JP6786903B2 - Intraocular lens insertion system, control device for controlling the intraocular lens insertion device - Google Patents

Description

The present disclosure relates to a control device for an intraocular lens insertion system, intraocular lens insertion for inserting an intraocular lens into the patient's eye.

An intraocular lens insertion device for inserting an intraocular lens into a patient's eye is known. For example, in the intraocular lens insertion device disclosed in Patent Document 1, the optical portion and the support portion of the intraocular lens are deformed inside the insertion portion and then ejected.

Japanese Unexamined Patent Publication No. 2011-139863

For example, when an intraocular lens is deformed by an intraocular lens insertion device (an intraocular lens insertion device or the like), the intraocular lens may be deformed inappropriately. As an example, if an intraocular lens insertion device presses on an improperly shaped intraocular lens, part of the intraocular lens can be damaged. Also, for example, if the intraocular lens insertion device ejects an intraocular lens having an improper shape into the patient's eye, the operator may take time to install the intraocular lens. Also, for example, if an intraocular lens insertion device ejects an improperly shaped intraocular lens into the patient's eye, the intraocular lens may damage the tissue of the patient's eye (capsule, cornea, iris, etc.). There is.

In addition, for example, the force of the intraocular lens insertion device pushing out the intraocular lens may damage the patient's eye. As an example, when part or all of the intraocular lens pops out of the intraocular lens insertion device, the intraocular lens that comes into contact with the posterior lens capsule by the force of the intraocular lens insertion device pushing the intraocular lens is the crystalline lens. It may damage the posterior capsule.

The present disclosure discloses an intraocular lens insertion system capable of suitably ejecting an intraocular lens by solving at least one of the above problems, a control device for controlling an intraocular lens insertion device, and a control method for an intraocular lens insertion device. And its program is intended to be provided.

In order to solve the above problems, the present invention is characterized by having the following configurations.
(1) The intraocular lens insertion system for inserting an intraocular lens has a drive unit, and an extrusion means for extruding a soft intraocular lens using the drive unit and an intraocular lens pushed by the extrusion means. It is characterized by including an observation means for acquiring an observation image and a determination means for determining a drive parameter of the drive unit based on the observation image.
(2) A control device for controlling an intraocular lens insertion device, which is a first interface for controlling a drive unit for pushing out a soft intraocular lens, and an intraocular lens pressed by the drive unit. It is characterized by having a second interface for inputting an observation image, a determination means for detecting the shape of the intraocular lens using the observation image, and a determination means for determining the drive parameter of the drive unit using the detection result. To do .

According to the present disclosure, the intraocular lens insertion system can be suitably injected an intraocular lens, it is possible to provide a control device for controlling the intraocular lens insertion device.

It is a schematic block diagram of the intraocular lens insertion system of this embodiment. It is a front view of a patient's eye imaged by the intraocular lens insertion system of FIG. It is a tomographic image of a patient's eye taken by the intraocular lens insertion system of FIG. It is the schematic of the insertion instrument part used in the intraocular lens insertion system of FIG. It is explanatory drawing about the deformation of an intraocular lens. It is explanatory drawing about the shape determination of an intraocular lens. It is explanatory drawing about the injection direction of an intraocular lens. It is a flowchart about injection of an intraocular lens. It is a flowchart about injection of an intraocular lens. It is a graph for demonstrating the extrusion rate. It is a figure for demonstrating the display of a transformation example.

Hereinafter, typical embodiments in the present disclosure will be described with reference to the drawings. FIG. 1 is a schematic configuration diagram of the intraocular lens insertion system 1 of the present embodiment. In the intraocular lens insertion system 1 of the present embodiment, an intraocular lens 2 that replaces the crystalline lens is inserted into the patient eye E from which the capsular bag has been removed. In the present embodiment, the intraocular lens 2 inserted by the intraocular lens insertion system 1 into the patient's eye E will be described as being installed in the capsular bag.

The intraocular lens insertion system 1 of the present embodiment includes an intraocular lens insertion device 100, a microscope unit 200, and a control device 300. The intraocular lens insertion device 100 of the present embodiment moves the intraocular lens 2 from the outside of the patient's eye E to the inside of the eye. In other words, the intraocular lens insertion device 100 of the present embodiment is an insertion means for the intraocular lens 2. The microscope unit 200 of the present embodiment observes the anterior eye portion Ea of the patient eye E, the intraocular lens insertion device 100, or the intraocular lens 2. In other words, the microscope unit 200 of the present embodiment is an observation means of the patient eye E, the intraocular lens insertion device 100, or the intraocular lens 2. The control device 300 of the present embodiment controls the intraocular lens insertion device 100 or the microscope unit 200. In other words, the control device 300 of the present embodiment is a control means for controlling the device (or instrument) involved in the insertion of the intraocular lens 2.

<Microscope part>
The microscope unit 200 of the present embodiment includes a microscope 205, an imaging optical system, an in-field display system 280, and a control device (control unit) 300. The microscope 205, the imaging optical system, and the in-field display system 280 of the present embodiment are built (accommodated) in the housing 203. The imaging optical system of the present embodiment includes a front image imaging optical system 270a and a tomographic image imaging optical system 270b. The user (operator) uses a microscope 205 or an imaging optical system as one of the observation optical systems (in other words, observation means) for observing the patient's eye E during surgery.

The microscope 205 of the present embodiment has an optical path PR from the patient's eye E to the operator's right eye and an optical path PL from the patient's eye E to the operator's left eye. The microscope 205 of the present embodiment is a binocular type microscope (of course, a monocular type microscope may be used). The microscope 205 of this embodiment has an objective lens 210. In the present embodiment, the objective lens 210 is arranged in a common optical path between the optical path PR and the optical path PL. In the present embodiment, the lens 212R, the lens 214R, and the eyepiece 218R are arranged in the optical path PR, and the lens 212L, the lens 214L, and the eyepiece 218L are arranged in the optical path PL. In the following description, the axis passing between the optical path PR and the optical path PL may be referred to as an axis L1.

In the present embodiment, the set of the lens 212R and the lens 214R and the set of the lens 212L and the lens 214L are moved in the optical axis direction by the microscope driving unit 290, respectively, and a pair of zoom systems (zoom system 216R, zoom system 216L). ) Is formed. The visible light source 277 of the present embodiment illuminates the anterior segment Ea of the patient eye E with visible light. In the present embodiment, the housing 203 can be moved in three axes (up, down, left, right, front and back) by an arm (not shown). Specifically, the position of the housing 203 can be adjusted by the arm so that the focal position of the objective lens 210 is placed on the anterior segment Ea.

The illumination light emitted from the visible light source 277 illuminates the anterior segment Ea from the front. The illumination light (that is, the reflected light) reflected by the anterior segment Ea passes (transmits) through the objective lens 210 and the beam combiner 240. After that, the light passing through the optical path PR reaches the operator's right eye via the zoom system 216R, the dichroic mirror 271, and the eyepiece lens 218R. On the other hand, the light passing through the optical path PL reaches the operator's left eye via the zoom system 216L, the beam combiner 240, and the eyepiece lens 218L. As a result, the operator can observe the front image of the anterior segment Ea by looking into the eyepieces 218R and 218L with the operator's left and right eyes.

<Front image imaging optical system>
The front image imaging optical system 270a of the present embodiment images (acquires) the front image IMGf of the anterior segment Ea. The front image imaging optical system 270a of the present embodiment includes an objective lens 210, a zoom system 216R, a dichroic mirror 271, an imaging lens 272, and a light receiving element 274. The light receiving element 274 of the present embodiment is an image pickup element (two-dimensional image pickup element). The light receiving element 274 of the present embodiment is arranged at a position substantially conjugated with the anterior segment Ea. The dichroic mirror 271 has a property of reflecting infrared light and transmitting visible light. The front image imaging optical system 270a of the present embodiment images the reflected light of the illumination light (infrared light) emitted from the infrared light source 276 in the patient's eye E. As a result, the front image imaging optical system 270a of the present embodiment images the front image IMGf of the anterior segment Ea. The front image imaging optical system 270a of the present embodiment can image the intraocular lens 2 located within the imaging range and the intraocular lens insertion device 100 in addition to the anterior ocular segment Ea.

FIG. 2 illustrates a front image IMGf imaged by the front image imaging optical system 270a of the present embodiment. The front view IMGf of FIG. 2 is formed in the anterior segment Ea of the patient eye E, the intraocular lens insertion device 100, the intraocular lens 2, the incision formed in the cornea of the patient eye E, and the anterior capsule of the capsular bag. C. C. C. (Continuous curvicular capslotomy) etc. are reflected. Since the cartridge portion 101 (see FIG. 4) of the present embodiment is translucent (passes light), the shape of the intraocular lens 2 filled inside the cartridge portion 101 can be changed to the cartridge portion. It can be observed from the outside of 101.

The image pickup means (acquisition means) of the front image IMGf is not limited to this. For example, the front image IMGf may be imaged (acquired) by scanning the laser beam. It suffices if the intraocular lens insertion system 1 can capture a frontal image IMGf (still image or moving image) of the patient's eye E. The front image IMGf of the present embodiment is a monochrome image (achromatic image), but the front image IMGf may be a color image (chromatic image).

<Tomographic image imaging optical system>
The tomographic image imaging optical system 270b of the present embodiment acquires, for example, a tomographic image IMGt of the anterior segment Ea of the patient eye E arranged at the surgical position. FIG. 3 illustrates a tomographic image IMGt imaged by the tomographic image imaging optical system 270b of the present embodiment. The tomographic image IMGt of FIG. 3 shows the anterior segment Ea of the patient eye E, the intraocular lens insertion device 100, the intraocular lens 2, the cornea of the patient eye E, the incision formed in the cornea of the patient eye E, and the like. It is crowded. In the tomographic image imaging optical system 270b of the present embodiment, similarly to the front image imaging optical system 270a described above, the shape of the intraocular lens 2 filled in the cartridge portion 101 is obtained from the outside of the cartridge portion 101. It can be observed.

The tomographic image imaging optical system 270b of the present embodiment includes an OCT unit 250. The tomographic image imaging optical system 270b of the present embodiment shares the objective lens 210 with other optical systems. The OCT unit 250 includes, for example, an optical interferometer and an optical scanner. The tomographic image imaging optical system 270b of the present embodiment irradiates the patient eye E with the measurement light. The tomographic image imaging optical system 270b of the present embodiment detects an interference state between the measurement light reflected from the patient's eye E and the reference light by a light receiving element (detector).

The optical scanner of the present embodiment is an irradiation position changing unit that changes the irradiation position of the measurement light on the patient's eye. In the present embodiment, the imaging position on the patient's eye E can be changed by the optical scanner. The optical scanner of this embodiment can scan in two dimensions. The optical scanner of this embodiment is connected to the control device 300. The control device 300 of the present embodiment controls the operation of the optical scanner based on the set imaging position information, and acquires the tomographic image IMGt based on the received signal from the detector.

In other words, the tomographic image IMGt is an image of a surface intersecting the imaging surface of the front image IMGf. That is, the image plane of the front image IMGf and the image plane (cross section) of the tomographic image IMGt intersect. In other words, the front image IMGf and the tomographic image IMGt are images obtained (observed) of an imaging target (patient eye E, intraocular lens 2, intraocular lens insertion device 100, etc.) from different directions.

The tomographic image imaging optical system 270b of the present embodiment has a device configuration of a so-called optical coherence tomography (OCT) for ophthalmology. As an example, the tomographic image imaging optical system 270b images a tomographic image IMGt of the anterior segment Ea of the patient eye E when the intraocular lens 2 is inserted into the patient eye E. The tomographic image imaging optical system 270b divides the light (infrared light) emitted from the measurement light source into the measurement light (sample light) and the reference light by a coupler (optical divider). Then, the tomographic image imaging optical system 270b guides the measurement light to the patient's eye E and guides the reference light to the reference optical system. After that, the detector (light receiving element) receives the interference light obtained by combining the measurement light reflected by the patient's eye E and the reference light.

The detector of this embodiment detects an interference state between the measurement light and the reference light. For example, in the case of the Fourier domain OCT, the spectral intensity of the interference light is detected by the detector, and the depth profile (A scan signal) in a predetermined range is acquired by the Fourier transform on the spectral intensity data. For example, Spectral-domain OCT (SD-OCT) and Swept-source OCT (SS-OCT) can be mentioned. Further, it may be Time-domain OCT (TD-OCT). In the case of SD-OCT, a low coherent light source (broadband light source) is used as the light source, and the detector is provided with a spectroscopic optical system (spectrum meter) that disperses the interference light into each frequency component (each wavelength component). The spectrum meter includes, for example, a diffraction grating and a line sensor.

For example, in the case of SS-OCT, a wavelength scanning light source (wavelength variable light source) that changes the emission wavelength at high speed in time is used as the light source, and for example, a single light receiving element is provided as the detector. The light source is composed of, for example, a light source, a fiber ring resonator, and a wavelength selection filter. Then, as the wavelength selection filter, for example, a combination of a diffraction grating and a polygon mirror, and a filter using Fabry-Perot Etalon can be mentioned. For the configuration of the optical tomography interferometer for ophthalmology, refer to JP2012-213634A, JP2008-29467A, and the like.

The tomographic image imaging optical system 270b may be used to image the frontal image IMGf of the patient's eye E (see, for example, Japanese Patent Application Laid-Open No. 2011-215134). In this case, the microscope unit 200 does not have to include the front image imaging optical system 270a. The configuration of the tomographic image imaging optical system 270b is not limited to the illustrated OCT form. It suffices if the intraocular lens insertion system 1 can capture a tomographic image IMGt (still image or moving image) of the patient's eye E. As an example, the patient eye E, the intraocular lens 2, or the intraocular lens insertion device 100 may be observed from a direction different from that of the front image IMGf in an optical system using the Shine Plook principle.

<Display system in the field of view>
The in-field display system 280 of the present embodiment is provided to display information related to surgery in the field of view of the microscope 205. The in-field display system 280 of the present embodiment includes a display unit 282, a projection lens (projection lens system) 284, and a half mirror 286. As the display unit 282, for example, a display device such as an LCD, an organic EL (OLED), or a liquid crystal projector may be used. The half mirror 286 of the present embodiment is arranged on the optical path PL and synthesizes the reflected light from the patient eye E illuminated by the visible light source 277 and the projected light from the display unit 282. In the present embodiment, an LCD is used for the display unit 282, and the control device 300 controls the display content of the display unit 282. The front image IMGf and the tomographic image IMGt may be displayed on the display unit 282.

<Control device>
Next, returning to FIG. 1, the control device 300 of the present embodiment will be described. The control device 300 of the present embodiment controls the operation of the intraocular lens insertion system 1. The control device 300 of the present embodiment includes a CPU 361 (processor), a ROM 362, a RAM 363, and a non-volatile memory 364. The CPU 361 of the present embodiment controls each part of the intraocular lens insertion system 1. The control device 300 or the CPU 361 may be called a computer. Various programs, initial values, and the like are stored in the ROM 362 of this embodiment. The RAM 363 temporarily stores various types of information. The non-volatile memory 364 of the present embodiment is a non-transient storage medium capable of retaining the storage contents even when the power supply is cut off. That is, the ROM 362, the RAM 363, or the non-volatile memory 364 is a storage means for storing data used by the computer.

For example, a USB memory detachably attached to the control device 300, a flash ROM built in the control device 300, or the like may be used as the non-volatile memory 364. For example, the USB memory may be a storage medium that can be read by a computer (CPU 361). In this case, the USB memory stores a program for causing the CPU 361 (computer) to execute the control method of the intraocular lens insertion device 100.

The control device 300 of the present embodiment includes a microscope drive unit 290, an infrared light source 276, a visible light source 277, an OCT unit 250, a light receiving element 274, a display unit 282, a memory 302, an operation unit 304, an external display 306, and a foot pedal 307. , The intraocular lens insertion device 100 and the like are connected. The operation unit 304 is manually operated. The operator can set the operating conditions of the intraocular lens insertion device 100, for example, by using the operation unit 304. The foot pedal 307 is operated by the operator, for example, for triggering the start of insertion of the intraocular lens 2. The control device 300 of the present embodiment obtains a tomographic image IMGt based on the output signal of the OCT unit 250, and obtains a front image IMGf based on the output signal of the light receiving element 274. That is, the control device 300 of the present embodiment has an interface for inputting an observation image (front image IMGf or tomographic image IMGt) of the intraocular lens 2 pressed by the drive unit 125.

The control device 300 of the present embodiment is at least one of a front image IMGf acquired by using the front image imaging optical system 270a, a tomographic image IMGt acquired by using the tomographic image imaging optical system 270b, and other surgery-related information. Is displayed on the screen of the external display 306. As other surgery-related information, the setting of the intraocular lens insertion device 100 and the like can be considered.

The control device 300 of the present embodiment analyzes the observation image (front image IMGf or tomographic image IMGt) acquired (input) from the microscope unit 200 and is being extruded by the extrusion means (plunger 121). The shape of the soft intraocular lens 2 is detected. Then, the control device 300 determines the drive parameter used for controlling the drive unit 125 in consideration of the detected shape of the intraocular lens 2.

In other words, the control device 300 of the present embodiment controls the first interface for inputting the observation image (front image IMGf or tomographic image IMGt) of the intraocular lens 2 and the driving unit 125 (driving means). The shape of the intraocular lens 2 being extruded is detected by using the second interface of the above and the observation image, and the parameter used for controlling the drive unit 125 is determined in consideration of the detected shape of the intraocular lens 2. Includes, and.

The intraocular lens insertion device 100 of the present embodiment uses a stepping motor as a power source for the drive unit 125. The control device 300 determines the control signal of the stepping motor of the drive unit 125 in consideration of the detected shape of the intraocular lens 2. As a result, the control device 300 of the present embodiment determines the pushing speed (including ON (operation) / OFF (stop)) of the plunger 121 driven by the power of the drive unit 125.

The control device 300 of the present embodiment analyzes the observation image (front image IMGf or tomographic image IMGt) by using image processing. The control device 300 of the present embodiment uses image processing to analyze the shape of the intraocular lens 2. As the image processing, for example, pattern matching, binarization, edge detection, and the like may be used. Template data used for pattern matching may be stored in ROM 362, non-volatile memory 364, or the like.

The control device 300 of the present embodiment is deformed by the length in the longitudinal direction (direction parallel to the extrusion axis A) and the deformation mechanism of the intraocular lens 2 deformed by the deformation mechanism as a shape analysis of the intraocular lens 2. The length of the intraocular lens 2 in the width direction (direction orthogonal to the extrusion axis A) and the shape of the support portion 4 (front support portion 4a or rear support portion 4b) (as an example, the tip portion of the support portion 4 faces. Direction) etc. are analyzed.

As described above, the control device 300 of the present embodiment determines the drive parameters used for controlling the drive unit 125 in consideration of the shape of the intraocular lens 2. Thereby, for example, damage to the intraocular lens 2 during extrusion can be suppressed. In addition, after the intraocular lens insertion device 100 ejects the intraocular lens 2 into the eye of the patient's eye E, the operator's work for installing the intraocular lens 2 in the eye can be reduced. For example, even an operator who is unfamiliar with inserting the intraocular lens 2 can insert the intraocular lens 2 into the eye of the patient eye E quickly and more safely.

In addition, for example, the intraocular lens insertion device 100 may be connected to another surgical device (cataract surgical device or cataract vitreous surgical device). For example, the microscope unit 200 outputs an observation image (front image IMGf or tomographic image IMGt). The control unit included in the cataract surgery device inputs the observation image, analyzes the observation image, considers the detected shape of the intraocular lens 2, and drives the driving means used for extruding the intraocular lens 2. The parameters may be determined. In this case, the surgical device functions as the control device 300. Further, the observation image may be input to the PC (personal computer), and the computer included in the PC may analyze the observation image, determine the drive parameter, and output the drive parameter from the PC. In this case, the PC functions as the control device 300. Further, the intraocular lens insertion device 100 having a built-in control unit may function as the control device 300.

The control device 300 may detect the shape of the intraocular lens 2 using only the front image IMGf. By using only the front image IMGf, for example, the configuration of the intraocular lens insertion system 1 can be simplified. Further, the control device 300 uses the tomographic image IMGt to detect the shape of the intraocular lens 2, so that the control device 300 is a part of the intraocular lens insertion device 100 that enters the eye of the patient's eye E, or the eye. The shape of the inner lens 2 can be suitably detected. In this embodiment, OCT is used for acquiring the tomographic image IMGt, and the configuration of the optical system of the intraocular lens insertion system 1 can be simplified. The control device 300 may detect the shape of the intraocular lens 2 by using only the tomographic image IMGt. In such a case, the configuration of the intraocular lens insertion system 1 can be simplified as compared with acquiring the front image IMGf and the tomographic image IMGt with different optical systems.

<Insert instrument part>
Next, the intraocular lens insertion device 100 of the present embodiment will be described with reference to FIGS. 4 and 5. FIG. 4A is an external perspective view of the intraocular lens insertion device 100 of the present embodiment as viewed from diagonally above. FIG. 4B is a schematic configuration diagram for explaining the internal configuration of the intraocular lens insertion device 100 of the present embodiment. The intraocular lens insertion device 100 of the present embodiment moves the intraocular lens 2 from the outside of the patient's eye E to the inside of the eye. In other words, the intraocular lens insertion device 100 of the present embodiment is an insertion means for the intraocular lens 2.

The intraocular lens insertion device 100 of the present embodiment includes a cartridge portion 101 and a handpiece portion 102. The cartridge portion 101 of the present embodiment is removable from the handpiece portion 102. In the present embodiment, when the intraocular lens 2 is inserted into the patient's eye E, the operator attaches the cartridge portion 101 to the handpiece portion 102.

At least a part of the cartridge portion 101 of the present embodiment is inserted into an incision formed in the sclera (or cornea) of the patient eye E. The cartridge portion 101 of the present embodiment has a deformation mechanism that deforms the intraocular lens 2 (details will be described later). The handpiece portion 102 of the present embodiment has a power means for moving the intraocular lens 2 from the outside of the eye to the inside of the patient's eye E.

The intraocular lens insertion device 100 of the present embodiment is used by exchanging the cartridge portion 101. The cartridge portion 101 of the present embodiment is a so-called disposable type (disposable mode). For example, the user (operator, caregiver) discards the used cartridge portion 101. That is, the intraocular lens insertion device 100 of the present embodiment uses a new cartridge portion 101 for each patient eye E. The intraocular lens 2 is pre-filled in the cartridge portion 101 of the present embodiment. The operator selects a cartridge portion 101 filled with an intraocular lens 2 corresponding to the eye characteristics of the patient's eye E, and attaches the selected cartridge portion 101 to the handpiece portion 102. The intraocular lens 2 may be filled in the intraocular lens insertion device 100 at the site of use.

The intraocular lens insertion device 100 of this embodiment is connected to the control device 300 via a cable 103. In the present embodiment, the power for the intraocular lens insertion device 100 to move the intraocular lens 2 is supplied from the control device 300 via the cable 103. The intraocular lens insertion device 100 may include a battery. Further, the control device 300 and the intraocular lens insertion device 100 may be connected wirelessly.

<Intraocular lens>
The intraocular lens 2 ejected by the intraocular lens insertion system 1 of the present embodiment will be described with reference to FIG. The intraocular lens 2 of the present embodiment includes an optical unit 3 and a support unit 4 as an example. In this embodiment, the optical portion 3 and the support portion 4 are integrally molded (sometimes referred to as a one-piece intraocular lens). The intraocular lens 2 of the second embodiment is a flexible intraocular lens. As a material for forming the intraocular lens 2, for example, a conventional foldable (or bendable) soft intraocular lens such as a simple substance such as HEMA (hydroxyethyl methacrylate) or a composite material of an acrylic acid ester and a methacrylic acid ester. You may use the material used for.

The optical unit 3 of the present embodiment applies a predetermined refractive power to the patient's eye E. In the present embodiment, in order to support the optical unit 3 in the eye, the support unit 4 is connected to the peripheral portion of the optical unit 3. The intraocular lens 2 of the present embodiment includes a pair of support portions 4 (front support portion 4a, rear support portion 4b). In the present embodiment, when the intraocular lens 2 is mounted on the mounting surface 113c (described later), the support portion 4 directed from the optical portion 3 toward the nozzle portion 131 is referred to as a front support portion 4a, and is a plunger. The support portion 4 directed in the direction of 121 is referred to as a rear support portion 4b.

Each support portion 4 extends outward from a peripheral portion (optical portion side surface 3c) of the optical portion 3. The support portion 4 of the present embodiment has a loop shape curved in the circumferential direction. The tip of the support portion 4 is a free end (sometimes referred to as an open loop type support portion). The pair of support portions 4 have a control shape with respect to the center (optical axis) of the optical portion 3, and extend in the same circumferential direction. The optical unit 3 of the intraocular lens 2 of the present embodiment includes a front optical surface 3a, a rear optical surface 3b, and an optical unit side surface 3c. In the intraocular lens 2 of the present embodiment, as an example, the front optical surface 3a and the rear optical surface 3b have different refractive powers. The anterior optical surface 3a of the present embodiment is directed toward the cornea in the eye, and the posterior optical surface 3b is directed toward the retina in the eye. The optical portion side surface 3c of the present embodiment connects the front optical surface 3a and the rear optical surface 3b.

The aspect of the intraocular lens is not limited to this. For example, an intraocular lens called a three-piece type may be used. In the three-piece type intraocular lens, for example, the optical portion and the support portion are formed of different members (different materials). The support of the three-piece intraocular lens is, for example, whisker-shaped. Further, an intraocular lens called a plate type may be used. The support portion of the plate-type intraocular lens is, for example, plate-shaped. Further, an intraocular lens having no support portion may be used.

<Cardridge section>
Returning to FIG. 4, the cartridge portion 101 of the present embodiment will be described. The cartridge portion 101 of the present embodiment is formed by injection molding using a resin material. The cartridge portion 101 of the present embodiment has a tubular shape. In the cartridge portion 101 of the present embodiment, the hollow portion 140 communicates from the base end to the tip end (see FIG. 5). The cartridge portion 101 of the present embodiment includes an insertion portion 111 and a mounting portion 113. The cartridge portion 101 of the present embodiment is translucent. That is, it can pass light. As a result, the imaging means (front image imaging optical system 270a, tomographic image imaging optical system 270b) of the microscope unit 200 changes the shape of the intraocular lens 2 housed inside the cartridge unit 101 to the shape of the intraocular lens 2 of the cartridge unit 101. It can be observed (imaged) from the outside.

The insertion portion 111 of the present embodiment has a tip portion inserted into an incision formed in the cornea of the patient's eye E. The insertion portion 111 of the present embodiment includes a nozzle portion 131 and a tapered portion 132. The nozzle portion 131 of the present embodiment has a hollow cylindrical shape with openings formed at both ends. The nozzle portion 131 of the present embodiment has a bevel 131a formed at the tip thereof. The bevel 131a of the present embodiment has an end face inclined with respect to a plane orthogonal to the extrusion axis A. If the direction in which the end face of the bevel 131a faces is described with reference to FIG. 4A, the end face is inclined to the left with respect to the plane orthogonal to the extrusion axis A. The intraocular lens insertion device 100 of the present embodiment ejects the intraocular lens 2 with the end face of the bevel 131a directed toward the retina of the patient eye E.

A tapered portion 132 is connected to the base end of the nozzle portion 131. The tapered portion 132 of the present embodiment has a tubular shape. The shape of the lumen of the tapered portion 132 tapers toward the tip. In the present embodiment, the intraocular lens 2 is folded small due to the tapered lumen shape. In this embodiment, the front optical surface 3a is valley-folded. A mounting portion 113 is connected to the base end of the tapered portion 132. The intraocular lens 2 before being pushed by the plunger 121 (described later) is arranged (set) on the mounting portion 113. The mounting portion 113 of the present embodiment includes a mounting portion main body 113a, a set lid 113b, and a mounting surface 113c.

The set lid 113b can rotate with respect to the mounting portion main body 113a. When the set lid 113b is closed, a tubular lumen space (hollow portion 140) is formed in the mounting portion 113. The cartridge portion 101 of the present embodiment opens the set lid 113b to fill the intraocular lens 2. Specifically, the user or the manufacturer temporarily opens the set lid 113b and places the intraocular lens 2 on the mounting surface 113c. When the set lid 113b is closed, the filled intraocular lens 2 is locked inside the mounting portion 113 by the locking mechanism. At the site of use, the intraocular lens 2 is ejected with the set lid 113b closed.

<Handpiece part>
The housing of the handpiece portion 102 of the present embodiment is made of metal. The handpiece portion 102 of the present embodiment has a power means for moving the intraocular lens 2. By the power means, the intraocular lens 2 moves from the outside of the patient's eye E to the inside of the eye. The handpiece unit 102 of the present embodiment includes a plunger 121, a power conversion unit 123, and a drive unit 125. The plunger 121 of the present embodiment comes into contact with the intraocular lens 2 and pushes the intraocular lens 2. The plunger 121 of the present embodiment is a rod-shaped member. The plunger 121 of the present embodiment includes a tip portion 121a and a base portion 121b. A tip portion 121a is provided at the tip of the plunger 121. The tip portion 121a of the present embodiment comes into contact with the intraocular lens 2 and pushes the intraocular lens 2.

A base portion 121b is connected to the base end side of the tip portion 121a. A power conversion unit 123 is connected to the base end side of the base unit 121b. The plunger 121 of the present embodiment moves along the extrusion shaft A by the power generated by the drive unit 125. The plunger 121 of the present embodiment can move (forward) the extrusion shaft A toward the tip end or move (backward) toward the proximal end of the extrusion shaft A by a control signal from the control device 300.

The power conversion unit 123 of the present embodiment has a conversion mechanism. The conversion mechanism of the present embodiment converts the rotary motion generated by the stepping motor (details will be described later) into a linear motion (direction parallel to the extrusion shaft A). The plunger 121 is connected to the conversion mechanism of the power conversion unit 123. A drive unit 125 is connected to the base end side of the power conversion unit 123. In this embodiment, a stepping motor is used as the drive unit 125. The rotation shaft of the stepping motor is connected to the conversion mechanism of the drive unit 125. The drive unit 125 and the control device 300 are connected via a cable 103. The cable 103 of the present embodiment is used as an interface for controlling the drive unit 125 for pushing out the flexible intraocular lens 2.

The control device 300 of the present embodiment can control the rotation direction of the shaft of the stepping motor, the rotation angle of the shaft of the stepping motor, and the rotation amount of the shaft of the stepping motor. As a result, the control device 300 can detect the advancing position (on the extrusion shaft A) of the tip portion 121a. Further, the control device 300 of the present embodiment can detect the amount of current consumed by the stepping motor. The control device 300 of the present embodiment can analyze the change in the amount of current consumed by the stepping motor and detect the moving load of the plunger 121. In other words, the control device 300 of the present embodiment can detect the load (stress, etc.) received by the moving (or stationary) intraocular lens 2 by detecting the moving load of the plunger 121. For example, the intraocular lens 2 being extruded is stressed by the viscoelastic substance injected into the cartridge portion 101, the frictional force between the intraocular lens 2 and the inner wall forming the hollow portion 140, and the like.

<Preparation for injection of intraocular lens>
The procedure (one example) of the intraocular lens insertion operation using the intraocular lens insertion system 1 of the present embodiment will be described with reference to FIGS. 5 to 10. 5 (a) to 5 (e) are cross-sectional views taken along the line II of FIG. 4, and for illustration purposes, only the housing portion of the cartridge portion 101 is cross-sectionald. As an explanation at the time of injection of the intraocular lens 2, the control device 300 controls the plunger 121 by the operation of the operator, FIGS. 5 (a), 5 (b), 5 (c), 5 (d), It will be described as proceeding in the order of FIG. 5 (e). The horizontal axis of FIG. 10 indicates the advancing position of the intraocular lens 2. A to e marked on the horizontal axis of FIG. 10 correspond to the positions of the respective intraocular lenses of FIGS. 5 (a) to 5 (e). The vertical axis of FIG. 10 shows the extrusion speed of the intraocular lens. The numerical value on the vertical axis of FIG. 10 is a relative value with the velocity SPD3 as a value of 1.0.

The surgeon lays the patient on his back on the operating table to place the patient's eye E in the surgical position. The surgeon holds the intraocular lens insertion device 100 with his left hand. At this time, the cartridge portion 101 is not attached to the intraocular lens insertion device 100. The surgeon operates the operation unit 304 with his right hand to select the insertion mode of the intraocular lens 2. In addition, the operator inputs the type (model number, etc.) of the cartridge portion 101 to be used. When the insertion mode is selected, the control device 300 retracts the plunger 121 to the initial position (position in FIG. 5A).

After confirming that the plunger 121 has been retracted to the initial position, the operator attaches the cartridge portion 101 to the handpiece portion 102 (state in FIG. 5A). The surgeon attaches the cartridge portion 101, which is filled with the intraocular lens 2 corresponding to the diopter of the patient's eye E, to the handpiece portion 102. Subsequently, the operator injects a viscoelastic substance (sliding agent) into the hollow portion 140 of the cartridge portion 101 using a syringe or the like.

Subsequently, the operator depresses the foot pedal 307 to the first step (first tilt angle) in order to advance the intraocular lens 2 to the standby position (position in FIG. 5C). When the control device 300 detects that the foot pedal 307 is depressed, the control device 300 advances the plunger 121 at a predetermined speed until the intraocular lens 2 reaches the standby position (see steps S101 and S103 in FIG. 8). .. At this time, the control device 300 of the present embodiment pushes out the intraocular lens 2 at the speed SPD1 until the intraocular lens 2 invades the tapered portion 132 (see sections a to b in FIG. 10). The control device 300 of the present embodiment detects the amount of movement (advance amount) of the plunger 121. The advancing position of the intraocular lens 2 is estimated from the detected movement amount of the plunger 121. The control device 300 may analyze the front image IMGf or the tomographic image IMGt to detect the traveling position of the intraocular lens 2.

The rear support portion 4b that comes into contact with the plunger 121 bends with the root portion as a fulcrum until the intraocular lens 2 invades the tapered portion 132. The tip portion of the bent rear support portion 4b faces the tip direction of the extrusion shaft A. That is, the rear support portion 4b is in a state of being tacked on the optical portion 3. In the present embodiment, when the rear support portion 4b is tacked, the tip portion of the rear support portion 4b is in a state of facing the front optical surface 3a. As will be described later, the front support portion 4a is also tacked to the same optical surface (front optical surface 3a) by the tapered portion 132.

The plunger 121 comes into contact with the optical unit 3 with the rear support portion 4b tacked. The plunger 121 moves the entire intraocular lens 2 toward the tip of the extrusion shaft A. When the entire intraocular lens 2 penetrates into the tapered portion 132, the optical portion 3 is deformed into a curved shape when viewed from the proximal end direction of the extrusion shaft A (see FIG. 5 (b)). Further, the tip portion of the front support portion 4a is deformed so as to approach the optical portion 3. In the control device 300 of the present embodiment, when the intraocular lens 2 is penetrated into the tapered portion 132, the extrusion speed of the intraocular lens 2 is once increased to the speed SPD2 and then decreased to the speed SPD3 while being decreased to the intraocular lens. 2 is brought to the standby position (see sections a to c in FIG. 10). At this time, the relationship between the extrusion speeds of the intraocular lens 2 is the relationship of speed SPD1 <speed SPD2. Further, the relationship of speed SPD2> speed SPD3 is established. The control device 300 of the present embodiment intends the intraocular lens 2 in the tapered portion 132 in which the amount of deformation of the intraocular lens 2 is large by increasing the extrusion speed when the intraocular lens 2 invades the tapered portion. Does not suppress deformation. Specifically, the control device 300 further increases the stress (friction force, repulsive force, etc.) due to the tapered shape by increasing the extrusion speed to SPD2, and makes the support portion 4 (front support portion 4a) into the optical portion 3. Get closer. As a result, for example, tacking defects of the support portion 4 (such as the support portion 4 not resting on the optical portion 3) are suppressed. Further, the control device 300 of the present embodiment suppresses a sudden change in stress applied to the intraocular lens 2 after tacking the support portion 4 by lowering the speed SPD2 to the speed SPD3. In other words, it suppresses unintended deformation of the intraocular lens 2.

As the plunger 121 advances toward the tip of the extrusion shaft A, the intraocular lens 2 is folded smaller. When the intraocular lens 2 reaches the standby position, the control device 300 stops the movement (advancement) of the plunger 121 (see FIG. 5C). In the intraocular lens 2 that has reached the standby position, the front support portion 4a and the rear support portion 4b are in a state of being tacked on the optical portion 3, and the entire optical portion 3 is folded into a small size (FIG. 5 (FIG. 5). c) See). In other words, the cartridge portion 101 of the present embodiment deforms the entire optical portion 3 so as to hold the front support portion 4a and the rear support portion 4b.

As described above, the control device 300 sequentially detects the traveling position of the plunger 121 by using the control signal to the drive unit 125. Further, the control device 300 sequentially detects the moving load of the plunger 121 by using the control signal to the drive unit 125. In the control device 300, the moving load of the plunger 121 exceeds a predetermined amount during the period from the initial position (see FIG. 5A) to the standby position (see FIG. 5C) of the intraocular lens 2. When this is detected, the progress (drive) of the plunger 121 is stopped, and a notification sound is sounded from the buzzer. At this time, the control device 300 displays a message indicating that the abnormal state has been detected on the external display 306. When the moving load of the plunger 121 is less than a predetermined amount, the control device 300 may determine that it is in an abnormal state.

When the intraocular lens 2 reaches the standby position, the operator arranges the cartridge portion 101 at the focal position of the objective lens 210. The control device 300 uses the front image imaging optical system 270a to acquire the front image IMGf in which the cartridge portion 101 is reflected (see step S102 in FIG. 8). The control device 300 displays the acquired front image IMGf on the external display 306. The control device 300 may sequentially update (display as a moving image) the front image IMGf displayed on the external display 306.

The control device 300 detects the shape (contour shape, etc.) of the intraocular lens 2 from the acquired front image IMGf by using image processing. The control device 300 determines the shape of the detected intraocular lens 2. When the control device 300 determines that the intraocular lens 2 has an allowable shape, the control device 300 displays a corresponding message (for example, “injectable”) on the external display 306. When the control device 300 determines that the intraocular lens 2 has an unacceptable shape, the control device 300 displays a corresponding message (for example, a warning prompting the replacement of the cartridge portion 101) on the external display 306 (see step S105 in FIG. 8).

When the intraocular lens 2 is determined to have an unacceptable shape, the control device 300 may display the replacement method of the cartridge portion 101 on the external display 306. When the shape of the intraocular lens 2 is determined to be an unacceptable shape, the control device 300 retracts the plunger 121 to the initial position. The operator replaces the cartridge portion 101 with reference to the message displayed on the external display 306. After that, the work described above is performed again to advance the intraocular lens 2 to the standby position.

In other words, the control device 300 of the present embodiment analyzes the shape of the intraocular lens 2 that has reached the standby position, and determines whether or not the intraocular lens 2 may be continuously extruded. That is, the control device 300 of the present embodiment is a determining means for detecting the shape of the intraocular lens 2 using the observation image and determining the driving parameter of the driving unit 125 using the detection result. The control device 300 may input the detection result and determine the drive parameter of the drive unit 125. If the shape of the intraocular lens 2 is unacceptable, the control device 300 prohibits the plunger 121 from advancing. That is, the control device 300 of the present embodiment determines the drive parameter used for pushing out the intraocular lens 2 in consideration of the shape of the intraocular lens 2.

FIG. 6 is an example of the shape of the intraocular lens 2 determined by the control device 300. 6 (a) to 6 (c) show the shape of the intraocular lens 2 that has reached the standby position. FIG. 6A is an example of the shape (deformed shape) of the intraocular lens 2 determined by the control device 300 of the present embodiment to be an allowable shape. 6 (b) and 6 (c) are examples of the shape (deformed shape) of the intraocular lens 2 which is determined by the control device 300 of the present embodiment to be an unacceptable shape.

In the shape of the intraocular lens 2 that has reached the standby position as illustrated in FIG. 6A, the tip portion of the front support portion 4a and the tip portion of the rear support portion 4b are on the optical portion 3 (the contour of the optical portion 3). It is located inside). In other words, the front support portion 4a and the rear support portion 4b are tacked on the optical portion 3.

On the other hand, in the shape of the intraocular lens 2 that has reached the standby position, which is illustrated in FIG. 6B, the tip of the front support portion 4a extends toward the tip of the extrusion shaft A (to the left of the paper surface). In other words, in the intraocular lens 2 of FIG. 6B, the front support portion 4a is not tacked. Further, in the shape of the intraocular lens 2 illustrated in FIG. 6B, the tip of the front support portion 4a protrudes from the tip of the nozzle portion 131. (The shape of the intraocular lens 2 in the region ER1 was compared with the shape of FIG. 6A).

In the shape of the intraocular lens 2 that has reached the standby position, which is illustrated in FIG. 6 (c), the tip of the rear support portion 4b is oriented toward the base end of the extrusion shaft A (to the right of the paper surface). In other words, in the intraocular lens 2 of FIG. 6C, the rear support portion 4b is not tacked. Further, in the shape of the intraocular lens 2 illustrated in FIG. 6 (c), the rear support portion 4b is bent in an S shape. (The shape of the intraocular lens 2 in the region ER2 was compared with the shape of FIG. 6A).

The control device 300 of the present embodiment uses image processing to detect the shape of the intraocular lens 2. For example, as image processing, pattern matching, binarization, edge detection, and the like may be used. Template data used for pattern matching may be stored in a storage means (ROM362 or non-volatile memory 364). The shape of the intraocular lens 2 may be detected by using an observation image (front image IMGf or tomographic image IMGt) in which a part of the intraocular lens 2 is reflected.

The control device 300 may determine the shape of the intraocular lens 2 depending on whether or not the size of the intraocular lens 2 detected from the front image IMGf is within a predetermined size. For example, it may be determined whether or not the length of the intraocular lens 2 extended in the direction of the extrusion shaft A is within the permissible range (the length of the portion of reference numeral Da and the length of the portion of reference numeral Db in FIG. Was compared). Alternatively, for example, the control device 300 may determine the shape of the intraocular lens 2 based on the length in the direction orthogonal to the extrusion axis A (the length of the portion of reference numeral Ha and the portion of reference numeral Hb in FIG. 6). The lengths were compared).

In the present embodiment, the intraocular lens that is stationary in the standby position is imaged, but the intraocular lens 2 that is being pushed out by the plunger 121 (in a moving state) is imaged and is intraocular. The shape of the lens 2 may be determined. Further, the intraocular lens 2 on the way to the standby position may be imaged. As will be described later with reference to FIG. 9, the drive parameter (for example, the extrusion speed) used for extrusion of the intraocular lens 2 may be changed in consideration of the shape of the intraocular lens 2.

<Intraocular lens injection>
Subsequently, the injection of the intraocular lens 2 will be described with reference to FIGS. 5 to 10. The surgeon looks into the microscope 205. Subsequently, the operator inserts the insertion portion 111 into the incision in the patient's eye E. Subsequently, the operator manipulates the orientation of the intraocular lens insertion device 100 so that the end face of the bevel 131a faces the retina. Subsequently, the operator depresses the foot pedal 307 to the second stage (second inclination angle). When the control device 300 detects that the foot pedal 307 is stepped on to the second stage, the control device 300 advances (advances) the plunger 121 that has stopped near the standby position toward the tip of the extrusion shaft A.

When the advance of the plunger 121 is resumed, the intraocular lens 2 is further folded smaller at the tapered portion 132. When the plunger 121 advances further, the intraocular lens 2 invades the nozzle portion 131, and the intraocular lens 2 gradually begins to pop out from the tip of the nozzle portion 131 (see FIG. 5D). The shape of the intraocular lens 2 protruding from the nozzle portion 131 is gradually restored. At this time, when the control device 300 of the present embodiment moves the intraocular lens 2 from the standby position to the nozzle portion 131, the extrusion speed of the intraocular lens 2 is advanced at a constant speed SPD3 (section c in FIG. 10). See ~ d). By pushing the intraocular lens 2 at a low speed, the stress applied to the intraocular lens 2 when the intraocular lens 2 is compressed to a small size (the cross-sectional area orthogonal to the extrusion axis A is reduced) is reduced. At the position d in FIG. 10, the intraocular lens 2 is in a state of half protruding from the nozzle portion 131.

As the plunger 121 advances further, the front support portion 4a and the optical portion 3 protruding from the nozzle portion 131 are gradually restored with the root portion of the rear support portion 4b as a fulcrum. The restored anterior optical surface 3a faces the cornea of the patient's eye E. The posterior optical surface 3b of the restored intraocular lens 2 faces the retina of the patient eye E. As the plunger 121 advances further, the intraocular lens 2 is completely ejected from the insertion portion 111 (see FIG. 5 (e)). The plunger 121 of the present embodiment advances even if its tip portion protrudes from the nozzle portion 131, and stops advancing when the protrusion amount reaches a predetermined amount.

Immediately after the intraocular lens 2 pops out from the nozzle unit 131, the control device 300 of the present embodiment temporarily accelerates the speed to SPD4. After reaching the speed SPD4, the speed is decelerated from the speed SPD4 (see sections d to e in FIG. 10). The moving speed of the intraocular lens has a relationship of speed SPD3 <speed SPD4. The relationship is speed SPD3 <speed SPD1 <speed SPD4 <speed SPD2. For example, by increasing the moving speed (exhaust speed) of the intraocular lens 2, the entire or large intraocular lens 2 is installed by the time the intraocular lens 2 ejected from the intraocular lens insertion device 100 is placed in the capsular bag. It is possible to suppress the event that the part is restored. As a result, after the intraocular lens insertion device 100 ejects the intraocular lens 2 into the eye, the operator installs the intraocular lens 2 restored in the anterior chamber of the patient's eye in the capsular bag. Can be suppressed. Further, by decelerating after increasing the speed to SPD4, for example, at least one of the intraocular lens 2 and the plunger 121 pushes the capsular bag to suppress the possibility of damaging the capsular bag.

The control device 300 may change at least one of the speed SPD3 and the speed SPD4. For example, the control device 300 may analyze the tomographic image IMGt to adjust the velocity SPD4 of the intraocular lens 2. Specifically, the control device 300 analyzes the tomographic image IMGt to detect the distance between the intraocular lens 2 and the posterior lens capsule (see FIG. 7). The control device 300 changes the speed SPD 4 according to the distance between the intraocular lens 2 and the posterior lens capsule. For example, the control device 300 slows down the moving speed of the intraocular lens 2 and the speed SPD4 when the distance between the intraocular lens 2 and the posterior lens capsule is closer than a predetermined value. This, for example, can reduce the possibility that the intraocular lens 2 pushes the capsular bag and damages the capsular bag. A predetermined value is stored in advance in a storage means (nonvolatile memory 364 or the like). Further, for example, when the distance between the intraocular lens 2 and the posterior lens capsule is longer than a predetermined value, the control device 300 makes the moving speed of the intraocular lens 2 faster than the speed SPD4. As a result, for example, it is possible to suppress an event in which the intraocular lens 2 is restored more than intended by the time it reaches the inside of the lens capsule.

The control device 300 of the present embodiment detects the deformed state of the intraocular lens 2 when the intraocular lens 2 is ejected from the intraocular lens insertion device 100. Specifically, the control device 300 detects the shape of the intraocular lens 2 by using the tomographic image IMGt acquired by the tomographic image imaging optical system 270b. The control device 300 acquires a tomographic image IMGt in the process in which the plunger 121 advances (see step S201 in FIG. 9). The control device 300 detects the shape of the intraocular lens 2 in the same manner as the analysis of the front image IMGf described above.

The control device 300 of the present embodiment uses the front image IMGf to determine the position (tomographic plane) at which the tomographic image IMGt is acquired. Specifically, the control device 300 detects the direction in which the intraocular lens insertion device 100 faces by analyzing the front image IMGf. The control device 300 sets the tomographic plane so that the tomographic image IMGt includes the extrusion axis A (controls the optical scanner of the tomographic image imaging optical system 270b).

The control device 300 determines whether or not the intraocular lens 2 is ejected from the intraocular lens insertion device 100 from the traveling position of the plunger 121 or the tomographic image IMGt (see step S202 in FIG. 9). When the intraocular lens 2 is ejected, the control device 300 displays a message indicating the completion of the ejection on the external display 306 (see step S203 in FIG. 9). When the intraocular lens 2 is not ejected, the control device 300 determines the shape of the intraocular lens 2 (see steps S204 and S206 in FIG. 9).

The control device 300 first determines whether or not the shape of the intraocular lens 2 is an allowable shape. As such a determination, for example, the shape determination of the intraocular lens 2 may be performed in the same manner as in FIG. 6 described above. When the shape of the intraocular lens 2 is an unacceptable shape, the control device 300 displays a corresponding message on the external display 306 (see step S205 in FIG. 9). For example, a message for having the operator pull out the insertion portion 111 inserted into the incision is displayed as a warning display. If the shape of the intraocular lens 2 is unacceptable, the control device 300 prohibits the plunger 121 from advancing (advancing) (determines the drive parameter).

When the intraocular lens 2 has an acceptable shape, the control device 300 compares the advancing position of the plunger 121 with the shape of the intraocular lens 2 to determine the state of shape restoration of the intraocular lens 2 ( See step S206 in FIG. 9). In the storage means, the traveling position of the plunger 121 and the shape data of the intraocular lens 2 at the corresponding position are stored in association with each other (stored in the form of table data). The control device 300 determines the shape of the intraocular lens 2 at the position with reference to the table data. The table data is stored in advance in a storage means (ROM362 or the like) by using an experiment, a simulation, or the like.

When the shape of the intraocular lens 2 is restored quickly, the control device 300 advances the plunger 121 at a low speed (see step S208 in FIG. 9). Specifically, the control device 300 determines the drive parameters used to drive the drive unit 125 and advances the plunger 121 at a low speed. If the shape of the intraocular lens 2 is not restored quickly, the control device 300 advances the plunger 121 at a normal speed (see step S207 in FIG. 9). Specifically, the control device 300 determines the drive parameters used to drive the drive unit 125 and advances the plunger 121 at a normal speed.

In this way, the control device 300 sequentially changes the pushing speed of the intraocular lens 2 in consideration of the shape of the intraocular lens 2 while pushing out the intraocular lens 2 with the plunger 121. As a result, unintended restoration of the intraocular lens 2 can be suppressed. By changing the traveling speed of the plunger 121, the intraocular lens 2 can be ejected in a suitable shape even if the stress applied to the bent intraocular lens 2 changes.

FIG. 7 is an example of transformation of the shape determination of the intraocular lens 2 performed by the control device 300. The control device 300 uses image processing to detect the ejection direction of the intraocular lens 2 protruding from the tip of the nozzle portion 131. The control device 300 determines the traveling speed of the plunger 121 according to the detected injection direction. The directions marked with reference numerals S2 and S3 in FIG. 7 are injection directions determined by the control device 300 of the present embodiment to be unacceptable.

For example, if the frictional force between the intraocular lens 2 and the inner wall forming the hollow portion 140 increases locally, the intraocular lens 2 may be ejected in an unintended direction (for example, the direction of reference numerals S2 and S3). There is sex. The control device 300 detects the injection direction of the intraocular lens 2 and adjusts the pushing speed of the intraocular lens 2 based on the detection result, so that it is easy to suppress the inconvenience of the injection direction due to the above-mentioned bias of the frictional force. Become.

On the other hand, the direction indicated by reference numeral S1 is the injection direction of the intraocular lens 2 determined by the control device 300 of the present embodiment to be within the permissible range. When the injection direction of the intraocular lens 2 is unacceptable, the control device 300 changes the traveling speed of the plunger 121. When the intraocular lens 2 is ejected in the direction of reference numeral S1, the restored intraocular lens 2 is likely to fit in the capsule of the patient's eye E. This reduces the work of the operator after the intraocular lens insertion device 100 ejects the intraocular lens 2.

As described above, the control device 300 of the present embodiment detects the shape of the intraocular lens 2 and controls the driving unit that pushes out the intraocular lens 2 based on the detected result. As a result, even an operator who is unfamiliar with the handling of the intraocular lens insertion device 100 can quickly insert the intraocular lens 2 into the eye of the patient eye E. The control device 300 detects the stress applied to the intraocular lens 2 (progress load of the plunger 121) and controls the progress of the plunger 121 in combination with the above-mentioned deformation detection result of the intraocular lens 2. May be good.

The control device 300 may detect the insertion state (insertion amount, insertion angle, etc.) of the intraocular lens insertion device 100 by using the observation image. For example, the control device 300 analyzes the reflected observation image (see FIGS. 2 and 3) of the intraocular lens insertion device 100. The control device 300 detects the center position of the pupil, the position of the incision, and the contour of the intraocular lens insertion device 100, and estimates the direction in which the extrusion axis A is facing. Then, the control device 300 determines whether or not the extrusion shaft A is oriented in the allowable direction. For example, the control device 300 determines whether or not the direction in which the straight line connecting the incision and the center of the pupil extends and the direction of the extrusion shaft A substantially coincide with each other. The control device 300 displays (superimposes on the observation image) a guide for guiding the direction of the extrusion shaft A on the external display 306 according to the determination result.

Further, FIG. 11 shows a display mode on the external display 306, which is shown as an example of transformation. In the transformation example, the control device 300 displays the front image IMGf and the tomographic image IMGt side by side on the external display 306. In this transformation example, the control device 300 displays the front image IMGf and the tomographic image IMGt as moving images. The control device 300 superimposes the guide G (guides Ga to Gd) on the observation image (front image IMGf or tomographic image IMGt). For example, the control device 300 analyzes the observation image to detect the central position of the pupil and the central position of the incision. The control device 300 displays a guide G on which the center of the pupil and the center position of the incision are located on the line. The control device 300 sequentially analyzes the observation image to be displayed as a moving image and updates the display of the guide G.

The surgeon may align the central axis of the intraocular lens insertion device 100 with the guide Ga and the guide Gc. That is, the guide Ga or the guide Gc is a guiding means for guiding the direction of the intraocular lens insertion device 100 (in other words, the direction of the extrusion shaft A). Further, the operator may align the tip of the nozzle portion 131 with the guide Gb and the guide Gd. That is, the guide Gb and the guide Gd are guiding means for guiding the insertion amount of the intraocular lens insertion device 100 into the patient eye E. In addition, the guide Gb and the guide Gd of the transformation example also guide the direction of the bevel 131a. When the orientation of the intraocular lens insertion device 100 (circumferential direction of the extrusion shaft A) is suitable, the guide Gb (guide Gd) and the contour shape of the nozzle portion 131 reflected in the observation image match. In FIG. 11, since the intraocular lens insertion device 100 is in a suitable orientation, the shape of the guide Gb (guide Gd) and the shape of the nozzle portion 131 match. That is, the guide Gd is a guiding means for guiding the direction of the intraocular lens insertion device 100 (circumferential direction of the extrusion shaft A).

The control device 300 may detect the intraocular lens insertion device 100 from the observation image and give a warning (notification) when the foot pedal 307 is depressed at an inappropriate position. As a warning, the control device 300 may display a warning message on the external display 306 and sound a buzzer. Further, the control device 300 may notify the alignment state of the intraocular lens insertion device 100 based on the positional relationship (alignment relationship) between the guide G and the intraocular lens insertion device 100. For example, as a notification method of the control device 300, the color of the guide G may be changed according to the proximity state of the guide G and the intraocular lens insertion device 100. Alternatively, for example, the control device 300 may analyze the observation image and issue a voice message for guiding the alignment position of the intraocular lens insertion device 100.

The guide G allows the operator to position the intraocular lens insertion device 100 at a suitable position and insert (inject) the intraocular lens 2 into the eye. Therefore, for example, even an operator who is unfamiliar with the operation of the intraocular lens insertion device 100 can preferably insert the intraocular lens 2.

The intraocular lens insertion system may include a robot arm, and the control device 300 may control the robot arm. In this case, the control device 300 may displace the intraocular lens insertion device 100 gripped by the robot arm (relative position, direction, etc. with respect to the patient eye E) based on the above-mentioned determination result.

Further, the control device 300 may detect the direction in which the end face of the bevel 131a faces. For example, the control device 300 detects the direction in which the bevel 131a is facing from the tomographic image IMGt (see FIG. 3) in which the intraocular lens insertion device 100 is reflected by image processing. For example, when the end face of the bevel 131a does not face the fundus direction, the control device 300 superimposes a guide for guiding the direction in which the end face of the bevel 131a faces on the tomographic image IMGt and displays it on the external display 306.

<Action and effect>
The intraocular lens insertion system 1 of the present embodiment has a drive unit, and is an observation image of an extruding means for extruding a flexible intraocular lens 2 using the drive unit and an intraocular lens 2 pushed by the extruding means. It is provided with an observation means for acquiring the above and a determination means for determining the drive parameter of the drive unit based on the observation image. As a result, the intraocular lens 2 can be suitably pushed out. For example, by observing a part or the whole of the intraocular lens insertion device 100 or a part or the whole of the intraocular lens 2 and determining the drive parameter of the drive unit, the unintended extrusion of the intraocular lens 2 is suppressed. it can. For example, it is possible to suppress an event in which the intraocular lens 2 is ejected into the eye of the patient eye E while maintaining an unintended shape. The determination means may detect the shape of the intraocular lens 2 using the observation image and determine the drive parameter of the drive unit using the detection result. Thereby, for example, the phenomenon that the intraocular lens 2 is ejected into the eye of the patient's eye E with an unintended shape can be further suppressed.

Further, the intraocular lens 2 used in the intraocular lens insertion system of the present embodiment has an optical unit 3 and a support unit 4 that supports the optical unit 3 in the eye of the patient's eye E, and the determination means is , At least the shape of the support portion 4 is taken into consideration to determine the drive parameters. As a result, even if the intraocular lens 2 has the support portion 4, the intraocular lens 2 can be suitably pushed out. For example, it is possible to suppress an event in which the tacking of the support portion 4 is released during the extrusion of the intraocular lens 2.

Further, the drive parameter used in the intraocular lens insertion system 1 of the present embodiment includes the extrusion speed of the intraocular lens 2. By changing the extrusion speed of the intraocular lens 2, the intraocular lens 2 can be suitably extruded. For example, the shape of the intraocular lens 2 can be maintained within an allowable range. The extrusion speed includes the extrusion stop.

Further, the observation means included in the intraocular lens insertion system of the present embodiment can acquire at least one of a front image IMGf and a tomographic image IMGt of the patient eye E. As a result, the shape of the intraocular lens can be detected without complicating the configuration of the system. For example, the configuration of a surgical microscope can be diverted.

Further, the control device 300 for inserting an intraocular lens of the present embodiment is a control device for controlling an intraocular lens insertion device, and is a first control device for pushing out a soft intraocular lens 2. It includes an interface, a second interface for inputting an observation image of the intraocular lens 2 pressed by the drive unit, and a determination means for determining a drive parameter of the drive unit based on the observation image. As a result, the intraocular lens 2 can be suitably pushed out. For example, it is possible to suppress an event in which the intraocular lens 2 is ejected into the eye of the patient eye E while maintaining an unintended shape. For example, an intraocular lens insertion device 100, an operating microscope, a cataract surgery device, or a personal computer may have a control device 300.

Further, the control method of the intraocular lens insertion device of the present embodiment uses the first step of inputting an observation image in which at least a part of the intraocular lens 2 is reflected and the observation image input in the first step. , A second step of detecting the shape of the intraocular lens 2 and a third step of determining a drive parameter of a drive unit for pushing out the intraocular lens 2 by using the detection result of the second step are included. .. As a result, the intraocular lens 2 can be suitably pushed out. For example, it is possible to suppress an event in which the intraocular lens 2 is ejected into the eye of the patient eye E while maintaining an unintended shape. In the present embodiment, the computer is made to execute such a control method as a program. Then, such a program is stored in the storage medium of the present embodiment and can be read by a computer. The observation image does not have to be an exact image. Any data related to the observed image will do.

The aspect of the intraocular lens insertion system is not limited to this. For example, it can be applied to the case where an intraocular lens (sometimes called a fake lens) installed in the anterior chamber of the patient's eye E is inserted (for the fake lens, for example, Japanese Patent Application Laid-Open No. 2005-523095). See).

The intraocular lens insertion device 100 of the present embodiment is composed of a cartridge portion 101 and a handpiece portion 102, but the aspect of the intraocular lens insertion device 100 is not limited to this. For example, it may be applied to a manual type intraocular lens insertion device that pushes out the intraocular lens 2 by the force of the operator's hand (for example, the intraocular lens insertion device described in Japanese Patent Application Laid-Open No. 2013-081759). For example, the control device 300 detects the shape of the intraocular lens 2 using the front image IMGf and the tomographic image IMGt, and if the intraocular lens 2 has an inappropriate shape, it is displayed on the external display 306 and a buzzer. The surgeon may be notified of the abnormal condition.

Further, the extrusion member (plunger or the like) of the intraocular lens insertion device that pushes out the intraocular lens 2 by the force of the operator's hand may be pushed by the actuator included in the intraocular lens insertion system. For example, when the intraocular lens insertion system 1 of the present embodiment is used, an intraocular lens insertion device (manual method) is attached to the handpiece portion 102 instead of the cartridge portion 101. That is, the plunger of the intraocular lens insertion device (manual method) is pushed out by the power means (stepping motor or the like) of the handpiece portion 102. The surgeon can select whether to manually eject the intraocular lens 2 without using the handpiece portion 102 or to eject the intraocular lens 2 manually using the handpiece portion 102 (electrically or the like).

Further, the intraocular lens insertion system 1 of the present embodiment observes the intraocular lens 2 and determines the drive parameter of the drive unit 125 based on the shape of the intraocular lens 2. However, without using these techniques, the intraocular lens insertion system may merely control the extrusion of the intraocular lens illustrated in FIG. That is, the control device 300 may change the traveling speed of the plunger 121 according to the traveling position of the plunger 121 regardless of the degree of deformation of the intraocular lens 2. In this case, the intraocular lens insertion system does not have to be provided with observation means. This allows, for example, an intraocular lens insertion system to have a simple configuration. For example, a control device that performs such extrusion control may be provided in the housing of the intraocular lens insertion device. The power source for pushing out the intraocular lens is not limited to the motor. For example, a gas (gas or the like) may be used. For example, the frictional force applied to the plunger 121 may be changed to change the extrusion speed for pushing out the intraocular lens.

Further, the intraocular lens insertion system may be provided with a guiding means (for example, the guide G in FIG. 11) for guiding the alignment of the intraocular lens insertion device 100 with respect to the patient eye E without the drive unit 125. Thereby, for example, even in the case of a manual type intraocular lens insertion device, the intraocular lens insertion device can be arranged at a suitable position and the intraocular lens 2 can be inserted.

The embodiments disclosed this time should be considered as exemplary in all respects and not restrictive. The scope of the present invention is shown not by the above description but by the scope of claims, and it is intended that the scope of claims and all modifications within the meaning and scope equivalent thereto are included.

2: Intraocular lens 100: Intraocular lens insertion device 200: Microscope unit 300: Control device

Claims (5)

An extrusion means that has a drive unit and uses the drive unit to extrude a flexible intraocular lens.
An observation means for acquiring an observation image of the intraocular lens pressed by the extrusion means, and an observation means.
A determination means for determining the drive parameter of the drive unit based on the observation image, and
An intraocular lens insertion system characterized by being equipped with. The intraocular lens insertion system according to claim 1.
The intraocular lens has an optical portion and a support portion that supports the optical portion in the eye of the patient's eye.
The determination means determines the drive parameter in consideration of at least the shape of the support portion.
An intraocular lens insertion system characterized by this. The intraocular lens insertion system according to claim 1 or 2.
The drive parameter includes the extrusion speed of the intraocular lens.
An intraocular lens insertion system characterized by this. The intraocular lens insertion system according to any one of claims 1 to 3.
The observation means can obtain at least one of a frontal image and a tomographic image of the patient's eye.
An intraocular lens insertion system characterized by this. A control device for controlling an intraocular lens insertion device.
The first interface that controls the drive unit for pushing out the soft intraocular lens,
A second interface for inputting an observation image of the intraocular lens pressed by the driving unit, and
A determination means for determining the drive parameter of the drive unit based on the observation image, and
A control device for controlling an intraocular lens insertion device, which comprises .