US20110282161A1

US20110282161A1 - Enhanced visualization illumination system

Info

Publication number: US20110282161A1
Application number: US13/190,142
Authority: US
Inventors: Prashant Bhadri; James Lescoulie; Sophia Fang; Matthew McCormick; Ralph Kems; Mark Humayun; Aaron Barnes
Original assignee: Doheny Eye Institute of USC
Current assignee: Doheny Eye Institute of USC
Priority date: 2006-11-10
Filing date: 2011-07-25
Publication date: 2011-11-17
Also published as: US10219695B2; US20100157620A1; US20170347883A1; US7654716B1

Abstract

A first light source producing a first light beam with a first intensity and a second light source producing a second light beam with a second intensity. A light filter device receives the first light beam and transmits a filtered portion of the first light beam. A first angling device reflects the filtered portion of the first light beam in a first angled direction and a second angling device reflects the second light beam in a second angled direction. A mirror receives and in turn reflects the filtered portion of the first light beam reflected by the first angling device and the second light beam reflected by the second angling device to form a converged light beam with a third intensity.

Description

CROSS-REFERENCE TO RELATED APPLICATION(S)

The present application is a divisional of U.S. application Ser. No. 12/641,269, filed Dec. 17, 2009, which is a continuation of U.S. application Ser. No. 11/938,233, filed Nov. 9, 2007, which claims the benefit of U.S. Provisional Patent Application Ser. No. 60/858,176 filed on Nov. 10, 2006. The foregoing applications are hereby incorporated herein by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to an illumination system for surgery, and more particularly, to an illumination system for enhanced lighting conditions for ophthalmic surgery.

BACKGROUND

During surgical procedures, a surgeon depends on an operating microscope and an illuminating light source, such as, for example, an endoilluminator, to visualize the anatomical structures of the eye on which an operation is being conducted. If the surgeon experiences limited visibility in posterior eye procedures, the current protocol is to generally increase the intensity of the illuminating light source. In this regard, the medical illumination industry offers light sources with higher intensities.
The higher intensity light source, however, is not always sufficient to accurately view the fundus of the eye. The fundus is in the posterior section of the human eye, which includes the retina, blood vessels, the optic nerve, the choroid, and the like. Each of these anatomical features has a specific color when viewed with an operating microscope. During surgery, some structures can be easily seen. However other features can potentially be washed out with the bright white light of the endoilluminator.
Current attempts to overcome this problem are unsophisticated and generally involve the use of red-free light to visualize certain features of the fundus such as the retinal blood vessels and pathologic focal atrophy of the nerve fiber layer. Accordingly, what is desired is an illumination system that improves the quality, intensity, and contrast of light to provide surgeons with better illumination during ophthalmic surgery.

SUMMARY OF THE INVENTION

An aspect of an embodiment of the present invention is directed toward an enhanced illumination system that improves the quality, intensity, and contrast of light.
An embodiment of the present invention provides an enhanced illumination system including: a light source configured to produce a light beam; an angling device configured to receive light produced by the light source and configured to be adjusted to a first position for reflecting at least a portion of the light beam in a first angled direction, and further configured to be adjusted to a second position for allowing the light beam to bypass the angling device; a mirror configured to reflect at least a portion of the light beam in response to the angling device being adjusted to the first position; a first output port for outputting the at least a portion of the light beam reflected by the mirror; and a second output port for outputting the light beam bypassing the angling device in response to the angling device being adjusted to the second position.
The enhanced illumination system may further include a light filter configured to receive the first light beam and generate a filtered light beam for transmitting to the first angling device.
The enhanced illumination system may further include a coupling system configured to couple the portion of the light beam to an optical fiber coupled to the first output port.
The enhanced illumination system may further include a shutter configured to receive the light beam from the light source and adjust an intensity of the light beam.
The mirror may be a substantially curved mirror.
The angling device may include a mirror or a beam splitter.
Another embodiment of the present invention provides an enhanced illumination system including: a first light source configured to produce a first light beam with a first intensity; a second light source configured to produce a second light beam with a second intensity; at least one light filter device configured to receive the first light beam and transmit a filtered portion of the first light beam; a first angling device configured to be adjusted to a first position for reflecting the filtered portion of the first light beam in a first angled direction; a second angling device configured to be adjusted to a second position for reflecting at least a portion of the second light beam in a second angled direction; a mirror configured to receive and reflect at least the filtered portion of the first light beam reflected by the first angling device and at least a portion of the second light beam for forming a converged light beam with a third intensity; and an output port for outputting the converged light beam.
The light filter device may be configured to filter out light of particular bandwidths.
The enhanced illumination may further include a coupling system configured to couple the converged light beam to an optical fiber coupled to the output port.
The enhanced illumination may further include a first shutter configured to adjust the first intensity of the first light source and a second shutter configured to adjust the second intensity of the second light source.
The mirror may be a substantially curved mirror.
The angling device may be a mirror or a beam splitter.
The converged light beam may converge bandwidth limited light from the first light source with substantially white light from the second light source.
The third intensity of the converged light beam may be greater than the first or second intensity alone.
Another embodiment of the present invention provides a method for generating enhanced illumination that includes: producing by a first light source a first light beam with a first intensity; producing by a second light source a second light beam with a second intensity; receiving the first light beam by a light filter device and transmitting a filtered portion of the first light beam; reflecting by a first angling device the filtered portion of the first light beam in a first angled direction; reflecting by a second angling device at least a portion of the second light beam in a second angled direction; receiving and reflecting by a mirror to reflect at least the filtered portion of the first light beam reflected by the first angling device and at least the portion of the second light beam reflected by the second angling device for forming a converged light beam with a third intensity; and outputting the converged light beam at an output port.
The method may further include configuring a first lens system to couple the first light beam to a first optical fiber, configuring a second lens system to couple the second light beam to a second optical fiber, and configuring a third lens system to couple the converged light beam to a third optical fiber.
The method may further include configuring a first shutter to adjust the first intensity of the first light source and configuring a second shutter to adjust the second intensity of the second light source.
The mirror may be a substantially curved mirror.
The angling device may be a mirror or a beam splitter.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic block diagram of an enhanced illumination control system according to one embodiment of the invention;

FIG. 2A is a more detailed schematic diagram of an enhanced illumination system in the enhanced illumination control system of FIG. 1 according to one embodiment of the invention;

FIG. 2B is a schematic diagram of an enhanced illumination system according to an alternative embodiment of the invention with one light source coupled to an angling device;

FIG. 2C is a schematic block diagram of an enhanced illumination system with an angling device positioned in the bypass position;

FIG. 2D is a schematic block diagram of an enhanced illumination system with two angling devices positioned in a bypass position; and

FIG. 3 is a photographic image of an enhanced illumination system according to another embodiment of the invention.

DETAILED DESCRIPTION

Surgeons generally need high intensity light to perform different types of eye surgeries, including vitreo retinal procedures. In a vitreo retinal procedure, the vitreous is removed by using small instrumentation through small openings (e.g. sclerotomies) in the wall of the eye. This procedure is commonly referred to as a pars plana vitrectomy. However, illumination through small sclerotomies inside the dark cavity of the eyeball is a challenge. In some cases, opacities inside the eye further degrade visualization. In addition, certain anatomical features of the fundus are not visible with the white light emitted via the illumination source.
According to one embodiment, bandwidth limited light may be used to enhance visualization of the fundus. For example, red-free light may be used for enhancing fundus photography and examination of the nerve fiber layer. Bandwidth limited light may also improve the contrast of fundus details and reduce (or eliminate) the loss of image quality associated with chromatic aberrations. Furthermore, the visualization and documentation of fundus structures may be improved and details may be distinguished which would otherwise be invisible with white light. The use of bandwidth limited light therefore improves the ability to differentiate fundus details by observing changes in their appearance under different bandwidths. Further, structures may be more accurately localized with regard to depth in the stratified layers of the fundus.
Accordingly, various embodiments of the present invention are directed to an enhanced illumination system that combines two or more light sources to provide different light quality, intensities, contrasts, and/or colors. Thus, depending on the particular need during surgery, the surgeon may manipulate the enhanced illumination system to combine the output of the two or more light sources into a single output that provides light that is enhanced or otherwise different over what would be output with only one of the light sources. The surgeon may also manipulate the enhanced illumination system to invoke only one of the light sources to provide white light or bandwidth limited light. Thus, the various lighting needs of the surgeon during different parts of the surgery may be met via the single enhanced illumination system.
FIG. 1 is a schematic block diagram of an enhanced illumination control system according to one embodiment of the invention. The system includes an illumination system 16 coupled to a computer 12 over a data communications link 14. The communications link 14 may be a direct wire, an infrared data port, a wireless communications link, local area network link, or any other communications medium known in the art.
According to one embodiment of the invention, the illumination system includes various output ports (or channels) 18 a, 18 b, 18 c configured to be coupled to one of more illumination outputs 20 a, 20 b, 20 c such as, for example, a fiber optic cable or light pipe. According to one exemplary embodiment, output port A is configured to output white light of a specified intensity, output port B is configured to output light of limited bandwidth, and output port C is configured to output light that is a combination of the light that would be output at port A and that would be output at port B. As a result, the light output at port C may be a light that has an intensity greater than what is output at port A or port B alone. In addition, the light that is output at port C may be light that is tinted as a result of the combination of the white light output at port A and the bandwidth limited light output at port B. Of course, a person of skill in the art should understand that port A may be configured so that in addition or in lieu of the white light that is output by port A, port A may also be configured to output bandwidth limited light. In addition, port B may be configured so that in addition or in lieu of the bandwidth limited light that is output by port B, port B may also be configured to output white light.
According to one embodiment of the invention, the computer 12 is configured with a memory containing computer program instructions that are executed by a processor for configuring and controlling the illumination system 16. The computer program instructions may provide, for example, a graphical user interface (GUI) which allows the user to view, set, and modify different parameters for controlling the light that is output via the output ports 18 a, 18 b, 18 c. A user input device 10 coupled to the computer 12, such as, for example, a keypad, keyboard, stylus, and the like, facilitates user control of the different parameters. The computer may also provide a screen that incorporates pressure-sensitive (touch screen) technology so that a user may view, set, and modify the different parameters by merely touching certain portions of the screen.
For example, the GUI may provide a turn on/off parameter for port A, turn on/off parameter for port B, light intensity parameter for port A, light intensity parameter for port B, filter selection parameter for port A, filter selection parameter for port B, and/or select/deselect parameter for port C. Each of these parameters may be set by a doctor or nurse prior to or during a particular ophthalmic procedure. According to one embodiment of the invention, computer program instructions are provided to process the entered parameters and transmit appropriate commands to the enhanced illumination system 16 for causing a desired type of illumination to be output via the selected port.
According to one embodiment of the invention, one or more mechanical buttons or switches may be provided by the illumination system 16 for being directly manipulated by a user in order to configure and set the various lighting parameters.
FIG. 2A is a more detailed schematic diagram of the enhanced illumination system 16 according to one embodiment of the invention. In the embodiment illustrated in FIG. 2A, the enhanced illumination system includes a light source A 50 and a light source B 66 which respectively emit light beam A and light beam B. Light beam A and light beam B are converged downstream into light beam C and output via output port C 18 c. According to one embodiment, converged light beam C has an intensity greater than the intensity of light beam A or light beam B alone.
More specifically, light source A 50 may emit light beam A through a mechanical shutter 52 that has an opening area that may be increased or decreased to respectively increase or decrease light intensity based on monitoring of the light path via a feedback system (not shown), and/or one or more commands from the computer 12. A person of skill in the art should understand that the mechanical shutter 52 may take any form conventional in the art. Light source A may be a halogen lamp, metal halide lamp, xenon, lamp, em-arc lamp, LED, or any other light source conventional in the art.
The light emitted from light source A is focused and collimated via a lens system 54. According to one embodiment of the invention, the lens system 54 is formed via one or more concave, convex, and/or meniscus lens, which allow increased coupling of the light beam A.
According to one embodiment of the invention, the collimated light beam A is received and reflected by an angling device 58. The angling device 58 may take the form of a mirror, beam splitter, or any like device conventional in the art that is capable of being rotated into a particular angle to allow light to be reflected onto one or more mirrors 64. According to one embodiment of the invention the light reflected by the angling device 58 is received by a single curved mirror and is in turn reflected by the mirror onto a coupling system 80. According to another embodiment of the invention, two flat mirrors placed at an angle may replace the single curved mirror.
The coupling system 80 focuses and collimates light beam A into output port C 18 c. Output port C may be, for example, an optical fiber channel.
The coupling system 80 also focuses and collimates light beam B from light source B 66. Light source B may be of a type similar to light source A. In this regard, light source B emits light through a mechanical shutter 68 which may be similar to the mechanical shutter 52 for light source A. The light emitted from the light source 66 is focused and collimated via a lens system 70 which may be similar to the lens system 54 for light source A.
According to one embodiment of the invention, at least one light filter device 72, such as a filter or a filter wheel including multiple filters, is placed in the path of collimated light beam B. According to one embodiment of the invention, the filter device 72 is adjusted based on one or more commands from the computer 12 to allow all or only certain bandwidths of the collimated light beam B to pass through. For example, the filter device 72 may block red light and allow other colors of light beam B to pass to generate a substantially red-free light. The filter device 72 may also be adjusted to allow or block other colors of light. The generating of a bandwidth dependent wavelength helps improve the viewing of the different structures of the fundus of the eye. The light filtering device 72 may also act as an attenuator to control light intensity.
According to one embodiment of the invention, light passing through the light filter device 72 is received and reflected by an angling device 76 which may be similar to the angling device 58 for light source A. The angling device 76 is rotated to a particular position for allowing the light beam to be reflected onto the mirror 64 and onto the coupling system 80. In this manner, light beam A and light beam B are combined in output port C 18C to generate a light beam C which has a greater intensity than light beam A or light beam B alone. In addition, the combination of light beam A in the form of a white light and light beam B in the form of a limited bandwidth light results in light beam C which is referred to a tinted light. Tinted light is beneficial because it enhances the contrast of fundus details.
In another embodiment of the invention, the coupling system 80 is replaced with a 2×1 optical coupler that combines light beam A and light beam B to light beam C.
Although the enhanced illumination system described with respect to FIG. 2A includes angling devices 58, 76 for both light source A 50 and light source B 66, a person of skill in the art should recognize that only one of the light sources may be Coupled to the angling device.
FIG. 2B is a schematic diagram of an enhanced illumination system 16 a according to an alternative embodiment of the invention where only one of the light sources is coupled to an angling device. In the embodiment illustrated in FIG. 2B, only light source A is coupled to the angling device 58, causing light beam A to reflect onto the mirror 64 for being output via output port C as light beam C. Light source B is not coupled to the angling device. Thus, light beam B is focused and collimated by a coupling system 78 which may be similar to the coupling system 80 for output via output port B.
Alternatively, instead of eliminating one or more angling devices, the one or more of the angling devices may be configured to be rotated into a first position when convergence of light beams is desired, and rotated into a second bypass position when convergence is not desired.
FIG. 2C is a schematic block diagram of an enhanced illumination system 16 b with one of the angling devices positioned in the bypass position. According to this embodiment, the angling device 76 associated with light source B is placed in the bypass position in response to one or more commands from the computer 12. When placed in the bypass position, the angling device 76 is not in the path of light beam B. As a result, light beam B is received by the coupling system 78 which focuses and collimates the light into the output port B.
FIG. 2D is a schematic block diagram of an enhanced illumination system 16 c with both of the angling devices positioned in the bypass position. According to this embodiment, both the angling device 58 and the angling device 76 are placed in the bypass position. In this regard, neither the angling device 58 nor the angling device 76 is in the path of light beam A or light beam B. As a result, light beam A is received by a coupling system 62 which focuses and collimates the light into the output port A, and light beam B is received by the coupling system 78 which focuses and collimates the light into the output port B.
FIG. 3 is a photographic image of an enhanced illumination system 16 c according to another embodiment of the invention. According to this embodiment, a mirror 110 and angling devices 100 a and 100 b are mounted on a rotation device 112. In this regard, the angling devices 100 a and 100 b are rotated to a particular position for allowing the light beams A and B to be reflected onto the mirror 110 and combine in output port C 18C to generate a light beam C. Alternatively, the rotation device 112 may be rotated so that the mirror 110 and angling devices 100 a and 100 b are placed in a bypass position. In this regard, neither the angling device 100 a or angling device 100 b is in the path of light beam A or light beam B. As a result, light beam A is output via output port A 18 a and light beam B is output via output port B 18 b. A fan 50 may also be included to cool the enhanced illumination system 16.
In another embodiment of the invention a sensor system coupled to one or more of the light sources may be used to monitor the bulb functionality and spectrum stability of the one or more light sources.
According to one embodiment of the invention, the enhanced illumination system is integrated into a vitrectomy machine. The integration into the vitrectomy machine provides practical advantages from an economic, transportability, ergonomic, and usability standpoint. Furthermore, the enhanced illumination system is designed to give the surgeon the option of using a single light source to cause light to be output by either output port A or output port B, or a combination of two light sources for complimentary illumination via output port C. For example, during a portion of a surgery that requires only white light of a desired intensity, the surgeon may cause the computer 14 to transmit commands to the illumination system to actuate port A for outputting white light with the desired intensity. In this regard, the angling device 58 may be rotated to be in a bypass mode, and ports Band C may be disabled. If however, instead of white light, bandwidth limited light is desired, the surgeon may alter the settings of the computer to cause the computer to transmit commands to the illumination system to actuate port B for outputting limited bandwidth light. In addition, if during a different portion of the surgery tinted light is desired for better visibility of the internal structures of the fundus, the surgeon may alter the settings of the computer to cause the computer to transmit commands to rotate the angling devices 58, 76 to be in angled positions to cause convergence of the white light from light source A and the bandwidth limited light from light source B, and actuate port C to cause output of the converged light via port C that is tinted for better contrast and has a higher intensity than the intensity allowed by light source A or B alone. Of course, a person of skill in the art should recognize that white light of higher intensity may also be provided by disabling the filter device coupled to light source B, and causing the convergence of white lights from light source A and light source B.
A person of skill in the art should recognize that the claimed enhanced illumination system allows for a high optical output intensity, in addition to improved visualization. For example, the use of bandwidth limited wavelength light allows physicians to operate with improved contrast for visualization of specific structures in the eye. Additional features include controlling not only the intensity, but also the quality of the light, which is improved by changing the color (or color temperature) of the light from the light source via the filter device 72, with the light produced from one or more channels.
The illumination system allows for various novel applications, including use inside the operating room or outside the operating room (office based procedures) for not only ophthalmic procedures but any other procedure that mayor may not relate to a human body by providing a high intensity output. The illumination system also allows for improved structural viewing by color contrasts, one or more outputs (with variable intensity and color), compatibility with numerous light sources (such as halogen, metal halide, xenon and em-arc), and/or constant monitoring of the status of the light source.
Furthermore, to those skilled in the various arts, the invention itself herein will suggest other variations to the described embodiment which in no way depart from the scope and spirit of the present invention. For example, although a filter wheel is depicted as being coupled to only light source B, a person of skill in the art should recognize that the filter wheel may also be coupled to light source A. Furthermore, a single light source or more than two light sources may be used in alternative embodiments of the enhanced illumination system in providing light beams A and B. In another embodiment, the enhanced illumination system may be implemented without the lens system. Furthermore, a person of skill in the art should also recognize that the various components of the enhanced illumination system of the above embodiments may be implemented as separate physical components, or one or more of the functionalities of the various components combined into a single physical component or housed in a single physical housing.
Furthermore, to those skilled in the various arts, the invention itself herein will suggest solutions to other tasks and adaptations for other applications. It is the Applicants' intention to cover all such uses of the invention and those changes and modifications which could be made to the embodiments of the invention herein chosen for the purpose of disclosure without departing from the spirit and scope of the invention. Thus, the present embodiments of the invention should be considered in all respects as illustrative and not restrictive.

Claims

1. An enhanced illumination system for ophthalmic surgery on an eye comprising:

a first light source configured to produce a first light comprising substantially white light;

a second light source configured to produce a second light comprising bandwidth limited light;

a coupling system for combining the first and second lights to produce a third light of tinted light directed through an output; wherein an intensity of the third light is greater than an intensity of the first light or an intensity of the second light, and

a fiber optic cable having a first end and a second end, the first end configured to receive from the output the third light, the second end configured to be inserted into the eye, wherein the fiber optic cable directs the third light onto a surgical area within the eye.

2. The enhanced illumination system for ophthalmic surgery of claim 1, wherein the second end is inserted through a sclerotomy in a wall of the eye.

3. The enhanced illumination system for ophthalmic surgery of claim 1, wherein at least one of the first and second light sources is a light emitting diode.

4. The enhanced illumination system for ophthalmic surgery of claim 1, wherein the second light source comprises two or more light emitting diodes to produce the bandwidth limited light.

5. The enhanced illumination system for ophthalmic surgery of claim 1, further comprising a shutter configured to adjust the intensity of the third light.

6. The enhanced illumination system for ophthalmic surgery of claim 1, further comprising a filter, wherein the bandwidth limited light is produced by passing light from the second light source through the filter.

7. The enhanced illumination system for ophthalmic surgery of claim 6, wherein the filter is configured to substantially block red light, and wherein the second light is substantially red-free light for generating the tinted light for enhancing fundus details and examination of a nerve fiber layer.

8. The enhanced illumination system for ophthalmic surgery of claim 1, further comprising a curved mirror to receive the first light and the second light and to reflect the first light and the second light into the coupling system.

9. The enhanced illumination system for ophthalmic surgery of claim 1, further comprising a first mirror to receive the first light and a second mirror to receive the second light, wherein the first and second mirrors are configured to reflect the first light and the second light into the coupling system.

10. The enhanced illumination system for ophthalmic surgery of claim 1, further comprising a sensor system coupled to at least one of the first and second light sources to monitor functionality and spectrum stability of the at least one of the first and second light sources.

11. An enhanced illumination system for a medical procedure comprising:

a coupling system for combining the first and second lights to produce a third light of tinted light at an output; wherein an intensity of the third light is greater than an intensity of the first light or an intensity of the second light, and

an optical fiber having a first end and second end, the first end configured to receive from the output the third light, the second end configured to be inserted into a body cavity, wherein the optical fiber directs the third light onto a tissue area,

wherein at least one of the first light source and the second light source is an light emitting diode.

12. The enhanced illumination system of claim 11, wherein the second end is inserted through a sclerotomy in a wall of the eye.

13. The enhanced illumination system of claim 11, further comprising a shutter configured to adjust the intensity of the third light.

14. The enhanced illumination system of claim 11, further comprising a filter, wherein the bandwidth limited light is produced by passing light from the second light source through the filter.

15. The enhanced illumination system of claim 14, wherein the filter is configured to substantially block red light, and wherein the second light is substantially red-free light for generating the tinted light for enhancing fundus details and examination of a nerve fiber layer.

16. The enhanced illumination system of claim 11, further comprising a curved mirror to receive the first light and the second light and to reflect the first light and the second light into the coupling system.

17. The enhanced illumination system of claim 11, further comprising a first mirror to receive the first light and a second mirror to receive the second light, wherein the first and second mirrors are configured to reflect the first light and the second light into the coupling system.

18. The enhanced illumination system of claim 11, further comprising a sensor system coupled to at least one of the first and second light sources to monitor functionality and spectrum stability of the at least one of the first and second light sources.

19. The enhanced illumination system of claim 11, wherein the second light source comprises two or more light emitting diodes to produce the bandwidth limited light.