TWI748677B - 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 ophthalmic equipment

In the structure of the eye, about two-thirds of the refractive power is determined by the curvature of the front surface of the cornea. Therefore, the shape of the cornea can be changed to significantly improve or eliminate the refractive error of the eye. The cornea is a multi-layered film, the front and back surfaces of which are almost concentric, and have a central thickness of about 0.5 to 0.6 mm and an edge thickness of about 0.6 to 0.8 mm. The multi-layer structure of the cornea from the front surface to the back surface is an epithelial cell layer (Epithelium), a front elastic layer (Bowman), a stroma layer (Stroma), a posterior elastic layer (Descemet), and an endothelial cell layer (Endothelium). The central thickness of the epithelial cell layer is about 70 μm, and the thickness of the front elastic layer is about 12 μm. The thickness of the stromal layer accounts for about 90% (about 500 μm) of the total thickness of the cornea, and it is mainly composed of regularly arranged collagen fibers and interconnected corneal cells. The endothelial cell layer is composed of a layer of hexagonal flat cells.

Based on the corneal structure described above, since the stromal layer of the cornea has sufficient thickness, for the purpose of correction, the anterior part of the stromal layer can be cut to change its contour, thereby changing the refractive power of the eye, while retaining most of the stromal tissue.

Various lasers are widely used in eye surgery, for example, glaucoma, cataract, refractive surgery and so on. For example, ultraviolet (UV) lasers are used in refractive surgery (or corneal remodeling). Examples of ultraviolet lasers include 193nm excimer lasers and fifth harmonic (213nm) neodymium lasers. shoot (Neodymium-Yttrium Aluminum Garnet; Nd-YAG laser) and so on. Specifically, these ultraviolet lasers are widely used in laser refractive keratectomy (PRK), and excimer laser in situ lamellar keratology (LASIK), etc., all of which use laser light ablation The corneal tissue changes its curvature to achieve the effect of changing the refractive power of the eye (correcting vision).

The laser ophthalmic equipment currently on the market for performing LASIK has a similar design. They all use the operating table on which the patient is located to align the visual axis of the patient's eye with the laser beam. Specifically, the patient will lie on an operating table that can move precisely along the XYZ axis, and the patient (that is, the surface of the cornea) will be moved by the operating table until the surface of the cornea reaches the laser ophthalmic device Until the focal point of the microscope, and then set the laser beam transmission path. In laser ophthalmology equipment, due to the large volume of the main cabinet equipped with the laser light source and the inconvenience of movement, the laser beam is usually transmitted through the optical system, so that the laser beam is turned into under the microscope after passing the optical system Downward direction to align the optical axis of the microscope. During the use of this kind of laser ophthalmic equipment, in order to align the visual axis of the patient’s eyes with the laser beam, the operating table on which the patient is located needs to be constantly moved. In this case, the operating table is relatively bulky and easy This causes inconvenience for the operator (for example, doctor or surgical assistant).

On the other hand, in eye surgery known to use lasers, patients first undergo a series of pre-surgery related examinations in a sitting position, and then move to the operating table and receive eye surgery in a lying position. In such a case, the various parameters of the patient's eyes will be slightly different between the sitting and lying positions, for example, the difference in the angle of astigmatism is caused by the different rotation angles of the eyeballs in the sitting and lying positions. The existence of such a difference will make the operations performed during the operation not precise enough, which will be a serious problem for operations that require high precision.

The object of the present invention is to provide a laser ophthalmological equipment, which enables a patient to receive the laser beam from the laser ophthalmic equipment in a sitting posture and perform laser ophthalmic surgery by using the laser ophthalmic equipment, and the alignment between the laser ophthalmic equipment and the patient’s eyes The accuracy is done by moving the laser ophthalmic equipment, and it is no longer necessary to move the patient's position relative to the laser ophthalmic equipment.

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; and a support bracket configured to support The patient’s head so that the exposed surface of its eyes is 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 based on the positioning result of the positioning device And it is moved to align the eyes of the patient supported on the support bracket, and apply the laser beam from the light guide device to the eyes of the patient; the moving table, the positioning device and the laser scanning applicator are set 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 the controller is configured to control the laser light source to emit a laser beam and control the laser The radioscan applicator makes it apply a laser beam to the patient's eyes.

With the above-mentioned laser ophthalmological equipment of the present invention, since the support bracket is configured to keep the exposed surface of the patient's eye perpendicular to the horizontal plane, the patient can not only receive related examinations before surgery in a sitting position, but also receive lasers from a sitting position. Scan the laser beam applied by the applicator to perform laser eye surgery. In this way, the state of the patient’s eyes will not be much different when undergoing related examinations before the operation and when the laser beam is applied for laser eye surgery, so that the operation of laser eye surgery can be more precise Therefore, it is particularly suitable for various laser ophthalmic surgeries that require high precision.

On the other hand, with the above-mentioned laser ophthalmic equipment of the present invention, the alignment between the patient’s eye and the laser ophthalmic equipment is carried out by moving the laser ophthalmic equipment, and it is no longer necessary to compare the laser ophthalmic equipment. The ophthalmological equipment moves the position of the patient (that is, it is not necessary to repeatedly move the operating table on which the patient lies), and the laser ophthalmic equipment according to the present invention is more convenient in operation and use.

1: Laser ophthalmology equipment

2: Laser light source

3: Light guide device

4: Support bracket

5: Positioning device

6: Laser scanning application device

7: mobile station

8: Controller

9: Eye tracking system

10: Fine-tuning device

20: Focusing lens

30: Light guide module

31: Light guide arm

100: Cabinet

200: operating platform

300: User interface

400: switch

E: eyes

L: Laser beam

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

[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 figure).

[Third Figure] 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 of the laser ophthalmic equipment and the laser scanning applicator moving relative to the patient's eye according to the 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 eye according to the embodiment of the present invention.

[Fifth Figure] is a partial schematic diagram of the laser ophthalmic equipment in use according to the embodiment of the present invention.

The first to third figures show a laser ophthalmic device 1 according to an embodiment of the present invention. The first figure is a three-dimensional schematic diagram of the laser ophthalmic device 1 according to an embodiment of the present invention. The X direction and 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. The second figure It is a schematic top view of the laser ophthalmic equipment 1 according to an embodiment of the present invention (some elements are omitted in the drawing), and the third figure is a block diagram of the laser ophthalmic equipment 1 according to an embodiment of the present invention.

The laser ophthalmological 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 moving table 7, and a positioning device arranged on the moving table 7 5 and laser scanning application device 6, and controller 8.

The laser light source 2 is configured to generate a laser beam L, for example, an excimer laser beam, with the excimer laser beam, a laser ophthalmic operation, for example, LASIK operation, 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 jointly configured to guide the laser beam generated from the laser light source 2 to be guided to the laser scanning applicator 6 and then toward the patient's eye E March.

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

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

By thus moving the table 7, the positioning device 5 can be moved to locate the position of the patient's eye E supported on the support bracket 4, for example, the position of the patient's left eye 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 the user manually operating the mobile station 7, but it is not limited thereto. For example, according to the accuracy requirements of different operations, the positioning device 5 may also be a microscope, etc., and the mobile station 7 may be an electric mobile station, which can electrically move the positioning device under the control of the controller.

Similarly, by moving the table 7, the laser scanning applicator 6 can be moved to align with the patient's eye E (for example, the patient's left eye) supported on the support bracket 4 based on the positioning result of the positioning device 5. Or right eye), this positioning can be referred to as the coarse positioning of the laser scanning applicator 6.

It should be noted that in the laser ophthalmic equipment 1 according to the present invention, the laser scanning application device 6 preferably further includes an eye tracking system 9 and a fine-tuning device 10. The eye tracking system 9 can relocate (track) the eyes of the patient 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 align with the patient’s eye E. This positioning can be called a laser scanning applicator 6. Fine positioning. Next, the laser beam L from the light guide 3 is applied to the patient's eye E via the laser scanning applicator 6 to perform laser ophthalmic surgery, for example, 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 ophthalmological apparatus 1 according to the present invention further includes 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 The laser beam L applied by the eye E can be focused on the target position of the eye E of the patient.

The controller 8 is configured to control the various components of the laser ophthalmic device 1. Specifically, the controller 8 can 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.

In addition, the laser ophthalmic equipment 1 also includes a cabinet 100 and an operating 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 station 7, and the positioning device 5 and the laser arranged on the mobile station 7 The scanning applicator 6 is set on the operating platform 200. The light guide arm 31 is connected to the light guide module 30 in the cabinet 100 and the mine on the operating platform 200. Radio scan application device 6 between. In other words, the cabinet 100 and the operating 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 operating platform 200).

In order to conveniently adjust the position of the laser ophthalmic equipment 1 to better meet the needs of the operator, the cabinet 100 and the operating platform 200 are both designed to be movable on the ground, for example, the cabinet 100 and the operating platform 200 have their own wheels, respectively. In order to move on the ground. On the other hand, the maximum length (or width) of the cabinet 100 is only 70 cm, and it can smoothly enter most elevators, which is more advantageous for the transportation of the laser ophthalmic equipment 1 according to the present invention.

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

As shown in Figure 4A, after the patient's head (eyes 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 support bracket 4 The position of the patient's eye E (for example, the left eye or the right eye) on the frame 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 moving table 7 (Rough positioning), as shown in the fourth figure B. After the laser scanning applicator 6 has been moved to the 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 accurately align 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. In this state, the laser scanning applicator 6 can apply laser to the patient's eye E Bundle L.

It should be noted that while the laser scanning applicator 6 is moved to align with the patient's eye E based on the positioning result of the positioning device 5, the positioning device 5 still continuously locates the position of the patient's eye E and the laser Scan the position of the applicator 6.

Referring again 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 that are connected to 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 station 7 and the fine-tuning device 10 of the laser scanning applicator 6, the operator can use the user interface 300 inputs the operating parameters of the laser ophthalmic device 1 (for example, operating parameters required to perform laser ophthalmic surgery) into the controller 8, and operates the switch 400 to issue a command, which is transmitted to the laser light source 2 through the controller 8 , 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 application device 6 through the light guide module 30 and the light guide arm 31 , And then applied to the patient's eye E.

In the 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 device 1, for example, the laser scanning application device 6 The result of coarse positioning and fine positioning. In addition, as shown in the first figure, the switch 400 is preferably a foot switch. The user can operate the mobile station 7 to move the laser scanning applicator 6 to aim at the patient's eye E, and then use a foot pedal. The foot switch is operated to issue a command to send 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 eyes E of the patient. However, those skilled in the art should understand that the present invention is not limited to the aforementioned type of user interface 300 and switch 400, other types of user interfaces and switches can also be used, as long as the aforementioned functions can be achieved. .

The fifth figure shows a partial schematic diagram of the laser ophthalmic device 1 in use according to the embodiment of the present invention. It can be clearly seen in the fifth figure that the patient’s head is supported on the support bracket 4 so that the exposed surface of the eye E is perpendicular to the horizontal plane (XY plane), and 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 this 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 Figure 5, the patient undergoes laser eye surgery in a sitting position.

In summary, with the laser ophthalmic device 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 remains in a sitting position, Therefore, in addition to receiving related examinations before surgery in a sitting posture, the patient can also receive the laser beam L applied from the laser scanning applicator 6 in a sitting posture to perform laser eye surgery. In this state, there will not be much difference in the state of the patient's eyes (for example, the angle of rotation of the eyes, etc.) when undergoing related examinations before surgery and when a laser beam is applied for laser eye surgery. , Making it possible to perform laser eye surgery more accurately. Therefore, the laser ophthalmic device 1 according to the present invention can perform laser ophthalmic surgery under more precise conditions, and is particularly suitable for various laser ophthalmic surgery requiring high precision.

In addition, with the above-mentioned laser ophthalmic equipment 1 of the present invention, the alignment between the patient's eye E and the laser ophthalmic equipment 1 is performed by moving the laser scanning applicator 6 of the laser ophthalmic equipment 1 , Instead of moving the patient relative to the laser ophthalmic device 1 for alignment. Therefore, the operator (that is, 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 patient's position 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 effects on patients receiving laser eye surgery in a sitting or lying position. Specifically, compared to the traditional psychological pressure when the patient undergoes ophthalmic surgery in a lying position on the operating table, the laser ophthalmic device 1 according to the present invention enables the patient to receive ophthalmic surgery in the same sitting position as when checking the eyes. Surgery causes relatively little psychological pressure on patients. In other words, with the laser ophthalmic device 1 according to the present invention, the patient can also undergo ophthalmic surgery with a more relaxed attitude.

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

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

1: Laser ophthalmology equipment

2: Laser light source

3: Light guide device

4: Support bracket

5: Positioning device

6: Laser scanning application device

7: mobile station

20: Focusing lens

30: Light guide module

31: Light guide arm

100: Cabinet

200: operating platform

300: User interface

400: switch

E: eyes

Claims (11)

A laser ophthalmological equipment 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 head of a patient, To keep the exposed surface of the eyes perpendicular to the horizontal plane; positioning device, configured to locate the position of the patient's eyes supported on the support bracket; laser scanning applicator, based on the positioning result of the positioning device Move to align the eyes of the patient supported on the support bracket, and apply the laser beam from the light guide device to the eyes of the patient; the moving table, the positioning device and the laser scanning applicator are Arranged on the mobile station, the mobile station is configured to move the positioning device and the laser scanning application device along the X direction, the Y direction and/or the Z direction; and a controller configured to control the laser light source to emit The laser beam and the laser scanning application device are controlled to apply the laser beam to the eyes of the patient. For example, the laser ophthalmic equipment of claim 1, wherein the laser scanning application device further includes an eye tracking system and a fine-tuning device, the eye-tracking system is configured to relocate the position of the patient's eye, and the fine-tuning device is configured to be based on the eye The repositioning result of the tracking system is used to fine-tune the position of the laser scanning applicator so that it is precisely aligned with the patient's eyes. For example, the laser ophthalmic equipment of claim 2, wherein the controller also 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. For example, the laser ophthalmic equipment of claim 1, further comprising: a cabinet, the laser light source and the controller are arranged in the cabinet, and the cabinet is configured to be movable on the ground; and the operating platform is separated from the cabinet Set, the support bracket, the mobile station, the positioning device, and the laser scanning application device are set on the operating table, and the operating platform is configured to be movable on the ground; wherein, the light guide device includes a guide A light module and a light guide arm, the light guide module is arranged in the cabinet, and the light guide arm connects the light guide module arranged in the cabinet and the laser scanning application device arranged on the operating platform . The laser ophthalmological equipment 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 to be aligned with the patient's eye The location of the device. For example, the laser ophthalmic equipment of claim 1, wherein the support bracket is configured to be adjustable in height along the Z direction. Such as the laser ophthalmic equipment of claim 1, wherein the mobile station is manually operated to move the positioning device and the laser scanning applicator along the X direction, the Y direction, and/or the Z direction. For example, the laser ophthalmic equipment of claim 1, wherein the positioning device is a camera. The laser ophthalmological equipment of claim 1, which further includes a focusing lens, and the focusing lens is arranged on the side of the laser scanning applicator facing the eye of the patient. For example, the laser ophthalmic device of claim 1, further comprising: a user interface connected to the controller, and the user can input the operating parameters of the laser ophthalmic device to the controller through the user interface, And monitor the operation of the laser ophthalmic equipment; And a switch, configured to send the laser beam command to the laser light source through the controller in response to the user’s operation after the operating parameter is input to the controller, so that the laser light source is The operating parameters emit the laser beam. For example, the laser ophthalmic equipment of claim 10, wherein the switch is a foot switch.

Images