JPH0767884A - Fiber probe for operation - Google Patents

Abstract

PURPOSE:To provide a fiber probe for operation which is formable to a smaller size and is easy to handle and with which an exact incision operation is possible. CONSTITUTION:The fiber probe for operation has a tube 21 formed with an opening 26 for irradiating the part to be irradiated with the light from a light source at its side wall part, an optical fiber 24 to be inserted into this tube 21 from its one end and a rod part 22 to be inserted into the tube 21 from the other end thereof. The rod part 22 has a reflection part inclined at the end and is arranged in a position where the part to be irradiated is irradiated with the light from the optical fiber 24 through the opening 26.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical fiber probe, and more particularly to a fiber probe most suitable for an ophthalmic laser surgical apparatus.

[0002]

2. Description of the Related Art In recent years, fiber probes using laser light have been widely used in the medical field.

For example, JP-A-60-250332 discloses
Disclosed is a fiber for laser beam side emission which enables side emission of laser light by obliquely cutting one end surface of an optical fiber, polishing the cut surface, and depositing a reflective material on the polished surface.

Further, Japanese Examined Patent Publication No. 59-18059 discloses a laser knife in which a right-angle prism is provided at the tip of an optical fiber to enable side emission of laser light.

Further, US Pat. No. 4,273,127 discloses a surgical instrument capable of focusing laser light in a fixed direction and position by providing a curved reflecting mirror at a predetermined distance from the tip of an optical fiber. .

A cataract is one of the diseases in the ophthalmological field. Cataract is a disease that is often seen in the elderly, but in general, the cataract causes the lens to become grayish white, and as the condition progresses, the lens hardens and the visual acuity deteriorates extremely. Often. At present, the most effective treatment method for cataract is to surgically remove all or part of the opaque lens and insert an artificial lens instead.

In particular, in the case of a relatively soft lens nucleus, 1) anterior lens incision, 2) ultrasonic aspiration of the lens nucleus and parenchyma, and 3) insertion of an artificial lens (IOL) into the remaining lens capsule. Surgery is performed according to the procedure. 1)
The anterior capsular incision is a continuous circular incision (CCCC: C
ongoing Circular Capsul
ohexis). The reasons are that the openings are symmetrical, cracks are less likely to occur at the margin of the anterior capsule, and there is little damage to the eye tissue.

Conventionally, continuous circular incision of the anterior lens capsule has often been performed using a scalpel in which the tip of an injection needle is bent at 90 °. (Kimiya Shimizu, Rinkan VOL.43, NO3.P.P.
381-383) On the other hand, although the use of the fiber probe using the above-mentioned laser light has been studied, it has not been put into practical use due to the problems described below.

[0009]

Problems to be Solved by the Invention JP-A-60-2503
Since the No. 32 side emission fiber has a simple structure, it can be applied to a small fiber probe having a relatively small core and clad diameter. However, when a laser beam having a high energy density is applied, the energy may destroy the reflective material coated on the cut surface of the optical fiber, which may cause a failure of the back surface reflecting mirror.
In that case, there is a great risk that the laser light to be laterally emitted from the optical fiber passes through the reflecting surface and goes straight, and is irradiated to an unintended tissue.

Since the laser knife of Japanese Examined Patent Publication No. 59-18059 utilizes the total internal reflection of the prism, there is no risk of erroneous irradiation unless a laser of large energy that destroys the prism is irradiated. However, in an optical fiber having an extremely small core and clad diameter, it is extremely difficult to provide the prism mechanism in the fiber probe.

Further, since the surgical instrument of US Pat. No. 4,273,127 utilizes the reflection of metal, there is no danger of breaking the reflection surface. However, in an optical fiber having an extremely small core and clad diameter, it is difficult to provide a mechanism such as a curved reflecting mirror in the fiber probe, and it is difficult to reduce the size like the laser knife.

In the cataract surgery of the relatively soft lens as described above, it is important to perform anterior capsule incision close to a perfect circle and cleanly and non-invasively to other tissues. Is right or wrong. However, anterior capsule incision with a scalpel is technically difficult, and therefore the success or failure of surgery largely depends on the experience and skill of the operator.

If the anterior capsule incision satisfying these conditions is not performed, the chin band and the lens capsule are damaged, or a series of surgical processes after the incision, such as lens delivery and lens nucleus emulsification suction. It adversely affects cortical suction, intraocular lens insertion, etc., and adversely affects the results in the late postoperative period.

In fact, when the operator's technique is inadequate, cracks often occur in the sac during anterior capsule incision.
In addition, if the anterior capsule incision is asymmetric, or if the incision edge is jagged even if it is circular, it is not uniform in the lens capsule during lens nucleus delivery, lens nucleus emulsification suction, cortical suction and intraocular lens insertion. There is a high risk of stress, cracking the capsular bag and eventually damaging the chinch. In addition, if the anterior capsule incision is asymmetric, the inserted IOL
However, there was also a problem that it was not possible to keep the optical center correctly after the operation.

In view of the above problems of the prior art, it is an object of the present invention to provide a surgical fiber probe that can be miniaturized, is easy to handle, and allows accurate incision.

[0016]

According to the present invention, there is provided a tube having an opening for irradiating an object to be irradiated with light from a light source, a tube, an optical fiber inserted from one end of the tube, and A rod portion inserted from the other end of the tube, the rod portion having a reflecting portion with an inclined end portion, and arranged at a position where the light from the optical fiber is irradiated to an irradiation target through the opening. The gist is a fiber probe for surgery, which is characterized in that

[0017]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a schematic view showing an embodiment of a laser probe according to the present invention.

In the figure, reference numeral 11 is a probe portion containing an optical fiber and a metal rod, 12 is a handpiece,
Reference numeral 13 is a fiber for guiding light. The probe unit 11 is
A metal rod which is linear and has a reflecting surface is arranged on the free end side. As will be described in detail below, the distal end portion 14 is provided with an opening for lateral emission.

When an infrared laser having a wavelength of about 3 μm is used as the light source, it is desirable that the light guiding fiber 13 is formed of a zirconium-based fluoride glass fiber in order to efficiently transmit the laser energy. In that case, in consideration of safety to the living body, anhydrous silica fiber may be used in the probe 11 and the zirconium-based fluoride glass fiber and anhydrous silica fiber may be connected in the hand piece 12. Light guiding fiber 1
3 is connected to a usual laser generator (not shown).

Next, the tip portion 14 of the laser probe will be described in detail with reference to FIGS. 2 to 5 are enlarged views showing the tip portion 14 of the laser probe of another aspect.

In the embodiment of FIG. 2, reference numeral 21 is a stainless pipe, 22 is a metal rod, and 24 is an optical fiber. At the right end of the metal rod 22, there is formed a plane mirror 23 forming an angle of about 45 degrees with respect to its axis. The left end of the optical fiber 24 is an emission end face 25 cut and polished at a right angle to the optical axis. An opening 26 for side emission is provided between the plane mirror 23 and the exit end surface 25.

The laser light emitted from the emission end face 25 of the optical fiber 24 is N. A. The opening 26 provided on the side of the stainless pipe is reflected by the plane mirror 23 while expanding at an angle according to (numerical aperture).
Is radiated from the side.

In the embodiment shown in FIG. 3, the left end of the optical fiber 34 is an exit end surface 35 cut and polished by about 45 degrees with respect to the optical axis, and the exit end surface 35 is bonded to the plane mirror 33 of the metal rod 32. Has been done. Side openings 36 are formed on both sides of the surfaces 33 and 35.

In this embodiment, the laser light emitted from the emission end face 25 of the optical fiber 34 is reflected by the plane mirror 33 and is condensed in the axial direction of the optical fiber due to the lens effect of the optical fiber 34. It is linearly radiated from the opening 36 provided.

Referring to FIG. 4, the right end of the metal rod 42 is formed with a concave mirror 43 which makes an angle of about 45 degrees with respect to its axis. The left end of the optical fiber 44 is an exit end surface 45 cut and polished at a right angle to the optical axis.
It has become. A side-illumination opening 46 is provided between the concave mirror 43 and the exit end surface 45.

In this embodiment, the laser light emitted from the emission end face 45 of the optical fiber 44 is the optical fiber 44.
N. A. Although it reaches the concave mirror 43 while spreading at an angle according to the (numerical aperture), it is condensed by the concave mirror 43, so that it is side-split from an opening 46 provided on the side of the stainless pipe in a spot shape.

In the embodiment shown in FIG. 5, the left end of the optical fiber 54 is an injection end face 55 which is molded and polished so as to match the cylindrical concave mirror 53 of the metal rod 52.

In this embodiment, the laser beam emitted from the emission end surface 55 of the optical fiber 54 is a cylindrical concave mirror 53.
Due to the lens effect of the optical fiber 54 and the optical fiber 54, the light is emitted in a spot shape from the opening 46 provided on the side of the stainless pipe.

FIG. 6 is a schematic view of a laser probe 60 in which a side-transmission opening provided on the side of a stainless pipe is filled with a light-transmissive resin. In this embodiment, the side-transmission opening provided on the side of the stainless steel pipe is filled with a light-transmissive resin 66. The other structure is the same as that of the embodiment shown in FIG.

As the resin with which the opening is filled, it is preferable to use a resin containing no --OH group in order to efficiently transmit laser energy, particularly when an infrared laser having a wavelength of about 3 μm is used as a light source.

Next, the details of the tip portion 64 of the laser probe will be described with reference to FIGS. 7 to 10 are enlarged cross-sectional views showing the tip portion 64 of the laser probe of another aspect.

In the embodiment shown in FIG. 7, a light-transmissive resin 71 is filled in the entire side opening provided on the side of the stainless pipe. The other structure is the same as that of the embodiment shown in FIG.

In FIG. 8, a light-transmissive resin 71 is filled in an opening for lateral emission (a cutout portion of the tube 31) provided on the side of the stainless steel pipe. Other configurations are similar to those of the embodiment shown in FIG.

In the embodiment shown in FIG. 9, a light-transmissive resin 91 is filled in the entire side opening provided on the side of the stainless steel pipe. Other configurations are similar to those of the embodiment shown in FIG.

In the embodiment shown in FIG. 10, a light-transmissive resin 101 is filled in an opening for lateral emission (a cutout portion of the tube 51) provided on the side of the stainless steel pipe. Other configurations are similar to those of the embodiment shown in FIG.

Next, with reference to FIGS. 11 and 12, a procedure for performing continuous anterior capsule incision in cataract surgery using the laser probe 110 of the present invention will be described. Figure 11
FIG. 12 is a longitudinal sectional view showing a state in which the probe portion 112 is inserted into the anterior chamber 113 from the scleral corneal portion 111 of the eyeball, and FIG. 12 is a view seen from above.

An opening 114 for laser irradiation is provided at the tip of the probe section 112, and in this embodiment, a wavelength of 3 is used.
A laser beam in the vicinity of μm is supplied from the opening 114 to the anterior lens capsule 11.
It is irradiated toward 5. When the opening 114 of the laser probe is moved in a circle along the anterior lens capsule 115 while irradiating the laser, the anterior lens capsule 11 is irradiated by the laser.
5 is cut into a circle indicated by reference numeral 116. That is, without bringing the laser probe into contact with the anterior lens capsule 115,
Further, it is possible to perform an anterior lens capsule incision into an arbitrary shape without applying any force to the anterior lens capsule 115.

Therefore, by using the laser probe according to the present invention, the performance of surgery can be improved regardless of the experience and skill of the operator.

[0039]

According to the laser probe of the present invention, a tube having an opening for irradiating an object to be irradiated with light from a light source is formed in a side wall of the tube, an optical fiber inserted from one end of the tube, and an optical fiber of the tube. A rod portion inserted from the other end, the rod portion having a reflecting portion with an inclined end portion, and being arranged at a position for irradiating the irradiation target with light from the optical fiber through the opening. Since it is characterized, it is safe even for laser light with large energy. It is also possible to realize a laser probe having an extremely small outer diameter of, for example, 80 to 500 μm. Therefore, by using the probe of the present invention, a continuous circular incision in the anterior capsule incision in cataract surgery can be performed extremely safely and accurately.

The present invention is not limited to the above embodiment. For example, the stainless pipe and the metal rod may be integrally formed.

[Brief description of drawings]

FIG. 1 is a schematic view showing an embodiment of a laser probe according to the present invention.

FIG. 2 is an enlarged sectional view of a portion indicated by reference numeral 14 in FIG.

FIG. 3 is an enlarged cross-sectional view similar to FIG. 2 showing another aspect.

FIG. 4 is an enlarged cross-sectional view similar to FIG. 2 showing still another aspect.

FIG. 5 is an enlarged cross-sectional view similar to FIG. 2 showing still another aspect.

FIG. 6 is a schematic view showing another embodiment of the laser probe according to the present invention.

7 is an enlarged cross-sectional view of a portion indicated by reference numeral 64 in FIG.

FIG. 8 is an enlarged cross-sectional view similar to FIG. 6 showing another aspect.

FIG. 9 is an enlarged sectional view similar to FIG. 6 showing another embodiment.

FIG. 10 is an enlarged cross-sectional view similar to FIG. 6 showing another aspect.

FIG. 11 is a vertical cross-sectional view showing a state where a continuous circular incision is made by the laser probe of the present invention.

FIG. 12 is a diagram of FIG. 11 viewed from above.

[Explanation of symbols]

 10, 60, 110 Laser probe 11, 61, 112 Probe part 12, 62 Handpiece 13, 63 Light guiding fiber 14, 64 Tip part 21, 31, 41, 51 Stainless pipe 22, 32, 42, 52 Metal rod 23,33 Plane mirror 43,53 Concave mirror 24,34,44,54 Optical fiber 25,35,45,55 Exit end face 26,36,46,56 Side radiation opening 71 Light transmission type resin

Claims (2)

[Claims] 1. In a surgical fiber probe, a tube having an opening for irradiating an irradiation target with light from a light source is formed on a side wall portion thereof, and an optical fiber inserted from one end of the tube. A rod portion inserted from the other end of the tube, the rod portion having a reflecting portion with an inclined end portion, and at a position where the light from the optical fiber is irradiated to the irradiation target through the opening. A surgical fiber probe characterized by being placed. 2. The light from the light source is infrared laser light, the optical fiber is made of anhydrous silica, the rod portion is made of metal, and the reflecting portion of the rod portion and the optical fiber are formed. The surgical fiber probe according to claim 1, further comprising a filling portion that is in contact with an end surface of the fiber.