JPH11356A - Ophthalmic laser treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ophthalmic laser treatment device capable of easily removing hardened cribration plates or blood vessel walls. SOLUTION: This ophthalmic laser treatment device is provided with a laser oscillating part 21 which continuously oscillates laser beams of wavelengths longer than 780 nanometers and an optical fiber 12 guiding the laser beams from the laser oscillating part 21 into the eye 14. The laser beams from the end of the optical fiber 12 are applied to the region to be treated of a blood vessel within the eye 14, from the outside of the blood vessel, to treat the blood vessel.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ophthalmic laser treatment apparatus suitable for treating blood vessels in the eye.

[0002]

2. Description of the Related Art Obstructive retinal vascular lesions and glaucoma caused by angiogenesis in the eye or squeezing of the optic nerve are known as a kind of eye diseases. In such cases, the lamina cribrosa and blood vessel walls in the optic disc are usually hardened,
Removing this hardening is effective in recovering from the disease.

[0003] In addition, central venous retinal occlusion and branch occlusion caused by occlusion of intraocular blood vessels are known. In the case of such a disease, it is effective to remove the occlusion of the blood vessel to recover the disease.

[0004]

However, a therapeutic device capable of easily removing the hardening of the lamina cribrosa and the blood vessel wall has not yet been developed so far. In addition, as a method for removing occlusion of intraocular blood vessels, pharmacotherapy is partially performed. However, depending on the patient, a sufficient therapeutic effect may not be obtained, and thus cannot be said to be a definitive treatment method.

An object of the present invention is to provide an ophthalmic laser treatment apparatus which can easily remove hardening of the lamina cribrosa and blood vessel wall. It is another object of the present invention to provide an ophthalmic laser treatment apparatus that can easily remove occlusion of intraocular blood vessels and can expect an effective treatment effect.

[0006]

According to one aspect of the present invention, there is provided a laser oscillation unit that oscillates a laser beam having a wavelength longer than 780 nanometers.
An optical fiber for guiding the laser light from the laser oscillation unit into the eye, and irradiating the laser light from the tip of the optical fiber to a treatment site of the intraocular blood vessel from outside the blood vessel to perform treatment of the blood vessel. It is a treatment device.

[0007] According to the above configuration, by irradiating the laser beam, the laser beam acts on the matrix of the cell at the treatment site, and the hardening of the lamina cribrosa and the blood vessel wall can be removed.
In this case, using laser light having a wavelength longer than 780 nanometers can prevent hemoglobin from coagulating with the laser light, and longer wavelengths are more excellent in tissue infiltration. However, vascular treatment can be easily performed. It is preferable that the laser oscillating section oscillates the laser light continuously as in claim 2.

According to another aspect of the present invention, there is provided a laser oscillator for oscillating a laser beam of a holo-mume YAG, and an optical fiber for guiding the laser beam from the laser oscillator into an eye. Comprising, inserting the optical fiber tip into the intraocular blood vessel,
An ophthalmic laser treatment apparatus for irradiating a treatment site with a laser beam from the tip of the optical fiber to treat a blood vessel.

According to the above configuration, for example, by irradiating a laser beam from inside the blood vessel to the occluded site of the blood vessel, the tissue at the occluded site can be easily destroyed. It is preferable that the laser oscillating section oscillates the laser light in a pulsed manner. The optical fiber has at least a tip portion inserted into a 30-gauge cannula as described in claim 5.

[0010]

Embodiments of the present invention will be described below. (Embodiment 1) FIG. 1 shows a schematic configuration of an ophthalmic laser treatment apparatus according to Embodiment 1 of the present invention. In the figure, reference numeral 10 denotes an intraocular surgical instrument.
Has a holding cylinder 11. An optical fiber 12 for guiding a laser beam is provided inside the holding cylinder 11. The optical fiber 12 is connected to a laser oscillation unit 20. A small-diameter portion 13 is formed on the distal end side of the holding cylinder 11, and the optical fiber 12 is inserted through the small-diameter portion 13. The laser oscillation unit 20 has a laser oscillation unit 21, and the laser oscillation unit 21 continuously oscillates laser light having a wavelength longer than 780 nanometers.

The intraocular surgical instrument 10 has a small diameter portion 13
Is inserted into the eye 14. The illumination fiber 15 is also inserted into the eye 14. The illumination optical fiber 15 is connected to the light source unit 22.

In the ophthalmic laser treatment apparatus having the above-described configuration, the small-diameter portion 13 of the intraocular surgical instrument 10 is inserted into the intraocular 14, and the intraocular surgical instrument (not shown) is used.
When the foot switch 23 is depressed while observing step 4, the laser oscillation unit 20 is turned on, the laser oscillation unit 21 oscillates, and laser light having a wavelength longer than 780 nm is introduced into the optical fiber 12. Optical fiber 12
Is capable of guiding laser light of a wavelength longer than 780 nanometers, and has a lamina cribrosa 16 in the optic disc of the eye 14.
Irradiate the laser light toward. In FIG. 1,
17 is a vitreous body and 18 is a retina.

Blood vessels and the optic nerve are concentrated on the lamina cribrosa 16, and when the lamina cribrosa 16 is hardened, angiogenesis and further squeezing of the optic nerve occur, resulting in obstructive retinal vascular lesions and glaucoma. Likely to progress.

By irradiating the sieve plate 16 with laser light as described above, the sieve plate 16 and the sieve plate 19 are irradiated.
The stiffening of blood vessels passing through can be removed. as a result,
Angiogenesis and squeezing of the optic nerve are suppressed, and treatment of obstructive retinal vascular lesions and glaucoma can be easily performed. In this case, the laser beam irradiated toward the sieve plate 16 is
Since the laser light has a wavelength longer than 780 nanometers, hemoglobin does not coagulate due to the laser light, and the longer wavelength has better tissue infiltration, so that blood vessels can be easily treated even from outside the blood vessel. can do.

When irradiating the laser beam toward the sieve plate 16, it is preferable that the laser beam output is low and the laser beam is applied for a long time.

(Embodiment 2) FIG. 2 shows a schematic configuration of a laser treatment apparatus according to Embodiment 2 of the present invention. In the present embodiment, the laser oscillating unit 21A in the laser oscillating unit 20 oscillates the pulse of the laser light of the holo-mume YAG. A 30-gauge cannula 13A is attached to the tip of the gripping cylinder 11, and the optical fiber 12 is inserted into the cannula 13A. Then, both the optical fiber 12 and the cannula 13A are inserted into the blood vessel. Other configurations are the same as those in the first embodiment.

FIGS. 3A and 3B show the tip shape of the cannula 13A. In FIG. 3A, the end face of the cannula 13A is cut perpendicularly to the central axis, and when inserting the cannula 13A into a blood vessel, a hole is first made in the blood vessel by laser light, and the hole is cut through the hole. Cannula 13
A and the optical fiber 12 are inserted into the blood vessel. FIG.
In (b), the end face of the cannula 13A is cut obliquely to the center axis (like the tip of an injection needle), and when inserted into a blood vessel, a hole is made in the blood vessel by laser light, The optical fiber 12 is inserted into the blood vessel together with the cannula 13A while pushing the hole with the inclined surface at the tip of the cannula 13A. FIG. 4 shows a state in which the cannula 13A and the distal end of the optical fiber 12 are inserted into the occluded blood vessel.

In the ophthalmic laser treatment apparatus having the above structure, the cannula 13A and the distal end of the optical fiber 12 are inserted into the occluded blood vessel while observing the inside of the eye 14 with a surgical microscope (not shown). 12
The tip of is directed to the occlusion site in the blood vessel. Then, when the foot switch 23 is depressed, the laser oscillation unit 20 is turned on, the laser oscillation unit 21A oscillates, and the
AG laser light is introduced into the optical fiber 12. The optical fiber 12 can guide the laser light of the holo-mumm YAG, and irradiates the laser light toward an occlusion site in a blood vessel. As a result, the tissue at the obstruction site is destroyed, and it becomes possible to easily treat central retinal occlusion and branch occlusion.

[0019]

As described above, according to the laser treatment apparatus of the first aspect, laser light having a wavelength longer than 780 nanometers is used. It is possible to treat from outside. In addition, the hemoglobin does not coagulate, and a patient-friendly laser treatment apparatus can be realized.

Further, according to the laser treatment apparatus of the third aspect, since the laser beam of the holo-mume YAG can be irradiated from the inside of the blood vessel to the occluded site, the tissue at the occluded site can be reliably destroyed. A great therapeutic effect can be expected.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an ophthalmic laser treatment apparatus according to a first embodiment of the present invention.

FIG. 2 is a schematic configuration diagram of an ophthalmic laser treatment apparatus according to a second embodiment of the present invention.

3A and 3B show the tip shape of the cannula, wherein FIG. 3A shows a case where the tip is a vertical surface, and FIG. 3B shows a case where the tip is an inclined surface.

FIG. 4 is a diagram showing a state in which a cannula tip is inserted into a blood vessel together with an optical fiber.

[Explanation of symbols]

 REFERENCE SIGNS LIST 10 intraocular surgical instrument 11 gripping cylinder 12 optical fiber 13 small diameter portion 13A cannula 14 intraocular 15 illumination fiber 16 sieve plate 20 laser oscillation unit 21, 21A laser oscillation unit 22 light source unit

Claims (5)

[Claims] A laser oscillating section for oscillating a laser beam having a wavelength longer than 780 nanometers; and an optical fiber for guiding the laser beam from the laser oscillating section into an eye. An ophthalmic laser treatment device for treating a blood vessel by irradiating a treatment site of an internal blood vessel from outside the blood vessel. 2. The ophthalmic laser treatment apparatus according to claim 1, wherein the laser oscillating unit continuously oscillates a laser beam. 3. A laser oscillating unit for oscillating the laser light of the horomum YAG, and an optical fiber for guiding the laser light from the laser oscillating unit into an eye, wherein the tip of the optical fiber is inserted into an intraocular blood vessel, An ophthalmic laser treatment apparatus for treating a blood vessel by irradiating a laser beam from the tip of the optical fiber to a treatment site. 4. The ophthalmic laser treatment apparatus according to claim 3, wherein the laser oscillating section oscillates a laser beam in pulses. 5. The ophthalmic laser treatment apparatus according to claim 3, wherein at least a tip of the optical fiber is inserted into a 30-gauge cannula.