JP4068101B2 - Surgical microscope - Google Patents

Description

  The present invention focuses the illumination light by a front lens arranged between the eye to be operated and the front focal position of the objective lens, guides the light into the eye to be operated, illuminates the inside of the eye, and looks into the eyepiece The present invention relates to a surgical microscope that performs intraocular surgery.

  2. Description of the Related Art Conventionally, a surgical microscope, for example, a surgical stereoscopic microscope apparatus having a configuration shown in FIG. 1 is known.

  In FIG. 1, 1 is a support, 2 is a first arm, 3 is a second arm, 4 is an XY fine movement device, 5 is an operator's microscope (also called a microscope device), 6 is an assistant's microscope, and 7 is A foot switch 8 is an eye to be operated.

  Conventionally, when performing surgery on the operated eye 8, as shown in an enlarged view in FIG. 2, the contact lens 9 is brought into contact with the cornea C of the operated eye 8 and the light guide 10 for intraocular illumination is inserted into the eye. Then, while looking into the eyepiece lens of the microscope apparatus, the surgical instrument 11 such as a cutter is used for surgery. In FIG. 2, reference numeral 12 denotes a crystalline lens, and reference numeral 13 denotes a vitreous cavity.

  In this conventional surgical microscope, since it is necessary to perform the operation with the light guide 10 in one hand, it is difficult to perform a fine operation, and the surgical instrument 11 is held in both hands, for example, as the surgical instrument 11 in one hand. It is desirable to have a tweezer and a cutter as the surgical instrument 11 in the other hand so that surgery can be performed.

  Therefore, as shown in FIG. 3, the front lens 15 is arranged in front of the operated eye 8 between the objective lens 14 installed in the objective tube of the microscope apparatus and the operated eye 8. It is desirable to use a surgical microscope capable of illuminating the intraocular eye 8 via the front lens 15. In FIG. 3, reference numeral 16 denotes an insertion site for the surgical instrument 11.

  However, when the front lens 15 is arranged between the objective lens 14 and the eye 8 to be operated in this way, if the focal length F1 of the front lens 15 is too long, the eyepiece of the microscope apparatus is not covered. The distance to the operation eye 8 becomes longer, and it becomes difficult for the operator to perform the operation. On the other hand, if the focal length F of the front lens 15 is too short, the subject eye 8 may be hit. In addition, there is also a problem that the physiological saline scatters and adheres to the front lens 15 when the surgical eye 8 is washed by applying the physiological saline to the surgical eye 8 during the operation.

  Further, when the vitreous body of the eye 8 to be operated is filled with biological fluid, the difference in the refractive index at the boundary surface between the crystalline lens 12 and the biological fluid is small, so that the scattered reflected light from the rear surface of the crystalline lens 12 is observed by the observation optical system. However, if the vitreous body is removed, the ratio of the scattered reflected light entering the optical path of the observation optical system increases, and there is a problem that glare occurs when the fundus is observed.

  The present invention has been made in view of the above-described circumstances. In order to perform an operation with a surgical instrument in both hands while disposing a head lens in front of the operated eye and illuminating the inside of the eye with microscope illumination. It is an object of the present invention to provide a suitable surgical microscope, and in particular, to provide a surgical microscope capable of preventing the occurrence of glare due to light reflected from the rear surface of the lens being mixed into the observation optical system.

The surgical microscope according to claim 1, an illumination optical system that irradiates illumination light toward a surgical eye, an objective lens that is provided in an objective lens barrel and faces the surgical eye, and the objective across the optical axis of the lens is provided on both sides of a pair of observation optical system for observing the eye to be operated, the illumination optical system slit plate is provided, the illumination light to the slit plate And a projection image of the slit hole on the fundus is parallel to a plane including both optical axes of the observation optical system. The slit plate can be moved in a direction perpendicular to the optical axis of the illumination optical system so that the slit illumination light is moved away from and close to the optical axis of the objective lens. And

Since the surgical microscope according to the present invention is configured as described above, it is possible to prevent the reflected light from the back surface of the crystalline lens from being mixed into the observation optical system due to the illumination during fundus observation, thereby preventing glare. It is suitable for illuminating the inside of the surgical eye with microscope illumination .

  Embodiments of the present invention will be described below with reference to the drawings.

  FIG. 4 is an external view of a surgical microscope according to the present invention. In FIG. 4, the same components as those described in the conventional example will be described with the same reference numerals.

  As shown in FIG. 4, the surgeon microscope 5 includes an objective lens barrel 20, an inverter 21, and a holding arm 22. FIG. 5 is an overall view showing the optical system of the surgeon's surgical microscope 5.

  In FIG. 5, reference numeral 30 is an eyepiece, reference numeral 60 is an observation optical system, and reference numeral 61 is an illumination optical system.

  A pair of observation optical systems 60 are provided on both sides of the optical axis O of the objective lens 14. Since the structure of this pair of observation optical system 60 is well-known, the code | symbol is attached | subjected to drawing and the name is listed below, and the detailed description is abbreviate | omitted.

  In FIG. 5, 62 is a zoom lens system, 63 is a beam splitter, 64 is an imaging lens, 65 is an image erecting prism, 66 is an eye width adjustment prism, and 67 is a field stop. The zoom lens system 62 includes zoom lenses 37, 37a, and 37b.

  The illumination optical system 61 includes an illumination light source 70, a condenser lens 71, an illumination field stop 72, and a slit plate 73. The slit plate 73 has a slit hole 73a. The slit plate 73 can be inserted and retracted from the illumination optical path of the illumination optical system 61, and the slit plate 73 can be moved in a direction orthogonal to the illumination optical axis O1 when inserted in the illumination optical path. ing. As shown in FIG. 5, the slit hole 73a is in a direction orthogonal to the illumination optical axis O1 and the movable direction of the slit plate 73, and a projected image 73b (that is, slit illumination light P3) on the fundus of the slit hole 73a is shown in FIG. As shown in FIG. 5, the pair of observation optical systems 60 extend so as to be parallel to the plane NP including both optical axes O2 and O2. In FIG. 9, the projected image is shown by a broken line in the sense that it is on the fundus.

  The illumination field stop 72 is conjugate with the front focal position u0 of the objective lens 14, and the front focal position u0 of the objective lens 14 is conjugate with the retina 8a of the fundus here.

  The reason why the slit plate 73 is provided in the illumination optical system 61 will be described below.

  As shown in FIG. 6, illumination light P is guided to the fundus of the surgical eye 8 through the front lens 15, the cornea C, and the crystalline lens 12, and the fundus of the surgical eye 8 is illuminated. The reflected light P1 from the fundus 8 is guided to the front lens 15 through the crystalline lens 12 and the cornea C, and is imaged in the air at the front focal position u0 of the objective lens 12 through the front lens 15.

  As shown in FIG. 6, when the vitreous body is filled with the biological fluid, the refractive index difference at the boundary surface between the crystalline lens 12 and the biological fluid is small, so that the reflectance of the illumination light P on the rear surface 12a of the crystalline lens 12 is high. The ratio of the scattered reflected light from the rear surface 12a of the crystalline lens 12 to the optical path of the observation optical system 60 is small.

  However, as shown in FIG. 7, when the vitreous body is removed and the eye of the surgical eye 8 is filled with gas or air, the portion 12b and the fundus where the illumination light P is scattered on the rear surface 12a of the crystalline lens 12 Since a part of the reflected light P1 from the light overlaps with the part 12b of the reflected light P2 from the portion 12b of the illumination light P, it is mixed in the optical path of the observation optical system 60, so that the fundus is observed through the eyepiece 30. Glare occurs.

  Therefore, the slit plate 73 is inserted into the optical path of the illumination optical system 61, and the fundus is illuminated through the cornea C and the crystalline lens 12 with the slit illumination light P3 as shown in FIG.

  If comprised in this way, as shown in FIG. 8, the part 12b in which the slit illumination light P3 is scattered on the rear surface 12a of the crystalline lens 12 and the part 12c in which the reflected light P1 from the fundus passes through the rear surface 12a of the crystalline lens 12 can be separated. become. Accordingly, it is possible to prevent the occurrence of glare due to the scattered reflected light P2 from the rear surface 12b of the crystalline lens 12 in the observation optical path of the observation optical system 60.

  Further, as shown in FIG. 5, the slit plate 73 is moved in a direction orthogonal to the illumination optical axis O1. Then, the slit light moves in the direction indicated by the arrow in FIG. 8, and the entire fundus 8a can be observed.

  FIG. 9 is a schematic view of the surgical eye viewed from the direction of the arrow X shown in FIG. 6 through the objective lens 14. As shown in FIG. 9, when the projection image 73b of the slit hole 73a on the fundus 8a, that is, the slit plate 73 is moved in a direction orthogonal to the illumination optical axis O1, the projection image 73b (slit illumination light P3 ) Is moved in the direction of separating and approaching the optical axis O of the objective lens 14 while maintaining a parallel relationship with the surface NP as indicated by a broken line. Here, the projection image 73b is drawn with a broken line because if the projection image 8b on the fundus 8a is seen through the objective lens 14, the position of the projection image 8b and the position of the zoom lens 37 will be present. It means to show the relationship.

  The embodiment has been described above. However, when the pupil diameter of the patient's eye is small, the observation light beam and the illumination light beam are easily displaced by the pupil. It is good also as a structure which provides the apparatus made small automatically in a surgical microscope.

It is a figure which shows schematic structure of the conventional surgical microscope. It is a figure which shows an example in the case of performing an intraocular surgery with a light guide in one hand and a surgical instrument in the other hand. It is a figure which shows an example in the case of carrying out intraocular surgery with a surgical instrument in both hands. It is a figure which shows schematic structure of the surgical microscope concerning this invention. It is a figure which shows the structure of the optical system of the surgical microscope concerning this invention. FIG. 5 is a schematic diagram for explaining a problem when a surgical microscope is provided with an illumination optical system to illuminate a surgical eye, and a longitudinal section of a surgical eye showing a state in which a biological fluid is filled in the eye FIG. It is a schematic diagram for explaining a problem when a surgical microscope is configured to illuminate a surgical eye by providing an illumination optical system, and when the vitreous body in the eye is removed and air is filled in the eye It is a longitudinal cross-sectional view of the surgical eye which shows the problem of this. FIG. 8 is a longitudinal sectional view of the surgical eye showing a state in which the fundus of the surgical eye is illuminated with slit illumination light in order to solve the problem shown in FIG. 7. FIG. 6 is a diagram showing a positional relationship between the projected image of the slit hole shown in FIG. 5 and both optical axes of a pair of observation optical systems, and on the fundus oculi when the surgical eye is viewed through the objective lens from the arrow X direction shown in FIG. It is explanatory drawing which shows typically the movement state of slit illumination light in.

Explanation of symbols

8 ... eye 14 to be operated ... objective lens 15 ... front lens 61 ... illumination optical system 60 ... observation optical system 73 ... slit plate 73a ... slit hole

Claims (1)

An illumination optical system that irradiates illumination light toward the surgical eye, an objective lens that is provided in the objective lens barrel and faces the surgical eye, and is provided on both sides of the optical axis of the objective lens are a pair of observation optical system for observing the eye to be operated by said illumination optical system slit plate is provided, the slit plate slit hole the illumination of the slit illumination light the illumination light to The slit plate is provided so as to extend in a direction orthogonal to the optical axis of the optical system and so that a projection image of the slit hole on the fundus is parallel to a plane including both optical axes of the observation optical system. Is a surgical microscope characterized in that it can be moved in a direction perpendicular to the optical axis of the illumination optical system so that the slit illumination light is moved away from and close to the optical axis of the objective lens.

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