WO1990008523A1 - Appareil medical de traitement des yeux - Google Patents

Appareil medical de traitement des yeux Download PDF

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Publication number
WO1990008523A1
WO1990008523A1 PCT/EP1989/001350 EP8901350W WO9008523A1 WO 1990008523 A1 WO1990008523 A1 WO 1990008523A1 EP 8901350 W EP8901350 W EP 8901350W WO 9008523 A1 WO9008523 A1 WO 9008523A1
Authority
WO
WIPO (PCT)
Prior art keywords
eye
ball
deflecting element
optical deflecting
rotary pulse
Prior art date
Application number
PCT/EP1989/001350
Other languages
German (de)
English (en)
Inventor
Erich Weimel
Stefan Pieger
Original Assignee
Aesculap Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aesculap Ag filed Critical Aesculap Ag
Publication of WO1990008523A1 publication Critical patent/WO1990008523A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser
    • A61F9/00821—Methods or devices for eye surgery using laser for coagulation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0075—Apparatus for testing the eyes; Instruments for examining the eyes provided with adjusting devices, e.g. operated by control lever
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/008—Methods or devices for eye surgery using laser

Definitions

  • the invention relates to a medical device for eye treatment with a slit lamp and a laser for generating a treatment beam which, together with the illuminating radiation generated by the slit lamp, can be directed into the eye of a patient via an optical deflection element, with a device for observation. of the eye and with an adjustment device which can be activated via an actuating element for adjusting the relative position of the device with respect to the eye.
  • Such a device is used to examine the inside of the eye and, if necessary, to carry out a treatment inside the eye by means of a superimposed treatment laser beam, for example by coagulating tissue.
  • a superimposed treatment laser beam for example by coagulating tissue.
  • the relative position of the device relative to the eye can be adjusted by an adjustment mechanism.
  • the device can, for example, be mounted on a cross table which can be moved with the aid of a drive, so that the lateral position and the distance of the device from the eye can be adjusted.
  • a height adjustment can also be provided, and generally the whole
  • a medical device can be pivoted about a vertical axis, which preferably passes through the examined eye, so that the illuminating radiation and the treatment radiation fall into the eye at different angles.
  • joy stick-like hand levers can be provided on the device, which move the cross table according to the respective deflection of the lever and which, in special embodiments, also by turning the hand lever ... about its longitudinal axis change the height of the device.
  • the hand lever provided for pivoting the deflecting element is actuated by special cross potentiometers or by separate levers.
  • a ball is freely rotatably mounted on the device for actuating the drive and is in frictional contact with the drive shafts of two rotary pulse generators held perpendicular to one another on the device, and in that each of the two rotary encoders controls the pivoting of the optical deflecting element about an axis.
  • the operator can control the illumination spot in the eye by rotating the freely rotatably mounted ball in any direction, the mutually perpendicular rotary pulse generators receiving the corresponding component of the rotary movement, so that simultaneous pivoting with the ratio required for the desired direction the angle of rotation about the two axes of the optical deflection element can take place.
  • Grasping the ball is particularly easy for the operator who looks into the eye through the observation device during operation and therefore cannot see the actuating elements, because it is sufficient to touch the ball and twist it in the desired direction without that it is then necessary to find an operating lever or the like.
  • actuating elements of the adjusting device are arranged.
  • the treating person will normally keep his hand on this joy stick-like actuating handle in order to be able to adjust the position of the entire device as required.
  • the thumb of the operating hand is normally located on the upper side of this handle anyway, so that an arrangement of the spherical adjusting element on the upper side of the handle enables the operator in the simplest way, in addition to actuating the joy stick.
  • Element also to use the spherical adjusting element for pivoting the optical deflecting element. This arrangement not only has the advantage that the operator has this spherical. Element meets in the simplest way, this spherical actuating element on the joy stick also in no way hinders the actuation of the joy stick in any way.
  • the ball is designed as a touch sensor and that a control which resets the optical deflecting element when the ball is not touching the zero position is provided.
  • the operator thereby has the advantage that when the lighting and treatment field is shifted to different regions of the eye, the zero position can always be easily assumed. To do this, it is sufficient to briefly let go of the spherical operating element. This release is determined by the ball designed as a touch sensor and automatically leads to a return of the
  • optical deflecting element in the zero position.
  • the resulting adjustment movement always takes place from the zero position. This facilitates orientation in the eye for the treatment person, who continues to look at the inside of the eye through the observation device.
  • the resetting can be achieved with high precision, since no mechanical elements are required which define a zero position and which can be adjusted and have to be adjusted.
  • the zero position is determined solely by electrical signals and can therefore be achieved with high precision.
  • Fir. 1 shows a schematic view of a medical device for observing the eye with a joy stick positioning of the device and a spherical actuator for the deflecting mirror and
  • FIG. 2 shows a simplified, enlarged sectional view of the joy-stic-like actuating lever for positioning the device with an actuating ball mounted therein for the pivoting of the optical deflection element.
  • the medical device for eye treatment shown in FIG. 1 comprises a foot 1 on which two swivel arms 3 and 4 are rotatably mounted about a vertical axis 2.
  • the first swivel arm 3 carries an observation device 6 r on a holder 5 running vertically upwards, of which a lens 7 and an eyepiece 8 are shown schematically in the drawing.
  • a doctor can look into the eye 9 of a patient.
  • the eye 9 is preferably located on the axis 2, so that when the swivel arm 3 is pivoted about this axis 2, the doctor has the possibility of looking into the eye 9 at different angles.
  • the second swivel arm 4 carries an optical deflecting element 11 in the form of a partially transparent mirror, which is located in front of the lens 7 and deflects a beam 12 incident vertically from above into the interior of the eye 9 on a holder 10 which also protrudes vertically upwards.
  • This beam of rays 12 is generated by a light source, which is not shown in the drawing and is designed as a slit lamp, and serves to illuminate a specific area in the eye, which the doctor can observe thereby.
  • laser radiation invisible to the eye is faded into the beam bundle -12, which is likewise directed into the eye via the optical deflection element 11 and is used there to treat the eye tissue, for example to coagulate the tissue.
  • the inside of the eye is observed through the objective 7 and through the optical deflection element designed as a partially transparent mirror.
  • This optical deflection element 11 is perpendicular
  • a corresponding drive for pivoting this optical deflecting element 11 in the manner described is located in the holder 10 and is not shown in the drawing.
  • the two swivel arms 3 and 4 are designed to be adjustable from the drawing relative to the foot in the horizontal plane in a manner not apparent from the drawing, in two perpendicular directions, so that both the distance of the optical device from the eye and a suitable position the lateral position can also be changed.
  • This adjustment of the optical device takes place by means of a drive, not shown in the drawing, which can be activated via an actuating lever 13 mounted on the foot 1 similar to a joystick.
  • a drive not shown in the drawing
  • the examining doctor can move the medical device into any position in the horizontal plane.
  • the actuating lever 13 has a rotatable outer sleeve, the rotation of which to change the height of the medical
  • the actuating lever 13 can also be designed to be rotatable overall about its longitudinal axis, in this case it is provided that the electrical signals generated by this rotary movement via a rotary pulse generator are used in a controller in order to divide the rotary components of the ball 14 to convert to the two directions of movement of the mirror. If the actuating lever 13 together with the ball 14 and the rotary pulse generators 17 and 18 is rotated about the longitudinal axis, the rotary pulse generators 17 and 18 will generate different signals when the ball 14 is rotated about a fixed rotary axis, depending on the relative speed - Sition the angular momentum encoder 17 and 18 are relative to the stationary axis.
  • An electrical signal characteristic of the angular position of the actuating lever 13 can be used in order to determine this relative position of the rotary pulse generators 17 and 18 relative to a fixed axis and thereby to achieve a corresponding movement of the deflecting mirror for each angular position of the actuating lever 13. This makes it possible that, regardless of the respective angular position of the actuating element 13 about its longitudinal axis, a rotation of the ball 14 about the same fixed axis of rotation always leads to the same pivoting of the deflecting element.
  • a ball 14 is freely rotatably mounted on the upper side thereof, which partially protrudes upward from the actuating lever 13.
  • This ball 14 is in frictional engagement with two mutually perpendicular receiving shafts 15 and 16 of two rotary pulse generators 17 and 18 held on the actuating lever 13, so that when the ball 14 is rotated, the rotational movement of the ball is transmitted to the receiving shafts 15 and 16.
  • Each receiving shaft 15 only receives the component of the rotary movement that takes place about an axis of rotation running parallel to the respective receiving shaft, i.e. the rotational movement of the ball is broken down into components and transmitted to the rotary pulse generators 17 and 18, which generate pulses in accordance with the respective rotational component of the ball.
  • These pulses are fed to a controller 20, which in turn actuates the swivel drive for the optical deflection element 11.
  • the ball 14 is designed as a touch sensor, i.e. the ball generates an electrical signal when it is touched by the treating doctor. This can be achieved, for example, by measuring the resistance between the ball and the actuating lever 13, which changes as a result of the hand resistance of the treating doctor as soon as the doctor touches the ball.
  • Another possibility of designing the ball as an actuation sensor is, for example, that it is checked whether an alternating voltage with a certain frequency is applied to the ball, which is picked up as an antenna via the body of the treating doctor and onto the ball is carried over when the doctor touches the ball.
  • touch sensors are known per se, so that a detailed description of such sensors is not provided here.
  • the touch signal is also fed to the controller 19 and is processed in it in such a way that, in the absence of the touch signal, that is to say when the ball is released, the optical deflection element 11 is automatically moved back to a zero or starting position, from which the next contact occurs and adjustment of the ball, the pivoting movement of the deflecting element takes place.
  • This enables the attending physician in the simplest manner to reproducibly achieve the starting position of the deflecting element simply by briefly releasing the ball. Starting from this zero position, the doctor can then wander again and again into the desired area of the eye, this automatic return to the zero position facilitating orientation over the observed eye area.

Landscapes

  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Veterinary Medicine (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Optics & Photonics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

Un appareil médical de traitement des yeux comprend une lampe à fente et un laser générateur d'un faisceau de traitement qui peut être guidé vers l'÷il d'un patient avec le faisceau d'éclairage généré par la lampe à fente au moyen d'un élément déflecteur optique, un dispositif d'observation de l'÷il et un dispositif d'ajustement de la position relative de l'appareil par rapport à l'÷il, réglable au moyen d'un élément d'actionnement. L'élément déflecteur optique est entraîné de façon à pivoter autour de deux axes perpendiculaires l'un à l'autre. Afin de simplifier l'actionnement de l'entraînement qui fait pivoter l'élément déflecteur optique, une bille montée de manière librement rotative sur l'appareil est en contact par friction avec les arbres moteurs de deux générateurs de moment angulaire montés perpendiculairement l'un à l'autre sur l'appareil. Chaque générateur de moment angulaire commande le pivotement de l'élément déflecteur optique autour d'un des axes.
PCT/EP1989/001350 1989-01-27 1989-11-11 Appareil medical de traitement des yeux WO1990008523A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19893902409 DE3902409C1 (fr) 1989-01-27 1989-01-27
DEP3902409.1 1989-01-27

Publications (1)

Publication Number Publication Date
WO1990008523A1 true WO1990008523A1 (fr) 1990-08-09

Family

ID=6372914

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP1989/001350 WO1990008523A1 (fr) 1989-01-27 1989-11-11 Appareil medical de traitement des yeux

Country Status (2)

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DE (1) DE3902409C1 (fr)
WO (1) WO1990008523A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0947219A3 (fr) * 1998-03-30 2000-03-01 CARL ZEISS JENA GmbH Méthode et appareillage de contrôle et de régulation des paramètres de traitement d'un dispositif de traitement ophthalmologique
WO2010006741A1 (fr) * 2008-07-16 2010-01-21 Carl Zeiss Meditec Ag Élément de commande pour la commande à une seule main d'appareils ophtalmologiques

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP4959249B2 (ja) * 2006-08-01 2012-06-20 株式会社レクザム 眼科装置

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4443075A (en) * 1981-06-26 1984-04-17 Sri International Stabilized visual system
GB2143052A (en) * 1983-07-06 1985-01-30 Lasers For Medicine Inc Laser ophthalmic surgical system
US4520816A (en) * 1983-01-12 1985-06-04 Schachar Ronald A Method and apparatus for delivering laser energy for ophthalmic use
EP0228778A1 (fr) * 1985-10-18 1987-07-15 Kowa Company, Ltd. Système de coagulation à laser
WO1987005205A1 (fr) * 1986-03-08 1987-09-11 G. Rodenstock Instrumente Gmbh Installation a laser pour l'examen et le traitement de l'oeil

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE7608689U1 (de) * 1978-09-14 Optische Werke G. Rodenstock, 8000 Muenchen Lichtkoagulator
DE3607721A1 (de) * 1986-03-08 1987-09-10 Rodenstock Instr Vorrichtung zur laserbehandlung des auges

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4443075A (en) * 1981-06-26 1984-04-17 Sri International Stabilized visual system
US4520816A (en) * 1983-01-12 1985-06-04 Schachar Ronald A Method and apparatus for delivering laser energy for ophthalmic use
GB2143052A (en) * 1983-07-06 1985-01-30 Lasers For Medicine Inc Laser ophthalmic surgical system
EP0228778A1 (fr) * 1985-10-18 1987-07-15 Kowa Company, Ltd. Système de coagulation à laser
WO1987005205A1 (fr) * 1986-03-08 1987-09-11 G. Rodenstock Instrumente Gmbh Installation a laser pour l'examen et le traitement de l'oeil

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0947219A3 (fr) * 1998-03-30 2000-03-01 CARL ZEISS JENA GmbH Méthode et appareillage de contrôle et de régulation des paramètres de traitement d'un dispositif de traitement ophthalmologique
US6312422B1 (en) 1998-03-30 2001-11-06 Carl Zeiss Jena Gmbh Process and arrangement for monitoring and controlling the treatment parameters in an ophthalmic treatment device
WO2010006741A1 (fr) * 2008-07-16 2010-01-21 Carl Zeiss Meditec Ag Élément de commande pour la commande à une seule main d'appareils ophtalmologiques

Also Published As

Publication number Publication date
DE3902409C1 (fr) 1990-08-23

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