following laser treatment can be performed.

(S12: Wear a contact lens)
First, the contact lens CL is attached to the contact lens holder at the tip of the holding portion 61. When the information representing the type of contact lens is included in the plan data, the control unit 101 causes the display unit 7 to display the information representing this type. The doctor or nurse can select the contact lens by referring to the displayed information.

(S13: Set the irradiation pattern etc.)
As in steps S1 to S3 of the first embodiment, the pattern of the irradiation light and the direction thereof are set.

(S14: Determine the direction of slit light)
Similar to step S4 of the first embodiment, the direction of the slit light is determined. In this process, in addition to the conditions set in step S13, the information recorded in the plan data can be referred to. For example, the direction of the slit light can be determined based on the orientation of the portion to be treated first of the treatment target region and the conditions set in step S13.

(S15: Change the direction of the slit)
As in step S5 of the first embodiment, the direction of the slit formed by the slit diaphragm 16 is changed.

(S16: Apply contact lens to patient's eye)
The user applies the contact lens CL mounted on the holder 61 to the cornea Ec of the patient's eye E. At this time, the arm of the holding portion 61 can be arbitrarily deformed. Also, at this stage, the moving mechanism 62 can be operated manually manually. In this example, it is assumed that a corner contact lens CL having a reflective surface inside is used.

  When the information indicating the type and / or the intensity of the treatment light is included in the plan data, the control unit 101 selects the type of the treatment light LT and / or sets the intensity. Further, the control unit 101 sets an arrangement pattern of the irradiation light (spots). In this example, a linear or arcuate array pattern is selected for treatment of the corners. Further, the control unit 101 can control the slit diaphragm 16 (diaphragm driving unit 16A) so as to have a predetermined slit width. The control unit 101 can execute predetermined control other than the above.

(S17: Start observation and shooting)
When the user performs a predetermined operation, the control unit 101 turns on the light source 11 of the illumination system 10. Thereby, the slit light in the direction determined in step S14 is irradiated to the patient's eye E (corner angle), and observation of the patient's eye E (corner angle) becomes possible. Also, the control unit 101 causes the image sensor 43 to start shooting. The shooting field includes at least a part of the illumination range of the slit light. Although moving image shooting is applied in this example, still image shooting may be performed at an appropriate timing. Still image photography is synchronized with control for irradiating aiming light LA and / or treatment light LT, for example.

  The control unit 101 can cause the display unit 7 to display the moving image of the patient's eye E (corner angle) acquired by the image sensor 43 in real time. The user adjusts the position and posture of the contact lens CL while referring to the observation image and the moving image of the corner so that the desired part of the corner is included in the observation visual field and the photographing visual field. Also, the user can perform a desired operation such as adjustment of the slit width.

(S18: Start irradiation of aiming light)
The control unit 101 controls the light source unit 2 and the laser irradiation system 50 to start the irradiation of the aiming light LA to the patient's eye E.

(S19: Aiming at the first treatment target site)
The user or the laser treatment apparatus first adjusts the position and posture of the contact lens CL so that the treatment site is irradiated with the aiming light LA.

  An example in which the laser treatment apparatus executes this adjustment process will be described. The data processing unit 110 identifies a region (corner angle region) in the photographed image corresponding to a corner by analyzing the photographed image (frame of moving image). This processing includes arbitrary image processing such as threshold processing on pixel values and pattern matching.

  Next, in the data processing unit 110, the specified corner area corresponds to which portion of the treatment target site (the whole or a part of the ring) of the corner shown in the plan data (the treatment target site data) Identify. An example of this process will be described. As described above, the treatment target site data is oriented, and the position and posture of the contact lens CL can be recognized. The data processing unit 110 can obtain the direction of the imaging field of the photographed image from the recognition result of the position and the posture of the contact lens CL, and specifies the portion of the treatment target region data corresponding to the direction. As another processing example, based on the fact that the corner area is substantially arc-shaped (where an arc approximating the corner area may be obtained), treatment target region data substantially corresponding to this corner area Ask for a part. This process includes, for example, an affine transformation that translates a corner area (arc-shaped area) on the treatment target site data. Note that this affine transformation does not include rotational movement. In addition, this affine transformation may include enlargement / reduction for matching the size of the corner area according to the imaging magnification and the size of the treatment target region data.

  Subsequently, the data processing unit 110 identifies a plurality of spot images by analyzing the photographed image. The plurality of spot images are arranged in a predetermined pattern (e.g., linear array or arc array).

  The data processing unit 110 obtains displacements between the plurality of spot images and the corner regions. Furthermore, the data processing unit 110 obtains the amount of change (rotational movement amount, tilt amount, etc.) of the position or posture of the contact lens CL that cancels this displacement. The amount of change corresponds to movement control information for controlling the movement mechanism 62.

  The control unit 101 controls the moving mechanism 62 based on the movement control information to guide the spot image (the irradiation position of the pattern of the aiming light LA) onto the corner area. Tracking can be performed in parallel with such processing. The tracking is processing for causing the position and posture of the contact lens CL and / or the irradiation position of the aiming light LA to follow the movement (eye movement, body movement, pulsation, etc.) of the patient's eye E. Tracking is a process of sequentially and sequentially obtaining displacement (displacement of a feature point) between a plurality of captured images (frames) acquired at different timings, and moving mechanism 62 and / or so as to cancel this displacement. Or a process of controlling the optical scanner 52 in real time.

  By carrying out the above-described process shown as a typical example, a pattern of aiming light LA is placed at the first treatment target site at the corner. A state in which aiming is made in this way is shown in FIG. 8A. In FIG. 8A, the symbol AI represents the corner of the eye E, the symbol L1 represents the illumination field (slit illumination field) by slit light, and the symbol M1 represents the first treatment target site (the first treatment target site). Symbol SP1 represents a spot group. The vertical direction and the horizontal direction in FIG. 8A correspond to the definition of the direction described above. In this example, the first treatment target site M1 is set at the uppermost position of the corner angle AI, but in general, the first treatment target site M1 can be set at any position of the corner angle AI. At this stage, the slit illumination field L1 includes the first treatment target site M1. The spot group SP1 is a plurality of spots of the aiming light LA. According to the state as shown in FIG. 8A, the user observes the first treatment target site M1 of the corner angle AI and the spot group SP1 is formed in this site M1, that is, the sight is matched to the site M1. Can confirm that In addition, when the spot group SP1 is formed at a position deviated from the part M1 (that is, when the aim is not matched), the user adjusts the position and the posture of the contact lens CL to adjust the part M1. You can aim it.

(S20: Irradiate therapeutic light)
When the user performs a predetermined operation using the operation unit 6 after the aiming of the treatment target site is completed, the control unit 101 controls the light source unit 2 and the laser irradiation system 50 to direct the treatment target site. The treatment light LT is irradiated. The therapeutic light LT has, for example, the same pattern as the aiming light LA. Generally, the pattern of the treatment light LT is emitted to a part or the whole of the range of the patient's eye E defined by the aiming light LA of the predetermined pattern, or to a range including a part or the whole of the defined range Be done.

(S21: Treatment complete?)
When the laser treatment of the patient's eye E is completed by the irradiation of the treatment light LT performed in step S20 (S21: Yes), the process of this example ends. On the other hand, when the laser treatment is to be continued (S21: No), the process of the present example proceeds to step S22. Steps S22 to S25 include processing for aiming at the site where the laser treatment is to be performed next.

  The determination of whether the laser treatment is complete may be performed automatically or by the user. In the case of the automatic determination, the laser treatment apparatus (for example, the control unit 101 or the data processing unit 110) records the treatment target site where the laser treatment has already been performed, and the history of this record (that is, the treatment where the laser treatment has already been performed) The entire target site) is compared with the target site data in the plan data. When this recording history reaches the entire range indicated by the treatment target site data, the laser treatment apparatus determines that the laser treatment is completed. As another example, it can be determined whether the laser treatment has been completed based on the change history of the direction of the pattern of the irradiation light and the change history of the direction of the slit illumination field. For example, when the start point and the end point of the laser treatment coincide with each other as in the case of a corner, the direction of the pattern of irradiation light or the like changes over 360 degrees between the start and the end of the laser treatment. It is possible to make the above determination using such a history of change in direction. Alternatively, the end point of the laser treatment is specified based on the treatment target site data (and the position of the first treatment target site) in the plan data, and the direction such as the pattern of irradiation light applied at this end point is reached to treat It can be determined that the laser treatment has been completed when the irradiation of the light LT is performed. As another example, it can be determined based on the photographed image of the patient's eye E whether the laser treatment has been completed. For example, the laser treatment apparatus (for example, the data processing unit 110) photographs the patient's eye E at least immediately before and / or immediately after the laser treatment (in the present example, moving image photographing is applied). The laser treatment apparatus detects a characteristic site (for example, a corner angle, a pupil, etc.) of the patient's eye E by analyzing the captured image acquired thereby, and is laser treatment completed from the position and direction of the characteristic site? It is possible to determine whether or not. If laser treatment of another part (other than the corner) of the patient's eye E is subsequently performed, the laser treatment apparatus can output (display etc.) information representing a change in the target of the laser treatment, for example. .

  The case where the user makes the determination will be described. The user can recognize the site where the laser treatment has already been performed. For example, in the case of a corner, it is possible to refer to the orientation of the image being observed, the operation contents of the contact lens CL up to that point, and the like. When it is determined that the laser treatment of the range planned by the preoperative planning is completed, the user performs a predetermined operation (treatment completion operation) using the operation unit 6.

  Laser treatment may be interrupted before the treatment of the area planned by preoperative planning is completed. For example, treatment is interrupted if the patient complains of pain. In such a case, the user can use the operation unit 6 to issue an instruction to stop the treatment. This instruction operation may be the above-described treatment completion operation or a different operation (treatment interruption operation). In the case where the operation for interrupting the treatment is the same as the operation for completing the treatment, the laser treatment apparatus records the record history of the treatment target region and the treatment target region data in the plan data as in the case of the automatic determination By comparing these, it can be determined whether the treatment completion operation corresponds to a treatment interruption.

  When the treatment is interrupted, the laser treatment apparatus (the control unit 101, the data processing unit 110, etc.) can generate information (interruption stage information) representing the interrupted stage. The interruption stage information is, for example, information indicating the position where the treatment was interrupted, the range where the treatment was performed, the range where the treatment was not performed, and the like. The interruption stage information is added, for example, to the treatment target site data in the plan data.

(S22: Generate control information)
If it is determined in step S21 that laser treatment is to be continued (S21: No), the data processing unit 110 generates control information by performing the above-described process on the image of the patient's eye E. The control information includes at least movement control information including information indicating the movement destination (rotation angle of the contact lens CL) of the irradiation position of the irradiation light (the aiming light LA and the treatment light LT) of the predetermined pattern. In this example, the control information may include information for changing the irradiation condition (irradiation condition control information) and information for changing the size and direction of the illumination field by the slit light (slit control information). Good.

(S23: Move the contact lens)
The control unit 101 controls the moving mechanism 62 based on the movement control information generated in step S22 to rotate the contact lens CL by the rotation angle indicated by the movement control information.

(S24: Move the slit diaphragm)
The control unit 101 controls the diaphragm drive unit 16A based on the slit control condition generated in step S22 to rotate the slit diaphragm 16 and arrange the slit diaphragm 16 in the direction indicated by the slit control condition. Note that step S23 and step S24 may be performed in the reverse order. Alternatively, step S23 and step S24 may be performed in parallel.

(S25: Target the next treatment target)
By the steps S23 and S24, the pattern of the aiming light LA is placed at the next treatment target site at the corner. FIG. 8B shows a state in which aiming is achieved at the next treatment target site (second treatment target site) M2 following the first treatment target site M1 shown in FIG. 8A. The second treatment target site M2 is disposed at a position adjacent to the first treatment target site M1 in the clockwise direction. The slit illumination field L2 includes the second treatment target site M2, and the spot group SP2 is formed in the slit illumination field L2 (and the second treatment target site M2). The user can confirm that the spot group SP2 is formed at the site M2, that is, that the sight M2 is aligned with the site M2, while observing the second treatment target site M2 of the corner angle AI. In addition, when the spot group SP2 is formed at a position deviated from the site M2 (that is, when the aim is not matched), the user adjusts the position and the attitude of the contact lens CL to adjust the site M2. You can aim it.

  When step S25 is completed, the process proceeds to step S20. In step S20, the treatment light LT having a predetermined pattern is emitted to the second treatment target site M2 in response to the operation by the user.

  The processes of steps S20 to S25 are repeatedly performed until it is determined as "Yes" in step S21. The state in the middle is shown in FIG. 8C. In FIG. 8C, the symbol Mi indicates the ith treatment target site, the symbol Li indicates a slit illumination field including the site Mi, and the symbol SPi indicates a spot group (i = 1 to n). The slit illumination field Li and the spot group SPi are set in a direction according to the i-th treatment target site Mi of the corner angle AI. The user can confirm that the site Mi is aimed while observing the i-th treatment target site Mi. In addition, when the spot group SPi is formed at a position deviated from the site Mi, the user can aim at the site Mi by adjusting the position and the posture of the contact lens CL.

[effect]
The effects of the laser treatment apparatus according to the present embodiment will be described.

  The laser treatment apparatus of the present embodiment has the following configuration similar to that of the first embodiment. The illumination system illuminates the patient's eye (E) with slit light. The irradiation system irradiates the patient's eye with laser light (aim light LA, treatment light LT). The setting unit sets a pattern of laser light emitted to the patient's eye. The determination unit determines the direction of the slit light based on the pattern set by the setting unit. The control unit controls the irradiation system (first control) for irradiating the patient's eye with the laser light of the pattern set by the setting unit, and illuminates the patient's eye with the slit light of the direction determined by the determination unit. Control of the illumination system (second control).

  The present embodiment further includes a holding unit (61) and a moving mechanism (62). The holder holds an auxiliary lens (contact lens CL, front lens, etc.) to be applied to the patient's eye. The moving mechanism has a function to move the auxiliary lens held by the holding unit. The control unit controls the irradiation system (first control) for irradiating the patient's eye with the laser light of the pattern set by the setting unit, and illuminates the patient's eye with the slit light of the direction determined by the determination unit. Control of the illumination system (second control) and control of the moving mechanism (third control) are performed synchronously. As in the case of the first embodiment, “execute synchronously” means that the execution timings of the first to third controls are synchronized, that is, they are linked (they are associated with each other). Means that). Note that one or more of the first to third controls may be executed asynchronously.

  As an example of synchronous control, the control unit can alternately execute the combination of the first control and the second control and the third control. For example, in the example shown in FIG. 7, control for irradiating the patient's eye irradiated with the slit light with the predetermined pattern of treatment light (combination of the first control and the second control: steps S17, S20 Etc.) and control for moving the auxiliary lens (third control: step S23 etc.) are linked.

  According to this embodiment, as in the first embodiment, since the direction of the illumination field of the slit light can be automatically changed according to the irradiation pattern of the laser light, the operability of the ophthalmic laser treatment is improved. Ru. Furthermore, the movement of the auxiliary lens is also automated. Therefore, the operability of the ophthalmic laser treatment using the auxiliary lens is improved.

Fourth Embodiment
The laser treatment apparatus according to the present embodiment controls the width of the slit light in addition to the control of the direction of the slit light. This laser treatment apparatus may have the same general configuration and optical system as the first embodiment (see FIGS. 1 and 2).

  A configuration example of a control system of the laser treatment apparatus is shown in FIG. The storage unit 102 in this example stores the related information 102 b in advance. Furthermore, in this example, a doctor ID reception unit 104 is provided, and the slit information determination unit 112 is provided in the data processing unit 110. Other components may be similar to those of the first embodiment and the like. Hereinafter, the codes used in the first embodiment are applied mutatis mutandis.

  An example of the related information 102b is shown in FIG. The related information 102b in this example includes a first related information 102b-1 and a second related information 102b-2. The first related information 102 b-1 is, like the related information 102 a of the first embodiment, the pattern of the irradiation light (the aiming light LA and / or the treatment light LT) and the direction of the slit formed by the slit diaphragm 16. (In other words, the direction of the slit light) includes information associated with it. The first related information 102 b-1 shown in FIG. 10 is the same information as the related information 102 a of the first embodiment, so the description thereof will be omitted. The first related information 102b may be different from the related information 102b.

  In the second related information 102b-2, each of a plurality of doctor IDs (doctor identification information) is associated with the width of a slit formed by the slit diaphragm 16 (that is, the width of slit light) (slit width information) Contains information. The doctor ID is identification information assigned to each doctor, and is used, for example, to identify a doctor at a medical institution. Moreover, doctor ID may be public identification information, such as a registration number described in a doctor's license.

The second related information 102 b-2 shown in FIG. 10 is table information in which a slit width “Wik” is associated with a combination of the irradiation pattern “Pi” and the doctor ID “Dk”. Pattern identification information "Pi" corresponding to n types of irradiation patterns is recorded in the column of irradiation patterns (n ≧ 1, i = 1 to n). In the doctor ID column, doctor IDs “Dk” corresponding to a plurality of doctors are recorded (m ≧ 2, k = 1 to m). Here, for a certain combination (i ₁ , k ₁ ) and (i ₂ , k ₂ ), Wi ₁ k ₁ = Wi ₂ k ₂ . That is, the n × m slit widths Wik do not have to be all different, and the same value may be included.

  Similar to the related information 102 a (first related information 102 b-1), the second related information 102 b-2 may be set as a default or may be set by the user. In addition, the user can arbitrarily change the second related information 102b-2 set as the default.

  The doctor ID reception unit 104 receives a doctor ID that uses the laser treatment apparatus. The doctor ID reception unit 104 may include character input means such as a keyboard. In this case, the doctor ID reception unit 104 is included in the operation unit 6. In addition, the doctor ID reception unit 104 may include means for reading the information recorded in the recording medium. For example, the doctor ID reception unit 104 includes a card reader that reads a doctor ID recorded on an ID card issued by a medical institution. The doctor ID reception part 104 is not limited to these, The specific form is arbitrary.

  The slit information determination unit 112 determines the direction of slit light based on the pattern set by the pattern setting unit 103, as in the slit information determination unit 111 of the first embodiment. In this process, the first related information 102b-1 is referred to.

  Further, the slit information determination unit 112 determines the width of the slit light based on the setting result by the pattern setting unit 103. The setting result by the pattern setting unit 103 includes at least one of the conditions that can be set by the pattern setting unit 103, such as the type of the set pattern and the orientation of the set pattern.

  The slit information determination unit 112 of this example determines the width of the slit light based on the pattern set by the pattern setting unit 103, the doctor ID received by the doctor ID reception unit 104, and the related information 102b. More specifically, the slit information determination unit 112 determines the slit width associated with the combination of the pattern “Pi” set by the pattern setting unit 103 and the doctor ID “Dk” received by the doctor ID reception unit 104. Identify "Wik". The specified slit width Wik is adopted as the slit width (width of slit light) in the processing.

  The specified slit width Wik may be used as it is for the second control at the subsequent stage, or the slit width Wik may be changed for the second control. As an example of the latter, it is possible to use the state of the patient's eye E, such as whether or not it is a small pupil eye, or a lesion such as turbidity, for the presence or absence of the change in the slit width Wik It is.

  The control unit 101 controls the light source unit 2 and the laser irradiation system 50 for irradiating the patient's eye E with the laser light of the pattern set by the pattern setting unit 103 (first control), and the slit information determination unit 112 Control (second control) the laser illumination system 50 for illuminating the patient's eye with slit light of the determined orientation and width. The second control in this example includes, for example, the control of the following two types of diaphragm drive units 16A: (1) A pair of slits of the determined direction (slit light) so that the slit diaphragm 16 forms (2) Change the distance between a pair of slit blades so that the slit diaphragm 16 forms a slit (slit light) of a determined width (a pair of slit blades are relatively rotated) Move to control).

  According to this embodiment, as in the first embodiment, since the direction of the illumination field of the slit light can be automatically changed according to the irradiation pattern of the laser light, the operability of the ophthalmic laser treatment is improved. Ru. Further, since the slit width can also be automatically adjusted, the operability can be further improved.

Fifth Embodiment
The laser treatment apparatus according to the present embodiment can adjust the slit width according to the preference of each doctor. This laser treatment apparatus may have the same general configuration and optical system as the first embodiment (see FIGS. 1 and 2).

  A configuration example of a control system of the laser treatment apparatus is shown in FIG. The storage unit 102 of this example stores the related information 102c in advance. Furthermore, in the present example, a doctor ID reception unit 104 is provided, and a slit width determination unit 113 is provided in the data processing unit 110. Also, the pattern setting unit 103 is not provided. Other components may be similar to those of the first embodiment and the like. Hereinafter, the codes used in the first embodiment are applied mutatis mutandis.

  An example of the related information 102c is shown in FIG. The related information 102 c of this example associates slit width information “Wk” with “Dk” of each of a plurality of doctor IDs (k = 1 to m, mm2). The related information 102c is configured in the same manner as a part of the second related information 102b-2 of the related information 102b of the fourth embodiment.

  The doctor ID reception unit 104 receives a doctor ID as in the fourth embodiment. The slit width determination unit 113 acquires slit width information “Wk” associated with the doctor ID “Dk” received by the doctor ID reception unit 104 from the related information 102 c, and based on the acquired slit width information “Wk” To determine the width of the slit light. This process may be the same as the process performed by the slit information determination unit 112 of the fourth embodiment. The control unit 101 controls the light source unit 2 and the laser illumination system 50 to illuminate the patient's eye E with the slit light of the width determined by the slit width determination unit 113. This control may be similar to the control of the slit width in the second control of the fourth embodiment.

  According to the present embodiment, since the slit width set in advance for each doctor can be applied automatically, the operability of the ophthalmic laser treatment is improved.

  The above-described embodiments are merely illustrative for practicing the present invention. A person who intends to practice the present invention can make any modification, omission, addition, substitution, etc. within the scope of the present invention.

DESCRIPTION OF SYMBOLS 1 laser treatment apparatus 2 light source unit 10 illumination system 16 slit diaphragm 16A diaphragm drive unit 50 laser irradiation system 52 light scanner 61 holding unit 62 moving mechanism 101 control unit 102 storage unit 102a, 102b, 102c related information 103 pattern setting unit 104 doctor ID Reception unit 110 Data processing unit 111, 112 Slit information determination unit 113 Slit width determination unit

Claims (2)

An illumination system that illuminates a patient's eye with the slit light including a slit diaphragm that generates slit light from illumination light output from a light source;
An irradiation system for irradiating the patient's eye with laser light;
A setting unit configured to set a pattern of laser light emitted to the patient's eye;
A determination unit that determines the direction of the slit light based on the pattern set by the setting unit;
The first control for controlling the irradiation system to irradiate the patient eye with the laser light of the pattern set by the setting unit, and the patient eye is illuminated with the slit light of the direction determined by the determination unit A control unit that executes a second control to control the slit diaphragm;
A storage unit for storing in advance related information in which slit width information is associated with each of a plurality of doctor identification information;
A reception unit for receiving doctor identification information;
The determination unit determines the width of the slit light based on the pattern set by the setting unit, the doctor identification information received by the reception unit, and the related information.
The said control part controls the said slit diaphragm so that the said patient eye may be illuminated with the slit light of the direction and width which were determined by the said determination part in said 2nd control. An illumination system that illuminates a patient's eye with the slit light including a slit diaphragm that generates slit light from illumination light output from a light source;
An irradiation system for irradiating the patient's eye with laser light;
A storage unit for storing in advance related information in which slit width information is associated with each of a plurality of doctor identification information;
A reception unit for receiving doctor identification information;
A slit width determination unit that acquires slit width information associated with the doctor identification information received by the reception unit from the related information, and determines the width of the slit light based on the acquired slit width information;
A control unit configured to control the slit diaphragm so as to illuminate the patient's eye with slit light having a width determined by the slit width determination unit.