JPH05500315A - Photocoagulator - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] Photocoagulator The present invention relates to a photocoagulation device incorporating a laser for treating ophthalmitis.

Laser photocoagulation has become a standard technique for treating retinal disorders. For this purpose, a laser beam is focused and aimed at the desired location on the retina. A variety of devices have been disclosed for this purpose. Such devices in various forms are EP-A- No. 0293126 and all of their devices are diode infrared The laser source and the clinician can identify the area being treated in the eye without being exposed to the laser light. Positioned to deflect the laser beam into the patient's eye for observation It includes a two-color beam splitter. One specific example of this device is Standard medical equipment consisting of an illumination system and a microscope, used to observe the inside of the eye. It is a unit that can be attached to the slit lamp traditionally used for Ru. The advantage of such a configuration is that the photocoagulator is compatible with the existing view of standard slit lamps. optical elements are available, which reduces the size, complexity and complexity of the photocoagulator itself. This means that costs can be minimized. As described in EP-A-0293126 The beam splitter that clinicians use to view a patient's eye, as shown in Attached to the head of the photocoagulator placed between the slit lamp microscope and the patient. Attachment of the photocoagulator is carried out so that the Observation beam and treatment the beams are aligned between the beam splitter and the patient's eye. A laser splitter splits the laser beam from a diode laser source located below the optical path of the microscope. deflecting the light to the optical path.

Slit lamps are usually equipped with suitable chin and head supports, which , the patient's head is positioned so that the focus of the slit lamp microscope is approximately on the retina. fine adjustments are made by adjusting the position of the microscope relative to the patient. It will be done. Similarly, the photocoagulator uses infrared light at a point that coincides with the focus of the slit lamp microscope. It may be equipped with a suitable optical system for focusing the line laser beam. stomach.

This configuration allows, in certain cases, specifically for the clinician to insert and use a contact lens in the patient's eye. Access to the patient's eye may be obstructed by the position of the photocoagulator head. I learned this from experience. In order to solve this problem, the existing photocoagulation device between the slit lamp microscope and the beam splitter (i.e. , a diverging lens) and move the focus of the microscope away from the microscope. This is done to increase the available working distance. Laser beam directly onto the retina optical energy in the patient's eye to focus the beam and observation beam. The so-called Goldmann-type three-mirror lens is applied to the patient's eye for the purpose of removing The above-mentioned system is useful in treatments that require contact lenses, such as lenses. It has been used effectively. In addition, usually the Goldmann type lens is, for example, a green lens. It is also used for anterior treatment, such as the treatment of the anterior part of the retina, such as in the case of disorders.

However, the so-called Meinstar, which can form a real image of the retina in front of the patient's eye, Other forms of treatment that require different types of contact lenses, such as There is also said to be such treatment within the limited movement of the slit lamp microscope. It is necessary to carry out the form. In such systems, contact lenses the therapeutic beam in front of the patient's eye so that it is refocused onto the retina. It is also necessary to focus the microscope.

In the conventional systems described above, in order to move the patient's head support backwards, , and/or to increase the range of movement at the rear of the microscope adjustment system. These treatments are not possible without adjusting the slit lamp. . The aforementioned adjustments required for the slit lamp can be achieved by adding a photocoagulator as a simple additional device. This would hinder the advantage of being able to provide

A device according to one aspect of the invention can be attached to an ophthalmic lens lamp. a photocoagulation device located between the slit lamp microscope and the patient's eye; The beam splitter attached to the head of the device can now be a small lens positioned so as to be able to direct a therapeutic beam into the patient's eye through the It consists of at least one laser source, which allows the device to be used in a During treatment, the bed doctor can use the beam spray without being exposed to the therapeutic light. so that the patient's eye can be observed by the slit lamp microscope through the The therapeutic laser beam and the slit lamp microscope are connected to the To selectively vary the working distance focused in front of the device, at least and an adjustable or removable lens between the beam splitter and the patient. placed between the person's eyes.

In this way, according to the invention, said microscope and therapeutic beam are placed on the retina. Longer working distances can be selected for directly focused treatment formats. Also, the focus of the microscope and treatment beam is focused on the eye by a contact lens. In treatment forms where it is necessary to match the real image of the retina created in front of the It is possible to shorten the distance used. The treatment beam and slit lamp microscope The adjustable lens is connected to the photocoagulator so that the focus of the microscope is adjusted simultaneously. in front of the beam splitter, i.e. between said beam splitter and the patient's eye. It is important to be located in In this way, the clinician can redirect the treatment beam. Easily switch from one operating mode to another without the need for focusing. switch the device to the contact lens that is applied to the patient's eye. can be changed).

The photocoagulator is adjusted by suitable means in front of the beam splitter. Single adjustable or removable, articulated or removably mounted It is preferable that the lens be equipped with a lens capable of In one form, the lens is A moving carriage allows movement into and out of the optical path. The simplicity of the photocoagulator In simple form, if it is desired to increase the working distance as described above, the light A single negative lens (i.e., a diverging lens) located within the path is provided. That Le lenses are modified to provide treatment where the focus matches the real image on the retina in front of the eye. to accommodate the working distance provided by an uncorrected slit lamp microscope. The light beam is moved out of the optical path. (In such configurations, the patient's eyes and the device The total working distance available between the treatment beam and the microscope is directly on the retina. compared to configurations that are focused on.

Alternatively, if other modes of operation are used, a negative lens with a long focal length may be substituted. This also increases the working distance, albeit at a shorter range. can.

In other preferred embodiments, a first negative lens is connected to the beam splitter. is permanently installed between the slit lamp microscope and the lens is always in front of the device. In this case, the focal length of the microscope can be increased by a predetermined amount. this place If the working distance is adjusted by using a converging or diverging lens of the beam splitter, at the front to properly focus the microscope and treatment beam relative to the device. This can be achieved by moving it back and forth.

In a particularly useful embodiment, the beam splitter and the slit lamp microscope are A permanently placed diverging lens in between allows the contact lens to project an image of the retina in front of the patient's eye. A focal point selected to provide a working distance for the microscope appropriate for the treatment to be made. Other forms of treatment in which the therapeutic light is focused directly onto the retina In order to increase the focal length by a predetermined amount so that the focal length can be adapted to the A diverging lens is movably mounted in front of the beam splitter. 2 By appropriately selecting the focal length of the two negative lenses, the removable lens Regardless of whether a lens is attached to the device, the beam is By displacing the head of said device out of position where it is precisely focused on a point. , in the size of the “spot” formed on the retina by the therapeutic beam. It has been found that approximately constant changes are possible. For many treatments of this kind The treatment beam is placed squarely on the retina to achieve a predetermined spot size. If it is desired to perform the treatment without precise focus, The configuration is valid. Photocoagulation against the slit lamp each time the working distance is adjusted Spot detection of out-of-focus beams without the need to reposition the instrument It is clearly effective that the It is fruitful. Along with the desired working distance, there is a substantially constant spot within the range of the working distance. In order to provide this size, it is necessary to use a permanent lens with a focal length of approximately -300mm. , a combination with a displaceable lens with a focal length of approximately -83mm is effective. , it turns out.

The accommodating lens minimizes the effect of back-reflecting light into the slit lamp microscope. In order to Preferably, it is tilted (e.g. 5-10 degrees) or slightly offset. Before Preferably, the lens located in front of the beam splitter is offset.

This is because, in order to tilt the lens, a larger acting force is required in front of the lens. This is because pace is necessary.

Next, an embodiment of the present invention will be described with reference to the drawings.

In the attached diagram, FIG. 1 is a longitudinal sectional view showing an apparatus according to the present invention, and FIGS. 2 to 5 show the apparatus. Providing a beam splinter and an adjustable lens system according to the invention Figure 6 is an enlarged front view of the head of the device. , and the attachment of the movable lens shows the structure.

As shown in FIG. 1, the photocoagulator 20 has a Available as a removable add-on. available in many standard forms As before, the slit lamp 30 has a tonometer attached to the base 14 and the microscope 15. We are prepared. A light source 16 for illumination is provided above the slit lamp mirror 17. This allows the clinician to use the slit lamp 30 normally. The patient's retina can be observed through a microscope 15.

As schematically illustrated in FIG. 1, the photocoagulator 20 is equipped with a slit lamp. The tonometer mounting 30 may be attached to the stand 14.

As shown in EP-A-0293126, the photocoagulator 20 may include one or more photocoagulators. includes a plurality of powerful infrared laser diodes 1, and the light from the diodes 1 is After being collimated by the lens 2 with a high numerical aperture, the output of the infrared laser diode 1 Along the longitudinal axis of the force, it is extended by a pair of anamorphic prisms 3, to which As a result, the size of the image on the axis is reduced. single If higher intensity than that obtained by a laser diode is required, a second infrared The beam from the laser diode is also The beam of the infrared laser diode 1 and Can be combined.

A visible laser light beam for aiming an infrared laser beam is a visible laser diode. generated by the code 4, collimated by the lens 5, and generated by the dichroic cube 7. combined with said infrared laser beam.

The combined visible and infrared beams are transmitted by a telescope lens 8.9. relayed and magnified, and then by the lens 10, the slit lamp microscope It can be focused at approximately the same focus as the mirror 15. the infrared light and visible laser light; and These telescope lenses are placed in a clinical position so that the slit lamp microscope 15 is focused. Adjustable by the doctor.

A wavelength selective mirror 11 is configured to reflect all of the infrared light into the patient's eye. Although the clinician's eyes are not exposed to the therapeutic light, the clinician can A beam beam that allows the patient's eye to be examined via the microscope 15 and the mirror 11 It acts as a splitter 11. For this purpose, the top or head of the device 20 is provided with a , aligned windows 32,33 are provided. As detailed below, the above Windows 32 and 33 have negative lenses (i.e. diverging lenses) inside them. Suitable means for attachment are provided.

As schematically illustrated in Figure 1, the treatment and aiming laser beams are placed on the retina. to remove optical energy from the patient's eye so that it is directly focused. A contact lens, such as a so-called Goldmann lens, is placed in the patient's eye. ing. Therefore, in such a system, the slit lamp microscope 15 is also Additionally, it must be focused directly onto the retina. Therefore, the head of device-20 and the patient's eye is determined by the maximum focal length of the slit lamp microscope 15. It will be subject to certain restrictions. This limits the clinician's access to the patient's eyes. with the patient's head supported on the slit lamp head and chin rest. However, it is difficult for clinicians to apply the contact lens 34. slit Regarding the limitations of the working distance W between the focal point F of the lamp microscope 15 and the therapeutic beam, , shown schematically in FIG. 2 (in FIG. 2, for clarity, specific parts of the device 20 are (Illustrations are omitted).

As shown in FIG. 3, the device according to the preferred embodiment has a permanently installed between the slit lamp microscope 15 and the beam splitter 11. A first negative lens 40 is provided. This diverging lens 40 allows the focal point F to be It is moved away from the microscope 15 to lengthen the working distance W. The telescope lens is adjustment to refocus the laser beam at a new focus of the microscope; It is stipulated.

As mentioned above, other forms of treatment involve creating a real image of the retina in front of the patient's eye. Different forms of contact lenses, such as Meinstar lenses, can be used by patients applied to the eyes. In this case, the slit lamp microscope 15 as well as the treatment beam and an aiming beam is focused on the retina by said contact lens. It needs to be focused at a point in front of the patient's eye so that the Advantages of this invention In a preferred embodiment, the first negative lens 40 has a working distance suitable for this form of treatment. with a focal length selected to provide W.

As shown in Figure 4, in a preferred embodiment, the light is focused directly onto the retina. If it is desired to apply the device for other forms of treatment, a longer working distance may be required. A separation W is required, which is adjacent to the window 32, i.e. the beam A second negative lens 41 is provided between the splitter 11 and the patient's eye 31. Therefore, it is achieved. As shown in FIG. 4, this allows the slit lamp microscope 15 and simultaneously increasing the focal length of the treatment beam and the aiming beam. This way By simply moving the second diverging lens 41 in and out of the optical path, a certain Even when switching from one form of treatment to another, clinicians , the device can be used effectively.

FIG. 6 shows the mounting structure of the movable lens 41, and the mounting structure is determined by the clinician. A knob 52 protruding from the casing (not shown) of the device enables manual operation. That is, it consists of a sliding carriage 50 that can move up and down on a rail member 51. . The rail member 51 engages with a slot formed in the side of the carriage 50. It is.

In order to reduce the effect of light reflected back into the microscope 15, as shown in FIG. , the lens 40 is tilted with respect to the optical axis. The lens 41 is also tilted. Alternatively, the central axis can be moved laterally from the optical axis, as shown in Figure 5. You can shift it slightly. This allows the working distance to be increased by tilting the lens 41. Shortening is avoided. As shown in FIG. 5, the lens 41 is aligned with respect to the optical axis A. By shifting, the focal point F will be displaced upward, but this is not recommended by the clinician. can be easily compensated for.

The adjustable lens can be varied in many ways. In simple form, the above The lens 40 may be omitted, and the working distance W shown in FIG. It is used in treatments where the focus is located on the real image of the retina. In some cases, this type of treatment In said configuration for therapy, a sufficient working distance is achievable. Therefore, focus F should be located above the retina itself, to increase the working distance W, a single A displaceable negative lens 41 is provided.

Alternatively, to provide a longer working distance W similar to that shown in FIG. The capability of the lens 40 may be increased. In this case, the movable lens 41 is A converging lens with an appropriate ability to shorten the distance W to the same value as shown in Figure 3 is used. can be done.

However, due to the configuration of the two negative (divergent) lenses, certain practical Lit is achieved. As mentioned above, in practice, many treatments require that the therapeutic beam It is executed without being precisely focused on the object.

In a preferred embodiment, the size of the "spot" is determined by moving the photocoagulator back and forth. Adjusted by moving.

By appropriately combining diverging lenses, the second diverging lens 41 can be placed in the optical path. a constant spot size for a particular displacement of the photoconcentrator, regardless of whether It may also be possible to realize a change in the angle. In practice, this means (at least for the desired This can only be achieved by moving a movable negative lens (while providing a useful distance W). I don't get it. This allows the clinician to, for example, focus the therapeutic beam directly onto the retina. the device can be adjusted to provide a predetermined spot size in the switch to another operating mode by moving the second lens 41 into the optical path. A similar spot size is created on the retinal virtual image plane formed in front of the patient's eye. There is an advantage in that it is provided. Therefore, the treatment mode is changed There is no need to adjust the position of the device 20 every time. With appropriate working distance, In order to provide a constant spot size change at the working distance, the lens A focal length of 1300mm for the lens 4o and 183mm for the lens 40. A combination with a focal length of m is useful.

By moving the second lens 41 into the optical path as described above, the working distance is reduced to approximately 1 It becomes 5mm longer. However, other focal length combinations are also possible.

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Claims (8)

[Claims] 1. A photocoagulation device that can be attached to a slit lamp for treating ophthalmitis, the photocoagulation device comprising: Before the LIT lamp could be located between the microscope and the patient's eye The treatment beam is connected to the device via a beam splitter attached to the head of the device. from at least one laser source positioned to be directable into the patient's eye; This makes it easier for the clinician to use the device during treatment. the slit run through the beam splitter without being exposed to medical light; The patient's eyes can be observed using a microscope, and the therapeutic laser A beam and the slit lamp microscope are focused in front of the device. at least one adjustable or removable device to selectively vary the distance of use. a possible lens is disposed between the beam splitter and the patient's eye. A photocoagulation device characterized by: 2. The adjustable or removable lens is arranged between the beam splitter and the beam splitter. A claimable lens consisting of a lens that is movable into and out of the optical path between the patient's eye and the patient's eye. The photocoagulator according to scope 1. 3. Claim 2, wherein said lens is mounted on a movable carriage. Photocoagulation device as described. 4. Claim 2 or 3, wherein the lens is a negative lens (divergent lens). The photocoagulation device according to item 3. 5. When the lens is located in the optical path, its central axis is aligned with the slit. The lamp is installed so that it is tilted or misaligned with respect to the central optical axis of the microscope. The photocoagulator according to claim 2, 3, or 4. 6. installed in the optical path between the beam splitter and the slit lamp microscope. Any one of claims 1 to 5, further comprising an eclipsed negative lens. Photocoagulation device as described in Section. 7. The negative lens has a central axis that corresponds to the central optical axis of the slit lamp microscope. According to claim 6, the device is provided so as to be tilted or displaced. Photocoagulation device. 8. The focal length of the lens is approximately −83 mm for the movable lens and approximately −83 mm for the movable lens; Regarding the lens between the beam splitter and the slit lamp microscope. The photocoagulator according to claim 4 or 6, wherein the distance is about -300 mm. .