JP3695901B2 - Laser therapy device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a laser treatment apparatus for performing treatment by irradiating an affected area with treatment laser light from a laser light source.
[0002]
[Prior art]
There is known a laser treatment apparatus that performs photocoagulation or the like by irradiating a treatment laser beam to the fundus of a patient's eye. In this type of apparatus, a detection system for detecting the output of the laser beam emitted from the laser light source is provided, and the laser output to be irradiated is adjusted so as to match the set value of the laser output set according to the treatment content. .
[0003]
The laser output detection system is usually installed immediately after laser emission from the laser light source. After the laser light passes through a light guide optical system such as an optical fiber, the spot size of the laser light is adjusted by the adjusting optical system and irradiated to the fundus.
[0004]
Also, in order to efficiently guide the laser light emitted from the laser light source to the affected area, alignment adjustment at the incident end to the optical fiber is also important. The adjustment was performed by observing the light collection state at the incident end to the optical fiber.
[0005]
[Problems to be solved by the invention]
However, in the installation of such a laser output detection system, there is a problem that even if there is an abnormality or loss in the light guide optical system due to the bending of the optical fiber or the displacement of the mounting portion, this cannot be known. .
[0006]
Further, even if the laser output fluctuates due to the adjustment of the spot size, there is a problem in that this cannot be detected and accurate output correction cannot be performed.
[0007]
Furthermore, there is a problem that accurate alignment adjustment of the optical fiber by observation is difficult and laborious.
[0008]
In view of the above problems, the present invention provides a laser treatment apparatus that can easily detect an abnormality of a light guide optical system and that can irradiate an affected area with a laser beam that is appropriately adjusted. To do.
[0009]
Another object of the present invention is to provide a laser treatment apparatus that facilitates alignment adjustment of an optical fiber.
[0010]
[Means for Solving the Problems]
In order to solve the above problems, the present invention is characterized by having the following configuration.
[0011]
(1) A laser treatment apparatus for conducting laser treatment by guiding treatment laser light from a laser light source to a laser irradiation optical system for irradiating the affected part with treatment laser light via an optical fiber attached to the optical fiber attachment part A first beam splitter for splitting the treatment laser light between the laser light source and the optical fiber, first detection means for detecting the output of the treatment laser light via the first beam splitter, and the laser irradiation A second beam splitter is provided in the optical system, the second detection means for detecting the output of the treatment laser light emitted from the optical fiber and incident on the laser irradiation optical system via the second beam splitter, and the treatment laser light The optical fiber end face for the condensing optical system that collects light and enters the optical fiber is moved in the axial direction (Z direction), and the incident end face of the optical fiber is orthogonal to the Z direction. Compare the detection signal of the alignment adjustment means that adjusts the optical axis by moving it to the first detection means and the second detection means, and warn of abnormalities such as breakage of the optical fiber when there is an opening more than a predetermined amount. And a control means for operating the alignment adjusting means to adjust the alignment so that the detection output of the second detecting means is increased in each of the XYZ directions when both detection signals have only a predetermined opening. , Provided.
[0016]
【Example】
An embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a schematic view of an external configuration of a laser photocoagulation apparatus. Reference numeral 1 denotes an apparatus main body, which stores a laser light source and an optical system that allows laser light to enter the optical fiber 2. Reference numeral 6 denotes an operation unit having various switches and a display for setting laser irradiation conditions for laser output and irradiation time. Reference numeral 5 denotes a slit lamp delivery for irradiating the affected part of the patient's eye with the laser light while observing the patient's eye. The laser irradiating part 3 for irradiating the laser light guided to the optical fiber 2 and the illumination part for illuminating the patient's eye with a slit. 4. A binocular microscope unit 5a is provided. Reference numeral 7 denotes a foot switch for sending a laser irradiation trigger signal.
[0017]
FIG. 2 is a diagram illustrating a schematic configuration of the optical system and control system of the apparatus.
[0018]
<Optical system>
Reference numeral 10 denotes a therapeutic laser light source that emits a therapeutic laser beam such as an argon laser. Reference numeral 11 denotes a beam splitter that transmits most of the laser light from the laser light source 10 and reflects a part thereof. The laser light reflected by the beam splitter 11 is received by the light receiving element 12. The light receiving element 12 detects the laser output emitted from the laser light source 10. Reference numeral 13a denotes a first safety shutter which, when instructed to enable treatment laser light irradiation, allows the laser light to pass away by driving the drive device 37, and when an abnormality occurs. In a predetermined case, the laser beam is blocked by being inserted into the optical path. Reference numeral 14 denotes a dichroic mirror, and the visible laser beam from the semiconductor laser 15 is made coaxial with the treatment laser beam via the collimator lens 16. A condensing lens 17 condenses each laser beam to the incident end face 2a of the optical fiber 2 and makes it incident. The mounting portion 20 of the optical fiber 2 can be moved by the mounting portion moving device 21 in the xy direction on the plane orthogonal to the optical axis of the condenser lens 17 and the z direction in the optical axis direction. The alignment of the incident end face 2a of the fiber 2 can be adjusted.
[0019]
Reference numeral 3 denotes a laser irradiation unit. Laser light guided by the optical fiber 2 is a relay lens 30, a zoom lens 31 that can move in the optical axis direction in order to change the spot size of the laser light, an objective lens 32, After passing through the beam splitter 35, it is reflected by the dichroic mirror 33, and is irradiated to the affected part of the patient's eye through the contact lens 34. The dichroic mirror 33 has a characteristic of reflecting a part of the visible laser light from the semiconductor laser 15 and the treatment laser light from the laser light source 10 and transmitting the observation light. The beam splitter 35 has a characteristic of transmitting most of the treatment laser light and reflecting a part thereof, and the output of the laser light reflected by the beam splitter 35 is detected by the light receiving element 36. Reference numeral 37a denotes a second safety shutter that cuts off the laser beam during the test oscillation, and reference numeral 37 denotes a driving device thereof.
[0020]
The light guide optical system that guides the laser light emitted from the laser light source 10 to the patient's eye includes the first safety shutter 13a on the main body 1 side, the condensing lens 17, the optical fiber 2, and the relay lenses 30 to 30 of the laser irradiation unit 3. And a dichroic mirror 33.
[0021]
An illumination unit 4 projects slit light. The illumination light from the illumination light source 40 is collimated by a condenser lens 41 and illuminates the slit 42. The illumination light that has passed through the slit 42 passes through the projection lens 43 and is then reflected by the split mirrors 45a and 45b to illuminate the patient's eye through the contact lens 34. A correction lens 44 corrects the optical path length of the illumination light reflected by the split mirror 45a. Reference numeral 5 denotes a binocular microscope for observing the patient's eyes.
[0022]
<Control system>
Signals detected by the light receiving elements 12 and 36 are subjected to predetermined processing by the detection processing circuits 12a and 36a, respectively, and are input to the control unit 50. An operation unit 6 and a foot switch 7 are connected to the control unit 50, and the power source unit 53 is operated in accordance with an input signal to control laser emission from the laser light source 10. The controller 50 is connected to the first safety shutter driving device 13, the second safety shutter driving device 37, the semiconductor laser 15, and the attachment moving device 21.
[0023]
The operation of the apparatus configured as above will be described. Prior to the surgery, the surgeon checks whether there is an abnormality in the light guide optical system and adjusts the alignment of the mounting portion 20. When the switch 60 disposed in the operation unit 6 is pressed to enter the test mode, the second safety shutter device 37 is activated and the optical path of the laser irradiation unit 3 is blocked. Further, the operator sets the laser output for test oscillation (the actual irradiation condition may be set), and when ready, presses the foot switch 52 to cause the laser beam to perform test oscillation.
[0024]
When laser light is emitted from the laser light source 10, the control unit 50 compares the detection signals of the laser outputs from the light receiving element 12 and the light receiving element 36, and a predetermined amount of opening (determined according to the setting of the laser output). Check if there is any. Here, if the laser output to be compared has a predetermined amount of opening, the warning lamp 61 of the operation unit 6 is turned on to notify the surgeon that there is an abnormality in the light guide optical system due to breakage of the optical fiber 2 or the like. . As a result, the surgeon can take measures against abnormalities in the light guide optical system before actual laser irradiation.
[0025]
If the controller 50 can confirm that there is no abnormality in the light guide optical system, the attachment unit moving device 21 is operated based on the detection signal of the light receiving element 36, and alignment of the laser light incident on the incident end surface 2 a by the condenser lens 17. Adjustment is performed automatically as follows. First, the attachment portion moving device 21 moves the attachment portion 20 in the x direction within a predetermined adjustment range to obtain a position where the laser output detected by the light receiving element 36 is maximized (which may be a movement amount from the reference). Next, the mounting portion 20 is moved in the y direction within a predetermined adjustment range, and similarly, a position where the laser output detected by the light receiving element 36 is maximized is obtained. Finally, the mounting portion 20 is moved in the z direction to obtain a position where the laser output detected by the light receiving element 36 is maximized, and the alignment adjustment is completed. Since the laser output detected by the light receiving element 36 is also displayed on the display 62 of the operation unit 6, the operator may manually move and adjust the mounting unit 20 while viewing this value.
[0026]
When the confirmation of the light guide optical system and the alignment adjustment are completed by the test oscillation, the test mode is canceled and the laser irradiation to the patient's eye is started. When the test mode is canceled, the second safety shutter device 37a is released. The surgeon sets the laser output, irradiation time, and the like with the switches 63 and 64 of the operation unit 6 according to the treatment purpose. Next, the surgeon focuses the aiming light from the semiconductor laser 15 on the affected area while observing the patient's eyes illuminated by the illuminating section 4 using the microscope section 5. Further, the spot size is adjusted by moving the zoom lens 31 with a spot size adjustment knob (not shown). When the READY switch 65 of the operation unit 6 is turned on and the foot switch 7 is stepped on, the treatment laser light can be irradiated. When aiming preparation is complete, the foot switch 7 is pressed to perform laser irradiation.
[0027]
The control unit 50 operates the power supply unit 53 in response to a trigger signal from the foot switch 7, and emits treatment laser light from the laser light source 10 so as to match the setting of irradiation conditions. The output of the emitted laser light is detected by the light receiving element 12, and the output of the laser light guided to the optical fiber 2 is detected by the light receiving element 36. Based on the output detection signal from the light receiving element 36 and the output setting signal set by the operation unit 6, the control unit 50 matches the laser output emitted from the optical fiber 2 and adjusted for the spot size to the set value. The output correction signal is output to the power supply unit 53 so that the laser output from the laser light source 10 is corrected so as to be stable. Since the detection signal after passing through the optical fiber 2 and the optical system for adjusting the spot size is used for the output correction, the loss of the optical fiber 2 and the fluctuation of the output due to the adjustment of the spot size are also corrected. Is irradiated with a laser beam controlled with a more accurate output.
[0028]
The detection of the laser output is always performed by the light receiving element 12 arranged before entering the optical fiber 2 (or every predetermined time). When the detection limit is exceeded by both detection signals, the first safety shutter is detected. The laser beam is blocked by 13a and the warning lamp 61 is turned on to notify the surgeon of the abnormality of the light guide optical system. In addition, the abnormality of the laser light source 10 can be detected based on the detection of the laser output by the light receiving element 12 and the output correction signal to the power supply unit 53. In this case as well, the laser light is cut off and the operator is informed accordingly. To inform.
[0029]
In the laser photocoagulation apparatus shown in the above embodiment, the laser irradiation side can be used by changing from a slit lamp delivery to various delivery units such as a binocular inverted mirror delivery. When the delivery unit is replaced, the mounting portion 20 of the optical fiber 2 on the main body 1 side is removed and replaced. In this case, it is particularly advantageous that the optical fiber mounting portion on the main body side can be easily aligned as described above. . Moreover, since the optical fiber is often broken at the time of replacement, troubles can be prevented by confirming the light guiding state before actual laser irradiation.
[0030]
In the embodiment, a light guide optical system having an optical fiber has been described as an example. However, a device of a type in which laser light is guided by a plurality of reflection mirrors may be used. Detection and alignment adjustment can be easily performed.
[0031]
【The invention's effect】
As described above, according to the present invention, it is possible to easily know an abnormality of a light guide optical system such as an optical fiber, and to correct an output variation after size adjustment by a spot size adjustment optical system and to accurately The affected laser beam can be irradiated to the affected part.
[0032]
Furthermore, alignment adjustment of the light guide optical system can be easily performed.
[Brief description of the drawings]
FIG. 1 is a schematic diagram of an external configuration of an apparatus according to an embodiment.
FIG. 2 is a diagram illustrating a schematic configuration of an optical system and a control system of the apparatus.
[Explanation of symbols]
2 Optical fiber 6 Operation part 10 Laser light source 12 Light receiving element 36 Light receiving element 50 Control part 61 Warning lamp 21 Mounting part moving device

Claims (1)

The treatment laser beam from the laser light source, via an optical fiber attached to the optical fiber attaching portion, and guided to the laser irradiation optical system for irradiating the treatment laser beam to the affected area, the laser treatment apparatus for performing laser treatment, laser A first beam splitter for dividing the treatment laser light is provided between the light source and the optical fiber, first detection means for detecting the output of the treatment laser light via the first beam splitter, and the laser irradiation optical system The second beam splitter is provided with a second detection means for detecting the output of the treatment laser light emitted from the optical fiber and incident on the laser irradiation optical system via the second beam splitter, and the treatment laser light is condensed. The optical fiber end face for the condensing optical system incident on the optical fiber is moved in the axial direction (Z direction), and the optical fiber end face is moved in the XY direction orthogonal to the Z direction. Compare the detection signal of the alignment adjusting means for adjusting the optical axis with the detection signals of the first detection means and the second detection means. Control means for operating the alignment adjustment means to adjust the alignment so that the detection output of the second detection means is increased in each of the XYZ directions when the detection signal has only a predetermined opening. A laser treatment apparatus comprising:

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