JPH10133122A - Surgical microscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily perform the changeover use and combination use of a coaxial illumination method and a 6 deg. illumination method. SOLUTION: This microscope is provided with an observing optical system 2 for observing an eye to be tested, a light beam guiding optical system 3 introducing almost all of the illuminating light beam from an illuminating optical system 1 to the eye to be tested E1 along the optical axis of the observing optical system, a total reflection prism introducing almost all of the illuminating light beam of the illuminating optical system to the eye E1 from an angle different from that of the illuminating light beam introduced by the light beam guiding optical system and a half prism P2 introducing a part of the illuminating light beam of the illuminating optical system to the light beam guiding optical system by transmitting it through the prism and introducing the remaining illuminating beam to the eye E1 from an angle different from that of the illuminating light beam introduced by the light beam guiding optical system. This microscope has a moving substrate 4 mounting the total reflection prism and the half prism in a prescribed direction and is provided with a moving means for locating either the total reflection prism or the half prism between the illuminating optical system and the light beam guiding optical system by moving the moving substrate in a prescribed direction.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical microscope for observing a reflected light beam from an eye to be examined with respect to an illumination light beam emitted from an illumination optical system.

[0002]

2. Description of the Related Art At present, when operating an eye to be inspected, a surgical microscope for enlarging and observing an image of the eye to be inspected at a predetermined magnification is widely used. The surgical microscope is provided with an observation optical system having a magnification unit for enlarging the image of the eye to be inspected to a predetermined magnification, and the surgeon views the magnified image of the eye through the observation optical system while observing the enlarged image. Undergoing surgery.

[0003] Cataract surgery is known as one of ophthalmic surgeries using such an operating microscope. This cataract surgery usually involves removing the internal tissue of the lens of the eye to be examined and inserting an intraocular lens (IOL) instead. Removal of the internal tissue of the lens is performed by inserting an inhaler into the lens and sucking out the internal tissue of the lens with this inhaler.If the internal tissue is incompletely sucked and the tissue remains in the lens, The cataract may recur due to the residual tissue. Therefore, the operation of sucking out the internal tissue of the lens needs to be performed while clearly observing the presence or absence of the residual tissue so as not to leave the residual tissue in the lens.

Here, in order to clearly observe the presence or absence of residual tissue in the lens, a transillumination image for observing the residual tissue with high contrast, that is, a so-called red reflex is effective. The red reflex can be generated by reflecting the illumination light beam at the fundus of the eye to be examined. As a method for generating the red reflex brighter and more uniformly, there is known a so-called perfect coaxial illumination method in which an illumination light beam is overlapped with an optical axis of an observation optical system.

FIG. 5 shows an operating microscope using the complete coaxial illumination method. In FIG. 5, E1 is the eye to be examined and E2 is
Is the surgeon's eye. The conventional surgical microscope using the complete coaxial illumination method includes an illumination optical system 1 for irradiating an eye to be inspected with an illumination light beam, an observation optical system 2 for observing the eye to be inspected, and substantially all of the illumination light beam of the illumination optical system 1. And a light beam guiding optical system 3 for guiding the light to the eye E1 along the optical axis of the observation optical system 2.

The illumination optical system 1 includes a light source L, an optical fiber F,
It has a condenser lens R1 and a relay lens R2, and the illumination light beam emitted from the light source L enters the light flux guiding optical system 3 via the optical fiber F, the condenser lens R1 and the relay lens R2. The observation optical system 2 includes a first objective lens R3, a variable power optical system K, a second objective lens R4,
Erect prism P3, rhombic prism P4 and eyepiece R
5, a reflected light beam from the eye E1 guided through the light beam guiding optical system 3 is reflected by the first objective lens R
The reflected light flux forms an image on the surgeon's eye E2 via the variable power optical system K, the second objective lens R4, the erect prism P3, the rhombic prism P4, and the eyepiece R5. The first objective lens R3 in the observation optical system 2
Each optical element except for is provided as a pair of right and left so that the subject's eye E1 can be stereoscopically observed, but only one side is shown in FIG.

[0007] The light beam guiding optical system 3 is specifically composed of a half mirror M1 disposed between the first objective lens R3 and the eye E1 on the optical axis of the first objective lens R3. Then, the illumination light beam incident from the illumination optical system 1 is guided to the eye E1 along the optical axis of the observation optical system 2 via the half mirror M1, and the reflected light beam from the eye E1 is transmitted for observation. The light is led to the optical system 2.

In this perfect coaxial illumination method, as shown in FIG. 6, an illumination light beam area X1 and a pair of variable power optical systems K
1, K2 partially overlap each other, so that a bright and uniform red reflex can be obtained.

Although a transillumination image is slightly darker than the perfect coaxial illumination method, a surgical microscope using a 0-degree illumination method has been proposed as a transillumination image that can be obtained in a practically acceptable degree. As shown in FIG. 7, the 0-degree illumination method has a light beam guiding optical system 3 different from the complete coaxial illumination method. Specifically, the first objective lens R3 and the variable power optical system K are used.
And the total reflection prism P0 arranged on the optical axis of the first objective lens R3, and the illumination light flux incident from the illumination optical system 1 is transmitted through the total reflection prism P0 to the light of the observation optical system 2. The eye is guided to the eye E1 along the axis. According to this method, as shown in FIG. 7, as in the case of the perfect coaxial illumination method, the illumination light beam can be guided along the reflected light beam, so that a red reflex can be obtained.

However, in an operating microscope using such a complete coaxial illumination method or a 0-degree illumination method (the two illumination methods are hereinafter simply referred to as “coaxial illumination method”), a bright red reflex is used. On the other hand, on the other hand, since the illumination light beam and the reflected light beam overlap each other or the illumination light beam and the reflected light beam approach each other, shadowless illumination in which the shadow of the eye E1 is not generated occurs. For this reason, the subject's eye E1
Has a disadvantage that the operation other than the removal of the lens in cataract surgery, such as the insertion of an IOL, is rather difficult to perform. Also, when the lens is dissected, the above-mentioned red reflex is not necessary, but in the case of the complete coaxial illumination method, the half mirror M1 is always arranged on the optical axis of the observation optical system 2, so that the observation is not performed. There is also a disadvantage that the brightness of the image is reduced.

For this reason, in recent years, the red reflex has become darker than the coaxial illumination method, but on the other hand, a surgical operation using a 6-degree illumination method capable of generating a shadow of an object to be observed and improving a three-dimensional effect. Microscopes have also been proposed. This 6
As shown in FIG. 9, the diagonal illumination method has a light flux guiding optical system 3 different from the coaxial illumination method. Specifically, the illumination between the first objective lens R3 and the variable power optical system K is performed. , A total reflection prism P1 arranged outside the reflected light flux. Then, the illumination light beam incident from the illumination optical system 1 is guided to the eye E1 via the total reflection prism P1. According to this method, as shown in FIG. 10, since the illumination light beam can be guided to the eye E1 at an angle slightly different from the reflected light beam, the shadow of the eye E1 can be generated, and the shadow of the eye E1 can be generated. The three-dimensional effect can be improved.

[0012]

However, in such a conventional operating microscope using the coaxial illumination method or the 6-degree illumination method, when the internal tissue of the crystalline lens is sucked, the coaxial illumination method and the insertion work of the IOL are required. In such a case, it is very difficult to switch the illumination method although a different illumination method is required during a series of operations, such as a 6-degree illumination method. This is because, in the conventional surgical microscope, the light beam guiding optical system for achieving any one of the illumination methods is simply fixedly provided. This was because it had to be replaced.

[0013] In addition to using only one of the coaxial illumination method and the six-degree illumination method, it is desired to simultaneously obtain a red reflection and a shadow of an observation object by using both of them simultaneously. Although there was a request, in the above-mentioned conventional surgical microscope, since the light flux guiding optical system for achieving one illumination method was simply provided in a fixed manner, it is not possible to simultaneously use the coaxial illumination method and the 6-degree illumination method. It was impossible.

In recent years, a light flux guiding optical system combining a 0-degree illumination method and a 6-degree illumination method has also been proposed (Japanese Patent Laid-Open No. Hei 4-246607). In addition, it is necessary to move a plurality of deflecting mirrors and the like, and the mechanism and operation are complicated.

The present invention has been made in view of such a problem in the conventional surgical microscope, and can easily and easily perform switching use and combination use between the coaxial illumination method and the 6-degree illumination method. An object of the present invention is to provide an operating microscope.

[0016]

According to a first aspect of the present invention, there is provided an observation optical system for observing an eye to be inspected, and substantially all of the illumination light beam from the illumination optical system. A light beam guiding optical system that guides the subject's eye along the optical axis;
First deflecting means for guiding substantially all of the illumination light flux of the illumination optical system to the subject's eye from an angle different from that of the illumination light flux guided by the light flux guiding optical system, and a part of the illumination light flux of the illumination optical system And a second deflecting means for guiding the remaining illumination light flux to the eye to be examined from an angle different from that of the illumination light flux guided by the light flux guidance optical system. In the microscope, the microscope has a moving substrate on which the first deflecting unit and the second deflecting unit are mounted along a predetermined direction, and the first deflecting unit is moved by moving the moving substrate in the predetermined direction. Or, any one of the second deflecting means is located between the illumination optical system and the light flux guiding optical system, or the first deflecting means and the second deflecting means the illumination optical system and the Retract from the space between the light beam guiding optical system It is configured as comprising the moving means.

According to a second aspect of the present invention, in the first aspect of the present invention, the first deflecting means and the second deflecting means pass substantially all of the illumination light beam of the illumination optical system. It is characterized by being attached to the moving substrate with a space portion interposed therebetween.

[0018]

An embodiment of the present invention will be described below in detail with reference to the drawings. FIG. 1 is a layout diagram showing the overall configuration of the present embodiment. In FIG. 1, the microscope is for observing an eye E1 to be inspected by a surgeon's eye E2. The illumination optical system 1, the observation optical system 2, and the light beam guiding optical system 3 are further provided with a first deflecting means. Reflection prism P1
(See FIG. 2), a half prism P2 as a second deflecting means
And a moving substrate 4 as moving means.

The illumination optical system 1 illuminates the eye E1 with an illumination light beam, and includes a light source L, an optical fiber F, a condenser lens R1, and a relay lens R2. Then, the illuminating light beam emitted from the light source L enters the light beam guiding optical system 3 to be described later via the optical fiber F, the condenser lens R1, and the relay lens R2.

The observation optical system 2 observes the subject's eye E1, and includes a first objective lens R3, a variable power optical system K, a second objective lens R4, an erect prism P3, a rhombic prism P4, and an eyepiece R5. It is composed of Then, a reflected light beam from the eye E1 guided through the light beam guiding optical system 3, which will be described later, is incident via the first objective lens R3, and the reflected light beam is changed to an arbitrary magnification by the variable power optical system K. The magnification is changed, and an image is formed on the eyepiece R5 via the second objective lens R4, the erect prism P3, and the rhombic prism P4. The optical elements other than the first objective lens R3 in the observation optical system 2 are provided as a pair of right and left so that the subject's eye E1 can be stereoscopically observed. However, FIG. 1 shows only one side thereof. As shown in FIG. 2, the variable power optical system K also includes a pair of left and right variable power optical systems K1 and K2.

The light beam guiding optical system 3 transmits substantially the entire illumination light beam of the illumination optical system 1 along the optical axis of the observation optical system 2 to the eye E1.
Specifically, similarly to the light beam guiding optical system 3 for achieving the conventional 0-degree illumination method, the first objective lens between the first objective lens R3 and the eye E1 to be examined is provided. R
3 comprises a total reflection prism P0 disposed on the optical axis. Almost all of the illumination light flux incident from the illumination optical system 1 is guided to the eye E1 along the optical axis of the observation optical system 2 via the total reflection prism P0.

As shown in FIG. 2, the total reflection prism P0 is located on the optical axis of the first objective lens R3 between the first objective lens R3 and the variable power optical system K, that is, as shown in FIG. Are arranged at intermediate positions between the variable magnification optical systems K1 and K2, so that the total reflection prism P0 does not block the reflected light beams of the first variable magnification optical systems K1 and K2. Therefore, when the surgeon's eye E2 observes the eye E1, the total reflection prism P0 does not enter the visual field of the surgeon's eye E2.

A total reflection prism P as a first deflecting means
Numeral 1 is arranged outside the reflected light beam, and guides substantially all of the illumination light beam of the illumination optical system 1 to the eye E1 from an angle different from that of the illumination light beam guided by the light beam guiding optical system 3. is there. The half prism P2, which is the second deflecting means, is disposed outside the field of view of the variable power optical system K, and a part of the illumination light flux of the illumination optical system 1 is guided by the light flux guiding optical system 3. The light flux is guided to the eye E1 from an angle different from that of the light flux. These total reflection prism P1 and half prism P2
The specific operation and arrangement will be described later.

The moving substrate 4 as a moving means is shown in FIGS.
Is a rectangular plate-like member, one of the total reflection prism P1 and the half prism P2 is located between the illumination optical system 1 and the light flux guiding optical system 3,
Alternatively, the total reflection prism P1 and the half prism P2 are retracted from between the illumination optical system 1 and the light beam guiding optical system 3. As shown in FIGS. 2 and 3, a total reflection prism P1 and a half prism P2 are mounted on the upper surface of the moving substrate 4 along the longitudinal direction of the moving substrate 4. The total reflection prism P1 and the half prism P2 are not arranged in close contact with each other, but are arranged with a space portion 5 having a width through which the illumination light flux of the illumination optical system 1 can pass. The moving substrate 4 having the total reflection prism P1 and the half prism P2 attached to the upper surface in this manner is similar to that of FIG.
As shown in (a) to (c), the moving board 4 is reciprocally movable along the longitudinal direction of the moving substrate 4 in association with an operation unit (not shown) and a stepping motor.

Next, the observation operation of the eye E1 when the present microscope is used for cataract surgery will be described. "Coaxial", "6 degrees" and "Combined"
When the lens of the eye E1 is incised, the "6 degree" switch is first pressed. Then, the movable substrate 4 is moved by the stepping motor, and the state shown in FIG. 2A, that is, the total reflection prism P1 is changed to the total reflection prism P0 as the illumination optical system 1 and the light beam guiding optical system 3.
The movable substrate 4 stops in a state where it is positioned between the moving substrate 4 and the moving substrate 4. That is, the total reflection prism P <b> 1 is arranged on the optical axis of the illumination optical system 1.

In the state shown in FIG. 2A, substantially all of the illumination light beams incident from the illumination optical system 1 pass through the total reflection prism P1 at an angle different from the optical axis of the observation optical system 2. The 6-degree illumination method is realized by being guided to the eye E1.
On the other hand, since the illumination light beam does not reach the total reflection prism P0 as the light beam guiding optical system 3, no deflection is performed by the light beam guiding optical system 3.

When removing the internal tissue of the lens, the "coaxial" switch is pressed. Then, the movable substrate 4 is moved by the stepping motor, and both the total reflection prism P1 and the half prism P2 are retracted from between the illumination optical system 1 and the light beam guiding optical system 3, as shown in FIG. That is, the moving substrate 4 stops in a state where the space 5 is located between the illumination optical system 1 and the light beam guiding optical system 3. That is, neither P1 nor P2 is arranged on the optical axis of the illumination optical system 1.

In the state shown in FIG. 2 (b), substantially all of the illumination light beam incident from the illumination optical system 1 is directed to the light flux guiding optical system 3 without being deflected by the total reflection prism P1 and the half prism P2. The light reaches the total reflection prism P0 and is guided to the eye E1 at an angle along the optical axis of the observation optical system 2 by the total reflection prism P0, thereby realizing a coaxial illumination method (0-degree illumination method).

Further, when inserting the IOL into the lens,
At any other time, the "combination" switch is pressed. Then, the moving substrate 4 is moved by the stepping motor, and the moving substrate 4 stops in a state shown in FIG. 2C, that is, in a state where the half prism P2 is positioned between the illumination optical system 1 and the total reflection prism P0. That is, the half prism P2 is arranged on the optical axis of the illumination optical system 1.

In the state shown in FIG. 2C, approximately half of the illumination light beam incident from the illumination optical system 1 is received at an angle different from the optical axis of the observation optical system 2 via the half prism P2. The 6-degree illumination method is realized by being guided to the optometry E1.
On the other hand, the total reflection prism P0 has a half prism P2.
The remaining approximately half of the illuminating light flux that has passed without being deflected is incident on the observation optical system 2 by the total reflection prism P0.
Is guided to the eye E1 at an angle along the optical axis, and the coaxial illumination method (0-degree illumination method) is also realized. That is, in this case,
The coaxial illumination method and the six-degree illumination method are simultaneously realized.

Next, a second embodiment of the present invention will be described with reference to FIG. The parts that are not particularly described are the same as those of the above-described embodiment (hereinafter, referred to as “first embodiment”). In the second embodiment, the light beam guiding optical system 3
Is constituted by a half mirror M2 instead of the total reflection prism P0, and the total reflection prism P1 as the first deflecting unit and the half prism P2 as the second deflecting unit are
Each is configured using a total reflection mirror M3 and a half mirror M4. In this embodiment, as shown in FIG. 4, the half mirror M2 and the total reflection mirror M3 are used.
And the half mirror M4 is different from the first embodiment,
It is arranged not between the first objective lens R3 and the variable power optical system K but between the first objective lens R3 and the eye E1. This is different from the case where the first deflecting means and the second deflecting means are constituted by prisms, and the illumination light beam deflected by the first deflecting means and the second deflecting means is converted into the first objective lens. This is because the light can be guided to the eye E1 without being refracted by R3.

Although the first and second embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments, but may be implemented in various forms within the scope of the technical idea. These different modes will be described below. The moving board 4 may be moved manually by the surgeon instead of the stepping motor.
2 and 3, the moving substrate 4 is arranged so as to be orthogonal to the optical axis of the first objective lens R3, but is arranged in parallel so that the total reflection prism P1 and the half prism P2 are arranged. It may be moved up and down.

[0033]

As described above, according to the present invention, there is provided a moving substrate on which the first deflecting means and the second deflecting means are mounted along a predetermined direction. By moving in a predetermined direction, one of the first deflecting means or the second deflecting means is located between the illumination optical system and the light beam guiding optical system, or the first deflecting means and the second deflecting means By providing moving means for retracting the deflecting means from between the illumination optical system and the light beam guiding optical system, by moving the first or second deflecting means, the coaxial illumination method or the 6-degree illumination method or both methods can be used. Lighting can be arbitrarily selected, and the lighting method can be switched during surgery. In particular, the illumination method can be switched simply by moving the moving substrate in a predetermined direction, and since multiple operations are not required,
Switching is very easy. Further, since a plurality of driving means are not required, the configuration is very simple.

According to the second aspect of the present invention, the first deflecting means and the second deflecting means are attached to the movable substrate via a space through which substantially all of the illumination light flux of the illumination optical system passes. With this arrangement, it is possible to switch to the 6-degree illumination method or the simultaneous illumination of the coaxial illumination method and the 6-degree illumination method, centering on the most commonly used coaxial illumination method, and to perform the most efficient switching. .

[Brief description of the drawings]

FIG. 1 is a layout diagram showing an overall configuration of a surgical microscope according to an embodiment of the present invention.

FIGS. 2A and 2B are explanatory diagrams showing a positional relationship between the light beam guiding optical system 3 and first and second deflecting means, which changes with the movement of the movable substrate 4, and FIG. State,
(B) shows a state in which the 0-degree illumination method is realized, and (c) shows a state in which the 0-degree illumination method and the 6-degree illumination method are simultaneously realized.

FIG. 3 is an exploded perspective view of a main part in the state of FIG. 2 (b).

FIG. 4 is a layout diagram showing an overall configuration of a surgical microscope according to two embodiments of the present invention.

FIG. 5 is a surgical microscope that achieves the conventional perfect coaxial illumination method.

6 is an explanatory diagram showing a relationship between an illumination light beam and a reflected light beam in the surgical microscope of FIG.

FIG. 7 is a surgical microscope that achieves the conventional 0-degree illumination method.

FIG. 8 is an explanatory diagram showing a relationship between an illumination light beam and a reflected light beam in the surgical microscope of FIG. 7;

FIG. 9 is a surgical microscope that achieves a conventional 6-degree illumination method.

FIG. 10 is an explanatory diagram showing a relationship between an illumination light beam and a reflected light beam in the surgical microscope of FIG. 10;

[Explanation of symbols]

 E1 Eye to be examined E2 Surgeon's eye L Light source F Optical fiber R3 First objective lens M1, M2, M4 Half mirror M3 Total reflection mirror P0, P1 Total reflection prism P2 Half prism 1 Illumination optical system 2 Observation optical system 3 Light flux guiding optical system 4 Moving board 5 Space

Claims (2)

[Claims] An observation optical system for observing an eye to be inspected; a light beam guiding optical system for guiding substantially all of an illumination light beam from an illumination optical system to the eye to be inspected along an optical axis of the observation optical system; First deflecting means for guiding substantially all of the illumination light flux of the system to the eye to be examined from an angle different from that of the illumination light flux guided by the light flux guiding optical system, and transmitting a part of the illumination light flux of the illumination optical system. A second deflecting means for guiding the remaining illumination light flux to the eye to be examined from an angle different from that of the illumination light flux guided by the light flux guidance optical system. A moving substrate having the first deflecting means and the second deflecting means attached along a predetermined direction, and moving the moving substrate in the predetermined direction to thereby provide the first deflecting means or the Illuminating either one of the second deflecting means with the illumination A moving unit that is located between an optical system and the light beam guiding optical system or that retracts the first deflecting unit and the second deflecting unit from between the illumination optical system and the light beam guiding optical system; An operating microscope, characterized in that: 2. The apparatus according to claim 1, wherein the first deflecting means and the second deflecting means are attached to the movable substrate with a space through which substantially all of the illumination light flux of the illumination optical system passes. The surgical microscope according to claim 1, wherein