JPS59125552A - Microscope for ophthalmic operation - 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 The present invention relates to an ophthalmic surgery microscope having a function of measuring the corneal shape of an eye to be examined and a function of measuring the refractive power of the eye to be examined.

The eye forms a precise optical system, and appropriate measures are taken to restore its function in the event of any disease. Particularly when some kind of surgery on the eyeball is feared, it is important to reconstruct the function and shape of the eyeball, and recovery of the eye's refractive power is an important key factor that determines the success or failure of the surgery. In recent years, with the aging of the population, anterior segment surgery, especially cataract surgery, has become more common, but it is difficult to accurately assess changes in corneal shape due to surgery and changes in eye refractive power due to intraocular lens insertion. This is an indispensable thing. For this reason, it is necessary to constantly measure changes in the shape of the cornea and the refractive power of the eye, not only after the surgery, but also during the surgery, in order to know whether or not the restoration process is normal. Traditionally, the surgical microscopes used to perform this type of eye surgery only had the observation and photographing function during the surgery, and were unable to measure the corneal shape and refractive state of the eye during the surgery. This requires a completely different device to perform the procedure, which requires a long interruption of the surgery, requires considerable effort, and is virtually impossible to perform using a full-fledged measuring device due to the layout.

The purpose of the present invention is to provide a surgical microscope with a function of measuring the corneal shape and eye refractive power, so that if necessary, the eye can be immediately examined and the surgical condition can be checked while the surgery can be proceeded with. That is.

According to the present invention, alignment between the eye refractive power measurement system or the corneal shape measurement system of the eye to be examined and the eye to be examined can be performed by microscopic observation, and furthermore, by using the corneal reflection image of the projection index of the corneal shape measurement system. It is not necessary to specifically provide an alignment means in the eye refractive power measurement system or the eye corneal shape measurement system. The present invention will be explained in detail below.

In FIG. 1, the light from the lamp 1 used to observe the anterior segment of the subject's eye is a half mirror 2, a condenser lens 3. Prism with lens 4. The eye Ep to be examined is illuminated through the objective lens 5. The light reflected from the anterior segment of the subject's eye is passed through the objective lens 5. Relay lens groups 6 and 7 pass through beam splitters 13 and 14
．． 8, and after being reflected by the flip-up mirror 9, the fixed mirror 10
．． It is observed by the observation eye E through the eyepiece lens 11.

When photographing the anterior segment of the subject's eye, use a strobe IIS! emits light and illuminates the anterior segment of the eye through the objective lens 5, and the light from the anterior segment passes through the objective lens 5. The light passes through the beam splitters 13 and 14 and the relay lens groups 6 and 7.8, passes below the flipped-up mirror 9, and is imprinted on a film or other image recording means 12.

Here, the optical system for measuring eye refractive power will be explained.

Light from a light source 20 for measuring eye refractive power enters a condenser lens 19 and illuminates a projection chart 18. The projection chart 18 is a slit 18a, 18b having at least three directions as shown in FIG.

18c, and the light passing through each slit is passed through a projection lens 29 and an aperture stop 28.1 having a ring-shaped aperture 28a shown in FIG. Relay lens 2'l, 17. perforated mirror 1
6. Relay lens 15. Beam splitter 14, 13
, passes through the objective lens 5 to the eye E to be examined, and projects each slit light onto the fundus.

The light reflected from the fundus is returned to the objective lens 5. The relay lens 15 passes through the beam splitters 13 and 14, the hole of the perforated mirror 16, the relay lens 21.37, the aperture stop 38 having an aperture 38a as shown in FIG. 4, and the projection lens 39.
The light reception chart 22 is then reached. The light reception chart 22 is conjugate with the projection chart 18 with respect to the perforated mirror 16, and the three slits 18a, 18b of the projection chart 18,
There are three slits 22a, 22b, 22c as shown in FIG. It is detected by light receiving elements 23a, 23b, and 23c placed at the rear. The best focusing plane of each slit (at this time, the received light output is maximum) is obtained by moving the lens systems La and Lb along the optical axis.
The refractive power of the eye Ep to be examined is calculated from the amount of movement from the initial position.

Here, the refractive power of the eye to be examined corresponding to each Surin (direction) is calculated and the spherical refractive power S, astigmatism C9 and astigmatic axis angle A are calculated.Next, the corneal shape measuring optical system will be explained.Light sources 34m, 34b, ..., 344, 341 are transmitted to the corresponding light guides 33a, 33b.

..., 3at, a3t, and the light source 32a at the other end.
.

32b, . . . , 324, 32j, forming a discrete ring-shaped light source, which is projected onto the cornea of the subject's eye Ep to form a corneal reflection image. The light reflected by the cornea emerges as if from a corneal reflected image, and is imaged onto a two-dimensional surface-shaped imaging device 36 by the objective lens 5, beam splitter 13, and projection lens 35.

Here, if the light sources 32a, 32b, . . . , 32j are arranged concentrically around the objective lens 5 as shown in FIG.
The image is projected onto the - of the image sensor 36 with a distortion corresponding to the shape of the cornea of the eye Ep. The curve of the cornea is calculated from this projected image. In other words, a ring-shaped projection chart is projected onto the subject's eye, and if the subject's eye does not have astigmatism, the corneal reflection image will also be a perfect circle, but if there is astigmatism, it will become an ellipse, and if there is irregular astigmatism, distortion will be added. The shape of the corneal reflection image is determined using a solid-state image sensor, and the corneal curvature R9 astigmatism degree I) and astigmatism axis angle A are calculated from the detection results. In addition to two-dimensional CCDs, solid-state imaging devices have 3 @q one-dimensional CCDs arranged radially or in parallel, and the coordinates of the intersection with the corneal reflection image or the height or diameter from a predetermined point to the intersection are determined. It may be something that is detected. As an example of specifying the corneal reflection image, the general quadratic curve equation ax2+b
+l=o is solved to calculate coefficients a to e.

The refractive power and corneal shape of the eye to be examined determined as described above are displayed on the image display atom 24 as shown in FIG. 7, for example. The image is observed or photographed via a mirror 26 and an observation or photographing optical system.

An example of a surgical microscope having both a refractive power constant function of 1110 and a corneal shape constant function of 1111 has been given above, but within this, the following arrangements are also possible. In other words, the beam splitters 13 and 14 have spectral characteristics as shown in FIG. 8 (the horizontal axis is the wavelength table 9g, the I axis is the transmittance) and separate the wavelengths, and the characteristic 13a is used for observing or photographing the anterior segment of the eye. It is also possible to use a shorter wavelength or a longer wavelength than characteristic 13b during measurement, or use a beam splitter.
13 and 14 may be used as flip-up mirrors and moved out of the optical path except during measurement. In addition, as a means of separating light for observation photography and measurement, it is also possible to separate the light for observation and photography by changing the frequencies of the light sources. Also, the light sources 32a, 32
It is also possible to use a ring-shaped line light source instead of b, . . . , 32j, or to arrange the light emitting elements themselves.

On the other hand, it goes without saying that an image pickup tube or the like can be used as a recording means to connect to video recording. Sunao)
For example, it would be better to replace the mirror IO in FIG. 1 with a half mirror and guide the light beam passing through it to the image pickup tube. FIG. 9 shows an example of the arrangement of a light source that projects onto the cornea of the eye to be examined. When observing or photographing the eye Ep to be examined, the light source is located near the objective lens 5 or near the optical axis as shown in 41a, and the shape of the cornea is measured. In this case, it can be switched or moved away from the objective lens 5 or the optical axis as shown in 41'a. As shown in FIG. 10, this situation is explained by a plurality of light sources 41 a, , 42 a, 43 & .
, - etc. are 41'a, 42'a, 43'a,...
・Move to such a position. As a result, the parts other than those on the corneal shape side are located near the objective lens, ensuring a space between the objective lens and the eye to be examined, and facilitating ophthalmic surgery.

Note that the plurality of light sources 41a, 42a, 43a,...
The above-mentioned effect will be enhanced if the microscope is made removable and removed from the microscope optical path except for when the corneal shape side is used. Furthermore, by moving the plurality of light sources 41a, 42a, 43a', . . . , etc., the diameter of the so-called ring-shaped chart changes, making it possible to measure the shape of the cornea at various heights of the eye to be examined.

FIG. 11 shows another example of the arrangement of light sources for corneal shape measurement, in which a plurality of rows are arranged concentrically with respect to the objective lens or the optical axis. Each ring-shaped light source moves concentrically as shown in FIG.

That is, 51a is 51'a, 51b is 51'b
, ..., 52a is 52'a, 52b is 5
It can move like 2'b.

By projecting a plurality of concentric ring-shaped indicators onto the subject's eye, corneal shapes at various heights relative to the subject's eye axis can be determined. Note that, instead of moving in the direction perpendicular to the optical axis, that is, in the peripheral direction, the same effect can be achieved by moving it along the optical axis, that is, in the direction of the eye to be examined.

FIG. 13 shows an embodiment in which a corneal reflection image of a light source projected toward the cornea is used for alignment for measuring the corneal shape measurement scale Oζ ocular refractive power in order to measure the corneal shape of the eye to be examined. The corneal reflected light from the light source 32a passes through the objective lens 5 and the beam splitter 13 and is observed by the observing eye E. At this time, a position conjugate with the focal plane of the observing eye E (an alignment chart 60 is provided. This chart is When observing with the observation eye E using a ring-shaped aperture 60a as shown in FIG. 14, a chart image 60/a and a cornea of the light sources 32a, 32b, . . . , 32j are shown in FIG. 15. Reflection image 32
'a.

32'b, . . . , 32' are observed at the same time, alignment is performed by, for example, adjusting these reflected images and the chart image so that they are concentric.

FIG. 16 shows the optical arrangement of each functional part of a surgical microscope that has the functions of illumination, observation photography, refractive power measurement, and corneal shape measurement. Pa is illumination, Pb is observation photography, Pc
indicates refractive power measurement, and Pd indicates corneal topography measurement system. Here, 14 and 14' are beam splitters, which may simply split a light beam or split based on wavelength.

It may also be a flip-up mirror.

FIG. 17 shows which part of the light beam K is used for each function, and Pa-pd is based on the above classification. Again, prism 41. The beam splitter 14 may be replaced with a mirror, a wavelength division mirror, or the like.

FIGS. 18(A) and 18(B) show how to take the luminous flux with respect to the objective lens 5 in other division examples. Note that other combinations may also be used.

FIG. 19 shows an example in which refractive power measurement and corneal shape measurement are placed in front of the objective 2 lens, and a combination with the above-mentioned FIGS. 16, 17, and 18 (human) to (E) is also possible.

What is shown in FIGS. 20 and 21 is an embodiment in which the index for corneal shape measurement is removable, and each ring index t.

~ta is the lamp 79a, 79b,..., 79i, 79j
This is a removable unit 80 that is removably arranged in an objective lens frame 81.

As explained above, according to the present invention, by adding the corneal shape measurement function and the refractive power measurement function, it is possible to easily observe the progress and condition of the surgery even during the surgery, so that the progress and condition of the surgery can be accurately observed. It is possible to judge whether the device is good or bad, and this can be reflected in the surgery.

[Brief explanation of the drawing]

FIG. 1 is a diagram of an actual case of the present invention. FIG. 2 is a diagram of a projection chart of the eye refraction measurement system. Figure 3 5. Figure 4 shows the light emitting side of each eye refraction measurement system. Diagram of the aperture stop on the light receiving side. FIG. 5 is a diagram of a light reception chart of the eye refraction measurement system. FIG. 6 is a diagram showing the arrangement of the light source of the corneal topography measurement system. FIG. 7 is an explanatory diagram of an image display element that displays measurement data of refractive power and corneal nozzle. FIG. 8 is a diagram of spectral transmittance characteristics when the observation and photographing optical system and the measurement optical system are separated by wavelength. FIGS. 9 and 10 are diagrams of an embodiment in which the light source of the corneal shape measurement system is movable. FIGS. 11 and 12 are diagrams of an embodiment in which light sources of a corneal topography measurement system are arranged in multiple rows and made movable. FIG. 13 is a diagram of an embodiment in which a corneal reflection image from a light source for measuring corneal shape is used for alignment. FIG. 14 is a diagram of a ring-shaped chart provided in the observation optical path of @microscope and serving as a reference for alignment. FIG. 15 is an explanatory diagram of how to take the corneal reflection image, the phosphor path for alignment, the light emitting light path for eye refraction measurement, and the light receiving light path. Figures 20 and 21 show the shape of the cornea. La and Lb are lens systems. Company rules 1 is a lamp for observing the anterior segment of the eye, 4 is a lens and prism, 5 is an objective lens, 9 is a flip-up mirror, 11 is an eyepiece, 12 is an image recording means, 18 is a projection for measuring anti-refractive power chart. 18a, 18b, and 18c are slits, 20 is a light source for measuring eye refractive power, and 24 is an image display element. 28. 38 is the aperture stop, 22 is the light reception chart. 23a, 23b, 23c are light receiving elements, 32a, 32b,
... 132j is a light source for corneal shape measurement, 36 is a solid-state image sensor, 60 is a chart remover for alignment, and 80 is a ttK unit. Out M person Canon Co., Ltd.

Claims (1)

[Scope of Claims] 1. Means for illuminating eye #J of eye to be examined, and means for observing or magnifying the illuminated anterior eye of eye to be examined. means for projecting a first index light beam onto the fundus of the eye to be examined and receiving reflected light of the index light beam from the fundus of the eye to be examined to measure eye refractive power; An ophthalmic surgical microscope characterized by having means for projecting a second index light beam onto the cornea of an eye to be examined, and receiving corneal reflected light of the index light beam to measure the corneal shape. 2. The scope of the patent claims, wherein the first projection index position and the fundus reflected light receiving position are moved relative to the fundus of the eye to be examined, and the amount of movement until they become mutually conjugate positions is detected to measure the eye refractive power. The ophthalmic surgery microscope according to item 1. 3. For ophthalmic surgery according to claim 1, which measures the corneal shape by projecting a corneal reflection image onto an image sensor and detecting the coordinates of the intersection or the height or diameter from a predetermined point to the intersection. microscope. 4. The ophthalmic surgical microscope according to claim 2, wherein the first indicator has slits in at least three directions. 5. The ophthalmic surgery microscope according to claim 3, wherein a corneal reflection image is detected by at least three one-dimensional image pickup devices. 6. The ophthalmic surgery microscope according to claim 1, which is provided with an image display means for displaying eye refractive power measurement data and corneal shape measurement data, and is configured to observe or photograph the measurement data together with the anterior segment of the eye to be examined. 7. The ophthalmic surgery microscope according to claim 6, which is equipped with an imaging tube and is capable of video observation and recording. 8. The ophthalmic surgical microscope according to claim 1, wherein the second indicator is movable in the peripheral direction or in the optical axis direction with respect to the optical axis for observing or photographing the anterior segment of the eye to be examined. 9. The ophthalmic surgery microscope according to claim 1, further comprising an alignment chart in the observation optical path for performing alignment with the corneal reflection image obtained by the second index.