JP4786215B2 - Surgical microscope equipment - Google Patents

Description

  The present invention relates to a surgical microscope apparatus used in ophthalmic surgery, and more particularly to a surgical microscope apparatus having a function of illuminating a surgical eye with slit light.

  Conventionally, in retinal vitreous surgery in the ophthalmic field, as shown in FIG. 16, a surgical contact lens 200 is placed on the cornea Ec of the eye E, and a light guide (optical fiber) 201 is placed in the eye. While inserting and illuminating the surgical site, a surgical instrument 202 such as a cutter or forceps was inserted into the eye for surgery. In such a surgical method, the surgeon must perform the operation with the light guide 201 held in one hand and the surgical instrument 202 held in the other hand, and it is difficult to perform a detailed operation. The problem was pointed out. In FIG. 16, symbol Ec indicates the cornea, and symbol Ev indicates the vitreous cavity.

  In order to cope with such a problem, a surgical microscope apparatus including a front lens that focuses illumination light and illuminates the inside of the eye between the eye to be operated and the front focal position of the objective lens has been proposed. (For example, refer to Patent Documents 1 and 2).

  FIG. 17 shows an external configuration of a surgical microscope apparatus 100 having a front lens (see Patent Document 1). The surgical microscope apparatus 100 includes a column 2 that supports the apparatus, a first arm 3 having one end connected to the upper end of the column 2, and a second arm 4 having one end connected to the other end of the first arm 3. A driving device 5 connected to the other end of the second arm 4, a surgeon's microscope 6 suspended by the driving device 5, an assistant's microscope 7 attached to the surgeon's microscope 6, A foot switch 8 for performing various operations with a foot is included. The drive device 5 acts to move the surgeon's microscope 6 and the assistant's microscope 7 three-dimensionally in the vertical and horizontal directions in response to an operation by the surgeon or the like.

  The surgeon's microscope 6 has a lens barrel portion 10 that houses various optical systems, drive systems, and the like. An upper part of the lens barrel unit 10 is provided with an inverter unit 12 that houses a known optical unit (image erecting prism) that converts an observation image obtained as an inverted image into an erect image. A pair of left and right eyepieces 11 </ b> L and 11 </ b> R are provided on the upper portion of the inverter unit 12. The surgeon looks into the eyepieces 11L and 11R and observes the eye E with both eyes.

  A pre-lens 13 is connected to the surgeon's microscope 6 via a holding arm 14. The upper end of the holding arm 14 is pivotally pivoted in the vertical direction so that the front lens 13 can be retracted from a position between the eye E to be operated and the front focal point of an objective lens (not shown). It has become. The retracted front lens 13 and holding arm 14 are stored in a storage unit (not shown).

  In such a conventional surgical microscope apparatus, the illumination light path is formed at the boundary surface where the reflected light is generated so that the reflected light of the illumination light from the surface of the surgical contact lens and the cornea does not enter the observation optical system and generate glare. A configuration in which the observation optical path is separated is employed.

  However, when a phakic eye or a pseudophakic eye is to be observed, the clarity of the observed image is reduced by the relatively weak reflected light from the crystalline lens or intraocular lens (IOL). Scattered light from the sclera is also a factor that deteriorates the contrast of the observed image.

  Considering this, the surgical microscope apparatus is capable of (1) changing the size and shape of the illumination field, (2) being able to move the illumination field to the observation site in the eye, and (3) the observation optical system. It is desirable to have functions such as the ability to change the angle (illumination angle) between the optical axis (observation optical axis) and the optical axis (illumination optical axis) of the illumination optical system. In particular, as a configuration for realizing (1) and (2), a method of incorporating a slit mechanism in an illumination optical system and illuminating the inside of the eye with slit light is effectively used (for example, Patent Document 2, 3).

  FIG. 18 shows the configuration of the optical system of such a surgical microscope apparatus (see Patent Document 2). In the surgical microscope apparatus 100 of FIG. 17, this optical system is housed in the lens barrel portion 10 of the surgeon's microscope 6 and includes an illumination optical system 20 and an observation optical system 30.

  The observation optical system 30 is provided in a pair on the left and right sides of the optical axis O of the objective lens 15. The left and right observation optical systems 30 include a zoom lens system 31, a beam splitter 32, an imaging lens 33, an image erecting prism 34, an eye width adjusting prism 35, a field stop 36, and an eyepiece lens 37. The zoom lens system 31 includes a plurality of zoom lenses 31a, 31b, and 31c. The beam splitter 32 is for separating part of the observation light from the eye E to be operated and guiding it to the assistant's microscope 7 and a TV camera (not shown).

  The illumination optical system 20 includes an illumination light source 21, a condenser lens 22, an illumination field stop 23, a slit plate 24, an illumination prism 25, and a collimator lens 27.

  A slit hole 24 a is formed in the slit plate 24. In addition, the slit plate 24 can be inserted into and removed from the illumination optical path of the illumination optical system 20, and in particular, when inserted in the illumination optical path, it can be moved in a direction perpendicular to the illumination optical axis O '. It is configured. The slit hole 24 a is formed in a direction orthogonal to both the illumination optical axis O ′ and the movable direction of the slit plate 24, and the projected image on the fundus is on a plane including the left and right observation optical axes of the observation optical system 30. It is formed in the shape extended in parallel with respect to.

  The illumination field stop 23 is provided at a position optically conjugate with the front focal position F of the objective lens 14. The objective lens 15 is arranged so that its front focal position F is conjugate to the fundus Er (retina).

  The illumination light source 21 is provided outside the lens barrel unit 10 in addition to the configuration accommodated in the lens barrel unit 10 of the surgeon's microscope 6, and the condenser lens in the lens barrel unit 10 is used to illuminate the illumination light with an optical fiber. It is possible to adopt a configuration leading to 22.

  In the conventional surgical microscope apparatus as described above, the direction (longitudinal direction) of the slit hole 24a when the slit plate 24 is inserted into the illumination optical path is always constant, and therefore the slit light that illuminates the inside of the eye The direction (longitudinal direction) is always the same as viewed from the surgeon. Further, in the conventional surgical microscope apparatus, the slit light is always irradiated into the eye from a certain direction.

  According to the surgical microscope apparatus having such a configuration, the following inconvenience may occur in retinal vitreous surgery. For example, when peeling off the growth membrane from the retina, it is necessary to proceed while carefully observing the adhesion site so as not to incise the blood vessel. However, since the growth membrane does not always adhere along a certain direction, it adheres in various directions, so in conventional surgical microscope devices that can irradiate slit light only from the same direction, Depending on the condition, a shadow may appear on the adhesion site, and clear observation may be hindered.

JP 2005-34285 A JP 2003-62003 A European Patent Application Publication No. EP1300109

  The present invention has been made in view of such circumstances, and an object of the present invention is to provide a surgical microscope apparatus capable of clearly observing the observation site regardless of the state of the observation site of the operated eye. And

In order to achieve the above object, an invention according to claim 1 is directed to an observation optical system that forms left and right observation optical paths for the left and right eyes of an operator, and an opposite side of the operator with the observation optical system in between. A rectangular exit pupil having a longitudinal direction extending from the center of the left and right entrance pupils of the observation optical system at a position, and an illumination light source that outputs illumination light that illuminates the eye to be operated; and the length of the exit pupil An illumination optical system including a slit member that forms a slit having the same direction as the longitudinal direction on the optical path of the illumination light, and both the observation optical path of the observation optical system and the illumination optical path of the illumination optical system pass through A surgical microscope apparatus having an objective lens, wherein another exit pupil having a rectangular shape whose longitudinal direction is different from the exit pupil of the illumination optical system is formed, and the longitudinal direction of the other exit pupil Other slits with the same direction as the longitudinal direction And a further slit member formed, wherein the has another illumination optical system for irradiating the other illumination light to the eye to be operated through the objective lens.

The invention according to claim 2 is the surgical microscope apparatus according to claim 1, wherein the other exit pupil of the other illumination optical system is a center of left and right entrance pupils of the observation optical system. The longitudinal direction is a direction perpendicular to the longitudinal direction of the exit pupil of the illumination optical system.

  The invention according to claim 3 is the surgical microscope apparatus according to claim 1 or 2, wherein the left and right observation optical paths for the assistant's left and right eyes passing through the objective lens are formed. A microscope is further provided, wherein the other exit pupil of the other illumination optical system is formed at a position opposite to the entrance pupil of the assistant's microscope with the observation optical system interposed therebetween. .

  The invention according to claim 4 is the surgical microscope apparatus according to claim 1 or 2, wherein the other illumination optical system is attached to and detached from a housing that houses the observation optical system. It is possible to attach and detach the other illumination optical system to and from the housing, and form left and right observation optical paths for the assistant's left and right eyes via the objective lens, and the same as the other exit pupils. It further includes an assistant's microscope that forms an entrance pupil at a position.

Further, the invention according to claim 5 is the surgical microscope apparatus according to claim 2, wherein the other illumination optical system includes a plurality of the other slit members, and the left of the observation optical system. On the left side of the observation optical axis, a left illumination optical system that includes an exit pupil whose longitudinal direction is a direction orthogonal to the longitudinal direction of the exit pupil of the illumination optical system and includes the other slit member, and the observation optical system A right illumination optical system that forms an exit pupil whose longitudinal direction is the same as the longitudinal direction of the exit pupil of the left illumination optical system on the right side of the right observation optical axis, and includes the other slit member. It is characterized by being.

  The invention according to claim 6 is the surgical microscope apparatus according to claim 3, wherein the other illumination optical system and the assistant's microscope are parallel to the left and right observation optical axes. The other exit pupil and the entrance pupil can be integrally rotated around a straight line passing through the intermediate position as an axis.

  The invention according to claim 7 is the surgical microscope apparatus according to claim 1, wherein the other exit pupil of the other illumination optical system has the illumination optical system sandwiched between the observation optical systems. The longitudinal direction is the same direction as the longitudinal direction of the exit pupil.

  The invention according to claim 8 is the surgical microscope apparatus according to claim 1, wherein the selection operation means is for selecting at least one of the illumination optical system and the other illumination optical system. And control means for illuminating the eye to be operated with illumination light from the selected illumination optical system and / or the other illumination optical system.

  The invention according to claim 9 is the surgical microscope apparatus according to claim 5, wherein at least one of the illumination optical system, the left illumination optical system, and the right illumination optical system is selected. And a control means for illuminating the operated eye with illumination light from the selected illumination optical system, left illumination optical system and / or right illumination optical system. It is characterized by that.

  According to the surgical microscope apparatus of the present invention, as illumination light for illuminating the eye to be operated, illumination light from the illumination optical system and other illumination light from other illumination optical systems having different irradiation directions are used. It is possible to use. Therefore, the illumination direction can be changed when a shadow is generated in the target region due to the state of the observation region of the operated eye and a good observation state cannot be obtained, so that a good observation state without a shadow can be obtained. it can. Thus, according to the present invention, it is possible to clearly observe the observation site regardless of the state of the observation site.

  An example of a preferred embodiment of a surgical microscope apparatus according to the present invention will be described in detail with reference to the drawings.

<First Embodiment>
The first embodiment of the surgical microscope apparatus according to the present invention has the same external configuration as the conventional one (see FIG. 17). The surgical microscope apparatus 1 according to the present embodiment includes a support column 2 that supports the apparatus, a first arm 3 connected to the upper end of the support column 2, a second arm 4 connected to the first arm 3, The driving device 5 connected to the second arm 4, the surgeon's microscope 6 suspended by the driving device 5, the assistant's microscope 7 attached to the surgeon's microscope 6, and various operations can be performed with the foot. And a foot switch 8 for performing.

  The surgeon's microscope 6 has a lens barrel portion 10 that houses various optical systems, drive systems, and the like. An upper part of the lens barrel unit 10 is provided with an inverter unit 12 that houses an optical unit (image erecting prism) that converts an observation image obtained as an inverted image into an erect image. A pair of eyepieces 11L and 11R is provided.

  A pre-lens 13 is connected to the surgeon's microscope 6 via a holding arm 14. The upper end portion of the holding arm 14 is pivotally pivoted in the vertical direction so that the front lens 13 can be inserted and removed at a position between the operated eye E and the front focal point of the objective lens. This front lens 13 is prepared in different powers (for example, 40D, 80D, etc.), and is selectively attached according to the observation site.

[Configuration of optical system]
1 and 2 show the configuration of an optical system provided in the surgical microscope apparatus 1 of the present embodiment. Here, FIG. 1 is a side view from the assistant's microscope 7 side, and FIG. 2 is a side view from the operator side. Note that the same reference numerals as those in FIG. 18 are used for the same components as those in the conventional surgical microscope apparatus, and the vertical and horizontal directions in the following description are directions when viewed from the operator unless otherwise specified. And

[Observation optics]
As shown in FIG. 2, the observation optical system 30 includes a left observation optical system 30 </ b> L and a right observation optical system 30 </ b> R provided as a pair on the left and right sides with the optical axis O of the objective lens 15 interposed therebetween. Here, the symbol OL indicates the observation optical axis of the left observation optical system 30L, and the symbol OR indicates the observation optical axis of the right observation optical system 30R. The left and right observation optical systems 30L and 30R respectively include a zoom lens system 31, a beam splitter 32 (only the right observation optical system 30R), an imaging lens 33, an image erecting prism 34, an eye width adjustment prism 35, a field stop 36, and the like. An eyepiece 37 is included. The zoom lens system 31 includes a plurality of zoom lenses 31a, 31b, and 31c.

  The beam splitter 32 of the right observation optical system 30R separates a part of the observation light guided from the operated eye E along the observation optical axis OR and guides it to the TV camera imaging system. The TV camera imaging system includes an imaging lens 54, a reflection mirror 55, and a TV camera 56. The TV camera 56 includes an image sensor 56a such as a CCD.

  The assistant's microscope 7 forms left and right observation optical paths for the left and right eyes of the assistant through the objective lens 15 and is reflected by the reflecting surface 50a of the prism 50 through the objective lens 15 as shown in FIG. It includes an imaging lens 51 that forms an image of observation light from the eye E, a reflection mirror 52, and an eyepiece lens 53. The assistant's microscope 7 may be provided with a dedicated zoom lens system (not shown). In that case, the zoom magnification of the observation image by the assistant's microscope 7 can be changed in conjunction with the zoom magnification of the zoom lens system 31 of the observation optical system 30. The entrance pupil of the assistant's microscope 7 is the reflecting surface 50 a of the prism 50.

[Illumination optics]
As shown in FIG. 1, the illumination optical system 20 includes an illumination light source 21, an optical fiber 21a, a condenser lens 22, an illumination field stop 23, a slit plate 24, an illumination prism 25, an exit aperture stop 26, and a collimator lens 27. Is done.

  The illumination field stop 23 is provided at a position optically conjugate with the front focal position F of the objective lens 14. At the time of observation, the vertical position of the lens barrel 10 of the surgeon's microscope 6 is adjusted so that the front focal position F of the objective lens 15 is conjugated to the fundus Er (retina).

  The illumination light source 21 in the present embodiment is provided outside the lens barrel portion 10 of the surgeon's microscope 6. One end of an optical fiber 21 a is connected to the illumination light source 21. The other end of the optical fiber 21 a is disposed at a position facing the condenser lens 22 in the lens barrel 10. The illumination light output from the illumination light source 21 enters the condenser lens 22 through the optical fiber 21a.

  At a position facing the other end (exit port) of the optical fiber 21, an exit aperture stop 26 that shields an arbitrary region of the exit port is disposed. When the area of the exit opening that is shielded by the exit aperture stop 26 is changed, the exit area of the illumination light is changed. For example, when the exit aperture stop 26 shields the upper region of the exit port, the illumination light is emitted only from the lower region of the exit port and reflected by the upper region of the reflecting surface 25 a of the illumination prism 25. When the lower region of the exit port is shielded, the illumination light is emitted only from the upper region of the exit port and reflected by the lower region of the reflecting surface 25a of the illumination prism 25. Therefore, the illumination angle when the upper region of the emission port of the optical fiber 21a is shielded is larger than the illumination angle when the lower region is shielded. Here, the illumination angle refers to the angle formed by the illumination optical axis O ′ incident on the eye E to be operated with respect to the optical axes OL and OR (optical axis O of the objective lens 15) of the observation optical system 30 (left and right in FIG. 1). Angle).

  The slit plate 24 corresponds to an example of the “slit member” of the present invention. As shown in FIG. 3, the slit plate 24 is formed of, for example, a disk-shaped member having a light shielding property, and has a plurality of rectangular shapes (for example, three). It has slit holes 24a1, 24a2, 24a3. The slit widths of the slit holes 24a1, 24a2, 24a3 are, for example, 2.5 mm, 5 mm, and 9 mm, respectively.

  The slit plate 24 has a rotation shaft 24b at the center thereof. The rotating shaft 24b is connected to a slit plate rotating mechanism (to be described later) that rotates the slit plate 24. Each slit hole 24a1, 24a2, 24a3 is formed at a position equidistant from the rotation center, and is selectively arranged on the illumination optical path of the illumination optical system 20 by the slit plate rotation mechanism. At this time, the slit holes 24a1, 24a2, and 24a3 arranged on the illumination optical path are the slit holes 24a in FIG.

  The slit plate 24 (and the slit plate rotating mechanism) is moved in a direction orthogonal to the illumination optical axis O ′ of the illumination optical system 20 by a later-described slit plate moving mechanism.

  The collimator lens 27 converts the illumination light that has passed through the slit hole 24a into a parallel light flux. The illumination light converted into a parallel light beam is reflected by the reflecting surface 25 a of the illumination prism 25, enters the objective lens 15, and is irradiated on the eye E through the front lens 13.

  The surgical microscope apparatus 1 of the present embodiment includes the following illumination optical system 40 corresponding to an example of “another illumination optical system” of the present invention in addition to the illumination optical system 20 described above. It is characteristic. The illumination optical system 40 is provided at a position opposite to the assistant's microscope 7 with the observation optical system 30 in between. Like the illumination optical system 20, the illumination light source 41, the optical fiber 41a, the condenser lens 42, the illumination A field stop 43, a slit plate 44 (another slit member), an illumination prism 45 having a reflection surface 45a, an exit aperture stop 46, a collimator lens 47, and a reflection mirror 48 are included. Symbol O ″ indicates the optical axis of the illumination optical system 40. Illumination light from the illumination optical system 40 is applied to the eye E at a predetermined illumination angle. The illumination angle by and the illumination angle by the illumination optical system 20 may be the same or different from each other.

  The slit plate 44 has the same configuration as the slit plate 24 of the illumination optical system 20 (see FIG. 3), and is further driven in the same manner as the slit plate 24 by the same slit plate rotating mechanism and slit plate moving mechanism. .

  FIG. 4 shows the positional relationship between the exit pupils of the illumination optical systems 20 and 40 and the entrance pupil of the observation optical system 30 when viewed from above the observation optical system 30. The downward direction in the figure is the operator side.

  The exit pupil of the illumination optical system 20 shown in FIG. 1 is the reflection surface 25 a of the illumination prism 25. The exit pupil 25a (identified as the reflecting surface 25a) of the illumination optical system 20 is formed at a position on the opposite side of the surgeon with the observation optical systems 30L and 30R interposed therebetween, and the observation optical systems 30L and 30R. It has a rectangular shape whose longitudinal direction is the direction connecting the left and right observation optical axes OL, OR (the left-right direction in FIG. 4). The slit plate 24 is arranged on the illumination optical path so that the longitudinal direction of the slit hole 24a faces the same direction as the longitudinal direction of the exit pupil 25a.

  2 is the reflecting surface 45a of the illumination prism 45. The exit pupil of the illumination optical system 40 shown in FIG. The exit pupil 45a of the illumination optical system 40 (identified with the reflecting surface 45a) is a line segment (horizontal direction in FIG. 4) perpendicular to the observation optical axes OL and OR of the observation optical systems 30L and 30R and connecting them. A direction that is formed at a position extending rightward and that is orthogonal to the longitudinal direction of the exit pupil 25a of the illumination optical system 20 is defined as the longitudinal direction. The slit plate 44 is disposed on the illumination optical path so that the longitudinal direction of the slit hole 44a faces the same direction as the longitudinal direction of the exit pupil 45a.

  As shown in FIG. 2, the entrance pupil PL of the left observation optical system 30L is formed at a position between the objective lens 15 and the zoom lens system 31 of the left observation optical system 30L, and the entrance pupil PR of the right observation optical system 30R. Is formed at a position between the objective lens 15 and the zoom lens system 31 of the right observation optical system 30R. As shown in FIG. 4, the entrance pupils PL and PR of the left and right observation optical systems 30L and 30R are formed around the observation optical axes OL and OR, respectively.

[Control system configuration]
Next, the configuration of the control system of the surgical microscope apparatus 1 according to the present embodiment will be described with reference to FIG.

  The control system of the surgical microscope apparatus 1 is configured around the control unit 60. The control unit 60 controls each part of the apparatus, and includes a microprocessor such as a CPU and a storage device such as a RAM and a ROM. A computer program for device control is stored in advance in a nonvolatile storage device such as a ROM, and each part of the device is controlled by a CPU or the like developing the computer program in a RAM and executing it. The control unit 60 corresponds to an example of the “control unit” of the present invention.

[Drive system]
As described above, the illumination optical system 20 is provided with the illumination light source 21, the illumination field stop 23, the slit plate 24, and the exit aperture stop 26. The controller 60 controls the illumination light source 21 to output the illumination light and stops the output.

  The slit plate 24 is driven by a slit plate rotating mechanism 61 and a slit plate moving mechanism 62. The slit plate rotation mechanism 61 includes a drive device such as a pulse motor, and rotates the slit plate 24 around the rotation shaft 24 b based on a control signal from the control unit 60. The control unit 60 sends a control signal including a pulse signal having a target number of pulses to the slit plate rotation mechanism 61. The slit plate rotating mechanism 61 rotates the slit plate 24 by an angle corresponding to the number of pulses of the pulse signal, and selectively arranges the slit holes 24a1, 24a2, and 24a3 on the illumination optical path.

  The slit plate moving mechanism 62 includes a driving device such as a pulse motor, and operates to move the slit plate 24 and the slit plate rotating mechanism 61 integrally based on a control signal from the control unit 60. The moving direction is the direction of arrow A shown in FIG.

  The illumination field stop 23 is driven by an aperture drive mechanism 63 that operates according to a control signal from the control unit 60 to change the aperture value. The aperture drive mechanism 63 has a known configuration for adjusting the aperture value of a known aperture member. Similarly, the exit aperture stop 26 is driven by a well-known aperture drive mechanism 64 that operates based on a control signal from the control unit 60, and shields an arbitrary area of the exit aperture of the optical fiber 21a to thereby change the illumination angle of illumination light. change.

  The illumination optical system 40 includes an illumination light source 41, an illumination field stop 43, a slit plate 44, and an exit aperture stop 46. The controller 60 controls illumination light output / output stop by the illumination light source 41.

  The slit plate 44 is driven by a slit plate rotating mechanism 65 and a slit plate moving mechanism 66. The slit plate rotating mechanism 65 and the slit plate moving mechanism 66 drive the slit plate 44 in the same manner as the slit plate rotating mechanism 61 and the slit plate moving mechanism 62, respectively. The slit plate moving mechanism 66 integrally moves the slit plate 44 and the slit plate rotating mechanism 65 in the direction of arrow B shown in FIG.

  The illumination field stop 43 is driven by a known stop drive mechanism 67 that operates according to a control signal from the control unit 60 to change the stop value. Similarly, the exit aperture stop 46 is driven by a well-known aperture drive mechanism 68 that operates based on a control signal from the control unit 60, and blocks an arbitrary area of the exit aperture of the optical fiber 41a so as to change the illumination angle of illumination light. change.

[Operation system]
The operation system of the surgical microscope apparatus 1, particularly the foot switch 8, will be described with reference to FIG. The foot switch 8 is provided with an illumination direction selection operation unit 70, a first illumination operation unit 71, and a second illumination operation unit 72. The first illumination operation unit 71 is for operating the illumination optical system 20, and the second illumination operation unit 72 is for operating the illumination optical system 40. Since the illumination optical systems 20 and 40 have the same configuration as described above, the first and second illumination operation units 71 and 72 also have the same configuration.

(Lighting direction selection operation section)
The illumination direction selection operation unit 70 corresponds to an example of the “selection operation means” of the present invention, and is operated to select an illumination direction of the eye E to be operated, that is, an irradiation direction of illumination light to the eye E to be operated. The The illumination direction selection operation unit 70 is constituted by, for example, a single button, and each time it is operated once, the first illumination mode using only illumination light from the illumination optical system 20 and the illumination optical system 40 are used. The second illumination mode based only on the illumination light and the third illumination mode based on both the illumination light from the illumination optical system 20 and the illumination light from the illumination optical system 40 are cyclically switched. The switching operation of the illumination mode is controlled by the control unit 60 that receives the operation signal from the illumination direction selection operation unit 70.

  In addition, the illumination direction selection operation part 70 can also be comprised by two buttons, for example. One button is operated to switch the output / output stop of the illumination light from the illumination optical system 20, and the other button is operated to switch the output / output stop of the illumination light from the illumination optical system 40. Moreover, you may comprise the illumination direction selection operation part 70 by three buttons for applying said 1st-3rd illumination aspect, respectively.

(First lighting operation unit)
The first illumination operation unit 71 is for operating the illumination optical system 20, and includes a slit switching operation unit 71A, a slit movement operation unit 71B, an illumination angle change operation unit 71C, and an illumination field stop operation unit 71D. The Here, the slit switching operation unit 71A, the slit movement operation unit 71B, and the illumination angle change operation unit 71C each correspond to an example of the “operation means” of the present invention.

  The slit switching operation unit 71A is operated to switch the slit width of the slit hole 24a. The slit switching operation unit 71A is constituted by, for example, a single button, and the slit holes 24a1, 24a2, and 24a3 are cyclically arranged on the illumination optical path every time it is operated once. . In this slit width switching operation, the control unit 60 that has received an operation signal from the slit switching operation unit 71A transmits a control signal including a pulse signal having the number of pulses corresponding to the operation signal to the slit plate rotation mechanism 61. The slit plate 24 is rotated according to the pulse signal.

  The slit switching operation unit 71A may be configured by three buttons or the like for arranging the slit holes 24a1, 24a2, and 24a3 on the illumination optical path.

  The slit movement operation unit 71B is operated to move the slit hole 24a on the illumination optical path. The slit movement operation unit 71B is constituted by a pair of front and rear buttons, for example.

  When a front (rear) button of the pair of front and rear buttons is operated, the control unit 60 transmits a control signal to the slit plate moving mechanism 62 based on the operation signal. Based on the control signal, the slit plate moving mechanism 62 moves the slit plate 24 and the slit plate rotating mechanism 61 along the arrow A in FIG. 1 to operate the slit-shaped illumination light projected on the fundus Er. When viewed from the operator, it is moved in the forward direction (backward direction), that is, in the direction opposite to the operator side (direction on the operator side) in FIG. The amount of movement of the illumination light is adjusted by, for example, the strength of stepping on the button or the number of operations.

  The illumination angle change operation unit 71C is operated to change the angle (illumination angle) of the illumination optical axis O ′ of the illumination optical system 20 with respect to the observation optical systems 30L and 30R (the optical axis O of the objective lens 15). The illumination angle changing operation unit 71C is composed of a pair of buttons, for example.

  When the pair of buttons are operated, the control unit 60 transmits a control signal to the aperture driving mechanism 64 based on the operation signal. The aperture drive mechanism 64 moves the exit aperture stop 26 along the same direction as the arrow A in FIG. 1 based on the control signal. At this time, when one of the pair of buttons is operated, the exit aperture stop 26 is moved upward in FIG. 1, and when the other is operated, it is moved downward. When the exit aperture stop 26 moves upward, the shielding area of the exit aperture of the optical fiber 21a moves downward, so that the illumination angle of the illumination light is reduced as described above. On the other hand, when the exit aperture stop 26 moves downward, the shielding area of the exit aperture of the optical fiber 21a moves upward, so that the illumination angle of illumination light increases.

  The illumination field stop operation unit 71D is operated to change the aperture value of the illumination field stop 23, and includes, for example, a button for increasing the aperture value and a button for decreasing the aperture value. When the illumination field stop operation unit 71D is operated, the control unit 60 receiving the operation signal transmits a control signal to the aperture drive mechanism 63, and the aperture value of the illumination field stop 23 is changed based on the control signal. The

(Second lighting operation section)
The second illumination operation unit 72 is for operating the illumination optical system 40, and includes a slit switching operation unit 72A, a slit movement operation unit 72B, an illumination angle change operation unit 72C, and an illumination field stop operation unit 72D. The Here, the slit switching operation unit 72A, the slit movement operation unit 72B, and the illumination angle change operation unit 72C each correspond to an example of the “operation means” of the present invention.

  The slit switching operation unit 72A is configured in the same manner as the slit switching operation unit 71A, the slit movement operation unit 72B is configured in the same manner as the slit movement operation unit 71B, and the illumination angle change operation unit 72C is similar to the illumination angle change operation unit 71C. The illumination field stop operation unit 72D is configured in the same manner as the illumination field stop operation unit 71D.

  When the third illumination mode in the above description of the illumination direction selection operation unit 70 is not applied, that is, when the configuration in which the illumination optical system 20 and the illumination optical system 40 are used simultaneously is not applied, the illumination operation unit One is sufficient. For example, if the first illumination operation unit 71 is configured to operate the illumination optical system (20 or 40) selected by the illumination direction selection operation unit 70, the second illumination operation unit 72 becomes unnecessary.

[Mode of operation]
The operation mode of the surgical microscope apparatus 1 according to the present embodiment having the above-described configuration will be described with reference to the drawings as appropriate. Hereinafter, operations related to switching of the illumination direction and operations related to movement of the illumination area will be described. Hereinafter, the illumination optical systems 20 and 40 may be referred to as “first illumination optical system 20” and “second illumination optical system 40”.

[Switching lighting direction]
For example, in an operation to peel off the growth film attached to the retina, the adhesion site may be difficult to see due to the shadow of the growth film. When it is difficult to observe the site of interest, according to the present embodiment, the site of interest can be clearly observed by switching the illumination direction. The flowchart of FIG. 6 represents an example of the illumination switching operation.

  At the start of observation, for example, illumination light from the first illumination optical system 20 is irradiated to the surgical eye E under the control of the control unit 60 (S1). As shown in FIG. 1, the illumination light is incident on the eye E from a position on the cornea Ec on the opposite side (operator side) of the illumination optical system 20 across the optical axis O of the objective lens 15.

  The surgeon observes the site of interest under this illumination light (S2). At this time, the slit width of the slit plate 24 and the like are adjusted as necessary. When the observation state of the target region is good (S3; Y), the surgery is performed while observing the target region in the illumination mode as it is (S11).

  On the other hand, when the observation state is not good, for example, the site of interest is difficult to see with a shadow (S3; N), the operator operates the illumination direction selection operation unit 70 (S4). Upon receiving the operation signal from the illumination direction selection operation unit 70, the control unit 60 stops the output of the illumination light from the illumination light source 21 of the first illumination optical system 20 (S5), and the second illumination optical system. 40 illumination light sources 41 are controlled to output illumination light (S6). The surgeon adjusts the slit width of the slit plate 44 as necessary.

  The illumination light from the second illumination optical system 40 is operated on the eye E from the position on the cornea Ec on the opposite side (left side in FIG. 2) of the second illumination optical system 40 across the optical axis O of the objective lens 15. Is incident on. That is, the illumination light from the second illumination optical system 40 illuminates a region including the region of interest from a direction orthogonal to the illumination light of the first illumination optical system 20.

  When the site of interest can be satisfactorily observed in this illumination mode (S7; Y), surgery is performed while observing the site of interest under the illumination mode (S11).

  On the other hand, when a good observation state cannot be obtained even with illumination light from the second illumination optical system 40 (S7; N), the operator operates the illumination direction selection operation unit 70 again (S8). The controller 60 receives an operation signal corresponding to this operation, and controls the illumination light source 21 of the first illumination optical system 20 to output illumination light (S9). Thereby, both the illumination light from the 1st illumination optical system 20 and the illumination light from the 2nd illumination optical system 40 inject into the to-be-operated eye E from the mutually orthogonal direction.

  When the site of interest can be satisfactorily observed in this illumination mode (S10; Y), surgery is performed while observing the site of interest in the illumination mode as it is (S11).

  On the other hand, when still a good observation state cannot be obtained (S10; N), the surgeon operates the illumination direction selection operation unit 70 as necessary, and observation in the case of single illumination by the first illumination optical system 20 is performed. In order to compare the state, the observation state in the case of single illumination by the second illumination optical system 40, and the observation state in the case of illumination by both the first and second illumination optical systems 20 and 40, step S2- Step S10 is repeated as appropriate.

  The surgeon performs an operation by selecting an optimal observation state among the three illumination modes (S11).

  According to the surgical microscope apparatus 1 of the present embodiment as described above, when the region of interest is shaded by the state of the observation region of the eye E to be operated and a good observation state cannot be obtained, it is orthogonal to the illumination direction. Since the region of interest can be illuminated by irradiating with another illumination light from the direction to perform, a good observation state can be obtained. Therefore, it is possible to clearly observe the observation site regardless of the state of the observation site.

[Move lighting area]
According to the surgical microscope apparatus 1 of the present embodiment, it is possible to move the illumination areas by two slit lights orthogonal to each other.

  For this purpose, first, the illumination direction selection operation unit 70 is operated to irradiate illumination light (slit light) from both the first illumination optical system 20 and the second illumination optical system 40. These two slit lights are projected onto the eye E to be operated with their longitudinal directions orthogonal to each other.

  The surgeon operates the slit movement operation unit 71B of the first illumination operation unit 71, so that the slit light from the first illumination optical system 20 is perpendicular to the longitudinal direction (width direction of the slit light), In other words, the slit light from the second illumination optical system 40 can be arbitrarily moved in the longitudinal direction.

  Similarly, the surgeon operates the slit movement operation unit 72B of the second illumination operation unit 72 to change the slit light from the second illumination optical system 40 in a direction perpendicular to the longitudinal direction (the width of the slit light). Direction), in other words, it can be arbitrarily moved in the longitudinal direction of the slit light from the first illumination optical system 20.

  Thus, by moving the slit light from the first illumination optical system 20 and the slit light from the second illumination optical system 40, for example, the positional relationship of the site of interest with respect to, for example, the optic nerve head or the macula is easily achieved. I can grasp it.

[Modification]
Various modifications of the present embodiment will be described.

(Modification 1)
In the above embodiment, a configuration in which two different illumination lights (slit lights) can be irradiated from directions orthogonal to each other is adopted, but the irradiation directions do not need to be orthogonal. That is, it is sufficient if the illumination light can be selectively irradiated from a plurality of different directions. For this purpose, for example, together with the first illumination optical system 20 having the exit pupil 25a at a position opposite to the operator across the observation optical systems 30L and 30R, the exit pupil 25a is centered on the optical axis O of the objective lens 15. What is necessary is just to provide another illumination optical system in the position displaced only by arbitrary angles from. An example of such a configuration will be described in second and third embodiments described later.

(Modification 2)
The second illumination optical system 40 (excluding the illumination prism 45. The illumination light source 41 may be externally mounted) is housed in one housing, and the housing is mounted on the lens barrel portion 10 of the microscope 6 for the operator. An attachment portion for attaching to the housing is formed on the casing. In addition, a holder portion that holds the mounting portion of the housing of the second illumination optical system 40 is provided in the portion of the illumination prism 45 of the barrel portion 10 of the surgeon's microscope 6. Thereby, the housing of the second illumination optical system 40 is configured to be detachable from the lens barrel portion 10 of the surgeon's microscope 6. The exit pupil of the second illumination optical system 40 when mounted on the lens barrel unit 10 is the reflection surface 45a of the illumination prism 45 as in the above embodiment.

  Similarly, the assistant's microscope 7 is also configured to be detachable from the lens barrel 10 of the surgeon's microscope 6. For this purpose, the zoom lens system is housed in the housing of the assistant's microscope 7 in addition to, for example, the imaging lens 51, the reflection mirror 52, and the eyepiece lens 53. Furthermore, the same mounting portion as the mounting portion of the housing of the second illumination optical system 40 is provided in the housing. The zoom lens system of the assistant's microscope 7 has the same configuration as the zoom lens system 31 of the surgeon's microscope 6, and the control unit 60 changes the zoom magnification in conjunction with the zoom lens system 31. The entrance pupil of the assistant's microscope 7 when the assistant's microscope 7 is mounted on the holder portion of the lens barrel 10 is formed on the reflecting surface 45a of the illumination prism 45, like the exit pupil of the second illumination optical system 40. The

  FIG. 7 shows the positional relationship between the exit pupil 45 a of the second illumination optical system 40 and the entrance pupil of the assistant microscope 7. The assistant's microscope 7 includes left and right optical systems corresponding to the left and right eyes of the assistant. The entrance pupil (left entrance pupil) 7L of the left optical system and the entrance pupil (right entrance pupil) 7R of the right optical system are respectively the reflecting surface 45a of the illumination prism 45, that is, the second illumination optical system 40. The exit pupil 45a is formed at the same position.

  According to the configuration of the present modification, the second illumination optical system 40 can be used as appropriate when the assistant's microscope 7 is not used, which is convenient. In the second embodiment to be described later, a configuration in which holder portions are provided on the left and right sides of the lens barrel portion 10 will be described.

(Modification 3)
There is known a surgical microscope apparatus configured so that the assistant's microscope 7 can rotate around the optical axis O of the objective lens 15. When the configuration of the present embodiment is applied to such a surgical microscope apparatus, the second illumination optical system 40 provided on the opposite side corresponds to the rotation of the assistant's microscope 7 and the assistant's microscope is provided. 7 can be configured to rotate together with the unit 7. At this time, the entrance pupil of the assistant's microscope 7 and the exit pupil of the second illumination optical system 40 are rotated by the same angle about the optical axis O in the same rotational direction. The optical axis O of the objective lens 15 is a straight line that is parallel to each of the left and right observation optical axes OL and OR and that passes through an intermediate position therebetween.

<Second Embodiment>
A second embodiment of the surgical microscope apparatus according to the present invention will be described. The present embodiment is characterized in that, in addition to the illumination optical system 20 positioned on the opposite side of the operator with the observation optical systems 30L and 30R interposed therebetween, illumination optical systems are provided on both the left and right sides of the observation optical systems 30L and 30R, respectively. It is what. In addition, the same code | symbol shall be used about the same component as the surgical microscope apparatus 1 of 1st Embodiment.

[Configuration of optical system]
FIG. 8 shows the configuration of the optical system of the surgical microscope apparatus 1 ′ of the present embodiment. This figure corresponds to FIG. 2 in the first embodiment described above, and shows the configuration of the optical system as viewed from the operator side. Here, in FIG. 8, the configuration of the TV imaging system (the imaging lens 54, the reflection mirror 55, and the TV camera 56) is omitted. The configuration of the optical system of the present embodiment when viewed from the left side with respect to the operator is the same as that of FIG. 1 of the first embodiment.

  The surgical microscope apparatus 1 'of this embodiment has a left illumination optical system 40L on the left side of the left observation optical system 30L when viewed from the operator side, and a right illumination optical system 40R on the right side of the right observation optical system 30R. is doing. These left and right illumination optical systems 40L and 40R correspond to an example of “another illumination optical system” of the present invention, and have the same configuration. Note that the illumination optical system 20 on the opposite side of the surgeon and the left and right observation optical systems 30L and 30R have the same configuration as in the first embodiment.

  Similarly to the illumination optical system 40 of the first embodiment, the left illumination optical system 40L is an illumination light source 41L, an optical fiber 41La, a condenser lens 42L, an illumination field stop 43L, and a slit plate 44L formed with a slit hole 44La (others) And an illumination prism 45L having a reflecting surface 45La, an exit aperture stop 46L, a collimator lens 47L, and a reflecting mirror 48L. The symbol O ″ L indicates the optical axis of the left illumination optical system 40L.

  The right illumination optical system 40R includes an illumination light source 41R, an optical fiber 41Ra, a condenser lens 42R, an illumination field stop 43R, a slit plate 44R (another slit member) in which a slit hole 44Ra is formed, and an illumination prism having a reflecting surface 45Ra. 45R, an exit aperture stop 46R, a collimator lens 47R, and a reflection mirror 48R. The symbol O ″ R indicates the optical axis of the right illumination optical system 40R.

  Each of the slit plates 44L and 44R has the same configuration as that of the slit plate 24 of the illumination optical system 20 in the first embodiment (see FIG. 3).

  The illumination angle of the illumination light (left illumination light) from the left illumination optical system 40L and the illumination angle of the illumination light (right illumination light) from the right illumination optical system 40R may be the same, Each may be different. Further, the illumination angles of the left illumination light and the right illumination light may be the same as or different from the illumination angle of the illumination light from the illumination optical system 20.

  9 shows the positional relationship between the exit pupil of the illumination optical system 20, the exit pupils of the left and right illumination optical systems 40L and 40R, and the entrance pupil of the observation optical system 30 when viewed from above the observation optical system 30. FIG. Represents. The downward direction in the figure is the operator side.

  The exit pupil of the illumination optical system 20 is the reflection surface 25a of the illumination prism 25 as in the first embodiment, is formed at a position on the opposite side of the operator across the observation optical systems 30L and 30R, and is observed. The optical system 30L has a rectangular shape whose longitudinal direction is the direction connecting the left and right observation optical axes OL, OR of the optical systems 30L, OR (the left-right direction in FIG. 9). The slit plate 24 is disposed on the illumination optical path such that the slit hole 24a is oriented in the same direction as the longitudinal direction of the exit pupil 25a.

  The exit pupil of the left illumination optical system 40L is the reflection surface 45La of the illumination prism 45L. The exit pupil 45La of the left illumination optical system 40L (identified as the reflecting surface 45La) is perpendicular to the observation optical axes OL and OR of the observation optical systems 30L and 30R (the left-right direction in FIG. 9). Is a position extending to the left, and the direction perpendicular to the longitudinal direction of the exit pupil 25a of the illumination optical system 20 is the longitudinal direction. The slit plate 44L is arranged on the illumination optical path so that the longitudinal direction of the slit hole 44La faces the same direction as the longitudinal direction of the exit pupil 45La.

  Similarly, the exit pupil of the right illumination optical system 40R is the reflection surface 45Ra of the illumination prism 45R. The exit pupil 45Ra of the right illumination optical system 40R (identified as the reflecting surface 45Ra) is perpendicular to the observation optical axes OL and OR of the observation optical systems 30L and 30R and extends to the right with the line segment connecting them. The direction that is formed and orthogonal to the longitudinal direction of the exit pupil 25a of the illumination optical system 20 is defined as the longitudinal direction. That is, the exit pupil 45La of the left illumination optical system 40L and the exit pupil 45Ra of the right illumination optical system 40R have the same direction as the longitudinal direction. The slit plate 44R is arranged on the illumination optical path so that the longitudinal direction of the slit hole 44Ra faces the same direction as the longitudinal direction of the exit pupil 45Ra.

  The entrance pupil PL of the left observation optical system 30L and the entrance pupil PR of the right observation optical system 30R are the same as in the first embodiment.

[Control system configuration]
The control system of the surgical microscope apparatus 1 ′ of the present embodiment has substantially the same configuration as that of the first embodiment, and is configured with a control unit 60 (control means) as the center. Hereinafter, the control system of the present embodiment will be described with reference to FIG. 5 showing the configuration of the control system of the first embodiment.

[Drive system]
As for the control of the illumination optical system 20, a slit plate rotating mechanism 61, a slit plate moving mechanism 62, an aperture drive mechanism 63, and an aperture drive mechanism 64 are provided as in the first embodiment.

  The left illumination optical system 40L (right illumination optical system 40R) is provided with an illumination light source 41L (40R), an illumination field stop 43L (43R), a slit plate 44L (44R), and an exit aperture stop 46L (46R). The controller 60 controls illumination light output / output stop by the illumination light source 41L (41R).

  The slit plate 44L (44R) is driven by a slit plate rotating mechanism 65L (65R) and a slit plate moving mechanism 66L (66R) (not shown). The slit plate rotating mechanism 65L (65R) has the same configuration as the slit plate rotating mechanism 65 of the first embodiment, and the slit plate moving mechanism 66L (66R) has the same configuration as the slit plate moving mechanism 66. Have

  Although not shown, the illumination field stop 43L (43R) is driven by a known diaphragm drive mechanism 67L (67R) that operates according to a control signal from the control unit 60, and changes the aperture value. The diaphragm drive mechanism 67L (67R) has the same configuration as the diaphragm drive mechanism 67 of the first embodiment. The exit aperture stop 46L (46R) is driven by a known aperture drive mechanism 68L (68R) that operates based on a control signal from the control unit 60, and shields an arbitrary area of the exit aperture of the optical fiber 41La (41Ra). And change the illumination angle of the illumination light. The aperture drive mechanism 68L (68R) has the same configuration as the aperture drive mechanism 68 of the first embodiment.

[Operation system]
The foot switch 8 of the surgical microscope apparatus 1 ′ will be described with continued reference to FIG. 5 of the first embodiment. The foot switch 8 of the present embodiment is provided with a left illumination operation unit 72L and a right illumination operation unit 72R in addition to the illumination direction selection operation unit 70 and the first illumination operation unit 71 similar to those of the first embodiment. (Not shown).

  The illumination direction selection operation unit 70 is operated to select at least one of the illumination optical system 20, the left illumination optical system 40L, and the right illumination optical system 40R as an optical system that irradiates illumination light. The illumination direction selection operation unit 70 can be configured by, for example, three buttons for switching between output / output stop of illumination light by the illumination optical system 20, the left illumination optical system 40L, and the right illumination optical system 40R.

  Further, the illumination direction selection operation unit 70 is configured by a single button, for example, “illumination optical system 20” → “left illumination optical system 40L” → “right illumination optical system 40R” → “illumination optical system 20 and left illumination optics”. System 40L "→" illumination optical system 20 and right illumination optical system 40R "→" illumination optical system 20, left illumination optical system 40L and right illumination optical system 40R " You may make it switch. When two or more optical systems are not used at the same time, for example, an optical system that irradiates illumination light in the order of “illumination optical system 20” → “left illumination optical system 40L” → “right illumination optical system 40R”. May be switched cyclically.

  The left illumination operation unit 72L is for operating the left illumination optical system 40L. Similar to the second illumination operation unit 72 in the first embodiment, the left illumination operation unit 72L, the slit switching operation unit 72LA, the slit movement operation unit 72LB, the illumination angle A change operation unit 72LC and an illumination field stop operation unit 72LD are included (not shown). These operation units 72LA to 72LD are configured in the same manner as the slit switching operation unit 72A, the slit movement operation unit 72B, the illumination angle change operation unit 72C, and the illumination field stop operation unit 72D of the first embodiment, respectively. The operation when each of the operation units 72LA to 72LD is operated is the same as that in the first embodiment.

  The right illumination operation unit 72R is for operating the right illumination optical system 40R, and includes a slit switching operation unit 72RA, a slit movement operation unit 72RB, an illumination angle change operation unit 72RC, and an illumination field stop operation unit 72RD. Configured (not shown). These operation units 72RA to 72RD are configured in the same manner as the slit switching operation unit 72A, the slit movement operation unit 72B, the illumination angle change operation unit 72C, and the illumination field stop operation unit 72D of the first embodiment, respectively. The operation when this is done is the same as in the first embodiment.

  When applying a configuration in which the illumination by the left illumination optical system 40L and the illumination by the right illumination optical system 40R are not used at the same time, the left illumination operation unit 72L and the right illumination operation unit 72R are integrated to perform a single operation. The left and right illumination optical systems 40L and 40R may be operated by the unit. Further, if the illumination optical system 20 and the left and right illumination optical systems 40L and 40R are not used simultaneously, one illumination operation unit is sufficient.

[Mode of operation]
An operation mode of the surgical microscope apparatus 1 ′ of the present embodiment having the above-described configuration will be described with reference to FIG. The flowchart shown in the figure shows an operation mode when a configuration in which two or more optical systems are not used simultaneously is applied. Note that the operation in the case of adopting a configuration in which a plurality of optical systems are used at the same time is the same as the operation shown in the flowchart, and therefore will be omitted.

  At the start of observation, for example, illumination light from the first illumination optical system 20 is irradiated to the surgical eye E under the control of the control unit 60 (S21). The surgeon observes the site of interest under this illumination light (S22). When the observation state of the target region is good (S23; Y), the surgery is performed while observing the target region in the illumination mode as it is (S32).

  On the other hand, when the observation state is not good (S23; N), the surgeon operates the illumination direction selection operation unit 70 (S24). The controller 60 stops the output of the illumination light from the illumination light source 21 of the illumination optical system 20 (S25), and controls the illumination light source 41L of the left illumination optical system 40L to output the illumination light (S26). The surgeon adjusts the slit width of the slit plate 44L as necessary.

  Illumination light from the left illumination optical system 40L enters the eye E from a position on the cornea Ec on the opposite side (right side in FIG. 8) of the left illumination optical system 40L across the optical axis O of the objective lens 15. .

  When the site of interest can be satisfactorily observed in this illumination mode (S27; Y), surgery is performed while observing the site of interest under the illumination mode (S32).

  On the other hand, when a good observation state cannot be obtained even with illumination light from the left illumination optical system 40L (S27; N), the operator operates the illumination direction selection operation unit 70 again (S28). The control unit 60 stops the output of the illumination light from the illumination light source 41L of the left illumination optical system 40L (S29), and controls the illumination light source 41R of the right illumination optical system 40R to output the illumination light (S30). The surgeon adjusts the slit width of the slit plate 44R as necessary.

  Illumination light from the right illumination optical system 40R enters the eye E from a position on the cornea Ec on the opposite side (left side in FIG. 8) of the right illumination optical system 40R across the optical axis O of the objective lens 15. .

  When the attention site can be satisfactorily observed in this illumination mode (S31; Y), the surgery is performed while observing the attention site in the illumination mode as it is (S32).

  On the other hand, when still a good observation state cannot be obtained (S31; N), the operator operates the illumination direction selection operation unit 70 as necessary, and the observation state in the case of illumination by the illumination optical system 20 and the left In order to compare the observation state in the case of illumination by the illumination optical system 40L and the observation state in the case of illumination by the right illumination optical system 40R, Steps S22 to S31 are appropriately repeated.

  The surgeon performs an operation by selecting an optimal observation state from the three illumination modes (S32).

  According to the surgical microscope apparatus 1 ′ of the present embodiment as described above, when a shadow is generated in the target region due to the state of the observation region of the eye E to be operated and a good observation state cannot be obtained, the illumination direction is adjusted. Since the region of interest can be illuminated by irradiating different illumination light from the orthogonal left direction or right direction, a good observation state can be obtained. Therefore, it is possible to clearly observe the observation site regardless of the state of the observation site.

[Modification]
Various modifications of the present embodiment will be described.

  The left and right illumination optical systems 40L and 40R (excluding the illumination prisms 45L and 45R. The illumination light sources 41L and 41R may be externally mounted) are housed in a single housing. An attachment portion for attaching the housing to the left side of the lens barrel portion 10 of the surgeon's microscope 6 as viewed from the operator is formed in the housing of the left illumination optical system 40L. Similarly, an attachment portion for attaching the housing to the right side of the lens barrel portion 10 of the surgeon's microscope 6 is formed in the housing of the right illumination optical system 40R. The left and right attachment parts have the same configuration. In addition, a holder portion that holds the mounting portion of the housing of the left illumination optical system 40L is provided in the portion of the illumination prism 45L of the lens barrel portion 10 of the surgeon's microscope 6, and the portion of the illumination prism 45R of the lens barrel portion 10 is provided. In addition, a holder portion for holding the mounting portion of the housing of the right illumination optical system 40R is provided. Accordingly, the respective housings of the left and right illumination optical systems 40L and 40R are configured to be detachable from the lens barrel unit 10. The exit pupils of the left and right illumination optical systems 40L and 40R when mounted on the lens barrel unit 10 are reflection surfaces 45La and 45Ra of the illumination prisms 45L and 45R, respectively.

  Further, similarly to the second modification of the first embodiment, an attachment portion is provided on the housing of the assistant's microscope 7, and the assistant's microscope 7 is configured to be detachable from the left and right holder portions of the lens barrel portion 10. . The entrance pupil of the assistant's microscope 7 when mounted on the left holder part is formed on the reflection surface 45La of the illumination prism 45L in the same manner as the exit pupil of the left illumination optical system 40L. On the other hand, the entrance pupil of the assistant's microscope 7 when mounted on the right holder part is formed on the reflection surface 45Ra of the illumination prism 45R, like the exit pupil of the right illumination optical system 40R.

  FIG. 11 shows the positional relationship between the exit pupils 45La and 45Ra of the left and right illumination optical systems 40L and 40R and the entrance pupil of the assistant microscope 7. When the assistant microscope 7 is attached to the mounting position of the left illumination optical system 40L, the left entrance pupil 7L and the right entrance pupil 7R of the assistant microscope 7 are respectively the reflecting surface 45La of the illumination prism 45L, that is, the left illumination optical system. It is formed at the same position as the 40L exit pupil 45La. On the other hand, when the assistant's microscope 7 is attached to the mounting position of the right illumination optical system 40R, the left entrance pupil 7L and the right entrance pupil 7R of the assistant microscope 7 are respectively the reflecting surface 45Ra of the illumination prism 45R, that is, the right illumination. It is formed at the same position as the exit pupil 45Ra of the optical system 40R.

  According to the configuration of this modification, the left and right illumination optical systems 40L and 40R can be used as appropriate when the assistant's microscope 7 is not used, which is convenient. Further, when the assistant microscope 7 is mounted on either the left or right side, the left illumination optical system 40L or the right illumination optical system 40R can be attached and used on the opposite side of the mounting position, which is convenient.

<Third Embodiment>
In the third embodiment of the surgical microscope apparatus according to the present invention, another illumination optical system is provided at a position facing the (first) illumination optical system 20 of the above embodiment. FIG. 12 shows an example of the configuration of the surgical microscope apparatus of the present embodiment.

  12 is a side view of the optical system when viewed from the side of the assistant microscope 7 shown in FIG. 17. This surgical microscope apparatus 1 ″ is the same as that of the first embodiment. A similar illumination optical system 20 and observation optical system 30 are provided, and at a position opposite to the illumination optical system 20 across the observation optical system 30 (that is, a position facing the illumination optical system 20; a position on the operator side). An illumination optical system 80 is provided.

  The illumination optical system 80 corresponds to an example of “another illumination optical system” of the present invention, and similarly to the illumination optical system 20, an illumination light source 81, an optical fiber 81a, a condenser lens 82, an illumination field stop 83, and a slit plate. 84 (another slit member), an illumination prism 85 having a reflecting surface 85a, an exit aperture 86, a collimator lens 87, and a reflecting mirror 88. The slit plate 84 has the same configuration as the slit plate 24 of the illumination optical system 20 (see FIG. 3). Reference OA indicates the optical axis of the illumination optical system 80. The illumination light from the illumination optical system 80 is irradiated to the eye E to be operated at a predetermined illumination angle. Here, the illumination angle by the illumination optical system 80 and the illumination angle by the illumination optical system 20 may be the same or different from each other.

  FIG. 13 shows the positional relationship between the exit pupils of the illumination optical systems 20 and 80 and the entrance pupil of the observation optical system 30 when viewed from above the observation optical system 30.

  The exit pupil of the illumination optical system 20 is the reflection surface 25a of the illumination prism 25 as in the first embodiment, is formed at a position on the opposite side of the operator with the observation optical system 30 in between, and the observation optical system It has a rectangular shape whose longitudinal direction is a direction connecting 30 left and right observation optical axes OL, OR.

  The exit pupil of the illumination optical system 80 is the reflecting surface 85a of the illumination prism 85, and is formed at a position opposite to the illumination optical system 20 (position on the operator side) with the observation optical system 30 in between. The exit pupil 85a (identified as the reflecting surface 85a) of the illumination optical system 80 has a rectangular shape whose longitudinal direction is the same as the longitudinal direction of the exit pupil 25a of the illumination optical system 20. The slit plate 84 is disposed on the illumination optical path so that the longitudinal direction of the slit hole 84a faces the same direction as the longitudinal direction of the exit pupil 85a.

  The surgical microscope apparatus 1 ″ of this embodiment includes a control system similar to that of the first embodiment (see FIG. 5). Here, the operation units 72A to 72D of the second illumination operation unit 72 of the foot switch 8 are used. Is used to operate the illumination optical system 80. When the illumination direction selection operation unit 70 of the foot switch 8 is operated, the optical system that irradiates illumination light is between the illumination optical system 20 and the illumination optical system 80. It should be noted that it may be switched cyclically in the order of “illumination optical system 20” → “illumination optical system 80” → “right illumination optical system 40R”.

  According to the surgical microscope apparatus 1 ″ of the present embodiment, when the observation site of the eye E to be observed is shaded and a good observation state cannot be obtained, the illumination direction is reversed. It is possible to illuminate the site of interest by irradiating with another illumination light from the direction, so it is possible to obtain a good observation state, so that the observation site is clearly observed regardless of the state of the observation site. It becomes possible.

<Various modifications>
The configuration described in detail above is merely an example of the configuration for carrying out the surgical microscope apparatus of the present invention. Therefore, arbitrary modifications within the scope of the present invention can be made. Below, such a modification is demonstrated.

  By applying both configurations of the second and third embodiments, the illumination direction can be switched between four directions, front, rear, left and right. FIG. 14 shows the positional relationship between the exit pupil of each illumination optical system and the entrance pupil of the observation optical system 30 in that case. By enabling illumination from such four directions, a clear observation state can be reliably obtained.

  In each of the above embodiments, the switching operation of the slit width of each illumination optical system, the operation of moving the slit, the operation of changing the illumination angle, the operation of changing the aperture value of the illumination field stop, etc. are controlled independently. However, it is also possible to control the operation of two or more illumination optical systems to be linked. For example, in the first embodiment, when both illumination light from the illumination optical system 20 and illumination light from the illumination optical system 40 are irradiated, for example, it corresponds to the operation of the slit switching operation unit 71A. The slit holes 24a, 44a of the slit plates 24, 44 can be switched and controlled.

  As a current surgical microscope apparatus, there is an apparatus equipped with an assistant's microscope in which left and right observation optical paths for assistants are formed with the optical axis O of the objective lens 15 interposed therebetween. FIG. 15 shows an example of the positional relationship between the exit pupil and the entrance pupil when the configuration of the present invention (first embodiment) is applied to such a type of surgical microscope apparatus. Note that the left and right observation optical paths of the assistant's microscope are arranged side by side in a direction orthogonal to the direction connecting the left and right observation optical axes OL and OR of the surgeon's microscope. Accordingly, as shown in FIG. 15, the entrance pupils 7L and 7R of the left and right observation optical paths of the assistant's microscope are arranged in the direction in which the entrance pupils PL and PR of the left and right observation optical paths of the surgeon microscope are arranged (as viewed from the operator side). It is arranged in a direction (front-rear direction as viewed from the operator side) orthogonal to the (left-right direction). The positional relationship between the exit pupil 25a of the illumination optical system 20 and the exit pupil 45a of the illumination optical system 40 is the same as in the first embodiment. Reference numeral 28 denotes a deflecting mirror disposed in the vicinity of the left and right observation optical paths of the surgeon's microscope 6 (for example, “deflecting mirror 9 in FIG. 1 of Japanese Patent Application Laid-Open No. 2004-139002 by the present applicant). "reference).

  In each of the above embodiments, a configuration including an illumination light source for each illumination optical system is employed, but a configuration in which a plurality of illumination light sources are integrated may be employed. In that case, it is configured such that the output destination of the illumination light generated by the illumination light source, that is, to which illumination optical system it is output can be selected.

<Appendix>
Other features of the embodiment described above will be described below.

  [Additional Item 1] Further comprising an operation means, wherein the slit member changes a slit width of the slit according to an operation from the operation means. The surgical microscope apparatus according to any one of the above.

  [Additional Item 2] Further comprising an operating means, wherein the other slit member changes a slit width of the other slit in accordance with an operation from the operating means. The surgical microscope apparatus according to any one of claims 9 to 9.

  [Additional Item 3] The apparatus further includes an operation unit and an illumination angle changing unit that changes an angle formed by the illumination optical axis of the illumination optical system with respect to the observation optical axis in accordance with an operation from the operation unit. The surgical microscope apparatus according to any one of claims 1 to 9, wherein the surgical microscope apparatus is characterized by the following.

  The diaphragm drive mechanism 64 (see FIG. 5) in the above embodiment corresponds to an example of “illumination angle changing means”.

  [Additional Item 4] Operation means and other illumination angle changing means for changing the angle formed by the illumination optical axis of the other illumination optical system with respect to the observation optical axis in accordance with an operation from the operation means. The surgical microscope apparatus according to any one of claims 1 to 9, further comprising a surgical microscope apparatus.

  The diaphragm drive mechanism 68 (see FIG. 5) in the above embodiment corresponds to an example of “another illumination angle changing unit”.

  [Additional Item 5] The apparatus further comprises: an operating means; and an illumination position changing means for changing an illumination position of the eye to be operated by the illumination light in accordance with an operation from the operating means. The surgical microscope apparatus according to any one of claims 1 to 9.

  The slit plate moving mechanism 62 (see FIG. 5) in the above embodiment corresponds to an example of “illumination position changing means”.

  [Additional Item 6] The apparatus further includes an operation unit and another illumination position changing unit that changes the illumination position of the eye to be operated by the other illumination light according to an operation from the operation unit. The surgical microscope apparatus according to any one of claims 1 to 9, wherein:

  The slit plate moving mechanism 66 (see FIG. 5) in the above embodiment corresponds to an example of “another illumination position changing unit”.

  [Additional Item 7] According to any one of the additional items 1 to 6, further comprising a foot switch for operating the device with a foot, wherein the operation means is provided in the foot switch. The surgical microscope apparatus as described.

  [Additional Item 8] A foot switch for operating the apparatus with a foot is provided, and the selection operation means is provided in the foot switch. The surgical microscope apparatus as described.

  [Additional Item 9] It can be inserted and removed between the eye to be operated and the front focal position of the objective lens, and the illumination light and the other illumination light are respectively focused to illuminate the inside of the eye to be operated. The surgical lens according to any one of claims 1 to 9, or any one of the above supplementary items 1 to 8, further comprising a front lens for performing the operation. Microscope device.

It is a schematic side view showing the structure of the optical system of 1st Embodiment of the surgical microscope apparatus which concerns on this invention. It is a schematic side view showing the structure of the optical system of 1st Embodiment of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the structure of the slit board contained in the illumination optical system of 1st Embodiment of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the positional relationship of the exit pupil of the illumination optical system of the 1st Embodiment of the surgical microscope apparatus which concerns on this invention, and the entrance pupil of an observation optical system. It is a block diagram showing the structure of the control system of 1st Embodiment of the surgical microscope apparatus which concerns on this invention. It is a flowchart showing an example of operation | movement of 1st Embodiment of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the positional relationship of the exit pupil of the illumination optical system, the entrance pupil of the observation optical system, and the entrance pupil of the assistant's microscope in the modification of the first embodiment of the surgical microscope apparatus according to the present invention. It is a schematic side view showing the structure of the optical system of 2nd Embodiment of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the positional relationship of the exit pupil of the illumination optical system of 2nd Embodiment of the surgical microscope apparatus which concerns on this invention, and the entrance pupil of an observation optical system. It is a flowchart showing an example of operation | movement of 2nd Embodiment of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the positional relationship of the exit pupil of an illumination optical system, the entrance pupil of an observation optical system, and the entrance pupil of an assistant's microscope in the modification of 2nd Embodiment of the surgical microscope apparatus which concerns on this invention. It is a schematic side view showing the structure of the optical system of 3rd Embodiment of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the positional relationship of the exit pupil of the illumination optical system of the 3rd Embodiment of the surgical microscope apparatus which concerns on this invention, and the entrance pupil of an observation optical system. It is the schematic showing the positional relationship of the exit pupil of the illumination optical system, and the entrance pupil of an observation optical system in the modification of the surgical microscope apparatus which concerns on this invention. It is the schematic showing the positional relationship of the exit pupil of the illumination optical system, the entrance pupil of the observation optical system, and the entrance pupil of the assistant's microscope in a modification of the surgical microscope apparatus according to the present invention. It is sectional drawing showing the aspect of the operation performed by inserting a light guide in eyes and illuminating an observation site | part. It is the schematic showing the external appearance structure of a surgical microscope apparatus. It is a schematic side view showing the structure of the optical system of the conventional surgical microscope apparatus.

Explanation of symbols

E Operated eye 1, 1 ', 1 "Surgical microscope device 6 Surgery microscope 7 Assistant microscope 8 Foot switch 10 Lens barrel 15 Objective lens O Optical axis 20 Illumination optical system 21 Illumination light source 21a Optical fiber 22 Condenser lens 23 illumination field stop 24 slit plate 24a slit hole 25 illumination prism 25a reflecting surface, exit pupil 26 exit aperture stop 27 collimator lens O 'optical axis 30 observation optical system 30L left observation optical system 30R right observation optical system OL, OR optical axis PL , PR Entrance pupil 31 Zoom lens system 32 Beam splitter 33 Imaging lens 34 Image erecting prism 35 Eye width adjustment prism 36 Field stop 37 Eyepiece 40 Illumination optical system 41 Illumination light source 41a Optical fiber 42 Condenser lens 43 Illumination field stop 44 Slit Plate 44a Slit hole 45 Illumination prism 45 Reflective surface, exit pupil 46 Exit aperture stop 47 Collimator lens 48 Reflective mirror 50 Prism 50a Reflective surface, entrance pupil of assistant's microscope O ″ Optical axis 60 Control units 61, 65 Slit plate rotation mechanism 62, 66 Slit plate moving mechanism 63 , 64, 67, 68 Aperture drive mechanism 70 Illumination direction selection operation unit 71 First illumination operation unit 72 Second illumination operation unit 71A, 72A Slit switching operation unit 71B, 72B Slit movement operation unit 71C, 72C Illumination angle change operation unit 71D , 72D Illumination field stop operation section

Claims (9)

An observation optical system for forming left and right observation optical paths for the left and right eyes of the surgeon;
A rectangular exit pupil whose longitudinal direction is the direction connecting the centers of the left and right entrance pupils of the observation optical system is formed at a position opposite to the operator across the observation optical system to illuminate the operated eye. An illumination optical system including an illumination light source that outputs illumination light, and a slit member that forms a slit on the optical path of the illumination light, the slit having a longitudinal direction that is the same as the longitudinal direction of the exit pupil;
An objective lens through which both the observation optical path of the observation optical system and the illumination optical path of the illumination optical system pass;
A surgical microscope apparatus comprising:
Form another rectangular exit pupil whose longitudinal direction is different from the exit pupil of the illumination optical system, and form another slit whose longitudinal direction is the same as the longitudinal direction of the other exit pupil. A surgical microscope apparatus comprising: another slit member; and another illumination optical system that irradiates the surgical eye with other illumination light via the objective lens. The other exit pupil of the other illumination optical system is formed on an extension of a line connecting the centers of the left and right entrance pupils of the observation optical system, and is orthogonal to the longitudinal direction of the exit pupil of the illumination optical system. The surgical microscope apparatus according to claim 1, wherein the direction is a longitudinal direction. Further comprising an assistant microscope that forms left and right observation optical paths for the assistant's left and right eyes via the objective lens;
The other exit pupil of the other illumination optical system is formed at a position opposite to the entrance pupil of the assistant's microscope with the observation optical system in between.
The surgical microscope apparatus according to claim 1 or 2, wherein the surgical microscope apparatus is characterized. The other illumination optical system can be attached to and detached from a housing that houses the observation optical system,
The left and right observation optical paths for the left and right eyes of the assistant passing through the objective lens are formed, and the entrance pupil is located at the same position as the other exit pupils. Further comprising an assistant microscope for forming
The surgical microscope apparatus according to claim 1 or 2, wherein the surgical microscope apparatus is characterized. The other illumination optical system is:
A plurality of other slit members,
A left illumination optical system including an exit pupil whose longitudinal direction is a direction orthogonal to the longitudinal direction of the exit pupil of the illumination optical system, on the left side of the left observation optical axis of the observation optical system, and including the other slit member The system,
The right illumination optical system including the other slit member, which has an exit pupil whose longitudinal direction is the same as the longitudinal direction of the exit pupil of the left illumination optical system on the right side of the right observation optical axis of the observation optical system When,
The surgical microscope apparatus according to claim 2, further comprising:   The other illumination optical system and the assistant's microscope are integrated so as to rotate the other exit pupil and the entrance pupil around a straight line that is parallel to the left and right observation optical axes and that passes through an intermediate position therebetween. The surgical microscope apparatus according to claim 3, wherein the surgical microscope apparatus is configured to be pivotable.   The other exit pupil of the other illumination optical system is formed at a position on the opposite side of the exit pupil of the illumination optical system across the observation optical system, and the longitudinal direction is the same as the longitudinal direction of the exit pupil The surgical microscope apparatus according to claim 1, wherein: A selection operation means for selecting at least one of the illumination optical system and the other illumination optical system;
Control means for illuminating the surgical eye with illumination light from the selected illumination optical system and / or the other illumination optical system;
The surgical microscope apparatus according to claim 1, further comprising: A selection operation means for selecting at least one of the illumination optical system, the left illumination optical system, and the right illumination optical system;
Control means for illuminating the operated eye with illumination light from the selected illumination optical system, the left illumination optical system and / or the right illumination optical system;
The surgical microscope apparatus according to claim 5, further comprising:

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