JP2592775Y2 - Photocoagulation equipment - Google Patents

Description

[Detailed description of the invention]

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a photocoagulation apparatus for performing photocoagulation treatment on the fundus of the eye with laser light,
A laser light source that oscillates laser light for photocoagulation therapy;
The present invention relates to a photocoagulation apparatus in which an optical system for condensing laser light oscillated from the laser light source on a photocoagulation point of an eye to be examined is attached to a slit lamp microscope.

[0002]

2. Description of the Related Art Conventionally, a telescope for condensing a therapeutic laser beam at a photocoagulation point such as a fundus of an eye and a laser light source are connected by an optical fiber, and the optical fiber is attached to an existing slit lamp microscope. The telescope is supported on an arm that is rotatably provided with a support shaft disposed at the upper part of the main body of the microscope as a fulcrum. 2. Description of the Related Art There is known a photocoagulation device which performs coagulation treatment and turns a telescope from a use position to a retracted position to be usable as a slit lamp microscope for ordinary examination.

[0003]

However, in the above-described photocoagulation apparatus, when the laser light is oscillated when the telescope is in a position other than the use position, for example, in the retracted position,
There was a risk that not only patients but also caregivers and third parties could be affected.

[0004] Therefore, an object of the present invention is to provide a configuration which can eliminate the disadvantages of such a photocoagulation device and improve safety.

[0005]

According to the present invention, there is provided a laser light source for oscillating laser light for photocoagulation therapy, and a laser light oscillated from the laser light source for an eye to be examined. In a photocoagulation apparatus in which an optical system for condensing light at a photocoagulation point is attached to a slit lamp microscope, the optical system is used for photocoagulation treatment by an arm rotatably provided on a main body of the slit lamp microscope. A rotatable support between a use position and a retracted position during a normal examination by a slit lamp microscope is provided, and detection means for detecting that the rotation position of the optical system is the use position is provided, The laser light source is allowed to oscillate laser light only when the detection unit detects that the rotation position of the optical system is the use position.

[0006]

According to such a configuration, the laser beam is focused only when the optical system for condensing the laser beam for photocoagulation treatment on the photocoagulation point of the eye to be examined is rotated to the use position during photocoagulation treatment. Is permitted, so that laser light is not erroneously oscillated when the optical system is at a position other than the use position.

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings. Here, a very common slit lamp microscope, in which the illumination light source is located above the optical axis of the microscope and is called the Goldman type, a laser light source for photocoagulation treatment and a telescope are used. 1 shows a photocoagulation device attached thereto.

FIG. 1 shows the whole apparatus of this embodiment, and FIG.
3 is a cross-sectional plan view taken along line AA of FIG. 1, FIG. 3 is a vertical cross-sectional view taken along line BB, and FIG. 4 is a vertical cross-sectional view taken along line CC.

In FIG. 1, two columns 36 are implanted on a gantry base 35, and a jaw table 37 and a forehead pad 38 are provided on the column 36 to support the head of the subject. I have. Further, on the upper surface of the gantry base 35, the movable table 31 is supported at three points by rollers and spheres (not shown), and can be finely moved in any desired direction in the horizontal direction by operating the joystick 32 in a tilted manner. In addition, the vertical movement base 33 provided on the movable base 31 can be finely moved in the vertical direction by rotating the joystick 32.

A main shaft 34 is provided at the front end of the vertical movement base 33, and the microscope arm 13 and the illumination system arm 24 are rotatably fitted to the main shaft 34, respectively.

On the microscope arm 13 is mounted a microscope 10 comprising a lens barrel 11 of the microscope main body, an eyepiece 12, a safety filter device 14, and the like.
The microscope 10 is used for magnifying observation of a portion to be inspected or a photocoagulation point of an eye to be inspected, and its focus surface coincides with the axis of the main shaft 34. Further, the safety filter device 14 is a device for protecting the examiner's eyes from reflected light such as corneal reflection of the therapeutic laser light, and the observation optical path of the microscope is shown in FIG. 3 immediately before the laser light oscillates. The light is blocked or dimmed by the filter 15.

On the other hand, on an illumination system arm 24, an illumination system 20 including an illumination lamp (not shown), an illumination lens barrel 21, a slit rotation knob 22, an illumination mirror 23 and the like are mounted. The part to be inspected is illuminated at the center of the. Since the observation light passes through the side of the illumination mirror 23, the illumination system arm 24 has a reference numeral 2 as shown in FIG.
4a and 24b.

In FIG. 1, reference numeral 41 denotes a laser light source that oscillates laser light for photocoagulation treatment. The laser light from the laser light source 41 is introduced into a telescope 43 through an optical fiber 42. The telescope 43 forms an image of a laser beam spot at the exit end of the optical fiber 42 through a lens system (not shown) and a coagulation point on the fundus via a scan mirror 46. The telescope 43 is fixed to a distal end of an arm 44 curved in a substantially semicircular arc shape. The arm 44 is provided to be rotatable horizontally by fitting a bearing 44a to a support shaft 52 implanted in an arm support base 51 fixed to the lens barrel 11 of the microscope 10 with a mounting screw 50, as shown in FIG. The telescopic use position at the time of photocoagulation treatment indicated by reference numeral a and the telescope retracted position at the time of normal examination by a slit lamp microscope indicated by reference numeral b can be rotated.

Next, the scan mirror 46 provided below the telescope 43 is swung up and down and left and right by manual operation to move the photocoagulation point of the laser beam in two directions, up and down and left and right. The moving mechanism will be described with reference to FIGS. 5 and 6 show the entire scan mirror swinging mechanism, and FIGS. 7, 8 and 9 show D in FIG.
-A cross-sectional plan view along the line D, a longitudinal cross-sectional view along the line EE, F
It is a longitudinal section by the -F line.

As shown in FIG. 6, a mirror support 45 is rotatably fitted to the lower end of the shaft 43a of the telescope 43. Projection 45a formed on this mirror support 45
The tip of is divided into two branches as shown in FIG.
A mirror support 47a, to which the scan mirror 46 is fixed, is mounted to be vertically swingable via 5b. As shown in FIGS. 5 and 7, a curved mirror lever 47 is integrally connected to the upper end of the mirror support base 47a. A pin 47c is planted on the upper surface of the intermediate portion of the mirror lever 47, and a spring 48 is stretched between the pin 47c and the pin 44c planted on the lower surface of the arm 44.
Needless to say, the mirror support 45, the mirror support 47a to which the scan mirror 46 is fixed, and the mirror lever 47 are attached to the arm 44 via the telescope 43 and the spring 48, and rotate together with the arm 44. .

On one side of an arm support base 51 fixed on the lens barrel 11, a vertical lever 53 is mounted so as to be able to swing up and down around a shaft 54 as a fulcrum. Then, as shown in FIG. 9, the V-groove 5 formed on the side
A steel ball 66 arranged on the arm support base 51 side is pressed against 3a by a spring 67, and thereby an urging force for returning the vertical lever 53 to a predetermined swing position, for example, a horizontal position, is given. .

A left and right lever 56 is pivotally supported on the lower surface of the up and down lever 53 by a shaft 55 so as to be able to swing right and left. As shown in FIG. 9, a steel ball 64 arranged on the upper and lower levers 53 is pressed against a V-groove 56a formed on the upper surface of the left and right levers 56 by a spring 65. , The urging force for returning to the front position, for example, is provided.

As shown in FIGS. 5 and 6, an operation lever 57 for swinging the scan mirror 46 is fixed below the rear end of the left and right levers 56. By operating the operation lever 57, the up / down lever 53
And the left and right levers 56 swing up, down, left and right in conjunction with the operation lever 57.

On the front end of the left and right levers 56, left and right pins 58 and upper and lower pins 59 are vertically and horizontally implanted, respectively. When the arm 44 is turned to the telescope use position shown by the solid line in FIG.
The rear end portion 47b abuts the left and right pins 58 and the upper and lower pins 59, and presses and engages the pins 58 and 59 by the pulling force of the spring 48, whereby the mirror lever 47 interlocks with the left and right levers 56 without play. It has become.

As described above, when the arm 44 is in the telescope use position and the mirror lever 47 is engaged with the pins 58 and 59, the examiner moves the lower end of the operation lever 57 back and forth (up and down) left and right with a finger. , The left and right lever 56 swings up and down and left and right around the shaft 54 or 55 together with the up and down lever 53, and the mirror lever 47 moves up and down and left and right through the up and down pins 59 or the left and right pins 58. Rocks. Thus, the mirror support 47a integrated with the mirror lever 47 swings up and down around the shaft 45b, or swings right and left around the shaft 43a to which the mirror support 45 is fitted as a fulcrum. Rocks.

The operation of the operation lever 57 causes the scan mirror 46 to swing up, down, left and right, thereby
The spot of the photocoagulation point of the laser beam irradiated on the eye to be examined via the camera can be arbitrarily moved in the two-dimensional directions of up, down, left, and right. Then, the microscope 10 is slightly moved to move the photocoagulation point as in the related art, so that the field of view of the microscope is not changed, and the spot of the laser beam can be moved within the desired field of view.

When the examiner releases his / her finger from the operation lever 57, the upper and lower levers 53 and the left and right levers 56 return to the predetermined swing positions in the above-described configuration, and accordingly, the operation lever 57 also moves to the predetermined position. Return. An operation lever 57 extending downward is arranged near the joystick 32 for finely adjusting the slit lamp microscope to a position most convenient for observation and photocoagulation treatment for the eye to be examined. It is convenient to move your finger to move the laser and move the laser spot. In the operation of the photocoagulation treatment of the fundus, one hand holds a contact lens that is constantly in contact with the eye to be examined, and the joystick 32 or the operation lever 57 is operated with the other hand.

As described above, the photocoagulation point of the laser beam can be moved by a simple operation without changing the visual field of the microscope, and the photocoagulation treatment can be performed efficiently.

The apparatus of the present embodiment is obtained by combining a photocoagulation device with an existing slit lamp microscope, and a therapeutic laser beam such as a telescope attached to the slit lamp microscope is applied to the photocoagulation point of the eye to be examined. By retracting the optical system for condensing light from the use position, it can be used for examination as a normal slit lamp microscope. Hereinafter, details of the evacuation operation will be described.

As described above, the arm 44 supporting the telescope 43 and the like is rotatable about the support shaft 52. Now, the arm 44 is rotated counterclockwise from the telescope use position at the time of photocoagulation treatment, that is, the position in front of the telescope shown by the solid line in FIG. And the telescope 43 also has the code 4
The mirror support 47a supports the scan mirror 46 together with the mirror support 45 fitted to the telescope 43 and the mirror lever 4 integrated therewith.
7 and the spring 48 rotate together to the retracted position.

Here, in the use position during the photocoagulation treatment, the rear end portion 47b of the mirror lever 47 is engaged with the left and right pins 58 in the left and right direction and the upper and lower pins 59 in the up and down direction by the action of the spring 48. However, when the arm 44 starts rotating to the retracted position, the rear end portion 47b of the mirror lever 47 remains at first, so that the front end portion rotates counterclockwise about the telescope 43 as an axis. When the arm 44 further rotates, the locking pin 44e implanted on the lower surface on the base end side of the arm 44 comes into contact with the rear end portion 47b of the mirror lever 47 and presses it. As a result, the rear end portion 47b moves counterclockwise, disengages from the left and right pins 58, and then is disengaged from the upper and lower pins 59 and is lowered by the spring 48 stretched on the mirror lever 47. It is locked at the step at the lower end of the pin 44e. Then, the mirror lever 47 rotates together with the arm 44 to the retracted position.

When the arm 44 rotated to the retracted position is rotated clockwise to return to the use position again, the mirror lever 47 also rotates clockwise, and the rear end 27b is firstly moved to the upper and lower pins. Abuts on the 59 inclined tip surface,
When further rotated, the rear end portion 27b is pushed up by the upper surface of the upper and lower pins 59 due to the inclination of the distal end surfaces of the upper and lower pins 59 and engages with the upper and lower pins 59, and then comes into contact with the left and right pins 58. Pressing and engaging.

The pivot angle between the use position and the retracted position of the arm 44 is such that the steel ball 62 contained in the click receiver 61 fixed to the arm support base 51 is moved by the spring 63 as shown in FIG. The arm 44 engages with V-grooves 44f (see FIG. 7) formed at two locations on the outer periphery of the base end of the arm 44.
Is regulated by being detachably locked.

Further, in relation to the rotation angle of the arm 44,
If the laser beam is carelessly oscillated when the telescope 43 is at a position other than the use position, there is a risk of damaging not only the patient but also a caregiver and a third person. The safety device is installed so that the oscillation of the laser beam is permitted only when the above condition is satisfied.

That is, as shown in FIG. 6, the detection position of the photoelectric sensor 60 mounted on the arm support base 51 and the light shielding plate 44d fixed below the arm bearing 44a.
The position of the slit coincides only when the arm 44 is at the use position, and the oscillation of the laser light source 41 is permitted only at that time. That is, by the photoelectric sensor 60 and the light shielding plate 44d,
Only when it is detected that the turning position of the arm 44 is at the use position, laser light oscillation of the laser light source 41 is permitted.

As shown in FIGS. 10A and 10B, a microswitch 70 is provided on the arm support base 51 in place of the photoelectric sensor 60 and the light shielding plate 44d. A pin 71 is provided on the lower surface, and when the arm 44 is rotated to the use position, the pin 71 is engaged with the micro switch 70 and the switch 70 is turned on. Only in this on state, oscillation of laser light is permitted. Is also good.

In this manner, the laser light is allowed to oscillate only when the telescope 43 is at the use position, so that the laser light does not erroneously oscillate when the telescope 43 is not at the use position. Thus, the safety of the device can be improved.

In the above configuration, when the arm 44 is in the telescope use position, the arm 44 restricts the rotation range of the illumination system 20 of the slit lamp microscope. When used as a photocoagulation device, the illumination range of the fundus can be projected on the fundus only near the optical axis of the microscope, and the arm 44 does not become an obstacle. When the arm 44 is rotated to the retracted position, the rotation range of the illumination system 20 is not limited, and the illumination system 20 can be used for a normal examination using a slit lamp microscope.

As described above, if the arm 44 is rotated to the telescope retreat position, the apparatus of the present embodiment can be used for a normal examination as a slit lamp microscope. Arm 4
When the mirror 4 is rotated to the telescope use position, the mirror lever 47 is engaged with the left and right pins 58 and the upper and lower pins 59 of the interlocking mechanism consisting of the upper and lower levers 53 and the left and right levers 56. The swing is transmitted to the scan mirror 46, and the swing operation of the scan mirror 46 by the operation lever 57 becomes possible. As described above, the photocoagulation point of the laser beam can be moved by a simple operation without changing the visual field of the microscope, and the photocoagulation treatment can be performed efficiently.

Since the oscillation of the laser light is permitted only when the telescope 43 is at the use position, the laser light is not erroneously oscillated when the telescope 43 is not at the use position. Safety can be improved.

[0036]

As is apparent from the above description, according to the present invention, a laser light source that oscillates laser light for photocoagulation treatment and the laser light oscillated from the laser light source are applied to the photocoagulation point of the eye to be examined. In a photocoagulation device in which an optical system for condensing light is attached to a slit lamp microscope, the optical system includes:
Arms rotatably provided on the body of the slit lamp microscope are rotatably supported at the use position during photocoagulation treatment and the retracted position during normal examination by the slit lamp microscope,
Detecting means for detecting that the rotation position of the optical system is the use position is provided, and the laser is used only when the detection means detects that the rotation position of the optical system is the use position. Since the laser light oscillation by the light source is configured to be permitted, the laser light oscillation is permitted only when the optical system is rotated to the use position during the photocoagulation treatment. An excellent effect that the laser light is not erroneously oscillated when it is at a position other than the position and the safety of the device can be improved is obtained.

[Brief description of the drawings]

FIG. 1 is a side view showing an overall configuration of a photocoagulation device according to an embodiment of the present invention.

FIG. 2 is a cross-sectional plan view taken along line AA of FIG.

FIG. 3 is a longitudinal sectional view taken along line BB of FIG. 1;

FIG. 4 is a longitudinal sectional view taken along line CC of FIG. 1;

FIG. 5 is a perspective view showing a configuration of a scan mirror swinging mechanism for swinging the scan mirror of the apparatus of the embodiment by manual operation.

FIG. 6 is a side view showing the configuration of the scan mirror swing mechanism.

FIG. 7 is a cross-sectional plan view taken along line DD of FIG. 6;

8 is a longitudinal sectional view taken along line EE in FIG.

FIG. 9 is a longitudinal sectional view taken along line FF of FIG. 6;

FIG. 10 is a top view and a side view showing another configuration example for detecting the rotation angle of the use position of the arm in the apparatus of the embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Microscope 11 Lens tube 12 Eyepiece 13 Microscope arm 20 Illumination system 31 Moving table 32 Joystick 33 Vertical movement base 34 Main shaft 35 Mounting base 41 Laser light source 43 Telescope 44 Arm 45, 47a Mirror base 46 Scan mirror 47 Mirror lever 48 Spring 53 up / down lever 56 left / right lever 57 operation lever 58 left / right pin 59 up / down pin 60 photoelectric sensor 70 micro switch

──────────────────────────────────────────────────続 き Continuing from the front page (72) Inventor Ichiro Kunimatsu 3-3-1 Chofugaoka, Chofu City, Tokyo Kowa Corporation, Optoelectronics Division, Chofu Factory (58) Field surveyed (Int.Cl. ⁶ , DB name) ) A61F 9/007 A61B 3/13 A61B 17/36 350

Claims (1)

(57) [Scope of request for utility model registration] A slit lamp microscope is provided with a laser light source for oscillating laser light for photocoagulation treatment and an optical system for condensing the laser light oscillated from the laser light source on a photocoagulation point of an eye to be examined. In the photocoagulation apparatus, the optical system is provided between a use position at the time of photocoagulation treatment and a retracted position at the time of normal examination by a slit lamp microscope by an arm rotatably provided on a main body of the slit lamp microscope. The optical system is rotatably supported, and a detection unit is provided for detecting that the rotation position of the optical system is the use position. The detection unit detects that the rotation position of the optical system is the use position. A photocoagulation device characterized in that oscillation of laser light by the laser light source is permitted only when a laser beam is detected.