TW202214186A - Laser ophthalmological apparatus - Google Patents

Abstract

An ophthalmic laser apparatus includes: a laser light source; a light guide device, configured to guide a laser beam generated from the laser light source; a support bracket, configured to support a patient's head for the patient's eye to be perpendicular to a horizontal plane; a positioning device, configured to position a position of the patient's eye; a laser beam projector, the laser beam projector being movable to be aligned with the patient's eye and projecting the laser beam from the light guide device; a moving stand, configured to move the positioning device and the laser beam projector along an X direction, a Y direction, and/or a Z direction; and a controller, configured to control the laser light source to irradiate the laser beam and to control the laser beam projector to project the laser beam toward the patient's eye.

Description

Laser Ophthalmology Equipment

The present invention relates to a laser ophthalmology device

In the structure of the eye, about two-thirds of the refractive power is determined by the curvature of the anterior surface of the cornea, therefore, the refractive error of the eye can be significantly improved or eliminated by changing the shape of the cornea. The cornea is a multi-layered constructed film, the anterior and posterior surfaces of which are nearly concentric, and have a central thickness of about 0.5 to 0.6 millimeters, and a peripheral thickness of about 0.6 to 0.8 millimeters. The multi-layered structure of the cornea consists of Epithelium, Bowman, Stroma, Descemet, and Endothelium in order from the anterior surface to the posterior surface. The central thickness of the epithelial cell layer is about 70 μm, and the thickness of the proelastic layer is about 12 μm. The thickness of the stromal layer accounts for about 90% of the total thickness of the cornea (about 500 μm), and is mainly composed of regularly arranged collagen fibers and interconnected corneal cells. The endothelial cell layer consists of a layer of hexagonal flat cells.

Based on the corneal architecture described above, since the stromal layer of the cornea has sufficient thickness, for corrective purposes, the anterior portion of the stromal layer can be resected to change its contour, thereby changing the power of the eye, while preserving most of the stromal tissue.

Various lasers are widely used in ophthalmic surgery, such as glaucoma, cataract, refractive surgery, etc. For example, ultraviolet (UV) lasers are used in refractive surgery (or corneal reshaping), where examples of UV lasers include 193 nm excimer lasers, fifth harmonic (213 nm) neodymium lasers (Neodymium-Yttrium Aluminum Garnet; Nd-YAG laser), etc. Specifically, these UV lasers are widely used in laser photorefractive keratectomy (PRK), excimer laser in situ lamellar orthokeratology (LASIK), etc., all of which utilize laser light ablation Corneal tissue to change its curvature, thereby achieving the effect of changing the eye's refraction (corrected vision).

The laser ophthalmic devices currently on the market for performing LASIK all have a similar design, in which the optical axis of the patient's eye is aligned with the laser beam by moving the patient's operating table. Specifically, the patient will lie on an operating table that is precisely movable along the XYZ axes, by which the patient (ie, the surface of his cornea) is moved until the surface of the cornea reaches the surface of the laser ophthalmology device. the focus point of the microscope, and then set the laser beam transmission path. In the laser ophthalmology equipment, because the main cabinet with the laser light source is quite bulky and inconvenient to move, the laser beam is usually transmitted through the optical system, so that the laser beam is turned under the microscope after passing through the optical system. Downward orientation to align the optical axis of the microscope. During the use of this laser ophthalmic equipment, in order to align the visual axis of the patient's eyes with the laser beam, it is necessary to constantly move the operating table where the patient is located. It is inconvenient for operators (eg, doctors or surgical assistants) to use.

On the other hand, in ophthalmic surgery known to use lasers, the patient first undergoes a series of pre-operative related examinations in a sitting position, and then moves to an operating table and undergoes ophthalmic surgery in a lying position. In such a case, various parameters of the patient's eyes may be slightly different in the sitting and lying positions, for example, the astigmatism angle is different due to the different rotation angles of the eyeballs in the sitting and lying positions. The existence of this difference can make the operation performed during surgery inaccurate, which can be a serious problem for surgery that requires high precision.

An object of the present invention is to provide a laser ophthalmology device that enables a patient to receive a laser beam from the laser ophthalmology device in a sitting position and thereby perform laser eye surgery, and the alignment between the laser ophthalmology device and the patient's eyes The calibration is performed by moving the laser ophthalmic device without the need to move the patient's position relative to the laser ophthalmic device.

The laser ophthalmic equipment provided according to the present invention includes a laser light source configured to generate a laser beam; a light guide device configured to guide the laser beam generated from the laser light source; a support bracket configured to support the patient's head so that the exposed surface of the eye is perpendicular to the horizontal plane; the positioning device configured to locate the position of the patient's eye supported on the support bracket; the laser scanning applicator, which is based on the positioning results of the positioning device and is moved to align the patient's eye supported on the support bracket and apply the laser beam from the light guide to the patient's eye; the moving table, the positioning device and the laser scanning applicator are arranged on this moving table and the mobile station is configured to move the positioning device and the laser scanning applicator along the X direction, the Y direction and/or the Z direction; and a controller configured to control the laser light source to emit a laser beam, and to control the laser beam A laser scanning applicator is used to apply a laser beam to the patient's eye.

With the above-mentioned laser ophthalmic apparatus of the present invention, since the support bracket is configured to keep the exposed surface of the patient's eyes perpendicular to the horizontal plane, the patient can receive the laser beam from the laser in the sitting posture in addition to receiving the relevant examination before the operation in the sitting posture. Scanning the laser beam applied by the applicator for laser eye surgery. As a result, the condition of the patient's eye does not vary much when undergoing relevant tests before surgery and when the laser beam is applied for laser eye surgery, allowing for more precise laser eye surgery operations and is therefore particularly suitable for various laser eye surgeries requiring high precision.

On the other hand, with the above-mentioned laser-ophthalmic device of the present invention, the alignment between the patient's eye and the laser-ophthalmic device is performed by moving the laser-ophthalmic device without moving relative to the laser-ophthalmic device. The position of the patient (ie, there is no need to repeatedly move the operating table on which the patient lies), the laser ophthalmic device according to the present invention is more convenient to operate and use.

The first to third figures show a laser ophthalmic apparatus 1 according to an embodiment of the present invention. The first figure is a three-dimensional schematic diagram of a laser ophthalmic device 1 according to an embodiment of the present invention. The X direction and the Y direction in the figure are two directions perpendicular to each other on the horizontal plane, and the Z direction is the direction perpendicular to the horizontal plane. It is a schematic top view of the laser ophthalmic device 1 according to the embodiment of the present invention (some components are omitted in the drawings), and the third figure is a block schematic diagram of the laser ophthalmic device 1 according to the embodiment of the present invention.

The laser ophthalmic equipment 1 according to the present invention includes a laser light source 2 , a light guide device 3 having a light guide module 30 and a light guide arm 31 , a support bracket 4 , a mobile table 7 , and a positioning device disposed on the mobile table 7 . 5 and the laser scanning applicator 6 , and the controller 8 .

The laser light source 2 is configured to generate a laser beam L, eg, an excimer laser beam, by means of which laser eye surgery, eg, LASIK surgery, can be performed on the patient's eye E.

The light guide module 30 and the light guide arm 31 of the light guide device 3 are configured together to guide the laser beam generated from the laser light source 2 to the laser scanning applicator 6 and then towards the patient's eye E march.

The support bracket 4 is configured to support the patient's head such that the exposed surface of the patient's eyes E is perpendicular to the horizontal plane. In other words, the patient is in a sitting position to undergo laser eye surgery by the laser beam L from the laser scanning applicator 6, as shown in the fifth figure. Preferably, the support bracket 4 is configured such that its height can be adjusted along the Z direction to meet the needs of different patients.

The moving stage 7 is configured to move the positioning device 5 and the laser scanning applicator 6 provided thereon in the X direction, the Y direction and/or the Z direction.

By this moving the table 7, the positioning device 5 can be moved to position the position of the patient's eye E supported on the support bracket 4, eg, the position of the patient's left or right eye. In the embodiment of the present invention, the positioning device 5 is a camera, and is configured to move along the X direction, the Y direction and/or the Z direction by manually operating the mobile stage 7 by the user, but it is not limited thereto. For example, according to the precision requirements of different operations, the positioning device 5 may also be a microscope, and the moving stage 7 may be an electric moving stage, which can make the positioning device move electrically under the control of the controller.

Likewise, by this moving stage 7, the laser scanning applicator 6 can be moved based on the positioning result of the positioning device 5 to be aligned with the patient's eye E (eg, the patient's left eye) supported on the support bracket 4 or right eye), this positioning may be referred to as a coarse positioning of the laser scanning applicator 6 .

It should be noted that, in the laser ophthalmic device 1 according to the present invention, the laser scanning applicator 6 preferably further includes an eye tracking system 9 and a fine-tuning device 10, and the eye tracking system 9 can reposition (track) the patient's eyes The position of E, and the fine-tuning device 10 can fine-tune the position of the laser scanning applicator 6 according to the repositioning result of the eye tracking system 9 to make it more accurately aligned with the patient's eye E, this positioning can be referred to as a laser scanning applicator 6 fine positioning. Next, the laser beam L from the light guiding device 3 is applied to the patient's eye E via the laser scanning applicator 6 for laser eye surgery, eg LASIK surgery.

The movement of the positioning device 5 and the laser scanning applicator 6 relative to the patient's eye E will be described in further detail below, and will not be repeated here.

Preferably, the laser ophthalmic device 1 according to the present invention further comprises a focusing mirror 20, which is arranged on the side of the laser scanning applicator 6 facing the patient's eye E, so that the laser scanning applicator 6 faces the patient's eye E. The laser beam L applied by the eye E can be focused at the target position of the eye E of the patient.

The controller 8 is configured to control various components of the laser ophthalmic apparatus 1 . Specifically, the controller 8 may control the laser light source 2 to emit a laser beam L, and control the laser scanning applicator 6 to apply the laser beam L to the eye E of the patient.

Besides, the laser ophthalmic device 1 further includes a cabinet 100 and an operation platform 200 . The laser light source 2 , the light guide module 30 of the light guide device 3 , and the controller 8 are arranged in the cabinet 100 , and the support bracket 4 , the mobile stage 7 , and the positioning device 5 and the laser are arranged on the mobile stage 7 . The scanning applicator 6 is disposed on the operating platform 200 . The light guide arm 31 is connected between the light guide module 30 in the cabinet 100 and the laser scanning applicator 6 on the operation platform 200 . In other words, the cabinet 100 and the operation platform 200 are connected to each other by the light guide arm 31 which connects the light guide module 30 in the cabinet 100 and the laser scanning applicator 6 on the operation platform 200 .

In order to easily adjust the position of the laser ophthalmic device 1 to better meet the needs of the operator, the cabinet 100 and the operation platform 200 are both designed to be movable on the ground. For example, the cabinet 100 and the operation platform 200 are respectively provided with their own wheels. for easy movement on the ground. On the other hand, the maximum length (or width) of the cabinet 100 is only 70 cm, and it is more advantageous for the transportation of the laser ophthalmic device 1 according to the present invention to be able to enter most elevators smoothly.

The fourth A and the fourth B show schematic diagrams of the positioning device 5 and the laser scanning applicator 6 of the laser ophthalmic apparatus 1 moving relative to the patient's eye E according to an embodiment of the present invention.

As shown in FIG. 4A, after the patient's head (eye E) has been supported on the support bracket 4, the operator first moves the positioning device 5 by operating the moving table 7 to position the position supported on the support bracket 4. The position of the patient's eye E (eg, left or right eye) on the rack 4 . Next, after the positioning device 5 has positioned the position of the patient's eye E, based on the positioning result of the positioning device 5 , the operator moves the laser scanning applicator 6 to a position aligned with the patient's eye E by operating the mobile stage 7 (coarse positioning), as shown in the fourth figure B. After the laser scanning applicator 6 has been moved to a position aligned with the patient's eye E by the operation of the mobile station 7, the eye tracking system 9 of the laser scanning applicator 6 will relocate the position of the patient's eye E , and according to the repositioning result of the eye tracking system 9 , the position of the laser scanning applicator 6 is fine-tuned by the fine-tuning device 10 to make it more precisely aligned with the patient's eye E (fine positioning).

After the above-mentioned coarse positioning and fine positioning, the laser scanning applicator 6 and the patient's eye E have been accurately aligned, and in this state, the laser scanning applicator 6 can apply laser to the patient's eye E bundle L.

It should be noted that during the process that the laser scanning applicator 6 is moved to be aligned with the patient's eye E based on the positioning result of the positioning device 5, the positioning device 5 is still continuously positioning the position of the patient's eye E and the laser. The location of the applicator 6 is scanned.

Referring back to the first and third figures, the laser ophthalmic device 1 according to the present invention further includes a user interface 300 and a switch 400 interconnected with the controller 8 . After the laser scanning applicator 6 has been moved to a position precisely aligned with the eye E by operating the mobile stage 7, and by the fine-tuning device 10 of the laser scanning applicator 6, the operator can use the user interface 300 inputs operating parameters of the laser ophthalmic apparatus 1 (eg, operating parameters required to perform laser ophthalmic surgery) to the controller 8, and operates the switch 400 to issue commands, which are communicated to the laser light source 2 through the controller 8 , so that the laser light source 2 emits a corresponding laser beam L according to the operating parameters input through the user interface 300 , and the laser beam L is transmitted to the laser scanning applicator 6 through the light guide module 30 and the light guide arm 31 . , and is then applied to the patient's eye E.

In an embodiment according to the present invention, as shown in the first figure, the user interface 300 includes a screen and a keyboard for the user to input operating parameters and monitor the operation of the laser ophthalmic apparatus 1 , eg, the laser scanning applicator 6 The coarse positioning and fine positioning results, etc. In addition, as shown in the first figure, the switch 400 is preferably a foot switch, and the user can use the foot switch after operating the mobile platform 7 to move the laser scanning applicator 6 to the patient's eye E. The foot switch is operated to issue a command to emit the laser beam L emitted by the laser light source 2 through the light guide module 30 , the light guide arm 31 and the laser scanning applicator 6 toward the patient's eye E. However, those skilled in the art should understand that the present invention is not limited to the above-mentioned types of user interfaces 300 and switches 400, and other types of user interfaces and switches can also be used, as long as the above-mentioned functions can be achieved .

FIG. 5 shows a partial schematic diagram of the use state of the laser ophthalmic device 1 according to the embodiment of the present invention. It can clearly be seen in the fifth figure that the patient's head is supported on the support bracket 4 so that the exposed surface of his eye E is perpendicular to the horizontal plane (XY plane), and that the laser scanning applicator 6 has been positioned by The device 5 and its own fine-tuning device 10 are precisely aligned with the patient's eye E, in which state the patient's eye E can receive the laser beam L from the laser scanning applicator 6, thereby performing laser ophthalmology Operation. In other words, as shown in FIG. 5 , the patient underwent laser eye surgery in a sitting position.

In summary, with the laser ophthalmic apparatus 1 of the present invention, since the support bracket 4 is configured to keep the exposed surface of the patient's eye E perpendicular to the horizontal plane (XY plane), that is, the patient is kept in a sitting position, Therefore, the patient can receive the laser beam L applied from the laser scanning applicator 6 in the sitting position in addition to receiving the relevant examination before the operation in the sitting position, so as to perform the laser eye surgery. In such a state, there is not much difference in the state of the patient's eyes (eg, the rotation angle of the eye, etc.) when undergoing a relevant examination before surgery and when a laser beam is applied for laser eye surgery , enabling more precise laser eye surgery operations. Therefore, the laser ophthalmic device 1 according to the present invention can complete the laser eye surgery under more precise conditions, and is particularly suitable for various laser eye surgery requiring high precision.

Besides, with the above-mentioned laser ophthalmic apparatus 1 of the present invention, the alignment between the patient's eye E and the laser ophthalmic apparatus 1 is performed by moving the laser scanning applicator 6 of the laser ophthalmic apparatus 1 , rather than moving the patient relative to the laser ophthalmic device 1 to align. Therefore, the operator (ie, the doctor or the surgical assistant) does not need to move the operating table where the patient is located repeatedly during the operation, but only needs to move the laser scanning applicator 6 to the position with the patient by operating the moving table 7 . The position where the eye E is aligned is sufficient. Therefore, the laser ophthalmic device 1 according to the present invention is more convenient in operation and use.

On the other hand, there are psychological implications for patients undergoing laser eye surgery in a sitting or lying position. In particular, compared to the psychological stress when the patient conventionally undergoes ophthalmic surgery in a lying position on the operating table, since the laser ophthalmic apparatus 1 according to the present invention enables the patient to undergo ophthalmic surgery in the same sitting posture as when examining the eyes Surgery, the psychological pressure caused to the patient is relatively small. In other words, with the laser ophthalmic apparatus 1 according to the present invention, the patient can also undergo ophthalmic surgery in a more relaxed state of mind.

The drawings of the embodiments described herein are intended to provide an understanding of the invention. In other words, the drawings are representative only and may not be drawn to scale. Some scales in the drawings may be exaggerated, while other scales may be reduced. Accordingly, the drawings are to be regarded as illustrative rather than restrictive.

Although various embodiments of the present invention have been described in the above-mentioned embodiments with reference to the accompanying drawings, the above-mentioned embodiments are only preferred embodiments of the present invention, and are not intended to limit the present invention to the above-mentioned descriptions and those shown in the accompanying drawings. features and structure shown. It should be understood that various other omissions, substitutions, changes and modifications that can be conceived by those skilled in the art without departing from the scope of the invention are also included within the scope of the invention.

1: Laser ophthalmic equipment 2: Laser light source 3: Light guide device 4: Support bracket 5: Positioning device 6: Laser scanning applicator 7: Mobile Station 8: Controller 9: Eye Tracking System 10: Fine-tuning device 20: Focusing mirror 30: Light guide module 31: Light guide arm 100: Cabinet 200: Operating Platform 300: User Interface 400: switch E: eyes L: laser beam

[Figure 1] is a three-dimensional schematic diagram of a laser ophthalmic device according to an embodiment of the present invention.

[The second figure] is a schematic top view of a laser ophthalmic device according to an embodiment of the present invention (some elements are omitted in the drawing).

[Figure 3] is a block diagram of a laser ophthalmic device according to an embodiment of the present invention.

[Fourth Figure A] is one of the schematic diagrams of the positioning device and the laser scanning applicator of the laser ophthalmic equipment moving relative to the patient's eyes according to an embodiment of the present invention.

[Fourth Figure B] is the second schematic diagram of the positioning device of the laser ophthalmic equipment and the laser scanning applicator moving relative to the patient's eyes according to an embodiment of the present invention.

[FIG. 5] is a partial schematic diagram of the use state of the laser ophthalmic device according to the embodiment of the present invention.

1: Laser ophthalmic equipment

2: Laser light source

3: Light guide device

4: Support bracket

5: Positioning device

6: Laser scanning applicator

7: Mobile Station

20: Focusing mirror

30: Light guide module

31: Light guide arm

100: Cabinet

200: Operating Platform

300: User Interface

400: switch

E: eyes

Claims (11)

A laser ophthalmic device, comprising: a laser light source, configured to generate a laser beam; a light guide device configured to guide the laser beam generated from the laser light source; a support bracket configured to support the patient's head such that the exposed surface of the patient's eye remains perpendicular to the horizontal plane; a positioning device configured to locate the position of the patient's eye supported on the support bracket; A laser scanning applicator that is moved to target the patient's eye supported on the support bracket based on the positioning results of the positioning device and applies the laser beam from the light guide to the patient's eye ; a mobile stage, the positioning device and the laser scanning applicator are disposed on the mobile stage, the mobile stage is configured to move the positioning device and the laser scanning applicator along the X direction, the Y direction and/or the Z direction; as well as A controller configured to control the laser light source to emit the laser beam and to control the laser scanning applicator to apply the laser beam to the patient's eye. The laser ophthalmic apparatus of claim 1, wherein the laser scanning applicator further comprises an eye tracking system and a fine-tuning device, the eye-tracking system is configured to reposition the position of the patient's eyes, the fine-tuning device is configured to The repositioning results of the tracking system are used to fine-tune the position of the laser scanning applicator to precisely align it with the patient's eye. The laser ophthalmic apparatus of claim 2, wherein the controller further controls the eye-tracking system and the fine-tuning device, so that the fine-tuning device automatically fine-tunes the laser scanning applicator according to the repositioning result of the eye-tracking system the location. Such as the laser ophthalmic equipment of claim 1, also include: a cabinet, the laser light source and the controller are disposed in the cabinet, and the cabinet is configured to be movable on the ground; and An operating platform is provided separately from the cabinet, the support bracket, the mobile stage, the positioning device, and the laser scanning applicator are provided on the operating table, and the operating platform is configured to be movable on the ground ; Wherein, the light guide device includes a light guide module and a light guide arm, the light guide module is arranged in the cabinet, and the light guide arm is connected to the light guide module arranged in the cabinet and the operation platform on the laser scanning applicator. The laser ophthalmic device of claim 1, wherein the positioning device continuously locates the position of the patient's eye and the laser scanning application while the laser scanning application device is moved into alignment with the patient's eye the location of the device. The laser ophthalmic device of claim 1, wherein the support bracket is configured to be adjustable in height along the Z direction. The laser ophthalmic apparatus of claim 1, wherein the mobile stage is manually operated to move the positioning device and the laser scanning applicator along the X, Y and/or Z directions. The laser ophthalmic equipment of claim 1, wherein the positioning device is a camera. The laser ophthalmic apparatus of claim 1, further comprising a focusing mirror disposed on a side of the laser scanning applicator facing the patient's eye. Such as the laser ophthalmic equipment of claim 1, also include: a user interface connected to the controller through which a user can input operating parameters of the laser-ophthalmic device to the controller and monitor the operation of the laser-ophthalmic device; and a switch, configured to transmit the command to emit the laser beam to the laser light source through the controller in response to the operation of the user after the operation parameter is input to the controller, so that the laser light source can be operated according to the operation parameter emits the laser beam. The laser ophthalmic equipment of claim 10, wherein the switch is a foot switch.

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