JP2019134998A - Laser treatment device - Google Patents

Abstract

To provide a laser treatment device which allows an operator to suitably observe both an observation image of a patient's eye and a display about an irradiation condition.SOLUTION: A laser treatment device for irradiating an affected part of a patient's eye with a treatment laser beam includes: illumination means for projecting an illumination light to an observation part of the patient's eye; presentation means for presenting an observation image of the observation part; and display means for displaying a parameter relating to the irradiation condition of the treatment laser beam on the observation image presented by the presentation means. The display means determines a display position of the parameter to be displayed on the observation image, with consideration given to an illumination region of the observation part illuminated by an illumination means.SELECTED DRAWING: Figure 5

Description

  The present disclosure relates to a laser treatment apparatus that irradiates an affected area of a patient's eye with treatment laser light.

  2. Description of the Related Art There is known a laser treatment apparatus that causes a surgeon to observe a patient's eye and irradiates a treatment laser beam to an affected part of the patient's eye. For example, in the laser treatment device disclosed in Patent Document 1, the color information range related to the selected laser wavelength is displayed in the observation field of the eyepiece unit for observing the observation image.

Japanese Patent Laid-Open No. 11-276500

  In the case where the observation image of the patient's eye and the display of the aspect different from the observation image (color information in Patent Document 1) are presented in the visual field of the operator, the observation information may be difficult to see due to the presentation information. In addition, the presentation information may be difficult to see depending on the observation image.

  An object of the present disclosure is to provide a laser treatment apparatus that allows an operator to visually recognize both an observation image of a patient's eye and a display related to irradiation conditions.

In order to solve the above problems, the present invention is characterized by having the following configuration.
A laser treatment apparatus for irradiating a treatment laser beam to the affected part of the patient's eye, and illuminating means for projecting illumination light to the observed region of the patient's eye, and presentation means for presenting an observation image of the observation site, said presentation Display means for displaying a parameter relating to the irradiation condition of the treatment laser light on the observation image presented by the means, the display means taking into account the illumination region of the observation site illuminated by the illumination means Then, the display position of the parameter to be displayed on the observation image is determined.

  According to the present disclosure, it is possible to provide a laser treatment apparatus in which an operator can preferably visually recognize a display regarding an observation image of a patient's eye and irradiation conditions.

It is a schematic block diagram of the control system and the optical system of the laser treatment apparatus of this embodiment. It is a figure explaining the deformation | transformation of the opening part of an illumination field stop. It is a figure explaining the deformation | transformation of the opening part of an illumination field stop. It is a figure explaining the deformation | transformation of the opening part of an illumination field stop. This is an observation image and parameters to be presented to the operator. It is explanatory drawing regarding the display position of a parameter. It is explanatory drawing regarding the display position of a parameter. It is a figure explaining the example of a change of the display position of a parameter. It is a figure for a comparison.

  Hereinafter, exemplary embodiments of the present disclosure will be described with reference to the drawings. As an example of an ophthalmic apparatus for observing a patient's eye for surgery, examination, or diagnosis, in this embodiment, in this embodiment, secondary cataract, iridotomy, laser vitrectomy, secondary cataract, selective laser trabeculoplasty ( A laser treatment apparatus that performs an operation such as Selective Laser Trabeculoplasty (SLT) using a giant pulse will be described.

  FIG. 1 is a schematic configuration diagram of a control system and an optical system of the laser treatment apparatus 1 of the present embodiment. As an example, the laser treatment apparatus 1 of the present embodiment includes a laser irradiation optical system 10, an aiming optical system 20, an illumination optical system 30, an observation optical system 40, a display optical system 50, and a control unit 60.

<Laser irradiation optical system>
The laser irradiation optical system 10 of the present embodiment is a treatment laser beam irradiation means, and is used for irradiating a treatment laser beam to a site to be treated. The laser irradiation optical system 10 of this embodiment includes a laser light source 11, an energy adjustment unit 13, a shift adjustment unit 15, a dichroic mirror 22, an expander lens group 23, a dichroic mirror 24, and an objective lens 25. The laser irradiation optical system 10 has an optical axis L1. The laser light source 11 emits treatment laser light for treating the tissue of the patient's eye Ep. In the present embodiment, a neodymium-doped YAG (yttrium, aluminum, garnet) crystal (Nd: YAG) is used as the laser rod of the laser light source 11. A wavelength conversion element (not shown) can convert infrared laser light (wavelength: 1064 nm) emitted from the laser light source 11 into visible laser light (wavelength: 532 nm). Note that other types of solid-state lasers, gas lasers, semiconductor lasers, and the like may be used as the treatment laser light.

  The energy adjustment unit 13 of the present embodiment is an energy adjustment unit that adjusts the emission energy of the treatment laser light, and is used to adjust the energy of the treatment laser light emitted from the laser treatment apparatus 1. The energy adjustment unit 13 of the present embodiment attenuates the treatment laser light emitted from the laser light source 11. The energy adjusting unit 13 of the present embodiment includes a half-wave plate and a polarizing plate. The half-wave plate and the polarizing plate are disposed on the optical axis L1, and the motor 14 is connected to the half-wave plate. The controller 60 can adjust the energy of the treatment laser light by rotating the half-wave plate. The shift adjusting unit 15 can shift the condensing position of the treatment laser light far or near with respect to the condensing position of the aiming light (hereinafter referred to as a focus shift). A motor 16 is connected to the shift adjustment unit 15, and the control unit 60 can adjust the focus shift position. In addition, the condensing position of aiming light and the condensing position of treatment laser light may be the same position.

<Aiming optics>
The aiming optical system 20 of the present embodiment is an aiming unit that irradiates a site to be treated with aiming light, and is used to aim at the site to be treated. The aiming optical system 20 of the present embodiment has an optical axis L2. The aiming optical system 20 of the present embodiment shares the optical path from the dichroic mirror 22 to the objective lens 25 with the laser irradiation optical system 10. An aiming light source 12, a collimator lens 21, and an aperture 27 are disposed in the optical path of the laser irradiation optical system 10 branched from the dichroic mirror 22. The aiming light emitted from the aiming light source 12 is separated into two light beams by the aperture 27 and then condensed at the tip of the objective lens 25.

<Illumination optics>
The illumination optical system 30 of the present embodiment is an illuminating unit that projects illumination light onto the observation site, and is used to illuminate the observation site including the tissue to be treated. The illumination optical system 30 of this embodiment includes a lamp 31, a condenser lens 32, an illumination field stop 33, a projection lens 34, and a prism 35. The illumination optical system 30 has an optical axis L3. For example, a white light emitting element or the like may be used for the lamp 31. The optical axis L3 passes through the opening area of the illumination field stop 33. The illumination field stop 33 is provided at a position optically conjugate with the observation site via the projection lens 34. That is, in this embodiment, the illumination field stop 33 can suppress the illumination range of the illumination light at the observation site. In other words, the illumination optical system 30 of the present embodiment forms an image of the opening portion of the illumination field stop 33 and an image of the light shielding portion at the observation site. The control unit 60 has a function as a dimming unit for the illumination light projected to the observation site, and in this embodiment, the light emission amount of the lamp 31 can be adjusted.

  The illumination optical system 30 of the present embodiment includes an adjusting unit that adjusts the illumination area of the illumination light projected onto the observation site. In the present embodiment, the opening shape of the illumination field stop 33 is deformed as the adjusting means. In the present embodiment, the driving means 36 is connected to the illumination field stop 33, and the control unit 60 can deform the opening shape of the illumination field stop 33. In the present embodiment, the three deformation mechanisms are combined to serve as the adjusting means. 2A to 2C show a state in which the opening diameter of the illumination field stop 33 is deformed by the first deformation mechanism. 3A to 3C show a state in which the shape of the opening of the illumination field stop 33 is deformed from a circular shape to a slit shape by the second deformation mechanism. 4A to 4C show how the slit angle (direction in which the long axis of the slit shape faces) is changed by the third deformation mechanism. The laser treatment apparatus 1 of the present embodiment can deform the opening shape of the illumination field stop 33 by combining the three deformation mechanisms described above. Thus, for example, when projecting slit-shaped light (hereinafter referred to as slit light), the slit width, slit length, and slit angle can be deformed. Each of the first to third deformation mechanisms can deform the opening shape of the illumination field stop 33 in multiple stages. For the mechanism of the illumination field stop 33, see, for example, Japanese Patent Application Laid-Open No. 6-142047. The method for deforming the opening shape of the illumination field stop 33 is not limited to the method in which the control unit 60 controls the driving unit 36. For example, the opening shape of the illumination field stop 33 may be changed by an operator manually operating a knob or dial connected to the illumination field diaphragm 33. In this case, the control unit 60 may detect an opening shape of the illumination field stop 33 by inputting an output signal of a detector provided in the illumination field diaphragm 33.

  In addition, although the shape of the illumination field stop 33 of this embodiment is a symmetrical shape centering | focusing on the optical axis L3, an asymmetrical shape may be sufficient. Further, the opening of the illumination field stop 33 may not be located on the optical axis L3. In addition, the deformation | transformation method of the opening shape of the illumination field stop 33 is not restricted to this. For example, the illumination optical system 30 may change only the slit angle. Moreover, you may project the light which leaves | separates in an observation site | part as illumination light.

  The illumination optical system 30 of the present embodiment can change the shape of the illumination light projected to the observation site into a circle, a substantially square, or a substantially rectangular (slit light) by the adjusting means described above. As a result, the observation site can be preferably observed. For example, by projecting slit light to the observation site, unnecessary reflection (flare, ghost) generated in the cornea of the patient's eye Ep can be suppressed, and the observation site (eg, the crystalline lens) can be suitably observed. In addition, the control part 60 of this embodiment can detect the opening shape (in other words, illumination shape) of the illumination field stop 33 using the control signal to the drive means 36. The illumination field stop 33 may change the opening shape by a manual operation by the user. The illumination field stop 33 may include a detector and output a signal related to the opening shape of the illumination field stop 33 to the control unit 60.

<Observation optics>
The observation optical system 40 according to the present embodiment is an observation unit that observes an observation site, and is used by an operator to observe the observation site of the patient's eye E. The observation optical system 40 of this embodiment is incorporated in a microscope 41. The observation optical system 40 of the present embodiment includes a variable magnification optical system 42, a beam splitter 51, an imaging lens 44, an erecting prism group 45, a field stop 46, and an eyepiece lens 47. The observation optical system 40 has an optical axis L4. The dichroic mirror 24 and the objective lens 25 are shared by the laser irradiation optical system 10 and the observation optical system 40. The variable magnification optical system 42 is used to change the observation magnification. For example, as the variable magnification optical system 42, a rotating drum in which a plurality of lenses having different refractive powers are combined may be used. Note that the observation optical system 40 may not include the variable magnification optical system 42.

  The beam splitter 51 is installed on the optical axis L4. The beam splitter 51 of this embodiment is an optical path combining unit, and combines the optical path of the display optical system 50 and the optical path of the observation optical system 40. Details of the display optical system 50 will be described later. The field stop 46 is provided at a position conjugate with the observation site via the lens of the observation optical system 40. The field stop 46 masks an unnecessary area of the observation image. The field stop 46 of this embodiment masks the periphery of the observation image. The eyepiece 47 of the present embodiment is a presentation unit that presents an observation image of an observation site to the operator, and is used by the operator to look into the operator's eyes Eo. The observation optical system 40 of this embodiment has diopter adjustment means. The diopter adjusting means moves the eyepiece 47 along the optical axis L4. By the diopter adjusting means, the field stop 46 and the fundus of the operator's eye Eo can be in an optically conjugate positional relationship.

<Display optical system>
The display optical system 50 of the present embodiment is used as a display unit that displays information related to the operation of the laser treatment apparatus 1 to display the irradiation conditions (information) of the treatment laser beam to the surgeon. The display optical system 50 according to the present embodiment shares the members from the beam splitter 51 to the eyepiece lens 47 with the observation optical system 40. A display unit 53 and a collimator lens 52 are provided in the optical path of the display optical system 50 branched from the observation optical system 40. The display optical system 50 has an optical axis L5. The beam splitter 51 joins the display optical system 50 to the observation optical system 40. The beam splitter 51 makes the optical axis L5 and the optical axis L4 coaxial. The display unit 53 has a display surface 53a. The display surface 53a is arranged at a position conjugate with the field stop 46 via the lenses (collimator lens 52, imaging lens 44).

  The control unit 60 of the present embodiment displays a parameter related to the treatment laser light irradiation condition on the display surface 53a. Specifically, the display regarding the type of laser light irradiated to the patient's eye Ep is set as the parameter Sa, the display regarding the energy of the laser light irradiated to the patient's eye Ep is set as the parameter Sb, the display regarding the burst number is set as the parameter Sc, and the focus shift. The display regarding the position is displayed on the display surface 53a as the parameter Sd (see FIG. 7). Information displayed on the display surface 53a is presented within the field of view of the operator's eye Eo looking through the eyepiece 47 (see FIG. 5). Note that the display content of each parameter is sequentially updated when the surgeon changes the operation panel or the like. Further, when the operator looks into the eyepiece 47, the parameter S is displayed in a predetermined direction on the display surface 53a so that the parameter S 'can be visually recognized as an erect image.

  Details of each parameter displayed on the display surface 53a will be described. The laser treatment apparatus 1 of the present embodiment can irradiate the patient's eye Ep with 1064 nm treatment laser light and 532 nm treatment laser light. A display corresponding to the wavelength of the treatment laser light irradiated to the patient's eye Ep is displayed at the position of the parameter Sa. As an example, when irradiating treatment laser light having a wavelength of 1064 nm, “YAG” is displayed at the position of parameter Sa (see FIG. 7). When irradiating treatment laser light having a wavelength of 532 nm, “SLT” is displayed at the position of parameter Sa.

  The energy adjustment unit 13 of the present embodiment can adjust the energy of the treatment laser beam in the range of 0.3 mJ to 10.0 mJ. A display corresponding to the energy value of the treatment laser beam emitted from the laser treatment apparatus 1 is displayed at the position of the parameter Sa. As an example, when irradiating a treatment laser beam of 2.0 mJ, a letter “E: 2.0” is displayed at the position of the parameter Sb (see FIG. 7).

  The laser treatment device 1 of the present embodiment can intermittently irradiate the treatment laser beam when the trigger switch 67 is pressed (referred to as a burst). In the present embodiment, the number of bursts can be adjusted between 1 and 3. A display corresponding to the number of bursts is displayed at the parameter Sc. As an example, when the number of bursts is 3, the letter “B: 3” is displayed at the parameter Sc (see FIG. 7).

  The shift adjustment unit 15 of the present embodiment can adjust the focus shift position in the range of −500 μm to +500 μm. A display corresponding to the focus shift position is displayed at the position of the parameter Sd. As an example, when the focus shift position is +125 μm, the character “P125” is displayed at the position of the parameter Sd (see FIG. 7).

  The parameter display mode is not limited to characters. For example, the parameters may be expressed by icons and indicators. The types of parameters displayed on the display surface 53a are not limited to the parameters Sa to Sd. For example, the cumulative number of times of irradiation of the treatment laser light after turning on the laser treatment apparatus 1 may be displayed. The type of parameter displayed on the display surface 53a may be selectable according to the operator's preference. For example, only the parameter Sa may be displayed on the display surface 53a. Further, the display position of the parameter may be selectable according to the operator's preference. It is preferable that these settings selected by the surgeon are stored in the nonvolatile memory 65. Here, it is more preferable to store the setting for each operator.

  In the present embodiment, an LCD (liquid crystal display) is used for the display unit 53. As the display unit 53, an organic EL display, a dot matrix LED, or the like may be used. In addition, the display unit 53 may be configured by combining an opening formed in an icon shape or an indicator shape and one or more light sources. Further, a liquid crystal panel may be arranged at the position of the field stop 46. In the present embodiment, the control unit 60 displays the parameter S in red.

<Interrelation between optical systems>
The mutual relationship of each optical system of the laser treatment apparatus 1 of this embodiment is demonstrated. In the present embodiment, the optical axis L3 and the optical axis L4 intersect at the observation site. In the present embodiment, the illumination field stop 33, the observation site, the field stop 46, the display surface 53a, and the fundus of the operator's eye Eo are optically conjugate (for reference, the optical axes in FIG. 1). The conjugate position is marked with an X). Thus, when the operator observes the observation region, the observation image is displayed on the observation region, the illumination area of the illumination optical system 30 (in other words, the projection image of the light shielding portion of the field stop 46), and the display unit 53. Can be visually recognized. Note that the observation optical system 40 may not include the field stop 46.
<Control unit>
The control unit 60 is an example of a control unit that controls the operation of the laser treatment apparatus 1. The control unit 60 of this embodiment includes a CPU 61 (processor), a ROM 62, a RAM 63, a nonvolatile memory 65, and the like. The CPU 61 controls each part in the laser treatment apparatus 1. The ROM 62 stores various programs, initial values, and the like. The RAM 63 temporarily stores various information. The nonvolatile memory 65 is a non-transitory storage medium that can retain stored contents even when power supply is interrupted. For example, a USB memory detachably attached to the control unit 60, a flash ROM built in the control unit 60, or the like can be used as the nonvolatile memory 65. You may use the non-volatile memory 65 as a memory | storage means to memorize | store the parameter regarding irradiation of a treatment laser beam. As the storage means, the RAM 63, the ROM 62, or another state holding medium (for example, dip SW) may be used.

  The control unit 60 of the present embodiment is connected to the laser light source 11, the motor 14, the motor 16, the aiming light source 12, the display unit 53, the display unit 66, the trigger switch 67, the buzzer 68, and the like. The control unit 60 of this embodiment is a display control unit of the display unit 53. The display unit 66 displays operating conditions and the like of the laser treatment apparatus 1. A parameter S described later is also displayed on the display unit 66. The control unit 60 of the present embodiment has a function as display control means for controlling the display of the display unit 66. The display unit 66 may have a touch panel function, and may also serve as a display unit and an input unit. The trigger switch 67 is operated by an operator to input a treatment laser light irradiation execution instruction.

<Display of observation image in area>
The display of parameters relating to the treatment laser light irradiation conditions will be described. FIG. 9 is illustrated for comparison with the display of this embodiment. An observation image IMG and parameters S ′ (Sa ′ to Sd ′) are presented in the visual field of the operator looking through the eyepiece 47. The observation image IMG corresponds to the observation site. The observation image IMG includes an illumination area U corresponding to the opening of the illumination field stop 33 and a light shielding area N corresponding to a projection image of the light shielding part of the illumination field stop 33. The parameter S ′ is a display relating to the irradiation condition (information) of the treatment laser beam. The parameter S ′ indicates a projection image of the parameter S displayed on the display surface 53a of the display unit 53.

  In FIG. 9, the parameter Sb ′ and the parameter Sc ′ overlap the illumination area U. As a result, information on the observation site in the illumination area U is missing. In addition, the information on the observation site in the illumination area U is difficult to see with the parameter S ′. As a result, for example, the operator has to take his eyes off the eyepiece 47 to check the display on the display unit 66. Further, since the illumination area U is bright, the brightness in the illumination area U and the brightness of the parameter S ′ (parameter Sb ′, parameter Sc ′) are close to each other, and it is difficult to visually recognize the parameter S ′. As a result, for example, an operator operates the operation member and the like to temporarily reduce the amount of illumination light. If the display of the parameter S ′ is too bright, only the parameter S ′ may be noticeable and it may be difficult to visually recognize the observation image IMG.

  FIG. 5 is a view of an observation image presented by the laser treatment apparatus 1 of the present embodiment. In FIG. 9 exemplarily shown for comparison, the parameter S ′ is displayed in the illumination area U. However, in this embodiment, the parameter S ′ is displayed outside the illumination area U as shown in FIG. The control unit 60 of the present embodiment determines the display position of the parameter S ′ in the observation image IMG in consideration of the illumination region U to the observation site (a method for determining the display position will be described later). Specifically, the control unit 60 displays the parameter at the position where the image of the light shielding part of the illumination field stop 33 is formed in the region of the observation image IMG. Accordingly, the operator can preferably visually recognize both the observation image IMG and the parameter S ′. In addition, the control unit 60 according to the present embodiment determines the brightness of the parameter S ′ in consideration of the amount of illumination light. Thereby, for example, the surgeon can preferably observe the observation image IMG even if the parameter S ′ is displayed.

<Determination of parameter display position>
The display position of the parameter S ′ determined by the control unit 60 will be described with reference to FIGS. The control unit 60 according to the present embodiment acquires information related to the aperture shape of the illumination field stop 33 from the nonvolatile memory 65. Specifically, in the nonvolatile memory 65, parameters used for controlling the driving unit 36 and parameters related to the aperture shape of the illumination field stop 33 are associated and stored in advance as table data. The control unit 60 calls data related to the aperture shape of the illumination field stop 33 corresponding to the control data used for controlling the driving unit 36 from the nonvolatile memory 65. And the control part 60 determines the display position of the parameter S using the data regarding the opening shape of the illumination field stop 33 called. Here, the control unit 60 determines the display position of the parameter S in consideration of the illumination area U. In other words, in the present embodiment, the adjustment unit of the illumination optical system 30, the nonvolatile memory 65, and the control unit 60 constitute an area detection unit that detects the illumination area U adjusted by the adjustment unit. And the control part 60 determines the display position of a parameter based on the illumination area | region U detected by the area | region detection part.

  FIG. 6 is a diagram for explaining the area of the display surface 53a. In FIG. 6, when the display surface 53 a is projected onto the position of the field stop 46, the area that overlaps the illumination area U is denoted by the symbol (U), the area that overlaps (shields) the field stop 46 is the light shielding area P, and the control unit 60. An area where it is determined that the parameter S can be displayed is shown as a displayable area M. The control unit 60 of the present embodiment determines that a region that does not overlap the illumination region (U) and does not overlap the light shielding region P is a displayable region M in which parameters can be displayed. When the control unit 60 reads data related to the aperture shape of the illumination field stop 33 from the nonvolatile memory 65, the control unit 60 uses the data to determine the distribution of the illumination area (U) on the display surface 53a. At this time, the control unit 60 considers the magnification of the observation optical system 40 when performing the distribution of the illumination area (U). Specifically, the magnification of the observation optical system 40 is taken into account using the signal of the detector provided in the variable magnification optical system 42. The control unit 60 calls the shape data of the field stop 46 stored in advance in the nonvolatile memory 65, and determines the distribution of the light shielding region P on the display surface 53a. And the control part 60 determines the area | region which does not overlap with the illumination area | region (U) and the light shielding area P among the area | regions of the display surface 53a as the displayable area | region M. FIG.

  FIG. 7 shows a state in which the control unit 60 displays the parameters S (Sa to Sd) in the displayable area M described above. The control unit 60 according to the present embodiment determines the display positions of a plurality of types of parameters in consideration of the distribution of the displayable area M. In detail, the control unit 60 may display some of the plurality of parameters at positions separated from the positions where other parameters are displayed in consideration of the shape of the illumination area U. More specifically, the control unit 60 may lay out the four types of parameters in two groups. The control unit 60 arranges the parameter Sa and the parameter Sb in the displayable area M above the page of FIG. 6, and arranges the parameter Sa and the parameter Sb in the displayable area M below the page of FIG. Yes. Thereby, since the parameter S is presented in the vicinity of the illumination area U, movement of the operator's line of sight can be suppressed. In addition, the control part 60 of this embodiment determines the brightness of the parameter S displayed on the display surface 53a in consideration of the lighting amount of the lamp 31. For example, the control unit 60 increases the display light amount of the parameter S as the illumination light amount increases. Accordingly, the operator can preferably visually recognize the parameter S ′ regardless of the amount of illumination light.

  As described above, the control unit 60 determines the display position of the parameter S in consideration of the illumination area U, and displays the parameter S on the display surface 53a. When the surgeon peeks through the eyepiece 47, the observation image IMG and the parameter S 'are displayed in the manner shown in FIG. Needless to say, if the observation optical system 40 does not include the field stop 46, the parameter S 'can also be displayed in the region indicated by the light-shielding region P in FIG.

<Example of change in display position>
FIG. 8 is a diagram illustrating an example of a change in the display position of the parameter S ′. In FIG. 8A, the control unit 60 displays the parameter S ′ outside the illumination area U in consideration of the slit-shaped illumination area U extending in the vertical direction on the paper surface. Unlike FIG. 5, the control unit 60 has a layout in which four types of parameters S (Sa to Sb) are arranged in the vertical direction on the paper without being separated. That is, the control unit 60 determines the display position of the parameter S ′ in consideration of the distribution of the illumination area U within the area of the observation image IMG. In FIG. 8B, the control unit 60 displays the parameter S ′ outside the illumination area U in consideration of the slit-shaped illumination area U extending from the upper right direction to the lower left direction on the paper surface. The control unit 60 lays out the four types of parameters S (Sa to Sb) in two groups as in FIG. 5 and 8 are laid out in the order of parameter Sa ′, parameter Sb ′, parameter Sb ′, and parameter Sc ′ from the upper side to the lower side of the page. As a result, even if the control unit 60 changes the display position of the parameter S ′ in consideration of the distribution of the illumination area U, the operator can easily search for the parameter S ′ to be confirmed.

  The display position of the parameter S ′ shown in FIGS. 5 and 8 is merely an example. The control unit 60 may determine the display position of the parameter S ′ according to the distribution (shape, area, position) of the illumination area U in the area of the observation image IMG. For example, the display position of the parameter S ′ may be determined according to the slit length, slit width, and slit angle of the slit light. In addition, even when the illumination area is separated into a plurality of areas, the parameter S ′ may be displayed at a position that does not overlap with each illumination area. Note that the parameter S ′ does not have to strictly avoid the illumination area U. That is, the parameter S ′ may overlap a part of the illumination area U. It is only necessary that the controller 60 determines the display position of the parameter S ′ in consideration of the illumination area U so that the overlap between the parameter S ′ and the illumination area U is reduced. Further, the display mode of each parameter S ′ may be changed depending on the distribution of the illumination area U. For example, when the distribution of the illumination region U is large in the region of the observation image IMG, the control unit 60 may reduce the display area of each parameter S ′. Further, the number of characters in each parameter S ′ may be reduced. For example, in FIG. 5, the parameter Sb ′ is displayed as “E: 2.0”, but this display may be omitted as “2.0”. In addition, the control unit 60 may increase or decrease the type of the parameter S ′ to be displayed in accordance with a change in the ratio in which the illumination area U is distributed.

<How to use>
An example of the operation of the laser treatment apparatus 1 will be described. When the surgeon turns on the laser treatment apparatus 1, a test irradiation is performed after a few seconds. The test irradiation is performed in a state where a safety shutter is inserted on the optical axis L1 of the laser irradiation optical system 10, and the treatment laser light emitted from the laser light source 11 is transmitted by a beam splitter installed on the optical axis L1. Reflected and incident on the photodetector. The control unit 60 calculates the energy of the treatment laser beam from the amount of received light detected by the photodetector and displays it on the parameter Sa on the display surface 53a. The test irradiation is performed every time energy is set by the operation unit, and the display of the parameter Sa is updated each time. Also, when the irradiation mode of the treatment laser beam is changed, the test irradiation and the parameter Sa display are updated.

  Thereafter, the surgeon operates an input switch or the like on the control panel to set irradiation conditions such as an irradiation mode, a laser output amount, and the number of irradiation pulses according to the purpose of treatment of the patient's eye Ep. When the setting is completed, the surgeon places the patient's eye Ep at a predetermined position. The operator sits in a predetermined position so as not to move, and then looks into the eyepiece 47. In the field of view of the surgeon, the observation image IMG and each parameter S ′ in the form shown in FIG. 5 are displayed. The surgeon moves the slit delivery of the laser treatment apparatus 1 by operating a joystick or the like so that the slit light projected by the illumination optical system 30 is on the patient's eye Ep while looking into the eyepiece.

  The surgeon adjusts the light quantity and focus of the slit light, sets the contact lens 26 on the patient's eye Ep, and observes the observation site of the patient's eye Ep while looking into the eyepiece 47 again. In laser irradiation, a switch provided on the joystick is operated to set the laser output amount. When the laser output amount is set, the control unit 60 controls the energy adjustment unit 13, the display unit 53, the display unit 66, and the like based on the set conditions. Note that the display of the parameter Sb 'is updated (changed) with the change of the laser output amount. The display of other parameters (Sa ′, Sc ′, Sd ′) is updated (changed) whenever the corresponding setting is changed.

  The aiming light emitted from the aiming light source 12 is divided into two and then enters the patient's eye Ep. Since the focus position of the treatment laser beam is shifted in the optical axis direction by the distance displayed as the parameter Sd ′ from the intersection of the two aiming lights, the surgeon sets the laser focus position to the affected area with reference to this intersection. Operate the joystick etc. to align it.

  When the alignment by the aiming light is completed, the surgeon transmits a trigger signal by pressing the trigger switch 67. Upon receipt of the trigger signal, the control unit 60 drives and controls the actuator to retract the safety shutter of the laser irradiation optical system 10 from the laser optical axis (optical axis L1) and emit therapeutic laser light.

  The treatment laser light is emitted from the laser light source 11 and then irradiated to the patient's eye Ep through the dichroic mirror 24, thereby causing tissue destruction due to plasma generation in the affected part of the patient's eye Ep. Based on the number of irradiations displayed in the parameter Sc ′, the control unit 60 emits the treatment laser light by the number of irradiations.

<Others>
In the present embodiment, the ocular lens 47 is used as the presenting means for presenting the observation image of the observation site where the illumination light is projected. However, the presenting means is not limited to this. It is only necessary to present an observation image to the surgeon. For example, a monitor connected to the laser treatment apparatus 1 may be used as the presenting means. In this case, for example, the imaging element is arranged on the optical path separated from the observation optical system 40 to image the observation site, and the observation image IMG is displayed on the monitor connected to the laser treatment apparatus 1 using the output signal of the imaging element. do it. In the observation image IMG displayed on the monitor, the parameter S relating to the irradiation condition of the treatment laser light may be displayed in the region of the observation image IMG in the same manner as in the present embodiment. Here, instead of the eyepiece 47 and the display optical system 50, the laser treatment apparatus 1 may include an EVF (electronic viewfinder).

  Alternatively, the observation image IMG may be taken by the observation optical system 40, and the control unit 60 may detect the illumination area U using image processing. The control unit 60 performs image processing and detects the illumination area U from the observation image. Then, the display position of the parameter is determined in consideration of the detected illumination area U. For example, the illumination area U may be detected by performing image processing using luminance information of the observation image. In the same manner as the above-described embodiment, a synthesized image may be generated by synthesizing the parameter S related to the irradiation condition of the treatment laser light on the observation image IMG and outside the detected illumination area U. By detecting the illumination area by image processing, it is considered that the illumination area U can be accurately detected with a simple configuration. Note that the amount of illumination light may be detected using image processing.

  Further, the change (change) in the display mode of the parameter S ′ changed by the display means is not limited to the brightness. For example, the display color of the parameter S ′ may be changed in conjunction with a change in the operating condition of the laser treatment apparatus 1. For example, when a color filter is inserted on the optical axis L3 of the illumination optical system 30, the hue of the observation image IMG approaches the hue of the parameter S ′, and the parameter S ′ may be difficult to see. In such a case, the control unit 60 may determine the display color of the parameter S ′ in consideration of the entire observation image IMG or the hue of the region of interest. As an example, the control unit 60 may display the parameter in green in the color observation mode (white illumination) and display the parameter in red in the red free observation mode (green illumination).

  In addition, although this embodiment demonstrated using the laser treatment apparatus 1, the application range of this technique is not restricted to the laser treatment apparatus 1. FIG. For example, the present invention may be applied to a slit lamp microscope (slit lamp). Further, the present invention may be applied to a mydriatic retinal camera that requires delicate observation. Further, the present invention may be applied to other devices for observing the anterior eye portion, devices for observing the fundus, and the like. With such an apparatus, the technique relating to the display of the parameter S ′ disclosed in the present embodiment can be applied when displaying the parameter relating to the operating condition of the apparatus. Note that the observation with a chromatic color has a large amount of information, and the appearance of the observation image is often important. The application of the present technology is considered particularly suitable when observing the observation site with a chromatic color.

<Action and effect>
The laser treatment apparatus 1 of this embodiment irradiates a treatment laser beam to an affected part of a patient's eye. The laser treatment apparatus 1 includes an illuminating unit that projects illumination light onto an observation site of the patient's eye Ep, a presentation unit that presents an observation image IMG of the observation site onto which the illumination light has been projected, and an observation image IMG. Display means for displaying the parameter S ′ relating to the irradiation condition of the treatment laser light, and the display means considers the illumination region U of the illumination means, and displays the display position of the parameter S ′ in the observation image IMG. decide. Thereby, the operator (operator) can preferably visually recognize the observation image IMG of the patient's eye Ep and the display (parameter S ′) regarding the irradiation condition. For example, it is possible to suppress the inconvenience that the parameter S ′ overlaps with the illumination region U and the observation site information is lost, making observation difficult. Further, the parameter S ′ overlaps the illumination area U, and the inconvenience that the operator cannot easily see the parameter S ′ can be suppressed by the brightness of the illumination area U. Therefore, it is easy for the surgeon to quickly treat the affected area.

  In addition, the illumination unit of the laser treatment apparatus 1 of the present embodiment includes an illumination field stop 33 having an opening and a light-shielding part at a position conjugate with the observation site, and an image of the opening (illumination region U) at the observation site. An image of the light shielding part (light shielding region N) is formed. The display means displays the parameter S ′ at the position where the image of the light shielding part is formed in the region of the observation image IMG. Thereby, for example, the contrast between the parameter S ′ and the background of the parameter S ′ can be easily obtained, and the operator can easily visually recognize the display content of the parameter “. Further, the control unit 60 can easily detect (detect) the illumination area and can display the parameter S ′ with a simple configuration.

  In addition, the parameter S ′ of the laser treatment apparatus 1 of the present embodiment includes a plurality of different types of parameters (Sa ′ to Sb ′), and the display unit considers the shape of the illumination region U and includes a plurality of parameters. Some of the parameters may be displayed at a position separated from the position where other parameters are displayed. Thereby, for example, a plurality of parameters can be displayed while maintaining the number of characters or the size of the characters of the parameter S ′. Therefore, the parameter S ′ can be displayed to the operator without impairing the presentation information. Further, it is easy to display the parameter S ′ in the vicinity of the illumination area U that can be said to be the operator's area of interest. As a result, the observation site is presented brightly, and the movement of the line of sight from the illumination area U (region of interest) that is the target of the surgeon can be reduced. Therefore, it is easy for the surgeon to quickly treat the affected area.

  Further, the laser treatment apparatus 1 of the present embodiment includes an adjustment unit for adjusting the illumination area U by the illumination unit, and an area detection unit that detects the illumination area U adjusted by the adjustment unit, and a display unit. Determines the display position of the parameter S ′ based on the illumination area U detected by the area detection unit. Thereby, even if the illumination area U changes, the parameter S ′ can be displayed at a suitable position on the observation image IMG. Therefore, the operator can easily observe the parameter S ′ while observing the observation site with various shapes of the illumination area U.

  In addition, the presenting means of the laser treatment apparatus 1 of the present embodiment includes a scaling unit that scales the observation site to form an observation image IMG. The display unit may detect a scaling amount of the scaling unit and determine a display position of the parameter S ′ based on the scaling amount. Thereby, for example, the display position of the parameter S ′ can be determined with higher accuracy.

  As a modification example of the laser treatment apparatus 1 of the present embodiment, the display unit may detect the illumination area U from the observation image IMG and determine the display position of the parameter S ′ in consideration of the illumination area U. . Accordingly, for example, even if unintentional refraction occurs in the illumination light by the contact lens 26, the illumination area U is detected from the observation image IMG by image processing, so that the detection error of the distribution of the illumination area U on the observation image IMG is detected. Is unlikely to occur. Therefore, it is easy to display the parameter S ′ at a suitable position.

  Further, the display unit of the laser treatment apparatus 1 of the present embodiment displays the parameter S ′ on the observation image IMG and outside the detected illumination area U. Thus, the operator can visually recognize the parameter S ′ without impairing the visibility of the observation image IMG. Further, the parameter S ′ can be arranged with high accuracy.

  Moreover, the illumination means of the laser treatment apparatus 1 of this embodiment is provided with the light quantity adjustment means which adjusts the light projection light quantity (illumination light quantity) of illumination light, and a display means is the observation image IMG according to the light projection light quantity. The display brightness of the parameter to be displayed is determined. Thus, the operator can easily visually recognize the parameter S ′ regardless of the amount of illumination light. For example, an event that the parameter S ′ is too bright for the observation image IMG and is difficult to observe is suppressed. Further, an event in which the observation image IMG is too bright with respect to the parameter S ′ and the parameter S ′ becomes difficult to visually recognize is suppressed.

  Further, the laser treatment apparatus 1 of the present embodiment has an eyepiece part (eyepiece lens 47) and an observation optical system 40 for observing an observation site, and the presenting means is within the observation field of view by the eyepiece part. An observation image IMG is presented. As a result, for example, even when the surgeon looks into the eyepiece and performs a precise (or delicate) observation, the observation image IMG and the parameter S ′ can be suitably viewed. Therefore, the operability of the laser treatment apparatus 1 is improved. Also, observation mistakes are unlikely to occur.

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

1: Laser treatment apparatus 30: Illumination optical system 40: Observation optical system 47: Eyepiece lens 50: Display optical system 53: Display unit 60: Control unit

In order to solve the above problems, the present invention is characterized by having the following configuration.
A laser treatment apparatus for irradiating an affected area of a patient's eye with treatment laser light, the illumination means for projecting slit light to the observation part of the patient's eye, the presentation means for presenting an observation image of the observation part, and the observation A display means for displaying a display in a mode different from an image on the observation image presented by the presenting means, and a display position of a display in a mode different from the observation image displayed on the observation image, Display position determining means for disposing outside the slit illumination area by the slit light .

Claims (5)

A laser treatment apparatus for irradiating an affected area of a patient's eye with treatment laser light,
Illuminating means for projecting illumination light onto the observation site of the patient's eye;
And presentation means for presenting an observation image of the observation site,
On the observation image which the presentation means presents, display means for displaying the parameters related to the irradiation conditions of the treatment laser beam,
With
The laser treatment apparatus, wherein the display unit determines a display position of the parameter to be displayed on the observation image in consideration of an illumination region of the observation site illuminated by the illumination unit. The laser treatment apparatus according to claim 1,
The illumination means includes an illumination field stop having an opening and a light shielding portion at a position conjugate with the observation site, and forms an image of the opening and an image of the light shielding portion on the observation site,
The display means displays the parameter on a light-shielding region by the light- shielding part in the region of the observation image;
A laser treatment apparatus. The laser treatment apparatus according to claim 1 or 2,
The parameter includes a plurality of parameters of different types,
In consideration of the shape of the illumination area, the display means displays a part of the plurality of parameters at a position separated from a position for displaying other parameters.
A laser treatment apparatus. The laser treatment apparatus according to any one of claims 1 to 3,
Adjusting means for adjusting the illumination area by the illumination means;
An area detection unit that detects the illumination area adjusted by the adjustment means;
The display means determines a display position of the parameter to be displayed on the observation image based on the illumination area detected by the area detection unit;
A laser treatment apparatus. The laser treatment apparatus according to any one of claims 1 to 4,
The presenting means includes a scaling means for scaling the observation site to form the observation image,
The display means detects a scaling amount of the scaling means, and determines a display position of the parameter based on the scaling amount;
A laser treatment apparatus .

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