KR20190012467A - Apparatus for ophthalmic laser treatment - Google Patents

Abstract

The present invention relates to an ophthalmic laser treatment apparatus. The present invention provides an ophthalmic laser treatment apparatus comprising: an insertion member including an image acquisition unit for securing an image therein and a treatment light irradiation unit for irradiating a treatment laser beam; and a fixing member fixed at a position adjacent to cornea and fixing a part of the insertion member at a position adjacent to the surface of the cornea. According to the present invention, since the treatment can be performed while confirming the state of the waterproof drainage flow path of a patient through the image unit, minimum treatment for an optimal position can be performed.

Description

[0001] APPARATUS FOR OPHTHALMIC LASER TREATMENT [0002]

The present invention relates to an ophthalmic laser treatment apparatus, and more particularly, to an ophthalmic laser treatment apparatus which is inserted into the cornea of an eyeball and irradiates a treatment position with a laser to treat a lesion.

The front of the eye is filled with liquid called waterproof. This liquid is produced by a ciliary body positioned adjacent to the lens. The liquid is drained to the lens site through the trabecular meshwork into the scleral sinus, also known as Schlemm's Canal. If the structural deformation of the trabecular meshwork or the debris of the tissue is not smoothly discharged through the fiber strands, the intraocular pressure may rise and the optic nerve may be damaged, which is called glaucoma.

Treatment of glaucoma is accomplished by expanding the channel of the trabecular meshwork to smooth the flow of waterproof or to reduce the production of waterproofing by the ciliary body. Such treatment is usually done by a drug treatment method. Recently, an apparatus for forming a water discharge flow path by irradiating a laser in a fiber main direction through an eyepiece equipped with a reflector as a non-invasive treatment method has been introduced. However, a non-invasive method can not secure a clear image of a trapezoidal band, It is difficult to perform precise treatment according to the state of the treatment position.

The present invention provides an ophthalmic laser treatment apparatus capable of ensuring a clear image of a trabecular meshwork in the eye and performing optimal treatment based on an image.

In order to attain the above object, the present invention provides an imaging apparatus including an insertion member including an image acquisition unit for securing an image therein and a treatment light irradiation unit for irradiating a treatment laser, and an insertion member fixedly installed at a position adjacent to the cornea, And a fixing member for fixing a position of a part of the insertion portion at a position adjacent to the surface of the insertion portion.

Here, the insertion member includes an insertion portion inserted into the cornea and a manipulation portion disposed at a proximal end side of the insertion portion to manipulate the bending operation of the insertion portion, and the end portion of the insertion portion includes a bending portion configured to bend, .

The therapeutic light irradiated from the therapeutic light irradiating unit is irradiated from the longitudinal direction of the therapeutic light irradiating unit to the side of the image obtaining unit in a direction inclined to the side of the image obtaining unit Can be investigated.

Alternatively, the image acquiring unit may include an image guide disposed at the center and a plurality of illumination light guides disposed along the periphery of the image guide unit, wherein the treatment light irradiation unit is disposed around the image guide, To form an annular shape.

Alternatively, the image acquiring unit and the treatment light guide may be constituted by a single module, and the image acquiring unit may include an image guide disposed at the center, and the treatment light irradiating unit may be disposed in an annular shape along the periphery of the image guide And the illumination light and the treatment laser for image acquisition are irradiated through the plurality of fibers.

According to the present invention, since the treatment can be performed while confirming the state of the patient's water discharging drainage channel through the image unit, there is an advantage that the minimum treatment for the optimal position can be performed.

1 is a sectional view showing a state of glaucoma treatment using an ophthalmic laser treatment apparatus according to a first embodiment of the present invention,
FIG. 2 is a plan view of the treatment of FIG. 1,
Fig. 3 is a plan view showing the insertion member of Fig. 1,
Fig. 4 is a cross-sectional view showing the insertion portion of Fig. 3,
Fig. 5 is a cross-sectional view showing an image obtaining section of Fig. 4,
Fig. 6 is a cross-sectional view showing the end of the insertion portion of Fig. 3,
7 is a cross-sectional view showing a cross section of the insertion portion according to the second embodiment,
8 is a cross-sectional view of the fiber module of FIG. 6,
9 is a block diagram schematically showing a light source connection structure of the ophthalmic treatment device according to the third embodiment.

Hereinafter, an ophthalmic laser treatment apparatus according to an embodiment of the present invention will be described in detail with reference to the drawings. In the following description, the positional relationship of each component is principally described based on the drawings. The drawings may be simplified for simplicity of the description or exaggerated when necessary. Therefore, the present invention is not limited thereto, and it is needless to say that various devices may be added, changed or omitted.

In the following embodiments, the ophthalmic laser treatment apparatus used for glaucoma treatment is mainly described. However, the present invention is not limited thereto. The present invention is applicable to an ophthalmic laser treatment apparatus which is inserted into the inside of the eye to treat various lesions .

FIG. 1 is a sectional view showing a glaucoma treatment using an ophthalmic laser treatment apparatus according to a first embodiment of the present invention, and FIG. 2 is a plan view showing a treatment state of FIG. 1 in a front view. As shown in Fig. 1, the ophthalmic laser treatment apparatus according to the present invention comprises an insertion member 10 and a fixing member 20.

Here, the insertion member 10 is inserted into the anterior chamber of the eye through the incision site of the cornea. The insertion member 10 is a configuration capable of acquiring an image of an end portion and irradiating a therapeutic laser through the end portion. Therefore, the user can proceed to the treatment by irradiating the laser to the treatment position while confirming the image of the treatment position.

The fixing member 20 fixes the position of the insertion member 10 at a portion of the cornea C that enters the incision site during the procedure. Therefore, the risk of damage to the cornea due to curved operation of the insertion member or carelessness of the user can be minimized. The fixing member 20 includes a body 21 and a fixing unit 22 connected to the body. The body 21 can be fixed without relative movement with the cornea in a state in which the bottom surface is in contact with the cornea, so that the relative position of the fixation member 20 and the eyeball can be kept constant. The bottom surface of the body can be fixed to the cornea in a suction manner, or the bottom surface of the body can be formed of a material having a high friction coefficient, and the user can maintain the position of the body by pressing in the vertical direction. On the other hand, the fixing unit 22 is formed on one side of the body to fix a part of the insertion portion 110 of the insertion member 10. At this time, the fixing unit may be configured to allow the insertion portion to be partially moved in the insertion direction so as to adjust the insertion length of the insertion portion, but to restrict movement in the horizontal direction with respect to the cornea surface. It is also possible that at least three fixed units are provided along the edge of the body so that the insertion unit can be fixed even when the insertion member is inserted through the corneal incision site on the opposite side in a state where the body is fixed. The fixed unit may be constructed using various structures that can fix the position of the duct among the gauge module and the clamp module.

In this ophthalmic laser treatment apparatus, the insertion portion 110 of the insertion member 10 is inserted through the position where the cornea C is incised. Then, the fixing member 20 maintains the position adjacent to the incision portion of the cornea, and fixes the insertion member 10. The end of the insertion member 10 is inserted up to a position adjacent to the fiber main body TM structure constituting the waterproof discharge passage of the eyeball. The state of the tissue is photographed as an image, You can proceed. As described above, the ophthalmic treatment apparatus according to the present embodiment can obtain a clear image of each treatment position to diagnose the condition of the patient, and can selectively treat only the part required for treatment, thereby enabling precise treatment It is possible to minimize the damage to tissues in which treatment is not necessary.

Hereinafter, the insertion member according to the present embodiment will be described in detail with reference to Figs. 3 to 6. Fig. Fig. 3 is a plan view showing the insertion member of Fig. 1, and Fig. 4 is a cross-sectional view showing a cross section of the insertion portion of Fig.

3, the insertion member 10 is configured to include a catheter 100 and an image acquisition unit 200 and a treatment light irradiation unit 300 inserted into the catheter. The catheter 100 includes an insertion portion 110 formed of a soft material inserted into an eyeball and a manipulation portion 120 provided on a base end side of the insertion portion and allowing a user to manipulate the operation of the insertion portion.

4, the insertion unit 110 includes a plurality of channels 111 in which an image acquisition unit 200, a treatment light irradiation unit 300, and an operation wire 112 are installed. The image acquisition unit 200, the treatment light irradiation unit 300, and the wire 112 are accommodated in the respective channels 111. The distal end of the wire 112 is fixed to the end of the insertion portion, and the proximal end of the wire 112 is provided to the operation portion 120. Accordingly, as the user operates the operation unit 120, the wire 112 is moved in the horizontal direction so that the end of the insertion unit 110 can be bent. At this time, the portion passing through the cornea and the portion outside the cornea are not bent, and only the portion inserted into the cornea can be bent. In the present embodiment, it is preferable that the bending portion 113 where the bending is generated by the operation of the operation portion of the insertion portion is 2 cm or less at the end of the insertion portion. As described above, when the insertion member 10 is fixed to the fixing member 20 in such a manner that the end portion of the insertion portion is rotatable, it is preferable to photograph and treat a predetermined range of the annular shape of the fiber- (See FIG. 2). However, the detailed structure of the wire and the bending portion can be easily configured using the curved structure of the conventional endoscope.

The image obtaining unit 200 is composed of a fiber endoscope having a small-diameter structure, and the treatment light irradiating unit 300 is composed of an optical fiber structure capable of delivering the laser to the treatment position, and each is inserted into the channel of the insertion unit. The base end of the image obtaining unit 200 may be connected to an illumination light source (not shown) and an image processing unit (not shown), respectively, so as to acquire an image of the end and display it to the user. The base end of the treatment light irradiation unit 300 is connected to a treatment light laser light source (not shown), and the treatment can be performed by irradiating the treatment light to the treatment spot.

5 is a cross-sectional view showing a section of the image acquiring unit of FIG. 5, an image acquisition unit 200 according to the present invention includes an illumination light guide 210 for transmitting illumination light, a light guide 210 disposed in a circumferential shape along an edge thereof, an image guide 220 for acquiring image information of a treatment position ) Is located at the center. At this time, the illumination light guide 210 and the image guide are each composed of ultra-small diameter optical fibers, and the diameter of the image obtaining unit 200 may be 1 mm or less. By minimizing the size of the image acquisition unit compared to the conventional one, it is possible to configure the diameter of the insertion unit to be 5 mm or less, thereby making it possible to perform treatment with minimized corneal incision.

Fig. 6 is a cross-sectional view showing a cross section of an end portion of the insertion portion of Fig. 3; The ophthalmic laser treatment apparatus according to the present embodiment acquires an image and carries out the treatment (for example, 5 mm or less from the surface of the fiber main body tissue) in the state adjacent to the fiber base (TM) at the treatment position. Accordingly, if the image acquisition unit 200 and the treatment light irradiation unit 300 are provided in separate channels, the position of the tissue shown in the image may be different from the position where the treatment light is irradiated. Therefore, in the present embodiment, the treatment light can be irradiated at an inclined angle to the image acquiring unit side in the longitudinal direction of the insertion unit 110, so that the treatment light can be accurately irradiated to the tissue position shown in the image. In this embodiment, the end of the channel into which the treatment light irradiating unit 300 is inserted is configured to be inclined in the direction of the image obtaining unit 200, so that the treatment light is irradiated in a direction deviated in one direction from the end of the insertion unit . However, this is merely an example, and the end portion of the treatment light irradiation part itself may form an inclined structure. In addition, various structures may be applied to irradiate the treatment light to the tissue shown in the image.

Hereinafter, some embodiments of various structures configured to irradiate the treatment light to the position of the tissue shown in the image will be described.

FIG. 7 is a cross-sectional view showing a cross section of the insertion portion according to the second embodiment, and FIG. 8 is a cross-sectional view showing the fiber module of FIG. In the first embodiment, the image acquisition unit and the treatment light irradiation unit 300 are configured as separate members and are inserted into separate channels, respectively. However, in the present embodiment, the image acquisition unit and the treatment light irradiation unit may include one fiber module (400). Therefore, as shown in FIG. 7, the size of the insertion portion can be further reduced by providing only one channel, except for the channel in which the operation wire is disposed.

As shown in FIG. 8, an image guide 220 is disposed at the center of the fiber module 400, as in FIG. The illumination light guide 210 is disposed in a circumferential shape along the periphery of the image guide 220. However, some of the guides may be configured to be optically connected to the therapeutic light laser light source other than the illumination light source, and configured to irradiate the therapeutic laser. In this case, since the treatment light irradiation unit 300 irradiated with the treatment light is disposed at a position very close to the illumination light guide 210 and the image guide 220 for acquiring an image, It is possible to do.

9 is a block diagram schematically showing a light source connection structure of the ophthalmic treatment device according to the third embodiment. In the above-described first and second embodiments, the illumination light guide forming the path through which the illumination light travels and the treatment light irradiation unit forming the path through which the treatment light travels are constituted by separate members. In contrast, in the present embodiment, it is possible to configure the illumination light and the treatment light to proceed along the same path.

The treatment laser generated in the treatment laser light source 30 and the illumination light source generated in the illumination light source 40 proceed along the same path by an optical element such as a reflection mirror or a beam splitter Lt; / RTI > 5, the optical fiber module according to the present embodiment includes a center image guide 220, a plurality of optical fibers 210 arranged in the circumferential direction along the periphery of the image guide, The illumination light and the treatment light laser are irradiated through the plurality of optical fibers arranged in the direction of the optical axis. At this time, it is also possible that the treatment light and the illumination light source transmit the respective lights at the same time, so that the treatment and the image taking can be performed at the same time, and the control using the optical element such as the shutter is performed so that the treatment laser and the illumination light are alternatively incident It is possible. In this case, since the therapeutic laser is irradiated through the same path as the illumination light, it is possible to irradiate the laser accurately to the tissue position shown in the image.

In the foregoing, an ophthalmic laser treatment apparatus including an insertion member having a structure in which an optical module is inserted and disposed in a catheter has been described. However, in the case of the second embodiment and the third embodiment, it is also possible to construct the ophthalmic treatment device by inserting the optical fiber module directly without a separate catheter.

Although the embodiments of the present invention have been described in detail, the present invention is not limited to the above embodiments. It will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the scope of the present invention as defined by the appended claims. Leave.

Claims (5)

An insertion member including an image acquisition unit for securing an image therein and a treatment light irradiation unit for irradiating a treatment laser; And
And a fixing member fixed at a position adjacent to the cornea and fixing a position of a portion of the insertion portion at a position adjacent to the surface of the cornea. The method according to claim 1,
The insertion member includes an insertion portion inserted into the cornea and a manipulation portion disposed on a base end side of the insertion portion to manipulate the bending operation of the insertion portion,
And an end of the insertion portion includes a bending portion configured to be bent. The method according to claim 1,
Wherein the image acquisition unit and the treatment light irradiation unit are disposed in separate channels of the insertion member,
Wherein the treatment light irradiated from the treatment light irradiation part is irradiated in a direction inclined from the longitudinal direction of the treatment light irradiation part to the side of the image acquisition part. The method according to claim 1,
Wherein the image acquiring unit includes an image guide disposed at the center and a plurality of illumination light guides disposed along the periphery of the image guide unit,
Wherein the treatment light irradiation unit is disposed around the image guide and is configured to form an annular shape together with the plurality of illumination light guides. The method according to claim 1,
Wherein the image acquiring unit and the treatment light guide are constituted by one module, the image acquiring unit includes an image guide disposed at the center, and the treatment light irradiating unit includes a plurality Wherein the illumination light and the treatment laser for image acquisition are irradiated through the plurality of fibers.

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