JP6973086B2 - Laser refraction correction device for ophthalmology, phototuning setting device for ophthalmology, phototuning system for ophthalmology, phototuning setting device for eyeglasses, and programs used for these, laser surgery device for ophthalmology - Google Patents

Description

The present disclosure relates to correcting the refractive properties of the eye by optically adjusting the refractive index of the translucent body using laser irradiation.

An ophthalmic laser surgical apparatus for treating a patient's eye by condensing the laser beam into the tissue of the patient's eye is known (see Patent Document 1). According to such a device, typical examples include corneal refraction correction by cutting the patient's cornea, cataract surgery by crushing the opaque portion of the crystalline lens of the patient's eye, and the like.
Further, as a phototuning method, for example, a method of adjusting the refractive index using a photochemical reaction proposed by Norbert Hampp et al. (For example, Patent Document 2), a hydrophobicity filed by Perfect Lens, Inc. A method for adjusting the refractive index by changing the hydrophilicity of the sex material (for example, Patent Document 3), and a method for adjusting the refractive index by changing the hydrophilicity of the hydrogel material proposed by Way Knox et al. (For example, Patent Document 4) or a method of changing the refractive index of the cornea by Way Knox et al. (For example, Patent Document 5) is known.

Japanese Unexamined Patent Publication No. 2015-37474 U.S. Patent Publication No. 2009-157178 U.S. Patent Publication No. 2014-135920 US Registration No. 8337553 US Registration No. 8617147

However, there is no example of commercialization of the above-mentioned photo tuning. The reason is that, for example, when forming a saw-shaped phase diffractive lens, a laser light source having a repetitive frequency much higher than that of a laser generally used in ophthalmology is required. As another problem, when phototuning is performed on a translucent body provided in the patient's eye, the position of the translucent body in the eye is unknown, and specifics for deriving a lens pattern suitable for the patient's eye. Lack of means.
However, there is not yet a device that combines the above-mentioned ophthalmic laser surgery device and photo tuning.

The present disclosure discloses an ophthalmic laser refraction correction device, an ophthalmic phototuning setting device, an ophthalmic phototuning system, a spectacles phototuning setting device, and a program used for these, and an ophthalmology, which can solve at least one of the above problems. It is a technical issue to provide a laser surgical device for eyeglasses.

In order to solve the above problems, the present disclosure is characterized by having the following configurations.

(1) An ophthalmic laser refraction correction device for adjusting the refractive index of the translucent body by condensing laser light inside the translucent body provided in the patient's eye.
An irradiation optical system for guiding the laser beam emitted from the laser light source unit for adjusting the refractive index of the translucent body into the inside of the translucent body provided in the patient's eye, and an irradiation optical system.
A scanning unit arranged in the optical path of the irradiation optical system and scanning the focused position of the laser beam, and a scanning unit.
By controlling the scanning unit and scanning the focused position of the laser beam in the irradiation region corresponding to the lens pattern of the preset multi-level phase diffractive lens, the multi-level phase diffractive lens is translucent. The control means formed inside the body and
It is characterized by having.
(2) An ophthalmic laser refraction correction device for adjusting the refractive index of the translucent body by condensing laser light inside the translucent body provided in the patient's eye.
An irradiation optical system for guiding the laser beam emitted from the laser light source unit for adjusting the refractive index of the translucent body into the inside of the translucent body provided in the patient's eye, and an irradiation optical system.
A scanning unit arranged in the optical path of the irradiation optical system and scanning the focused position of the laser beam, and a scanning unit.
A control means for controlling the scanning unit.
The laser beam is applied to an irradiation region corresponding to a preset lens pattern based on the position information of the translucent body in the tomographic image captured by the tomographic imaging device and the refraction characteristics of the patient's eye measured by the refraction measuring device. A control means for forming a lens inside the translucent body by scanning the condensing position of
It is characterized by having.
(3) An ophthalmic phototuning setting device for setting a lens pattern formed by condensing laser light inside a translucent body provided in a patient's eye.
It is characterized by comprising a setting means for setting the lens pattern based on the position information of the translucent body in the tomographic image captured by the tomographic imaging device and the refraction characteristics of the patient's eye measured by the refraction measuring device. do.
(4) With the photo tuning setting device for ophthalmology of (3),
A tomographic image pickup device that captures a tomographic image of the patient's eye including the translucent body,
A refraction measuring device for measuring the refraction characteristics of the patient's eye including the translucent body,
Photo tuning system for ophthalmology.
(5) A phototuning setting device for spectacles for setting a lens pattern formed by condensing laser light inside a spectacle lens.
It is characterized by providing a setting means for setting the lens pattern based on the refraction characteristics of the entire eyeball when wearing spectacles and the optical arrangement information of the anterior eye portion with respect to the spectacle lens when wearing spectacles (6) (6). By being executed by the processor of the apparatus according to any one of 1) to (5), at least one of the control of the scanning unit by the control means and the setting of the lens pattern by the setting means is performed on the apparatus. A program characterized by being executed.
(7) An ophthalmic laser surgical apparatus that treats the patient's eye by condensing the laser beam into the tissue of the patient's eye.
A laser light source unit capable of selectively emitting a first laser beam for treating the patient's eye and a second laser beam for adjusting the refractive index of the translucent body.
A scanning unit arranged in the optical path of the irradiation optical system and scanning the focused position of the first laser beam or the second laser beam.
A first surgical mode for treating the patient's eye with a first laser beam and a second surgical procedure for phototuning with a second laser beam for adjusting the refractive index of the translucent body. Mode switching means for switching between modes and
When set to the first surgical mode by the mode switching means, the patient's eye is treated by controlling the scanning unit to scan the condensing position of the first laser beam.
When the second surgical mode is set by the mode switching means, the scanning unit is controlled to scan the focused position of the second laser beam in the irradiation region corresponding to the preset lens pattern. Thereby, a control means for forming the lens inside the translucent body, and
It is characterized by having.

It is a figure when the example of the translucent body which concerns on this Example is seen from the front. It is a figure when the example of the translucent body which concerns on this Example is seen from the side. It is a figure which shows an example when a lens is formed in the translucent body which concerns on this Example. It is a side view which shows an example of the lens pattern which concerns on the saw type phase type diffractive lens. It is a side view which shows an example of the lens pattern which concerns on a multi-level phase type diffractive lens. It is a front view which shows an example of the lens pattern which concerns on a multi-level phase type diffractive lens. It is a flowchart which shows an example of setting the lens pattern which concerns on this Example. It is an optical figure which shows an example of the laser refraction correction apparatus for ophthalmology which concerns on this Example. It is an optical figure which shows an example of the optical arrangement at the time of treating a patient eye in the laser refraction correction apparatus for ophthalmology which concerns on this Example. It is an optical figure which shows an example of the optical arrangement at the time of performing photo tuning in the laser refraction correction apparatus for ophthalmology which concerns on this Example. It is a figure which shows an example of the eyeball interface which concerns on this Example. It is a flowchart which shows an example of planning which concerns on this Example. It is a flowchart which shows an example at the time of performing the additional photo tuning which concerns on this Example. It is a figure which shows an example of the tomographic image before the eyeball interface which concerns on this Example is attached to a patient's eye. It is a figure which shows an example of the tomographic image after the eyeball interface which concerns on this Example is attached to a patient's eye.

Typical embodiments of the present disclosure will be described below.
<Overview>
<Photo tuning reaction>
One aspect of this embodiment is to correct the refractive properties of the eye (eg, optical power, aberrations) by optically adjusting the refractive index of the translucent body using laser irradiation, eg, It can be used in the fields of ophthalmic medicine and optics. In the following description, an optical technique for optically adjusting the refractive index of a translucent body will be described as phototuning. The photo-tuned translucent body may be used to correct myopia, hyperopia, astigmatism, higher-order aberrations, chromatic aberration and the like of the eye to be inspected. In addition, multifocal adjustment may be performed. The phototuning technique may allow one or more lenses different from the refractive index of the translucent body to be written inside the translucent body by adjusting the refractive index of the translucent body.

Another aspect of this embodiment is to form (manufacture) a phototuned lens by optically adjusting the refractive index of the translucent body using laser irradiation, for example, in the field of ophthalmology. , Available in the field of optics.

As a phototuning method, for example, a method of adjusting the refractive index using a photochemical reaction proposed by Norbert Hampp et al. (For example, US Patent Publication No. 2009-157178), filed by Perfect Lens. A method of adjusting the refractive index by changing the hydrophilicity of a hydrophobic material (for example, US Patent Publication No. 2014-135920), refraction by changing the hydrophilicity of a hydrogel material proposed by Way Knox et al. Examples include, but are not limited to, a method of adjusting the rate (eg, US Registration No. 8337553) or a method of changing the refractive index of the cornea by Way Knox et al. (Eg, US Registration No. 8617147).

<Translucent body for photo tuning>
The translucent body may be, for example, a translucent body having a first refractive index and having light transmittance. The refractive index of the translucent body is adjusted by photo tuning. The translucent body to which phototuning is applied may typically be an artificial translucent body (see the translucent body 600 in FIGS. 1 and 2), for example, an intraocular lens. For example, an artificial lens (for example, an intraocular lens (IOL, ICL), an spectacle lens, a contact lens, or an artificial cortex may be used. As the artificial translucent body, a general optical material may be used. Further, the translucent body to which phototuning is applied may be a natural lens (for example, an intraocular lens or a crystalline lens).

In the case of an artificial translucent body, an optical material dedicated to phototuning (for example, an optical polymer material designed to have a relatively high absorption characteristic of ultraviolet rays) may be used. The high absorption characteristics of ultraviolet rays can promote the two-photon absorption of the laser.

If the artificial translucent body is an intraocular lens, the intraocular lens may be, for example, an intraocular lens designed to be inserted into either the anterior chamber of the eye, the posterior chamber of the eye, or the intraocular body. good. The intraocular lens may be, for example, an intraocular lens that is inserted into the eye and has lens characteristics in advance. Further, the intraocular lens may have lens characteristics added by phototuning the optical material inserted into the eye.

When phototuning an artificial translucent body, phototuning is performed at least in the state where the artificial translucent body is provided for the eye and before the artificial translucent body is provided for the eye. You may. Examples of the provision of the artificial translucent body for the eye may be the case where the translucent body is inserted into the eye or the case where the lens is provided in front of the eye via the spectacle frame.

The translucent body may have a main body having front and rear surfaces and forming lens characteristics. That is, the translucent body may be formed with the property of refracting or diffracting light to diverge or focus. In this case, the front surface and the rear surface may be substantially flat. Of course, the front surface and the rear surface may be curved surfaces. In this embodiment, the anterior surface is described as the outside and the posterior surface is described as the retinal side. In the case of an intraocular lens, a support portion (loop) may be provided in addition to the main body. The main body is used as an optical unit having lens characteristics.

By phototuning, one lens may be formed or a plurality of lenses may be formed inside the translucent body (for example, the first lens 600 and the second lens in FIG. 3). See 620).

The focal point of the laser beam is moved to write the lens inside the translucent body. By condensing the laser beam inside the translucent body, the refractive index inside the translucent body is corrected. As a result, the refractive index of the region irradiated with the laser is adjusted to a second refractive index different from the first refractive index. Utilizing this, the focus of the laser beam is moved to the irradiation region corresponding to the preset lens pattern, so that the lens corresponding to the lens pattern is formed inside the translucent body. The irradiation region of the laser is a refractive index changing region having a second refractive index, and functions as a lens having a second refractive index inside the translucent body.

The laser beam may be irradiated in order from the surface (front surface or rear surface) of the translucent body, for example. Of course, the laser beam may be emitted from the middle between the front surface and the rear surface of the translucent body. The irradiation start position may be appropriately set by a photo tuning method. In this case, the laser beam may be irradiated in order from the rear surface side, whereby the refractive index change region is not arranged in the optical path of the next laser beam, so that a predetermined lens pattern can be smoothly formed.

<Writing of multi-level phase diffractive lens>
In the phototuning technique according to the present embodiment, one or a plurality of multi-level phase diffractive lenses (hereinafter, may be abbreviated as MP diffractive lenses) may be written inside the translucent body (FIG. 5). Lens 610). The processor may control a scanning unit that scans the focused position of the laser light, and may scan the focused position of the laser light in the irradiation region of the translucent body corresponding to the lens pattern of the multi-level phase diffractive lens. .. This makes it possible to form a multi-level phase diffractive lens inside the translucent body. The processor can preset the lens pattern.

When a plurality of MP diffractive lenses are written, each MP diffractive lens may be formed in a different region in the anteroposterior direction (optical axis direction) of the translucent body body.

The multi-level phase diffractive lens is a lens that approximates a phase diffractive lens (Kinoform) to multi-level. The multi-level phase diffractive lens is formed, for example, by approximating a diffractive lens having a saw-shaped cross-sectional shape (see lens 610 in FIG. 4) with a stepped cross-sectional shape (lens 610 in FIG. 5).

The multi-level (number of steps) in the MP diffraction lens may be, for example, 9 levels or less and 4 levels or more, and for example, the multi-level may be 8. When the multi-level is 8, a diffraction efficiency of 95% can be obtained, and when the multi-level is 9, a diffraction efficiency of 96% can be obtained. Diffraction efficiency of 81% at the 4th level, 87.5% at the 5th level, 91.2% at the 6th level, and 93.4% at the 7th level can be obtained. By the way, at the 3rd level, the diffraction efficiency is 68.4%, and at the 10th level, the diffraction efficiency is 96.8%.

By setting the multi-level to 9 levels or less, sufficient diffraction efficiency can be obtained for correction, and the laser irradiation pattern can be simplified. Simplification of the irradiation pattern leads to shortening of the operation time, for example, and can reduce the burden on the eye to be inspected in the operation.

The number of multi-levels may be varied depending on the refractive properties of the eye. The number of multi-levels is counted as the number of layers, and one layer may be formed by, for example, an integral multiple of the thickness of the refractive index change region generated by one pulse of a pulse laser. Each layer may be formed substantially parallel to the front surface. In the case of correction of myopia or hyperopia, the pattern of the MP diffractive lens may be, for example, an annular ring pattern when viewed from the front-back direction of the translucent body (see FIG. 6). Further, in the case of correction of astigmatism or higher-order aberrations, the lens pattern may be another pattern.

For example, when writing an MP diffractive lens, a laser beam may be irradiated at each distance from the surface of the translucent body. For example, after scanning the focal point of the laser beam with an XY scanner at a first distance in the XY direction, the laser beam may be irradiated. The focus of the laser beam may be changed to a second distance by scanning the focus of the laser beam in the Z direction with a Z scanner. In this case, the XY direction is defined as a direction orthogonal to the front-back direction (optical axis direction) of the translucent body, and the Z direction is defined as the front-back direction (optical axis direction) of the translucent body. Of course, the laser beam may be irradiated for each cross section in the radial direction of the lens. Regarding the method of forming the MP phase type lens into a translucent body, for example, a method of writing a plurality of multi-level phase type lenses in silica glass by a femtosecond laser by Yamada et al. (K. Yamada, K. Itoh, See “Multilevel phase-type diffractive lenses in silica glass induced by filamentation of femtosecond laser pulses”, Opt.Let., 29 (16), p1846-1848 (2004)).

When the light incident on the phototuned translucent body passes through the refractive index change region, an optical path difference (phase change) due to the second refractive index occurs. Further, the magnitude of the optical path difference differs depending on the thickness of the refractive index change region in the front-back direction. Therefore, by adjusting the thickness of the refractive index change region, it is possible to obtain a pattern of the phase type diffractive lens according to the desired refractive index. In this case, the pattern of the multi-level phase diffractive lens can be obtained by approximating the phase diffractive lens (Kinoform) according to the desired refraction characteristic.

One of the specific examples when planning a lens pattern is shown below.

を発生させる小プリズムを作成すればよく、近似的には、ｘ方向及びｙ方向の頂角θｘ（ｘ、ｙ）、θｙ（ｘ、ｙ）が、

の小プリズムの分布をＩＯＬ内の深さＩに作成すれば良い。ただし、ｎ’は調整後の透光体の屈折率、ｎは調整前の透光体の屈折率である。
６）θｘ（ｘ、ｙ）、θｙ（ｘ、ｙ）を基に、屈折レンズ又は回折レンズに対応するパターンを作成する。つまり、θｘ（ｘ、ｙ）、θｙ（ｘ、ｙ）は、レンズパターンに変更される。ここで、屈折レンズは、光の屈折現象を利用したレンズとして表すことができ、回折レンズは、modulo 2pπ kinoformとして表すことができ、マルチレベルに近似されてもよい。1) Measure the aberration We (x, y) of the entire eyeball at the pupil position 2) Measure the anterior segmental eyeball shape from the cornea to the translucent body (for example, IOL) with a tomographic image 3) Target after surgery Set the aberration Wt (x, y) of the entire pupil 4) Based on the result of 2), convert We (x, y), Wt (x, y) to the aberration at the depth I where you want to create a lens in the translucent body. do. Here, the converted aberrations are represented by We'(x, y) and Wt'(x, y), respectively. For example, the conversion process may be performed by back light tracing.
5) Next, in I, δx (x, y) and δy (x, y) of the touch in the x direction and the y direction, respectively.

It suffices to create a small prism that generates

The distribution of the small prisms of the above may be created at the depth I in the IOL. However, n'is the refractive index of the translucent body after adjustment, and n is the refractive index of the translucent body before adjustment.
6) Based on θx (x, y) and θy (x, y), a pattern corresponding to a refraction lens or a diffractive lens is created. That is, θx (x, y) and θy (x, y) are changed to the lens pattern. Here, the refraction lens can be represented as a lens utilizing the refraction phenomenon of light, and the diffractive lens can be represented as a modulo 2pπ kinoform, which may be approximated to multi-level.

In the above 1 to 6), a so-called Higher-order diffractive lens in which p is an integer larger than 1 may be used to correct chromatic aberration. In this case, one or more layers may have a function of correcting chromatic aberration. The chromatic aberration correction may control the resolution or the depth of focus in consideration of the chromatic aberration of the entire eyeball.

In the region perpendicular to the optical axis at the depth I of the translucent body, a plurality of different refracting lenses or diffractive lenses (kinoforms) may be created and multifocalized.

Alternatively, the diffraction efficiency may be lowered and the focal point may be increased by using a positive value other than an integer as p. Alternatively, a plurality of target aberrations Wt (x, y) of the entire eyeball may be set, and the lens may be superimposed to make the focal point multifocal.

When obtaining the target wavefront in the translucent body, a spherical aberration value may be added separately in order to control the depth of focus.

In finding Wt'(x, y), KH Brenner, "Method for designing arbitrary two-dimensional continuous phase elements", Opt.Let., 25 (1), p31-33 ( The method of 2000) may be used. That is, the phase distribution of the phase plate may be obtained from the target PSF distribution (KHBrenner, "Method for designing arbitrary two-dimensional continuous phase elements", Opt.Let., 25 (1), p31-33 (2000). )). In this case, the phase distribution of the lens including multiple focal points may be designed and approximated to multi-level.

In the above, We (x, y) may be calculated based on the axial length, the shape of the anterior eyeball obtained in 2), the shape of the translucent body (for example, IOL), and the refractive index. .. Further, We (x, y) may be calculated based on the subjective value and the objective value (for example, the autoref value).

When the translucent body has lens characteristics in advance, the sum of the lens characteristics provided in advance and the lens characteristics written by photo tuning is the refraction characteristic of the translucent body. Further, when the translucent body does not have the lens characteristic in advance, the lens characteristic written by photo tuning becomes the refraction characteristic of the translucent body.

The amount of change from the first refractive index may be changed for each irradiation position in the translucent body. That is, the second refractive index may be different from the first refractive index basically provided by the translucent body. That is, the amount of change in the refractive index due to photo tuning may be changed according to the required refractive index. In this case, the pattern of the MP diffraction lens may be optically designed by setting the thickness of the refractive index change region and the amount of change in the refractive index. Further, a gradient index lens may be formed in which the average refractive index is adjusted by changing the pulse energy or the irradiation interval.

It should be noted that the translucent body may be provided with the function of multifocal (for example, double focus and triple focus). The number of multi-levels and the above p-value may be adjusted to make the focal point multifocal. For example, in a translucent body, a plurality of diffraction structures may be overlapped to be multifocal, or a plurality of diffraction structures may be provided at different positions in the optical axis direction to be multifocal. Furthermore, the translucent body (for example, on the IOL and on the cornea) is divided in the direction orthogonal to the optical axis direction (front-back direction), and different lenses are formed in the divided segment units to perform multifocalization. May be good. Further, the chromatic aberration may be corrected by forming a phase Fresnel lens using a light diffraction phenomenon in a translucent body.

As described above, by writing the multi-level phase diffractive lens inside the translucent body, the laser irradiation pattern is simplified, and it is not always necessary to use a laser light source having a very large repeat frequency such as several tens of MHz. .. That is, as a result, a repeat frequency (for example, several hundred kHz) similar to that of an ophthalmic laser surgical apparatus whose main application is treatment of the patient's eye (for example, cutting of the cornea, crushing of a turbid part of cataract, etc.) is achieved. A laser light source having a laser light source can be used. Therefore, the writing of the multi-phase diffractive lens is suitable for treating the patient's eye tissue and phototuning with the same ophthalmic laser surgical apparatus.

Even if the processor forms a multi-level phase diffractive lens inside the translucent body by gradually changing the size of the irradiation region in the radial direction of the lens according to the anteroposterior direction of the translucent body. good.

<Planning>
Next, an example of setting a lens pattern in the case of performing photo tuning with a translucent body provided in the patient's eye will be shown (see FIG. 7). The pattern setting is typically done by the processor.

For example, the pattern of the lens to be written may be set based on the refraction characteristic RC of the eye and the position information TP of the translucent body. The refractive characteristic RC of the eye here is the refractive characteristic of the eye when a translucent body to which phototuning is applied is inserted into the eye. The refraction characteristic of the eye to be inspected may be, for example, any of the wave surface aberration of the entire eyeball, the subjective eye refractive power of the eye, and the objective optical power of the eye. The refraction characteristic RC of the eye may be measured by a refraction measuring device.

The position information TP of the translucent body may be acquired based on, for example, an anterior ocular tomographic image captured by a tomographic imaging device. The anterior segment tomographic image is an anterior segment tomographic image including a translucent body to which phototuning is applied. There may be. If the crystalline lens remains, the crystalline lens is also imaged. Further, the tomographic image of the anterior segment of the eye may be tomographic data in a certain meridian direction of the anterior segment of the eye, or may be three-dimensional tomographic data of the entire anterior segment of the eye.

The position information of the translucent body may be automatically detected by image processing, or may be detected by the position designation by the manual operation of the examiner. When the translucent body is an artificial translucent body, the position information of the natural lens (cornea or crystalline lens) of the patient's eye may be acquired based on the anterior ocular segment tomographic image together with the position information of the artificial translucent body. .. As a result, the position information of tissues and artificial objects related to the refraction characteristics of the eye can be acquired and used for pattern setting. When the translucent body is a natural lens, the position information of the natural lens (cornea or crystalline lens) of the patient's eye may be acquired based on the anterior ocular segment tomographic image.

The processor obtains the optical arrangement information of the anterior eye portion including the translucent body based on the position information of the cornea and the position information of the translucent body. The optical arrangement information of the anterior eye portion may be the relative positional relationship between the cornea and the translucent body, or may be the absolute position of the cornea and the translucent body. The optical arrangement information may be one-dimensional position information regarding the optical axis direction of the eye, or may be two-dimensional position information according to one direction orthogonal to the optical axis direction of the eye and the optical axis direction of the eye. It may be three-dimensional position information. In this case, if the crystalline lens remains, an optical arrangement including the crystalline lens is required.

Next, the processor obtains the correction amount of the refraction characteristic performed by phototuning based on the refraction characteristic RC of the eye. As the correction amount, the difference in the refraction characteristic RC of the eye with respect to the preset target refraction characteristic may be obtained. The target refraction characteristic may be arbitrarily set for each operator or patient, or may be set as a fixed value in advance. The target refraction characteristic may be, for example, any one of a three-dimensional PSF distribution of the entire eyeball, a wavefront aberration, and an optical power of refraction. Further, as the correction amount, the refractive power characteristic (for example, eye refractive power (spherical power, astigmatic power, etc.)) and aberration (irregular astigmatic component, spherical aberration, etc.) to be corrected in the refractive power RC of the eye may be obtained.

The amount of correction may be defined as the amount of change in the refractive characteristics (phototuning amount) of the entire eye corrected by phototuning. The amount of correction corresponds to the change information of the refraction characteristics of the eye preset to be corrected by photo tuning.

When the correction amount is obtained, the processor calculates the refraction characteristic to be written to the translucent body in order to obtain a preset correction amount by using the optical arrangement information of the anterior eye portion including the translucent body. .. Here, the processor considers the optical arrangement information of the anterior segment including the translucent body, the refractive index of each tissue of the anterior segment, and the first refractive index of the translucent body, and sets the correction in advance. The refractive index of the lens required to correct the amount may be calculated. In this case, for example, the refraction characteristic of the lens to be written to the translucent body can be obtained by using an optical simulation such as a ray tracing method for the image formation state of the light by the written lens. In this case, the refraction characteristic of the lens may be determined as the refraction characteristic of a lens system composed of a plurality of lenses, or may be determined as the refraction characteristic of one lens.

When forming an MP diffractive lens, the refraction characteristics of the phase diffractive lens are approximated to multi-level, and the refraction characteristics of the MP diffractive lens are calculated.

Further, the refraction characteristic which is the basis of the MP diffraction lens may be obtained by iterative calculation in consideration of the target optical characteristic, and may be approximated to the multi-level in consideration of the preset multi-level. In this case, the target refraction characteristic may be approximated to the multi-level in consideration of the preset multi-level by multiplying the spatial frequency filter. More specifically, when the target refraction characteristic is set as the three-dimensional PSF, the phase distribution is obtained by repeating the three-dimensional PSF related by the diffraction integration and the phase distribution of the phase type diffractive lens.

When the refraction characteristic of the lens to be written is calculated as described above, the corresponding lens pattern is set. In this case, the position of the lens may be set with reference to the surface position of the translucent body. By using the position information of the translucent body as a reference, reliable laser irradiation becomes possible. In this case, as the lens pattern to be written, the pattern of each lens in the lens system may be set based on the refraction characteristics of the lens system composed of a plurality of lenses. In this case, a plurality of lens patterns are set.

In this case, the processor may scan the focused position of the laser beam in the irradiation region of the translucent body corresponding to the lens pattern based on the position information of the translucent body and the refraction characteristic of the patient's eye. As a result, a lens corresponding to the set lens pattern is formed inside the translucent body.

According to the above method, for example, the correction amount of photo tuning can be obtained in consideration of the optical arrangement of the translucent body in the anterior eye portion. This makes it possible to perform photo tuning with high accuracy according to the characteristics of the patient's eye.

In addition to the tomographic image of the anterior segment of the eye, axial length information (distance from the cornea to the retina) may be obtained. The processor obtains optical placement information of the entire eyeball including the cornea, translucent body, and retina based on the tomographic image of the anterior segment of the eye and the axial length information. This makes it possible to more accurately simulate the image formation state of the lens formed on the translucent body with respect to the retina. In this case, the processor may obtain optical arrangement information of the entire eyeball including the cornea, the translucent body, and the retina based on the tomographic image of the entire eyeball from the cornea to the retina.

When determining the refraction characteristics of the lens to be written on the translucent body, a refraction measuring device provided in the ultrashort pulse laser device may be used as a method for obtaining the refraction characteristics of the eye, or an ultrashort pulse laser. A refraction measuring device arranged at a position different from the device may be used. Similarly, as a method for obtaining tomographic information of the eye, a tomographic imaging device provided in an ophthalmic laser device (for example, an ophthalmic laser refraction correction device, an ophthalmic laser surgical device) may be used, or an ophthalmic laser may be used. A tomographic imaging device located at a position different from the device may be used.

The processor acquires the first position information which is the position information of the translucent body in the first tomographic image based on the first tomographic image acquired for planning the lens pattern to be written in advance. May be good. Further, the processor is the position information of the translucent body in the second tomographic image based on the second tomographic image acquired after the lens pattern is planned and the eyeball interface is attached. The second position information may be acquired. Further, the processor may associate the first position information with the second position information and set a lens pattern for the translucent body in the second tomographic image (see FIG. 12).

<Laser device for photo tuning>
In the phototuning according to the present embodiment, an ultrashort pulse laser device (for example, a femtosecond laser device or a picosecond laser device) capable of effectively generating a laser for writing a lens on a translucent body may be used (Fig.). 8). Of course, if photo tuning can be realized, it is not limited to the ultrashort pulse laser device.

The ultrashort pulse laser device for phototuning may be a multifunction device with an ultrashort pulse laser device for ophthalmology for treating anterior ocular tissue (eg, cornea, lens), or for phototuning. It may be a single machine of. Typical treatments for the anterior ocular tissue are crushing and cutting, such as crushing of the opaque lens in cataract, refractive surgery by cutting the inside of the cornea, and CCC surgery by cutting the front of the lens. be.

The ultrashort pulse laser apparatus may include at least a laser light source for generating a laser for phototuning and an irradiation optical system for guiding the light of the laser for phototuning to a translucent body. The irradiation optical system may be used to guide the laser beam for adjusting the refractive index of the translucent body into the inside of the translucent body provided in the patient's eye.

The laser beam emitted from the laser light source causes a change in the refractive index at the laser focal point to the translucent body due to a non-linear effect (eg, multiphoton absorption). As a laser light source for phototuning, it is advantageous to use an ultrashort pulse laser in the visible band (for example, the green band) in order to generate a two-photon absorption effect in the ultraviolet band. Of course, even an ultrashort pulse laser in the near infrared region can obtain a certain effect.

The irradiation optical system may include, for example, a relay optical system, an optical scanner, and an objective lens. The optical scanner may include an XY scanner and a Z scanner. For a specific configuration, refer to, for example, Japanese Patent Application Laid-Open No. 2015-37474.

The irradiation optical system may be an optical system for guiding the light of the laser for photo tuning to the translucent body arranged in the eye. In this case, an eyeball interface may be arranged between the irradiation optical system and the eye.

<Multifunction device>
The ophthalmic laser device is a multifunction device capable of generating both a first laser, which is a laser for treating anterior ocular tissue, and a second laser, which is a laser for writing a lens on a translucent body. It may be present (see FIG. 8). The first laser emits a laser capable of treating anterior ocular tissue, unlike a laser for phototuning. That is, the characteristic of the first laser is to crush or cut a part of the anterior ocular tissue, whereas the characteristic of the second laser is to change the material of the translucent body to change the refractive index of the translucent body. It differs in that it is changed. In the multifunction device, the irradiation optical system can guide the first laser and the second laser to the translucent body. The first laser and the second laser may selectively irradiate the translucent body.

The ophthalmic laser apparatus may include at least a laser light source unit, an irradiation optical system, and a scanning unit. The laser light source unit may be capable of selectively emitting a first laser beam for treating the patient's eye and a second laser beam for adjusting the refractive index of the translucent body. The scanning unit may be arranged in the optical path of the irradiation optical system and may scan the focused position of the first laser beam or the second laser beam.

The ophthalmic laser device may be provided with a mode switching unit, which is a first surgical mode for treating the patient's eye using the first laser beam and a second for adjusting the refractive index of the translucent body. You may switch to the second surgical mode for performing photo tuning using the laser beam of.

When set to the first surgical mode, the control unit provided in the ophthalmic laser device treats the patient's eye by controlling the scanning unit to scan the focused position of the first laser beam. May be. Further, when the control unit is set to the second surgical mode, the control unit controls the scanning unit to scan the focused position of the second laser beam in the irradiation region corresponding to the preset lens pattern. , The lens may be formed inside the translucent body.

According to the above-mentioned multifunction device, treatment (crushing, cutting) of the patient's eye and phototuning can be realized with one device.

More specifically, the first laser differs from the second laser in at least one of the emission wavelength and the laser output. Typically, the center wavelength may be in the near-infrared region due to the characteristics of the first laser. The laser power may have a higher power than the threshold at which the anterior ocular tissue is disrupted or cleaved. Further, regarding the characteristics of the second laser, the central wavelength may be in the visible region (for example, the green band), the laser output is lower than the threshold value at which the anterior ocular tissue is crushed or cut, and the light transmission is transmitted. It may have an output that can adjust the refractive index of the body. ..

The compound machine is a first laser light source for generating a first laser and a second laser light source for generating a second laser, which is different from the first laser light source. And may be provided respectively.

The compound machine includes a laser light source for generating laser light having a wavelength corresponding to either the first laser or the second laser (see light source 312 in FIGS. 9 and 10), and laser light from the laser light source. It is configured to include a light source conversion optical element (see the wavelength conversion optical element 314 of FIGS. 9 and 10) for converting the light source of the light source into a light source corresponding to either one of the first laser and the second laser. You may. As the wavelength conversion optical element, for example, a nonlinear optical crystal may be used. Typical examples of the nonlinear optical crystal include, but are not limited to, a KTP crystal, a BBO crystal, an LBO crystal, and the like for converting the fundamental wavelength of 1064 nm to the second harmonic of 532 nm.

When a wavelength conversion optical element is used, the irradiation optical system includes a first optical system for guiding the first laser to the eye without passing through the wavelength conversion optical element, and a wavelength conversion optical element is arranged, and the first laser is arranged. May be provided with a second optical system for converting the second laser into a second laser and guiding the second laser to the eye. In this case, the first optical path corresponding to the first optical system and the second optical path corresponding to the second optical system may be arranged respectively, and the optical path switching unit (optical path switching in FIGS. 9 and 10) may be arranged. The optical system may be selected by (see section 318). Further, the present invention is not limited to this, and the optical system may be selected by inserting and removing the wavelength conversion optical element from the optical path by the driving unit.

The ophthalmic laser apparatus according to the present embodiment may include a correction optical member (see the correction optical member 500 in FIG. 8) for correcting the difference in laser characteristics between the first laser and the second laser. .. For example, when the wavelength characteristics of the first laser and the second laser are different, the imaging performance of the focal point of the laser beam (for example, focal position, aberration characteristics) even if the position of the optical scanner is the same. Is different. Therefore, as the correction optical member, for example, an optical member (for example, an aberration correction lens) for correcting the imaging performance of the focal point of the laser beam may be inserted and removed in the optical path of the irradiation optical system. The correction optical member may be arranged between the laser light source and the objective lens, or may be arranged between the objective lens and the eye, as long as it is the optical path of the irradiation optical system. In this case, the correction optics are designed to ensure optical performance that can achieve the purpose of the laser (crushing or cutting of anterior ocular tissue, phototuning).

According to the correction optical member, both the treatment of the anterior ocular tissue and the phototuning can be performed with high accuracy. For example, the above correction is advantageous when an additional phototuning function is provided for an ultrashort pulse laser device having an optical system optimized for crushing or cutting anterior ocular tissue. In photo tuning, it is necessary to accurately irradiate a predetermined irradiation site of a translucent body arranged in the eye with a laser, and high-precision imaging performance is required. Therefore, an optical system optimized for disrupting or cutting anterior ocular tissue may not be able to meet this requirement. Therefore, by providing the correction optical system, it is possible to sufficiently satisfy the image formation performance in the crushing or cutting of the anterior ocular segment tissue and also the image formation performance in the photo tuning, which is advantageous.

As another example, the above correction may be applied even when an ultrashort pulse laser device having an optical system optimized for phototuning is additionally provided with a function of crushing or cutting anterior ocular tissue. It is advantageous.

As the adaptive optics member, for example, a wavefront compensation device may be used. The wave surface compensation device may be, for example, a shape-variable mirror, a digital micromirror device, or an LCOS (optical phase modulation element). The wavefront compensating device may be controlled, for example, to correct the imaging performance of the focal point of the laser beam between the first laser and the second laser. For example, the difference in the imaging performance of the focal point of the laser beam between the first laser and the second laser is calculated in advance (for example, simulation). The first aberration compensation data corresponding to the first laser and the second aberration compensation data corresponding to the second laser are stored in the storage unit. The processor may read the aberration compensation data corresponding to the selected laser from the storage unit and operate the wavefront compensation device. Of course, an aberration meter for measuring aberrations related to the irradiation optical system may be provided in the ultrashort pulse laser apparatus, and the processor may control the wave surface compensation device based on the measurement result of the aberration meter.

Further, the correction optical member may be an eyeball interface arranged between the irradiation optical system and the eye. For example, a first eyeball interface corresponding to the first laser and a second eyeball interface corresponding to the second laser may be prepared. In this case, the lens characteristics, refractive index, etc. of the optical member provided on the eyeball interface are set according to the laser.

<Donut-shaped beam>
The characteristics of the laser beam may be a donut-shaped beam. As a method for forming a donut-shaped beam, for example, an optical vortex method (for example, US Pat. No. 2015-164689) may be used, or an axicon lens may be used. Further, polarized light may be used to form a donut-shaped beam. According to the donut-shaped beam, the focal range of the laser beam in the XY direction can be widened (the lateral resolution can be improved), which is particularly advantageous for stepped processing, that is, when writing an MP diffractive lens.

<Installation of refraction measurement device>
The ophthalmic laser device may include a refraction measuring device (measuring optical system) for measuring the refraction characteristics of the eye (see the refraction measuring device 90 in FIG. 7). By providing the refraction measuring device, for example, the lens pattern can be set without necessarily using an external device. As another application, the correction effect by photo tuning can be confirmed without necessarily using an external device.

The processor may display the measurement result of the refraction characteristic of the patient's eye on the display unit. When the refraction characteristic of the eye is measured with the eyeball interface attached, the processor may simulate and display the measurement result without the eyeball interface attached. In this case, the refraction characteristic of the eyeball interface may be obtained in advance, and the influence of the refraction characteristic may be canceled.

The refraction measuring device may be a patient eye fitted with an eye interface and may measure the refraction characteristics after at least one lens has been formed inside the translucent body by phototuning.

The refraction measuring device may be arranged coaxially with the optical axis of the irradiation optical system, or may be a separate axis. The refraction measuring device includes a light projecting optical system that projects a measurement index onto the fundus of the eye through the optical path of the irradiation optical system and a light receiving optical system that receives light reflected from the fundus of the eye by the measurement index via the optical path of the irradiation optical system. You may prepare. The refraction measuring device may be a refraction measuring device for measuring the refraction characteristics of the eye via the eyeball interface.

The refraction measuring device may be an aberration measuring device (typically, a wavefront sensor) for measuring the wavefront aberration of the eye, and can accurately measure the refraction characteristics of the eye. The refractive power measuring device may be an optical power measuring device for measuring the refractive power of the eye (typically, an autorefraction meter), and the refraction characteristics of the eye can be measured at low cost.

The refraction measuring device may be used to measure the refraction characteristics of the eye at least before, during, and after irradiation with the laser. Further, the refraction measuring device may be used to measure the refraction characteristics of the eye before or when the eyeball interface is attached to the eye.

As an example of using the refraction measuring device, for example, by measuring the refraction characteristics of the eye after the completion of phototuning using the refraction measuring device, the operator can easily confirm the correction effect by phototuning.

More specifically, the first refraction characteristic may be measured in a state where the eye is attached to the eyeball interface and before the start of phototuning. Next, the second refraction characteristic may be measured in a state where the eye is attached to the eyeball interface and after phototuning is performed. The processor may seek the difference D between the first refraction characteristic and the second refraction characteristic. By obtaining the difference D by the processor, the correction effect of the lens written in the translucent body by photo tuning can be easily obtained.

The processor may display the first refraction characteristic and the second refraction characteristic on the same screen of the monitor. By obtaining the difference D, the correction effect by phototuning can be evaluated even when the measurement result by the measurement optical system changes due to the influence of the optical portion of the eyeball interface.

The processor may determine whether or not the photo tuning has been performed as expected by comparing the correction amount by the preset photo tuning with the difference D. Further, the processor may display the preset correction amount and the difference D on the same screen of the monitor. According to the above control, the operator can easily confirm whether or not the photo tuning is performed as expected and the target correction effect is obtained.

By using an aberration measuring device such as a wavefront sensor when measuring the refraction characteristics of the eye, the correction effect of writing the lens on the translucent body in the eye can be confirmed accurately, including higher-order aberrations. ..

When the refraction measuring device is provided in the ophthalmic laser device, the refraction measuring device may be used for phototuning calibration as well as confirmation of the correction effect after the actual surgery. For example, the change in the refraction characteristics before and after irradiating the translucent body for calibration (for example, the model eye in which the translucent body is installed) with the laser is used to control the laser irradiation optical system or set the lens pattern. Calibration may be performed with respect to the calculation method at the time of performing.

The refraction measuring device has, for example, a configuration for capturing a tomographic image of the entire eyeball, and measures the refraction characteristics of the eye based on the morphological information of the entire eyeball (for example, the morphological information of the anterior segment of the eye and the axial length). May be good. Further, the refraction measuring device may include, for example, a configuration for capturing a tomographic image of the anterior segment of the eye including the cornea and the crystalline lens, and may measure the refraction characteristics of the eye based on the morphological information of the anterior segment of the eye and the axial length. .. For the axial length, data obtained by a well-known axial length measuring device may be used. The refraction measuring device may measure the refraction characteristics of the eye using a tomographic imaging device described later. As another example of the refractive index measuring device, it may have a configuration capable of measuring the shape of the corneal membrane of the eye and the axial length, and can be used, for example, in prescribing a phototuned intraocular lens to replace a natural crystalline lens. , The power of the phototuned intraocular lens may be determined based on the shape of the eye's cornea and the axial length. Further, the refraction measuring device may be, for example, a folopter for subjectively measuring the refractive power of the eye.

<Feedback control of photo tuning based on refraction characteristics>
The processor may set a lens pattern to be additionally formed on the translucent body based on the refraction characteristics after at least one lens is formed inside the translucent body by phototuning. In this case, the change information of the refraction characteristics before and after the photo tuning with the eyeball interface attached and the change information of the refraction characteristics preset to be corrected by the photo tuning (target refraction characteristics and preoperative refraction characteristics). It may be compared with the change). If the difference is large, additional photo tuning may be done. Further, before the photo tuning, the change information of the refraction characteristics before and after the eyeball interface is attached is obtained in advance, and the change information is subtracted from the refraction characteristics after the phototuning with the eyeball interface attached. The refraction characteristic may be compared with the target refraction characteristic. If the difference is large, additional photo tuning may be done.

For example, by measuring the refraction characteristics while the eye is attached to the eyeball interface, if the correction effect by phototuning is different from the assumption, it is easy to perform additional phototuning (see FIG. 14). For example, the processor may calculate the deviation amount between the preset correction amount and the difference D, and obtain the lens pattern corresponding to the calculated deviation amount. When determining the lens pattern, the processor may calculate the refraction characteristic to be written to the translucent body in order to obtain the deviation amount by using the optical arrangement information of the anterior eye portion including the translucent body.

By additionally writing the obtained lens pattern on the translucent body, it is possible to compensate for the deviation of the correction effect. In this case, if the correction is overcorrected, a lens that compensates for the excess may be newly written, and if the correction is insufficient, a lens that compensates for the shortage may be newly written.

When a plurality of lenses are written, the refraction characteristic may be obtained after all the preset number of lenses are written. In this case, in addition to the plurality of lenses already written, a lens corresponding to the deviation amount is newly written.

When a plurality of lenses are written, the refraction characteristic may be obtained at a stage where the number of written lenses is smaller than a preset number. In this case, the processor may change at least one of the refraction characteristics of the lens to be written next or the number of lenses based on the amount of deviation.

As described above, the refraction characteristic measured by the refraction measuring device after the first phototuning is fed back to the tuning amount by the second phototuning (for example, the refraction characteristic of the lens, the number of lenses, etc.). The correction of the optometry can be performed more accurately.

In the above description, the refraction characteristics are measured with the eye attached to the eyeball interface, but the present invention is not limited to this. For example, it is possible to confirm the correction effect by measuring the refraction characteristics before and after phototuning in a state where the eyeball interface is not arranged between the irradiation optical system and the eye. In addition, additional photo-tuning after confirming the correction effect is possible, and feedback of photo-tuning based on the measurement result of the refraction characteristic is also possible.

In the above, the processor may obtain the refraction characteristics before the eye is attached to the eyeball interface and the refraction characteristics after the eye is attached to the eyeball interface and before the phototuning is performed. good. Thereby, the processor can obtain the change C of the refraction characteristic before and after the eye is attached to the eyeball interface.

The processor is after the eye is attached to the eye interface, and the change C of the refraction characteristic is subtracted from the refraction characteristic after phototuning is performed, so that the eye after the eye interface is removed from the eye. The refraction characteristic of the above may be obtained as an expected value. This makes it possible to confirm the correction effect of photo tuning when the eye is attached to the eyeball interface. The processor may be able to compare the refraction characteristics of the eye obtained as expected values with the target refraction characteristics. As a comparison method, the processor may display these in parallel or obtain the difference.

<Installation of tomographic imaging device>
The ophthalmic laser apparatus may include a tomographic imaging device (tomographic imaging system) for imaging (imaging) a tomographic image of the eye (see the tomographic imaging device 71 in FIG. 8). Thereby, for example, in acquiring the position information of the translucent body, an external device is not always necessary.

The tomographic imaging device may be arranged coaxially with the irradiation optical system or may have a separate axis. The tomographic imaging device may be, for example, a device that images a tomographic image using any of light, ultrasonic waves, and magnetism. Of course, it is not limited to these. The device (optical system) for optically imaging a tomographic image may be, for example, an OCT optical system or a Scheimpflug optical system. The tomographic image pickup device may be a tomographic image pickup device that captures a tomographic image of the eye via an eyeball interface. The tomographic image may be, for example, two-dimensional tomographic data or three-dimensional tomographic data.

The tomographic image pickup device may be, for example, a tomographic image pickup device for capturing a tomographic image of the anterior segment of the eye. The tomographic imaging device may capture an anterior ocular tomographic image including a translucent body to which phototuning is applied, and further an anterior ocular tomographic image including a cornea and a translucent body to which phototuning is applied. May be imaged. The tomographic image pickup device may be a tomographic image pickup device capable of capturing a tomographic image of the entire eyeball (including the cornea, translucent body, and retina). In this case, if the crystalline lens remains in the eye, the crystalline lens may be imaged.

The processor may acquire the position information of the translucent body by using the tomographic imaging device provided in the ophthalmologic laser apparatus. In this case, the processor can accurately detect the position of the translucent body when performing photo tuning by obtaining the tomographic information when the eyeball interface is attached to the eye. As a result, the pattern of the lens to be written on the translucent body is calculated in a form close to the state of the eye at the time of photo tuning, so that photo tuning can be performed with high accuracy. The position information of the translucent body may be at least one of the position information of the front surface and the rear surface of the translucent body. The processor may calculate the lens pattern by using the tomographic information before the eyeball interface is attached to the eye. Then, the processor may set the irradiation position in the irradiation optical system by using the tomographic image with the eyeball interface attached to the eye in order to write the lens pattern calculated before the attachment.

By arranging both the refraction measuring device and the tomographic imaging device in the ophthalmology laser device, it is possible to acquire both the refraction characteristics of the eye and the tomographic data in a state close to that at the time of phototuning. By using both the refraction characteristics and the tomographic data, photo tuning can be performed more accurately.

For example, after performing photo tuning, the refraction characteristics may be measured and a tomographic image may be acquired. The processor may calculate the pattern of the lens to be written using the obtained refraction characteristics and tomographic images. As a result, even when the state of the eye to be inspected changes in the first photo tuning (for example, the position of the translucent body changes), the position of the translucent body can be accurately detected, and the second Photo tuning can be performed well.

The tomographic image pickup device may capture a tomographic image of the eye during laser irradiation, and the processor may detect (monitor) the movement of the eye based on the captured tomographic image. Further, the processor may correct the laser irradiation position according to the movement of the eye. Further, the processor may stop the laser irradiation according to the movement of the eye.

The processor may detect the position of the translucent body to which the phototuning is applied based on the captured tomographic image of the eye. Further, the processor may correct the laser irradiation position according to the position of the translucent body. Further, the processor may stop the laser irradiation depending on the position of the translucent body.

The tomographic imaging device may capture a tomographic image of the eyeball interface during laser irradiation, and the processor may detect the position of the eyeball interface based on the captured tomographic image. Further, the processor may correct the laser irradiation position according to the position of the eyeball interface. Further, the processor may stop the laser irradiation depending on the position of the eyeball interface.

Examples of the above-mentioned ophthalmic laser device include a laser surgical device for ophthalmology, a laser refraction correction device for ophthalmology, and the like. Further, the technique related to phototuning of the present embodiment is applied as, for example, a laser refraction correction device for ophthalmology, a phototuning setting device for ophthalmology, a phototuning system for ophthalmology, a phototuning setting device for eyeglasses, and a program used for these. Can be done.

<Application of photo tuning to spectacle lenses>
Hereinafter, an example of applying photo tuning to a spectacle lens will be described. Of course, basically, the same method as the above description can be used, so the above description can be referred to for specific contents.

For example, the processor may set the lens pattern for the spectacle lens based on the refraction characteristics of the entire eyeball when the spectacles are worn and the optical arrangement information of the anterior segment of the eye with respect to the spectacle lens when the spectacles are worn. In this case, the processor may calculate the refraction characteristic to be written to the spectacle lens, set the lens pattern corresponding to the calculated refraction characteristic, and perform phototuning with the set lens pattern.

In this case, the refraction characteristics of the entire eyeball when wearing spectacles may be acquired at least by using an eye refraction measuring device. In this case, the refraction characteristics of the entire eyeball with the naked eye may be acquired by the refraction measuring device, and the refraction characteristics of the spectacle lens may be acquired by the lens meter or the design value of the lens. By synthesizing the refraction characteristics of the naked eye and the refraction characteristics of the spectacle lens, the refraction characteristics of the entire eyeball when wearing spectacles can be obtained. When synthesizing the refraction characteristics, for example, it may be calculated by replacing it with a predetermined position on the optical axis (for example, the position of the pupil of the eye). In addition, the refraction of the entire eyeball when wearing spectacles is obtained by measuring the eye with a refraction measuring device (for example, projecting a measurement index through a spectacle lens to obtain reflected light from the fundus of the eye). The characteristics may be obtained directly.

Optical placement information of the anterior segment of the eye with respect to the spectacle lens when wearing spectacles may be acquired using, for example, an eye position meter (eye position measuring device (see, for example, Japanese Patent Application No. 2013-202632)) or a measure (for example, see Japanese Patent Application No. 2013-202632). , A ruler), or may be acquired using a design value of a lens or an eyeglass frame. The optical arrangement information of the anterior segment of the eye with respect to the spectacle lens may be, for example, a three-dimensional position of the eye with respect to the spectacle lens, a two-dimensional position (for example, an up / down / left / right position) is obtained, and another direction (for example, a front-back direction). ) May be used. Further, the vertical and horizontal positions of the eyes with respect to the spectacle lens may be the positions of the eyes with respect to the spectacle frame. Further, the optical arrangement information inside the anterior segment of the eye may be acquired by the tomographic imaging device. Further, the optical arrangement information of the lens itself (for example, the shape of the lens) may be acquired by a lens shape measuring device (for example, a tomographic imaging device), or the set value of the lens may be used. As the lens shape measuring device, the lens shape may be measured by the amount of movement of the stylus when the stylus is brought into contact with the lens.

More specifically, when setting the lens pattern for the spectacle lens, for example, the wave surface aberration W1 of the entire eyeball with the naked eye, the eye position (eye position) EP with respect to the spectacle frame when wearing spectacles, and the fundus yellow spot when wearing spectacles. A lens pattern to be written on the spectacle lens may be obtained based on the light beam position LEP on the spectacle lens when the light beam focused on the spectacle lens passes through the spectacle lens and the power distribution M of the spectacle lens at the position LEP. ..

For example, by obtaining the eye position EPF in the distant view state, the luminous flux position LEPF corresponding to the eye position EPF in the distant view state can be obtained. Further, the frequency distribution MF of the spectacle lens at the luminous flux position LEPF is obtained from the design data of the lens meter or the spectacle lens.

For example, by obtaining the eye position EPN in the near vision state, the luminous flux position LEPN corresponding to the eye position EPF in the near vision state can be obtained. Further, the frequency distribution MN of the spectacle lens at the luminous flux position LEPN can be obtained from a lens meter capable of measuring the frequency distribution or design data of the spectacle lens.

The processor obtains the wavefront aberration W2 of the entire eyeball when wearing spectacles based on the wavefront aberration W1 of the entire eyeball with the naked eye and the power distribution MF of the spectacle lens, and is carried out by phototuning based on the obtained wavefront aberration W2. The amount of correction of the refractive characteristics to be corrected is obtained. When the correction amount is obtained, the processor calculates the refraction characteristic to be written to the spectacle lens in order to obtain the preset correction amount by using the optical arrangement information of the anterior eye portion with respect to the spectacle lens. Here, the processor corrects a preset correction amount in consideration of the optical arrangement information of the spectacle lens and the anterior segment of the eye, the refractive index of each tissue of the anterior segment of the eye, and the first refractive index of the spectacle lens. You may calculate the refraction characteristics of the lens required for this. Further, the processor sets a lens pattern corresponding to the refraction characteristic to be written.

After that, the processor sets the irradiation position by setting (matching) the obtained lens pattern with the luminous flux position LEP on the spectacle lens. Photo tuning is performed on the spectacle lens at the set irradiation position. At the time of irradiation, a soft gel close to the refractive index of the spectacle lens material is sandwiched between plate glass or a lens and brought into close contact with the lens surface on the irradiating side, so that the influence of the refractive index on the surface of the spectacle lens is reduced. Alternatively, it may be irradiated in a liquid.

When phototuning the spectacle lens, the spectacles may be fixed to the ultrashort pulse laser device. In this case, the irradiation position may be set with respect to the spectacle lens by detecting the position of the spectacle lens using a tomographic imaging device. Further, if the positional relationship between the spectacle lens and the device is known, the irradiation position may be set using the known positional relationship. In addition, photo-tuning may be performed on the spectacles worn by the patient.

In the above description, phototuning is applied to the lens position corresponding to far vision, or phototuning is performed to the lens position corresponding to near vision, but the present invention is not limited to this, and other lens positions of the spectacle lens are applied. Similarly, photo tuning may be performed.

The spectacle lens to be photo-tuned may be a spectacle lens actually worn by the patient or a new spectacle lens. When performing photo tuning on a new lens, the irradiation position may be set on the assumption that the lens is placed on the spectacle frame. In the case of new spectacle lenses, it is possible to install a laser device at the lens factory and manufacture lenses using photo tuning.

When the wavefront aberration W2 of the entire eyeball when wearing spectacles is obtained, the wavefront aberration W2 of the entire eyeball when wearing spectacles may be directly obtained by the wavefront sensor.

The technique related to phototuning of the present embodiment can be applied to an ophthalmic laser surgical apparatus for treating a patient's eye by condensing a laser beam into the tissue of the patient's eye. Further, the technique related to phototuning of the present embodiment can be applied to a laser device for spectacles that corrects a patient's eye by condensing a laser beam inside the spectacle lens. In the following example, the laser surgical apparatus for ophthalmology will be described as an example, but the present invention is not limited to this, and other apparatus can also be applied.

In this embodiment, the setting device for setting the lens pattern of photo tuning is not limited to the configuration arranged in the laser device. For example, the setting device may be provided in a tomographic imaging device, a refraction measuring device, or an external PC. The transmission and reception of each data may be performed by wire or wireless.

<Example>
Hereinafter, one of the typical examples of the present embodiment will be described with reference to the drawings. In the following description, as an example, the direction along the optical axis of the laser beam applied to the patient's eye E is defined as the Z direction. One of the directions intersecting in the Z direction (vertically intersecting in the present embodiment) is defined as the X direction. The direction in which both the Z direction and the X direction intersect (vertically intersect in the present embodiment) is defined as the Y direction. The X, Y, and Z directions may be set as appropriate. For example, when the direction is defined based on the patient's vertical and horizontal directions, the X direction may be the patient's horizontal direction and the Y direction may be the patient's vertical direction, the X direction may be the patient's vertical direction, and the Y direction may be the patient's horizontal direction. , The Z direction may be the axial direction of the eye E.

<Overall configuration>
The ophthalmic laser surgical apparatus 1 of this embodiment is used for treating the tissue of the patient's eye E and performing phototuning on the artificial translucent body (see FIG. 8). In this embodiment, an ophthalmic laser surgical apparatus 1 capable of treating the crystalline lens of the patient's eye E and performing phototuning on an artificial translucent body inserted into the eye is illustrated. The technique may, of course, be applied to the treatment of tissues of the anterior eye including the cornea and lens. Phototuning may also be applied to the natural translucent body, i.e., the tissue of the patient's eye E.

The laser irradiation unit 300 includes a laser light source unit 310 and a laser irradiation optical system (laser delivery) 320. The laser light source unit 310 is arranged inside the main body 2. The laser irradiation optical system (light guide optical system) 320 is an optical system arranged to guide the laser light from the laser light source unit 310 to the eye E.

The interface unit 50 is close to the cornea of the patient's eye E, reduces the difference in refractive index, and reduces the aberration of the laser beam generated by the difference in refractive index. This reduces, for example, surface reflections on the cornea and lens. The observation / photographing unit 70 captures a front image of the anterior segment of the patient's eye E and a tomographic image of the anterior segment. The observation / photographing unit 70 includes, for example, a tomographic imaging device 71 and a frontal imaging unit 75. The tomographic imaging device 71 captures (acquires) a tomographic image of the patient's eye E. The frontal imaging unit 75 captures an image of the anterior segment of the patient's eye E. The operation unit 400 is provided for operating the device 1. The control unit 100 controls the entire device in an integrated manner.

<Laser irradiation unit>
The laser irradiation unit 300 may include, for example, a laser light source unit 310 and a laser irradiation optical system (laser delivery) 320. The laser light source unit 310 emits a laser beam (laser beam) for surgery. The laser irradiation optical system 320 includes an optical member for guiding the laser beam. The laser irradiation optical system 320 includes, for example, a scanning unit 330, an objective lens 305, and various optical members. The objective lens 305 is provided on the optical path between the scanning unit 330 and the patient's eye E. The objective lens 305 concentrates the laser beam that has passed through the scanning unit 330 on the tissue of the patient's eye E.

The laser light emitted by the laser light source unit 310 is used to induce plasma in the tissue by non-linear interaction. Non-linear interaction is one of the interactions caused by light and matter, and is an action in which a response that is not proportional to the intensity of light (that is, the density of photons) appears. The laser surgical apparatus 1 for ophthalmology of the present embodiment concentrates (focuses) the laser light in the transparent tissue of the patient's eye E, thereby concentrating (sometimes referred to as “laser spot”) or condensing position. It causes multiphoton absorption slightly upstream of the optical path (light beam). The probability of multiphoton absorption is not proportional to the intensity of the light and is non-linear. When an excited state is generated by multiphoton absorption, plasma bubbles are generated in the tissue, and the tissue is cut or crushed. The above phenomenon is sometimes referred to as photodisruption. In light destruction due to non-linear interaction, it is difficult for the influence of heat from the laser beam to be applied to the periphery of the condensing position. Therefore, fine treatment is possible. The smaller the pulse width of the laser beam, the more efficiently light destruction occurs with less energy.

The laser light source unit 310 can also adjust the refractive index in the translucent body (photo tuning) by absorbing multiple photons.

The laser light source unit 310 can emit a first laser, which is a laser for crushing or cutting the anterior eye tissue, and a second laser, which is a laser for writing a lens on a translucent body. More specifically, the laser light source unit 310 has a laser light source 312 for generating a laser beam having a wavelength corresponding to the first laser, and a wavelength corresponding to the second laser from the first laser light from the laser light source. A wavelength conversion optical element 314 for converting to a laser may be provided.

As the laser light source 312, a device that emits a laser beam having a pulse width of 1 femtosecond to 10 nanoseconds is used. As the laser light source 312, for example, a device that emits a laser beam in an infrared region having a pulse width of 500 femtoseconds and a center wavelength of 1040 nm (wavelength width is ± 10 nm) may be used. Further, the laser light source unit 310 uses a laser light source capable of emitting a laser beam having an output that causes a breakdown when the spot size of the laser spot is 1 to 15 μm.

When the wavelength conversion optical element 314 is used, the irradiation optical system 320 includes a first optical system (see FIG. 9) for guiding the first laser to the eye without passing through the wavelength conversion optical element and the wavelength conversion optical element 314. May be provided with a second optical system (see FIG. 10) for converting the first laser into a second laser and directing the second laser to the eye. In this case, the first optical path corresponding to the first optical system and the second optical path corresponding to the second optical system may be arranged respectively. The optical system may be selected by driving the optical path switching unit 318.

In the laser irradiation optical system 320, the laser light source unit 310 is upstream and the patient eye E is downstream. Then, the mirror 301, the mirror 302 to the lens 303, the lens 304, and the beam combiner 72 may be arranged along the optical axis L1 toward the downstream from the laser light source unit 310.

The mirrors 301 and 302 adjust the optical axis of the laser beam. The lens 303 is used to form an intermediate image formation of the scanning unit 330 and the laser beam. The lens 304 forms a pupil conjugate position. The beam combiner 72 combines the optical axis L1 with the optical axis L3 of the observation / photographing unit 70. The mirrors 301 and 302 have a structure in which the reflecting surfaces are orthogonal to each other, and are held by a tiltable holding member. By moving and tilting the reflective surfaces of the mirrors 301 and 302, the optical axis of the laser light emitted from the laser light source unit 310 can be adjusted. By adjusting the mirrors 301 and 302, the axis of the laser beam is aligned with the optical axis L1.

<Correction optical member>
The correction optical member 500 is a correction optical member for correcting the difference in laser characteristics between the first laser and the second laser. The correction optical member 500 is arranged in the optical path of the second laser beam at the time of photo tuning. The correction optical member 500 may be arranged in the optical path of the irradiation optical system 320 by driving the drive unit 510. The correction optical member 500 may be arranged in the vicinity of the wavelength conversion optical element 314.

<Scanning unit>
The scanning unit 330 may scan the focused position of the laser beam focused by the objective lens 305 by scanning the laser beam. That is, the scanning unit 330 moves the focused position of the laser beam to the target position. The scanning unit 330 of the present embodiment may include a Z scanning unit 350 and an XY scanning unit 360. The scanning unit 330 may be arranged in the optical path of the laser irradiation optical system (laser delivery) 320.

The Z scanning unit 350 may include, for example, a concave lens 351 and a convex lens 352, and a drive unit 353. The drive unit 353 moves the concave lens 351 along the optical axis L1. The movement of the concave lens 351 changes the divergence state of the beam that has passed through the concave lens 351. As a result, the focused position (laser spot) of the laser beam moves in the Z-axis direction.

The XY scanning unit 360 may include an X scanner 361 and a Y scanner 364. The X scanner 361 may scan the laser beam in the X direction by swinging the galvano mirror 363 by the drive unit 362. The Y scanner 364 may scan the laser beam in the Y direction by swinging the galvano mirror 366 by the drive unit 365. The lenses 367 and 368 are conjugated with two galvanometer mirrors 363 and 366.

The scanning unit 330 may be configured to be capable of scanning the laser beam in the XY directions. For example, a polygon mirror may be used for scanning in the main scanning direction (for example, the X direction), and a galvano mirror may be used for scanning in the sub-scanning direction (for example, the Y direction). Further, the resonant mirror may be used in correspondence with the X direction and the Y direction. Further, the two prisms may be rotated independently. Further, an acousto-optic-deflector (AOD) may be used with respect to the main scanning direction. In this way, the scanning unit 330 may move the laser spot three-dimensionally (in the XYZ direction) within the eye tissue (inside the target) of the patient eye E.

A beam combiner (beam splitter) 72 for making the laser optical axis coaxial with the observation / photographing optical axis may be arranged between the scanning unit 330 and the objective lens 305. The combiner 72 has a characteristic of reflecting the laser beam and transmitting the illumination light of the observation / photographing unit 70. The objective lens 305 is a lens fixedly arranged with respect to the irradiation end unit 42. The objective lens 305 forms an image on the target using the laser beam as a laser spot. The spot size of the laser spot is, for example, about 1 to 15 μm.

<Interface unit>
The interface unit 50 (see FIG. 11) is close to the cornea of the patient's eye E, weakens the refractive power of the cornea, and has a role of facilitating the laser light reaching (focusing) the eye tissue such as the crystalline lens. The interface unit 50 of the present embodiment is configured to cover at least a part of the cornea without directly contacting the cornea. The interface unit 50 mainly includes a cover glass 51. The cover glass 51 is, for example, an optical member that covers the cornea. The cover crow 51 may be, for example, a flattened lens or an immersion lens. For example, a flattening lens transmits a laser and flattens the anterior surface of the cornea.

The cover glass 51 is a member that covers the cornea, and may be at least sized to cover NA in which the laser spot is focused. The cover glass 51 is a transparent member having translucency, and is formed of, for example, glass or resin. The cover glass 51 may be located on the liquid surface of the liquid and may have a role of covering the liquid.

The interface unit 50 is close to the cornea of the patient eye E adsorbed on the suction ring 281. Alternatively, the suction ring 281 may be adsorbed after the positions of the patient eye E and the interface unit 50 are first determined. The inside of the suction ring 281 is filled with, for example, a liquid (physiological saline). The cover glass 51 and the liquid cancel the refractive power of the cornea. As a result, the laser beam is suppressed from being refracted from the objective lens 305 to the target crystalline lens.

The interface unit 50 may be configured to come into direct contact with the cornea. For example, the interface unit 50 may be a unit that presses the cornea by bringing the cover glass 51 into contact with the cornea. As a result, when the cornea comes into contact with the cover glass 51, the position of the cornea is positioned with respect to the laser irradiation optical system 320. The cover glass 51 may have, for example, a contact surface that covers the cornea so as to cover a laser irradiation region such as inside the cornea.

<Focus guidance unit>
The fixation guidance unit 120 projects, for example, an fixation target for fixing the eye to be inspected (see FIG. 3). The fixation guidance unit 120 may change the line-of-sight direction of the patient's eye E before docking by changing the presentation position of the fixation target. The fixation guidance unit 120 guides the fixation direction of the eye E in order to guide the irradiation optical axis of the surgical laser and the optical axis of the patient's eye to a predetermined positional relationship.

<Eyeball fixing unit>
The eyeball fixing unit 280 (see FIGS. 4 and 5) is a unit for fixing the patient's eye E to the objective lens 305. By fixing the patient's eye E to the objective lens 305, the laser can be suitably focused on the patient's eye E. The eyeball fixing unit 280 transmits (adds) the suction pressure applied from the suction pump (not shown) to the suction ring 281 via the suction pipe. It should be noted that the present invention is not limited to this, and laser irradiation may be performed without fixing the eyeball. Further, laser irradiation may be performed without using the interface unit 50. In this case, a tracking mechanism may be provided to correct the laser irradiation position according to the movement of the eye.

<Observation optical system 70>
The observation optical system 70 (also referred to as an observation / imaging unit) 70 (see FIG. 3) allows the operator to observe the patient's eye E and photographs the tissue to be treated. As an example, the observation optical system 70 of the present embodiment includes a tomographic imaging device 71 and a frontal imaging unit 75. The optical axis L3 of the observation optical system 70 is coaxial with the optical axis L1 of the laser beam by the beam combiner 72. The optical axis L3 is branched into an optical axis L4 of the tomographic image capturing unit 71 and an optical axis L5 of the front imaging unit 75 by the beam combiner 73.

<Fault imaging device>
The tomographic imaging device 71 may acquire a tomographic image of the tissue of the patient's eye E, for example, by using a technique of optical interference. The tomographic imaging device 71 acquires, for example, a tomographic image of the anterior segment of the patient's eye E.

As an example, the tomographic imaging device 71 may be an OCT (optical coherence tomography) device. The tomographic imaging device 71 may include a light source, a light divider, a reference optical system, a scanning unit, and a detector.

The light source emits light for acquiring a tomographic image. The light divider divides the light emitted by the light source into reference light and measurement light. The reference light is incident on the reference optical system, and the measurement light is incident on the scanning unit. The reference optical system has a configuration that changes the optical path length difference between the measurement light and the reference light. The scanning unit scans the measurement light on the anterior eye portion in a two-dimensional direction. The detector detects the state of interference between the measurement light reflected by the tissue and the reference light that has passed through the reference optical system. The ophthalmic laser surgical apparatus 1 scans the measurement light and detects the interference state between the reflection measurement light and the interference light to acquire information in the depth direction of the anterior segment of the eye.

A tomographic image of the anterior segment of the eye is acquired based on the acquired information in the depth direction. In the ophthalmic laser surgical apparatus 1 of the present embodiment, the target position for condensing the pulsed laser beam is associated with the anterior ocular segment tomographic image of the patient's eye E. As a result, the ophthalmic laser surgical apparatus 1 can create data for controlling the operation of irradiating and scanning the pulsed laser beam by using the anterior ocular segment tomographic image. Various configurations can be used for the tomographic image capturing unit 71. For example, any of SS-OCT, SD-OCT, TD-OCT and the like may be adopted as the tomographic imaging device 71. Further, the laser surgical apparatus 1 for ophthalmology may capture a tomographic image by using a technique other than optical interference.

<Front shooting unit>
The frontal imaging unit 75 (see FIG. 8) acquires a frontal image of the patient's eye E. The frontal imaging unit 75 photographs the patient's eye E illuminated by visible or infrared light. The frontal image of the patient's eye E taken by the frontal imaging unit may be displayed on the display unit 420 (described later). The operator can observe the patient's eye E from the front by looking at the display unit 420.

<Refraction measurement device>
The refraction measuring device 90 is a refraction measuring device for measuring the refraction characteristics of the eye, and in this embodiment, a wavefront sensor is used. The refraction measuring device 90 is coaxial with the tomographic imaging device 71 via the beam combiner 92.

<Operation unit>
The operation unit 400 may include, for example, a trigger switch 410, a display unit 420, and the like. The trigger switch 410 inputs a trigger signal for emitting the therapeutic laser light from the laser irradiation unit 300. The display unit 420 is used as a display means for displaying a tomographic image and an anterior eye portion image of the patient's eye E and displaying surgical conditions. The display unit 420 may have a touch panel function, and may also serve as an input means for setting the surgical conditions and the surgical site (laser irradiation position) on the tomographic image. It should be noted that a mouse, which is a pointing device, a keyboard, which is an input device for inputting numerical values, characters, and the like, can also be used as an input means.

<Control unit 100>
The control unit 100 includes a CPU 101, a ROM 102, a RAM 103, a non-volatile memory (not shown), and the like. The CPU 101 as a processor has various controls for the ophthalmic laser surgical apparatus 1 (for example, control for creating control data described later, control for the laser light source unit 310, control for the scanning unit 330, control for adjusting the scanning speed of the condensing position, etc.). Controls. The ROM 102 stores various programs, initial values, and the like for controlling the operation of the laser surgical apparatus 1 for ophthalmology. The RAM 103 temporarily stores various types of information. The non-volatile memory is a non-transient storage medium that can retain the storage contents even when the power supply is cut off.

A laser irradiation unit 300, an observation / photographing unit 70, an operation unit 400, a fixation guidance unit 120, a suction pump, a perfusion suction unit, and the like are connected to the control unit 100.

Prior to the irradiation of the laser beam for surgery, the control unit 100 sets the position information for irradiating the laser beam for surgery based on the surgical site (region) set in the tomographic image display area. The control unit 100 emits laser light from the laser light source unit 310 based on the set surgical site, surgical conditions, and irradiation pattern, controls the scanning units (galvanomirrors 363 and 366), and makes the laser spot in the eyeball tissue. Move and cut, crush, or phototune the translucent body of the eye tissue.

In this embodiment, a first surgical mode for crushing or cutting the anterior ocular tissue and a second surgical mode for performing phototuning can be selectively set. The examiner can select the surgical mode using the operation unit 400. In this case, the operation program, laser irradiation conditions, and the like corresponding to each surgical mode are stored in the memory.

When set to the first surgical mode, the irradiation optical system 320 is set to an optical arrangement for irradiating the eye E with the first laser (FIG. 9). In this case, the correction optical member 500 is out of the optical path of the irradiation optical system 520. For the specific operation of the first surgical mode, refer to, for example, Japanese Patent Application Laid-Open No. 2015-195922.

When set to the second surgical mode, the irradiation optical system 320 is set to an optical arrangement for irradiating the eye E with the second laser (FIG. 10). In this case, the correction optical member 500 is arranged in the optical path of the irradiation optical system 520.

<Preoperative planning>
FIG. 13 is a diagram showing an example of a procedure in the second surgical mode, and is a diagram showing an example of preoperative planning. In this embodiment, the tomographic information and the refractive characteristics of the patient's eye E are acquired before the operation, and planning in photo tuning is performed.

The surgeon acquires tomographic information of the eye E by a tomography device, for example, a few days before surgery. The tomography device may be a tomography device arranged as a housing separate from the device 1, and the tomography device may be a device that photographs the patient's eye E in a sitting position. Further, the tomography device may be a tomography device 71 integrally provided in the device 1, and the tomography device may be a device that photographs the patient's eye E while lying down. good.

Similarly, the surgeon acquires the refraction properties of the eye E with a refraction property device, for example, a few days before surgery. The refraction characteristic device may be a refraction characteristic device arranged as a housing separate from the device 1, and the refraction characteristic device may be a device for photographing the patient's eye E in a sitting position. Further, the refraction characteristic device may be a refraction characteristic device 90 integrally provided in the device 1, and the refraction characteristic device is a device for measuring the refraction characteristic of the eye E while lying down. You may.

When an external device is used for the tomography device and the refraction characteristic device, it is preferable that data can be exchanged between the external device and the device 1. For example, it may be connected by wire or wirelessly, or data may be exchanged by a storage medium such as a flash memory.

The control unit 100 obtains the refraction characteristics of the lens to be written on the translucent body based on the tomography information obtained by the tomography device and the refraction characteristics obtained by the refraction characteristic device. Further, the control unit 100 obtains lens patterns 610 and 620 to be written on the translucent body 600 based on the obtained refraction characteristics.

When the eyeball fixation is completed, the control unit 100 may acquire a tomographic image of the patient's eye E by the tomographic imaging device 71 provided in the device 1. The control unit 100 is between a first tomographic image taken preoperatively by the tomographic device (see FIG. 11) and a second tomographic image acquired by the tomographic imaging device 71 after eye fixation (see FIG. 12). Associate the positional relationship of. As a result, the planning contents set before the operation can be associated with the tomographic image at the time of photo tuning. Therefore, the control unit 100 can perform the operation according to the surgical conditions set before the operation. When the first tomographic image is acquired by the external tomographic image pickup device, the first tomographic image and the first tomographic image are taken into consideration in consideration of the difference in the imaging magnification between the external tomographic image pickup device and the tomographic image pickup device 71. The image magnification of at least one of the second tomographic images may be adjusted by image processing. Further, the lens pattern to be written may be corrected in consideration of the difference in the imaging magnification.

More specifically, the control unit 100 associates the positional relationship between the translucent body in the first tomographic image and the translucent body in the second tomographic image, and the translucent body in the second tomographic image. A preset lens pattern may be set inside the translucent body in the second tomographic image with reference to the position of. The control unit 100 sets the laser irradiation conditions based on the lens pattern set for the translucent body in the second tomographic image. Further, photo tuning is performed with the second laser based on the set irradiation conditions.

The first tomographic image may be used for planning the lens pattern, and the second tomographic image may be used for setting the irradiation position in the irradiation optical system. The control unit 100 sets the irradiation position by, for example, setting (matching) the lens pattern acquired by using the first tomographic image with respect to the translucent body on the second tomographic image. May be good. For the lens pattern, for example, the lens pattern may be set based on the first tomographic image and the refraction characteristics of the eye.

The position of the translucent body of the patient's eye E taken by an external device before the operation in the undocked state and the position of the translucent body of the patient's eye E taken by the tomographic imaging device 71 after docking match. It may not be. For example, the position of the translucent body changes depending on the inclination of the crystalline lens. In addition, the translucent body and the eye (for example, the cornea) may be deformed due to the influence of the eyeball interface.

Therefore, as described above, the control unit 100 may correct the planning content set based on the preoperative tomographic image to a content suitable for the intraoperative tomographic image. For example, the control unit 100 first detects a translucent body in the eye to be inspected. Subsequently, the control unit 100 associates the translucent body in the first tomographic image with the translucent body in the second tomographic image. Thereby, the surgical conditions set for the translucent body of the first tomographic image are associated with the second tomographic image. Therefore, the control unit 100 can irradiate the second laser toward a predetermined position inside the translucent body set in advance. That is, the control unit 100 can perform photo tuning under the surgical conditions set by the planning.

For example, the control unit 100 may associate the first tomographic image with the second tomographic image based on the detected position information of the translucent body. In this case, the control unit 100 may make an association by detecting the surface of the translucent body by image processing.

The control unit 100 may determine whether or not the translucent body and the eye (for example, the cornea) are in a deformed state based on the second tomographic image. When the deformation is detected, the control unit 100 determines the irradiation position in consideration of the deformation state between the first tomographic image before the deformation and the second tomographic image after the deformation when the deformation is detected. May be set.

In the above description, the tomographic information and the refraction characteristics of the patient's eye E are acquired before the operation, and planning in photo tuning is performed, but the present invention is not limited to this. For example, the refraction characteristics of the patient's eye E are acquired in advance before the operation, and the control unit 100 plans based on the refraction characteristics obtained in advance and the tomographic image acquired by the tomographic imaging device 71 after the eyeball is fixed. May be done.

The control unit 100 may perform planning in photo tuning using the refraction characteristic device 90 provided in the device 1. Further, the control unit 100 may confirm the correction effect in photo tuning or additionally perform photo tuning by using the refraction characteristic device 90 provided in the device 1.

1 Ophthalmic laser surgery device 71 Tomographic imaging device 90 Refraction measurement device 100 Control unit 101 CPU (processor)
310 Laser light source unit 312 Laser light source 314 Wavelength conversion optical element 320 Laser irradiation optical system 330 Scan unit 500 Correction optical member

Claims (5)

A ophthalmic laser refractive device for adjusting the refractive index of the artificial translucent body by focusing the laser beam on the inside of the artificial translucent body provided in the patient's eye,
A laser beam for adjusting the refractive index of the artificial translucent body which is emitted from the laser light source unit, an irradiation optical system for guiding the laser beam inside the a provided artificial translucent body to the patient's eye,
A scanning unit arranged in the optical path of the irradiation optical system and scanning the focused position of the laser beam, and a scanning unit.
A control means for controlling the scanning unit.
The three-dimensional position information of the artificial translucent body in the tomographic image captured by the tomographic imaging device and the refraction characteristics of the patient's eye measured by the refraction measuring device in the state where the artificial translucent body is inserted. The lens is formed inside the artificial translucent body by three-dimensionally scanning the focused position of the laser beam in the irradiation region corresponding to the lens pattern set in advance based on the refraction characteristics of the patient's eye. Control means and
A laser refraction correction device for ophthalmology, which comprises. Based on the refractive properties of the eye E and the position information of the artificial light transmitting body, ophthalmic laser refractive according to claim 1, comprising setting means for setting the lens pattern formed on the artificial translucent body by adjusting the refractive index Corrective device. A tomographic imaging device for imaging a tomographic image of the patient's eye including the artificial translucent body is provided.
The laser refraction correction device for ophthalmology according to claim 2, wherein the setting means acquires position information of the artificial translucent body based on a tomographic image captured by a tomographic image pickup device. The setting means is
The first position information, which is the position information of the artificial translucent body in the first tomographic image acquired for pre-planning the lens pattern to be written, and the eyeball interface after the lens pattern is planned. Corresponds to the second position information, which is the position information of the artificial translucent body in the second tomographic image acquired after the lens is mounted.
The laser refraction correction device for ophthalmology according to any one of claims 2 to 3, wherein the lens pattern is set for the artificial translucent body in the second tomographic image. Comprising a refraction measuring device for measuring the refractive properties of the patient's eye containing the artificial light transmitting body, the refraction measuring device, a patient eye eyeball interface is mounted, at least one of the lenses is the artificial light transmission The laser refraction correction device for ophthalmology according to any one of claims 1 to 4, which measures the refraction characteristics of the patient's eye after being formed inside the body.

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