WO2016159331A1 - Dispositif laser pour chirurgie ophtalmologique, dispositif ophtalmologique, programme de commande de dispositif ophtalmologique, et programme de commande pour chirurgie ophtalmologique - Google Patents

Dispositif laser pour chirurgie ophtalmologique, dispositif ophtalmologique, programme de commande de dispositif ophtalmologique, et programme de commande pour chirurgie ophtalmologique Download PDF

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Publication number
WO2016159331A1
WO2016159331A1 PCT/JP2016/060858 JP2016060858W WO2016159331A1 WO 2016159331 A1 WO2016159331 A1 WO 2016159331A1 JP 2016060858 W JP2016060858 W JP 2016060858W WO 2016159331 A1 WO2016159331 A1 WO 2016159331A1
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Prior art keywords
eye
unit
ophthalmic
light
ophthalmic laser
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PCT/JP2016/060858
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English (en)
Japanese (ja)
Inventor
柴田　隆義
村上　なほ
真也 岩田
佳紀 熊谷
類 福岡
通浩 滝井
遠藤　雅和
Original Assignee
株式会社ニデック
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Priority claimed from JP2015073995A external-priority patent/JP2016193032A/ja
Priority claimed from JP2015073991A external-priority patent/JP2016193028A/ja
Priority claimed from JP2015073992A external-priority patent/JP2016193029A/ja
Priority claimed from JP2015073993A external-priority patent/JP2016193030A/ja
Application filed by 株式会社ニデック filed Critical 株式会社ニデック
Publication of WO2016159331A1 publication Critical patent/WO2016159331A1/fr

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    • 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
    • A61F9/009—Auxiliary devices making contact with the eyeball and coupling in laser light, e.g. goniolenses

Definitions

  • One of the present disclosure relates to an ophthalmic laser surgical apparatus and an ophthalmic surgical control program for treating an eye by irradiating a subject's eye with surgical laser light.
  • One of the present disclosure relates to an ophthalmologic apparatus that irradiates light to the eyes and receives reflected light, and an ophthalmologic apparatus control program that controls the ophthalmologic apparatus.
  • One of the present disclosure relates to an ophthalmologic apparatus that fixes the position of the eye with respect to the apparatus main body by an eye fixing section, and an ophthalmologic apparatus control program that controls the ophthalmologic apparatus.
  • an ophthalmic laser surgical apparatus that irradiates a surgical laser beam to an eye with an interface interposed between an eye of a subject and the apparatus main body.
  • the interface used in the ophthalmic laser surgical apparatus described in Patent Document 1 includes an eyeball fixing interface for fixing the anterior eye part.
  • an ophthalmologic apparatus is known that irradiates a subject's eyes with light, receives reflected light, and processes a light reception signal (for example, generation of an eye observation image or eye inspection).
  • an ophthalmic laser surgical apparatus disclosed in Patent Document 2 images a patient's eye illuminated by visible light or infrared light with a front observation unit and displays it on a monitor.
  • an ophthalmic laser surgical apparatus that irradiates an eye with surgical laser light while a subject's eyes are fixed.
  • an ophthalmic laser surgical apparatus described in Patent Document 3 includes a suction ring for fixing the eye. The alignment of the suction ring is performed in a state where the annular suction ring and the symbol mark indicating the axis of the eyeball are displayed on the display unit.
  • an eye examination or an operation may be performed in a state where the position of the eye with respect to the apparatus main body is fixed by an eye fixing unit.
  • an ophthalmic laser surgical apparatus described in Patent Document 3 includes a suction ring for fixing the eye. The alignment of the suction ring is performed with the suction ring and the eye photographed from the front being displayed on the display unit.
  • the processing result of the received light signal may vary depending on the positional relationship between the apparatus main body and the eyes.
  • the suction ring is aligned while the positional relationship between the annular suction ring and the axis of the eyeball is compared.
  • the optimal position of the suction ring with respect to the eye is not uniquely determined, it is difficult to perform alignment with high accuracy. If the coupling position of the eye fixing portion with respect to the eye is shifted, aberration may occur or undesirable eye deformation may occur.
  • the eye fixing unit is coupled to the eye, it may be difficult to couple the eye fixing unit to the eye unless the subject's eyes are sufficiently opened.
  • Various inconveniences can occur when it is not easy to determine whether the eye is fully opened. For example, when the eye fixing part and the eye are once combined, if it is found that the eye opening is insufficient, it is necessary to redo the opening and try again.
  • the present disclosure aims to provide an ophthalmic laser surgical apparatus, an ophthalmologic apparatus, an ophthalmologic apparatus control program, and an ophthalmic surgery control program that solve at least one of the problems of the prior art.
  • One of the typical purposes of the present disclosure is to provide an ophthalmic laser surgical apparatus capable of suppressing an influence caused by displacement of at least one of the position and the angle of the interface with respect to the apparatus main body.
  • One of the typical purposes of the present disclosure is to suppress the effect of changing the position of the eye with respect to the apparatus body when receiving the reflected light reflected by the eye and processing the received light signal.
  • One of the typical purposes of the present disclosure is to provide an ophthalmic laser surgical apparatus and an ophthalmic surgical control program capable of coupling an eye fixing unit to an appropriate position of the eye with higher accuracy.
  • One of the typical purposes of the present disclosure is to provide an ophthalmic apparatus and an ophthalmologic apparatus control program for smoothly coupling an eye fixing unit to an eye.
  • An ophthalmic laser surgical apparatus provided by an exemplary embodiment of the present disclosure is an ophthalmic laser surgical apparatus that treats the eye by irradiating an eye of a subject with a surgical laser beam, and the surgical laser Of the optical path of light, an interface interposed between the apparatus main body and the eye, and at least a part of the interface are detachably mounted, and a mounting interface which is the mounted interface is attached to the apparatus main body.
  • a holding unit that holds at least one of the position and the angle in an adjustable state, and a control unit that controls the operation of the ophthalmic laser surgical apparatus, and the control unit includes the main body of the mounting interface.
  • an embodiment according to the present disclosure includes the following configuration.
  • An ophthalmologic apparatus provided by an exemplary embodiment of the present disclosure controls a light source that irradiates light to a subject's eye, a light receiving element that receives reflected light reflected by the eye, and an operation of the ophthalmologic apparatus.
  • a controller wherein the controller acquires position information indicating the position of the eye with respect to the apparatus main body, and adjusts the amount of light emitted from the light source to the eye according to the acquired position information. To do.
  • An ophthalmologic apparatus provided by an exemplary embodiment of the present disclosure is fixed to the apparatus main body, and receives a light source that irradiates light on a subject's eye and reflected light reflected by the eye.
  • a front image capturing unit that captures a front image of the anterior eye part, and a control unit that controls the operation of the ophthalmologic apparatus, wherein the control unit acquires position information indicating the position of the eye with respect to the apparatus main body. Then, at least one of the gain and offset of the front image captured by the front image capturing unit is adjusted according to the acquired position information.
  • An ophthalmologic apparatus control program provided by an exemplary embodiment of the present disclosure is an ophthalmologic apparatus control program for controlling an ophthalmologic apparatus, and the ophthalmologic apparatus includes a light source that emits light to an eye of a subject, A light receiving element that receives reflected light reflected by the eye, and the ophthalmic apparatus control program is executed by a processor of the ophthalmic apparatus to acquire position information indicating the position of the eye with respect to the apparatus body And causing the ophthalmologic apparatus to execute a step and a light amount adjustment step of adjusting a light amount of light emitted from the light source to the eye according to the acquired position information.
  • an embodiment according to the present disclosure includes the following configuration.
  • An ophthalmic laser surgical apparatus provided by an exemplary embodiment of the present disclosure is an ophthalmic laser surgical apparatus that treats the eye by irradiating the eye of a subject with surgical laser light, and is coupled to the eye
  • An annular eye fixing unit that fixes the position of the eye with respect to the apparatus body, a light receiving element that captures an image of the eye, and a control unit that controls the operation of the ophthalmic laser surgical apparatus,
  • the control unit detects a center of the annular eye fixing unit, and controls a coupling operation executed to couple the eye fixing unit to the eye with reference to the detected center of the eye fixing unit.
  • An ophthalmic surgical control program provided by an exemplary embodiment of the present disclosure is an ophthalmic surgical control program for controlling an ophthalmic laser surgical apparatus, and the ophthalmic laser surgical apparatus is coupled to an eye of a subject.
  • an annular eye fixing unit that fixes the position of the eye with respect to the apparatus body is provided, and the ophthalmic surgery control program is executed by the processor of the ophthalmic laser surgical apparatus, thereby the center of the annular eye fixing unit.
  • the laser surgical apparatus is used.
  • an embodiment according to the present disclosure includes the following configuration.
  • An ophthalmologic apparatus includes a front image capturing unit that captures a front image of the anterior eye part of the eye at different magnifications according to a distance between the apparatus main body and a subject's eye.
  • An eye fixing unit that fixes the position of the eye with respect to the apparatus body by being coupled to the eye, and a control unit that controls the operation of the ophthalmic apparatus, and the control unit displays the front image.
  • a size target indicating the size of the eye fixing unit is superimposed on the front image of the display unit.
  • An ophthalmologic apparatus control program provided by an exemplary embodiment of the present disclosure is an ophthalmologic apparatus control program for controlling an ophthalmologic apparatus, and the ophthalmologic apparatus is responsive to a distance between the apparatus main body and a subject's eye.
  • a front image capturing unit that captures a front image of the anterior segment of the eye at different magnifications, and an eye fixing unit that fixes the position of the eye relative to the apparatus body by being coupled to the eye
  • FIG. 1 is a diagram illustrating an overall configuration of an ophthalmic laser surgical apparatus 1.
  • FIG. 2 is a diagram illustrating a schematic configuration of a front image capturing unit 30.
  • FIG. 3 is a diagram showing a schematic configuration of a fixation target projection unit 40.
  • FIG. It is a figure which shows the outline of the mechanical structure of the ophthalmic laser surgery apparatus.
  • 6 is a cross-sectional view of an immersion interface 91 coupled to an eye E.
  • FIG. FIG. 6 is a cross-sectional view of an applanation interface 92 coupled to an eye E. It is a flowchart of IF adjustment operation control processing (eye fixed part standard) performed by the controller of the ophthalmic laser surgical apparatus 1.
  • FIG. 6 is a diagram illustrating an example of an IF adjustment in-progress image 105.
  • FIG. 6 is a diagram schematically illustrating a case where the vertical positions of the IF lenses 100 and 110 are deviated from a reference axis S.
  • FIG. 4 is a diagram schematically showing a case where the vertical positions of IF lenses 100 and 110 are on a reference axis S.
  • FIG. It is a flowchart of IF adjustment operation control processing (lens standard) performed by the controller of the ophthalmic laser surgical apparatus 1. It is explanatory drawing for demonstrating one of the modifications of the method of detecting the vertical position 121.
  • FIG. 6 is a diagram schematically illustrating a case where the vertical positions of the IF lenses 100 and 110 are deviated from a reference axis S.
  • FIG. 4 is a diagram schematically showing a case where the vertical positions of IF lenses 100 and 110 are on a reference axis S.
  • FIG. It is a flowchart of
  • the ophthalmic laser surgical apparatus 1 is illustrated as an example of an ophthalmologic apparatus that performs an operation or examination of a subject (patient or subject).
  • the ophthalmic laser surgical apparatus 1 can treat both the cornea and the crystalline lens of the eye E of the subject.
  • the technology exemplified in the present embodiment includes an ophthalmologic apparatus (for example, an apparatus for photographing an eye, an apparatus for measuring visual acuity, an apparatus for measuring intraocular pressure, and an eye shape) for examining an eye of a subject. This includes techniques applicable to measuring devices and the like.
  • the technique exemplified in the present embodiment also includes a technique that can be applied to other surgical apparatuses (for example, an apparatus that performs photocoagulation of the fundus using a laser).
  • the surgical laser light source 2 emits surgical laser light for treating the eye E.
  • the pulsed laser light emitted from the surgical laser light source 2 is condensed in the tissue of the eye E, plasma is generated at the condensing position (spot), and the tissue is cut and fractured. Is called.
  • the above phenomenon is sometimes referred to as photodisruption.
  • a device that emits pulsed laser light in femtosecond to picosecond order can be used.
  • the direction along the optical path of the surgical laser beam emitted from the surgical laser light source 2 is defined as the Z direction.
  • One of the directions intersecting the Z direction (vertically intersecting in the present embodiment) is defined as the X direction.
  • a direction that intersects both the Z direction and the X direction is defined as a Y direction.
  • the reference light source 3 emits reference light (reference laser light) serving as a reference for performing various controls.
  • the reference light in the present embodiment is used when detecting the positional relationship (XY positional relationship) between the optical axis of the surgical laser beam and the imaging region captured by the front image capturing unit 30 (described later). May be used.
  • the reference light of the present embodiment may be used when detecting the inclination of the light receiving element 31 (see FIG. 2) in the front image photographing unit 30.
  • the reference light of this embodiment may be used when detecting the irradiation position of the surgical laser light.
  • the reference light source 3 of the present embodiment can emit reference light for projecting the reference target 108 (see FIG. 8) having a predetermined shape on the optical path.
  • the reference visual target 108 has a shape spreading in a one-dimensional direction or a two-dimensional direction on a plane perpendicular to the optical axis of the reference light.
  • the reference light source 3 can also emit reference light for projecting a spot-like spot onto the optical path.
  • the wavelength of the reference light emitted from the reference light source 3 can be selected as appropriate.
  • the type of light source employed as the reference light source 3 can be selected as appropriate.
  • a He—Ne laser light source that emits red laser light having a wavelength of about 632 nm
  • an SLD laser light source that emits laser light having a broad wavelength
  • an IR laser light source that emits laser light in the infrared region, and the like are used as the reference light source 3. It may be adopted.
  • the dichroic mirror 4 is provided in the optical path of the surgical laser beam.
  • the dichroic mirror 4 combines the surgical laser light emitted from the surgical laser light source 2 and the reference light emitted from the reference light source 3.
  • the zoom expander 5 is provided between the surgical laser light source 2 and the XY scanning unit 10 (described later) in the optical path of the surgical laser light.
  • the zoom expander 5 can change the beam diameter of the surgical laser light.
  • the control unit 50 (described later) drives the zoom expander 5 to change the beam diameter of the surgical laser beam, thereby operating the surgical laser beam emitted from the objective lens 20 (described later) toward the eye E. Can be adjusted.
  • the high-speed Z-scanning unit 6 is a part of the Z-scanning unit that scans the spot where the surgical laser beam is collected in the Z direction.
  • the high-speed Z scanning unit 6 is provided between the zoom expander 5 and the XY scanning unit 10 in the optical path of the surgical laser light.
  • the high-speed Z scanning unit 6 of the present embodiment includes a moving optical element 7 having negative refractive power and a high-speed Z scanning driving unit 8 that moves the moving optical element 7 along the optical axis.
  • a galvano motor or the like that can move the moving optical element 7 at a high speed may be used for the high-speed Z scanning drive unit 8.
  • a lens 9 is provided between the moving optical element 7 and the XY scanning unit 10.
  • the lens 9 guides the laser light that has passed through the high-speed Z scanning unit 6 to the XY scanning unit 10.
  • the moving optical element 7 moves in the optical axis direction
  • the spot of the surgical laser beam on the eye E moves in the Z direction.
  • the high speed Z scanning unit 6 can scan the spot in the Z direction at a higher speed than the wide range Z scanning unit 18 (described later).
  • the XY scanning unit 10 scans the surgical laser beam in the XY direction intersecting the optical axis.
  • the XY scanning unit 10 of this embodiment includes an X deflection device 11 and a Y deflection device 12.
  • the X deflection device 11 scans the surgical laser beam in the X direction.
  • the Y deflection device 12 further scans the surgical laser beam scanned in the X direction by the X deflection device 11 in the Y direction.
  • galvanometer mirrors are employed for both the X deflection device 11 and the Y deflection device 12.
  • a scanner such as a polygon mirror or an acousto-optic device
  • a scanner such as a polygon mirror or an acousto-optic device
  • at least one of the X deflection device 11 and the Y deflection device 12 may include a plurality of scanners.
  • the relay unit 14 is provided between the XY scanning unit 10 and the objective lens 20.
  • the relay unit 14 relays the surgical laser light that has passed through the XY scanning unit 10 to the objective lens 20 by the upstream relay optical element 15 and the downstream relay optical element 16.
  • the wide-range Z scanning unit 18 is a part of the Z scanning unit that scans the spot in the Z direction.
  • the wide-range Z scanning unit 18 of the present embodiment moves the optical unit including the XY scanning unit 10 and the upstream relay optical element 15 along the optical axis by the wide-range Z scanning drive unit 19, thereby The optical path length between the side relay optical element 15 and the objective lens 20 is changed.
  • the spot is scanned in the Z direction.
  • the wide-range Z scanning unit 18 can scan a spot in a wide range in the Z direction as compared with the high-speed Z scanning unit 6.
  • the configuration of the wide-range Z scanning unit 18 can be changed as appropriate.
  • the ophthalmic laser surgical apparatus 1 includes at least one of optical elements (for example, the upstream relay optical element 15, the downstream relay optical element 16, and the objective lens 20) located on the downstream side of the XY scanning unit 10.
  • the spot may be scanned in the Z direction by moving in the optical axis direction. It is also possible to scan the spot in the Z direction using only the high-speed Z scanning unit 6.
  • the objective lens 20 is arranged on the downstream side of the optical path of the surgical laser light with respect to the downstream side relay optical element 16 of the relay unit 14.
  • the surgical laser light that has passed through the objective lens 20 is focused on the tissue of the eye E via the interface 90.
  • the interface 90 is interposed between the apparatus main body and the eye E among optical paths of various lights (surgical laser light, reference light, observation light, OCT light, and fixation target projection light) that pass through the objective lens 20. Coupled to eye E.
  • the interface 90 of the present embodiment optically and physically connects the apparatus main body and the eye E (mediates propagation of light between the apparatus main body and the eye E).
  • Various configurations for example, an immersion interface, an applanation interface, etc.
  • Details of the interface 90 will be described later with reference to FIGS. 5 and 6.
  • the dichroic mirror (optical axis combining unit) 22 is provided between the objective lens 20 and the downstream relay optical element 16 in the optical path of the surgical laser beam.
  • the dichroic mirror 22 has coaxial optical axes of various lights propagating between the ophthalmic laser surgical apparatus 1 and the eye E.
  • the dichroic mirror 22 reflects most of the surgical laser light emitted from the surgical laser light source 2 toward the objective lens 20.
  • the dichroic mirror 22 reflects part of the reference light emitted from the reference light source 3 and transmits the rest (details of the optical path of the reference light will be described later).
  • the dichroic mirror 22 transmits most of the observation light, the OCT light, and the fixation target projection light.
  • the observation light is reflected light that is reflected by the eye E and enters the front image capturing unit 30.
  • the OCT light is light emitted from the cross-sectional image photographing unit 23 for photographing a cross-sectional image.
  • the fixation target projection light is light emitted from the fixation target projection unit 40 in order to fix the eye E.
  • the front image capturing unit 30 is a part of a capturing unit that captures an image of the eye E.
  • the front image capturing unit 30 captures a front image of the eye E (in this embodiment, a front image of the anterior segment) by receiving the reflected light (observation light) reflected by the eye E.
  • the front image capturing unit 30 can also capture at least a part of the interface 90 attached to the apparatus main body.
  • reflected light of infrared light emitted from the alignment / illumination light source 64 (see FIG. 4) of the alignment index projection unit 63 is received by the front image capturing unit 30 as observation light. Details of the front image capturing unit 30 will be described later with reference to FIG.
  • the cross-sectional image capturing unit 23 is also a part of the image capturing unit that captures an image of the eye E.
  • the cross-sectional image photographing unit 23 can photograph a cross-sectional image of the eye E.
  • the cross-sectional image photographing unit 23 can also photograph a cross-sectional image of the interface lenses 100 and 110 (details will be described later with reference to FIGS. 5 and 6) included in the interface 90.
  • the cross-sectional image capturing unit 23 of the present embodiment includes an OCT light source, a light splitter, a reference optical system, a scanning unit, and a light receiving element.
  • the OCT light source emits OCT light for taking a cross-sectional image.
  • the optical splitter divides the OCT light emitted from the OCT light source into reference light and measurement light.
  • the reference light enters the reference optical system, and the measurement light enters the scanning unit.
  • the reference optical system has a configuration that changes the optical path length difference between the measurement light and the reference light.
  • the scanning unit scans the measurement light in a two-dimensional direction (XY direction).
  • the detector detects an interference state between the measurement light reflected by the subject and the reference light that has passed through the reference optical system.
  • the measurement light is scanned, and the interference state between the reflected measurement light and the reference light is detected, whereby information in the depth direction of the object to be imaged is acquired.
  • a cross-sectional image to be imaged is acquired based on the acquired depth information.
  • the cross-sectional image photographing unit 23 can be used for the cross-sectional image photographing unit 23.
  • any one of SS-OCT, SD-OCT, TD-OCT, etc. may be adopted for the cross-sectional image photographing unit 23.
  • the ophthalmic laser surgical apparatus 1 may capture a cross-sectional image of an imaging target using a technique other than optical interference (for example, Shine-Pluke).
  • the fixation target projection unit 40 can project a fixation target that guides the line of sight of the eye E of the subject onto the eye E. That is, the fixation target projection unit 40 is used for performing fixation of the eye E.
  • the fixation target projection unit 40 of the present embodiment can change the projection state of the fixation target onto the eye E. Details of the fixation target projecting unit 40 will be described later with reference to FIG.
  • the dichroic mirror 24 is coaxial with the imaging optical axis of the front image capturing unit 30 (that is, the optical axis of the reflected light incident on the front image capturing unit 30) and the projection optical axis of the fixation target projecting unit 40. Specifically, in the present embodiment, most of the reflected light incident on the front image capturing unit 30 is transmitted through the dichroic mirror 24, and most of the light of the fixation target projected from the fixation target projection unit 40 is dichroic. Reflected by the mirror 24.
  • the dichroic mirror 25 has the photographing optical axis of the front image photographing unit 30 and the projection optical axis of the fixation target projecting unit 40 coaxial with the photographing optical axis of the cross-sectional image photographing unit 23. Specifically, in the present embodiment, most of the reflected light incident on the front image capturing unit 30 is transmitted through the dichroic mirror 25. Most of the light of the fixation target projected from the fixation target projection unit 40 also passes through the dichroic mirror 25. Further, most of the reference light projected from the reference light source 2 also passes through the dichroic mirror 25. Most of the OCT light for taking a cross-sectional image is reflected by the dichroic mirror 25.
  • the irradiation position detection unit 26 is provided on an optical path branched from the optical path of the surgical laser light extending from the surgical laser light source 2 to the eye E.
  • the optical path of the surgical laser light extending from the scanning units 6, 10, 18 to the dichroic mirror 22 is branched by the dichroic mirror 22.
  • An irradiation position detector 26 is installed on the optical path of light that passes through the dichroic mirror 22 among the branched optical paths. However, the installation position of the irradiation position detector 26 can be changed.
  • the irradiation position detection unit 26 detects the irradiation position of the surgical laser beam. As described above, in the present embodiment, the irradiation position detection unit 26 is provided downstream of the scanning units 6, 10, and 18 in the optical path of the surgical laser beam. Therefore, the irradiation position detection unit 26 can more accurately detect the irradiation position of the surgical laser beam scanned by the scanning units 6, 10, and 18. That is, the drive accuracy of the elements (galvanometer mirrors and lenses) of the scanning units 6, 10, and 18 are also detected. In the present embodiment, the surgical laser light emitted from the surgical laser light source 2 and the reference light emitted from the reference light source 3 are coaxial.
  • the irradiation position detection unit 26 of the present embodiment can detect the irradiation position of the surgical laser beam that is coaxial with the reference light by detecting the reference light. Further, the irradiation position detection unit 26 may directly detect the surgical laser beam.
  • Various devices can be appropriately employed for the irradiation position detection unit 26. As an example, in this embodiment, a wavefront sensor is employed as the irradiation position detection unit 26. In this case, the wavefront of the laser beam is also detected in addition to the irradiation position.
  • the half mirror 27 branches the optical path of the reference light transmitted through the dichroic mirror 22.
  • One of the branched optical paths extends to the irradiation position detector 26 and the other extends to the mirror 28.
  • the mirror 28 reflects the reference light incident from the half mirror 27 and makes it incident on the half mirror 27 again.
  • the optical axis of the reference light incident on the mirror 28 and the optical axis of the reference light reflected by the mirror 28 are coaxial.
  • the reference light reflected by the mirror 28 is reflected again by the half mirror 27 and reflected by the dichroic mirror 22. Thereafter, the reference light passes through the dichroic mirror 25 and the dichroic mirror 24 and enters the front image capturing unit 30. As a result, the reference light is projected onto the light receiving element 31 (see FIG.
  • the optical elements including the dichroic mirror 4, the dichroic mirror 22, the half mirror 27, and the mirror 28 serve as a reference light projection unit that projects the reference light onto the light receiving element 31.
  • the dichroic mirror 4 emits reference light with the optical axis of the surgical laser light and the optical axis of the reference light coaxially from the surgical laser light source 2 side of the scanning laser beam 6, 10 and 18 in the optical path of the surgical laser light. insert.
  • the dichroic mirror 22 divides the optical axis of the reference light from the optical axis of the surgical laser light on the eye E side of the scanning units 6, 10 and 18 in the optical path of the surgical laser light, thereby supplying the reference light. Projecting on the light receiving element 31. In this case, the relationship between the optical axis of the surgical laser beam and the optical axis of the reference beam is maintained even when the states of the scanning units 6, 10, and 18 change due to deterioration or impact.
  • the optical path of the reference light is at least a part of the optical path of the surgical laser light extending from the surgical laser light source 2 to the irradiation position detector 26 (specifically, from the dichroic mirror 4 to the dichroic mirror 22). And a common optical path.
  • the irradiation position of the surgical laser beam is appropriately detected by both the irradiation position detector 26 and the front image.
  • the optical path of the surgical laser beam extending from the dichroic mirror 22 to the eye E and the optical path of the reference light extending from the dichroic mirror 22 to the front image capturing unit 30 is a front image from the eye E. This coincides with the optical path of the reflected light for photographing the front image extending to the photographing unit 30.
  • the reference light projection unit of the present embodiment projects the reference light onto the light receiving element 31 of the front image photographing unit 30 along an optical axis whose relationship with the photographing optical axis of the cross-sectional image photographing unit 23 is predetermined.
  • the optical path of the reference light and the photographing optical path of the cross-sectional image photographing unit 23 are common at least in part (between the dichroic mirror 22 and the dichroic mirror 25 in the present embodiment). In this case, even if the correspondence between the imaging region of the front image and the imaging region of the cross-sectional image (in this embodiment, the scanning range of the OCT light scanned by the scanning unit of the cross-sectional image imaging unit 23) changes, both Is determined by reference light reflected on the front image.
  • the arrangement position of the reference light source 3 can be changed.
  • the ophthalmic laser surgical apparatus 1 may project the reference light on the light receiving element 31 without passing through the scanning units 6, 10, and 18. .
  • the reference light source 3 may be arranged instead of the mirror 28.
  • the ophthalmic laser surgical apparatus 1 can also use the laser light generated by the surgical laser light source 2 as reference light. That is, the surgical laser light source 2 and the reference light source 3 can be shared. In this case, the ophthalmic laser surgical apparatus 1 uses the laser light generated by the surgical laser light source 2 as the surgical laser light and the reference light, and outputs the light from the surgical laser light source 2 and the light receiving element. At least one of a filter for protecting 31 may be changed.
  • the control unit 50 includes a CPU 51, a ROM 52, a RAM 53, a nonvolatile memory (not shown), and the like.
  • the CPU 51 performs various controls of the ophthalmic laser surgical apparatus 1 (for example, control of the surgical laser light source 2, control of the reference light source 3, operation control of the scanning units 6, 10, and 18, image shooting control, and fixation target projection).
  • Control controls of the ophthalmic laser surgical apparatus 1 (for example, control of the surgical laser light source 2, control of the reference light source 3, operation control of the scanning units 6, 10, and 18, image shooting control, and fixation target projection).
  • Control controls the ophthalmic laser surgical apparatus 1 (for example, control of the surgical laser light source 2, control of the reference light source 3, operation control of the scanning units 6, 10, and 18, image shooting control, and fixation target projection).
  • Control controls of the ophthalmic laser surgical apparatus 1 (for example, control of the surgical laser light source 2, control of the reference light source 3, operation control of the scanning units 6, 10, and 18, image shooting control, and fixation target projection).
  • the display unit 54 can display various images.
  • the operation unit 55 is operated by a user (for example, an operator, an examiner, an assistant, etc.).
  • the control unit 50 receives input of various operation instructions by the user via the operation unit 55.
  • various devices such as a touch panel, various buttons, a keyboard, and a mouse provided in the display unit 54 may be appropriately employed.
  • the display unit 54 and the operation unit 55 may be incorporated in the apparatus main body of the ophthalmic laser surgical apparatus 1 or may be another device connected to the apparatus main body by wire or wirelessly.
  • Various devices for example, a monitor, a projector, etc.
  • display images can be used for the display unit 54.
  • FIG. 1 illustrates the case where one control unit 50 is used as the controller of the ophthalmic laser surgical apparatus 1.
  • the ophthalmic laser surgical apparatus 1 may be controlled by a plurality of controllers.
  • the ophthalmic laser surgical apparatus 1 may include an apparatus main body including various optical elements and actuators, and a personal computer connected to the apparatus main body.
  • the controller of the personal computer may create laser irradiation control data
  • the controller of the apparatus main body may control the driving of the actuator in accordance with the created irradiation control data.
  • display control of the display unit 54, analysis of captured images, calculation of various parameters, and the like may be executed by a controller of a personal computer. That is, it is not necessary for all the control processes described later to be executed by one controller of the apparatus main body.
  • the front image capturing unit 30 will be described with reference to FIG.
  • the front image capturing unit 30 of the present embodiment includes a light receiving element 31, a lens 32, and a light receiving adjustment unit (focus adjustment unit) 33.
  • the light receiving element 31 receives reflected light (observation light) reflected by the eye E.
  • the light receiving element 31 of the present embodiment captures an image of the eye E (specifically, a front image of the anterior eye part) by receiving the reflected light from the eye E.
  • a two-dimensional light receiving element for example, CCD, CMOS, etc.
  • the lens 32 conjugates the imaging target region of the eye E and the light receiving element 31.
  • the light receiving adjustment unit 33 adjusts the light receiving state of the reflected light in the light receiving element 31.
  • the light receiving adjustment unit 33 of the present embodiment can adjust the focus state of the reflected light in the light receiving element 31. That is, the light receiving adjustment unit 33 according to the present embodiment moves the light receiving element 31 in a direction along the optical axis (imaging optical axis) of reflected light (in the direction of arrow A in FIG. 2), so that the light receiving element 31 and the region to be imaged are obtained.
  • a motor or the like is used for the light receiving adjustment unit 33 of the present embodiment.
  • the front image photographing unit 30 may include a light receiving adjustment unit 34 that moves an optical element (for example, a lens 32) provided on the photographing optical path in a direction along the optical path (in the direction of arrow B in FIG. 2).
  • the ophthalmic laser surgical apparatus 1 can adjust the focus state by moving at least one of the light receiving element 31 and the optical element along the optical axis.
  • the ophthalmic laser surgical apparatus 1 may adjust the light receiving state (for example, the imaging magnification of the front image) other than the focus state by driving the light receiving adjustment unit 34.
  • the front image photographing unit 30 may include a light receiving adjustment unit 36 for inserting the optical element 35 on the photographing optical axis and removing the optical element 35 from the photographing optical axis (arrow C in FIG. 2). reference).
  • the ophthalmic laser surgical apparatus 1 can adjust the light receiving state in stages according to various conditions. For example, the ophthalmic laser surgical apparatus 1 may switch the imaging magnification of the front image by switching the insertion and removal of the optical element 35 between when the cornea is operated and when the lens is operated. Further, the ophthalmic laser surgical apparatus 1 may switch between insertion and removal of the optical element 35 according to the type of the interface 90 used.
  • Two or more of the light receiving adjustment units 33, 34, and 36 may be driven together, or any one of them may be driven independently.
  • the light receiving adjustment units 33, 34, and 36 of the present embodiment out of the optical path of the surgical laser light extending from the surgical laser light source 2 to the eye E out of the optical path of the reflected light from the eye E extending from the eye E to the light receiving element 31.
  • the light receiving state of the reflected light in the light receiving element 31 is adjusted by driving the member. Therefore, even if light reception adjustment is performed, there is no effect on the surgical laser beam.
  • the fixation target projection unit 40 will be described with reference to FIG.
  • the fixation target projection unit 40 of the present embodiment includes a fixation target projection light source 41, a first diaphragm 42, a second diaphragm 43, a lens 44, a movable stage 45, a fixation target movement drive unit 46, a fixed lens 47, and movable optics.
  • An element 48 and an optical element movement drive unit 49 are provided.
  • the fixation target projection light source 41 emits light (fixation target projection light) for projecting the fixation target onto the eye E of the subject.
  • the amount of fixation target projection light emitted from the fixation target projection light source 41 is changed by the control unit 50.
  • the first diaphragm 42 and the second diaphragm 43 make the light flux of the fixation target projection light incident on the projection optical path of the fixation target a certain size.
  • the lens 44 is disposed at a predetermined position with respect to the first diaphragm 42 and the second diaphragm 43 in the projection optical path.
  • the movable stage 45 is equipped with a fixation target projection light source 41, a first diaphragm 42, a second diaphragm 43, and a lens 44.
  • the movable stage 45 can move in a direction intersecting the optical axis (projection optical axis) of the projection optical path (in the direction of arrow D in FIG. 3).
  • the fixation target moving drive unit 46 moves the movable stage 45.
  • a motor or the like can be used for the fixation target movement drive unit 46.
  • the fixed lens 47 is fixed on the projection optical path.
  • the movable optical element (for example, movable lens) 48 moves between an insertion position where the movable optical element (for example, a movable lens) is inserted on the projection optical path and a removal position where the movable optical element 48 is removed from the projection optical path (see arrow E in FIG. 3).
  • the optical element movement drive unit 49 moves the movable optical element 48.
  • Various actuators such as a motor and a solenoid can be used for the optical element movement drive unit 49.
  • the ophthalmic laser surgical apparatus 1 of the present embodiment can change the projection state of the fixation target projected onto the eye E.
  • the ophthalmic laser surgical apparatus 1 can change the amount of fixation target projection light projected onto the eye E by adjusting the power supplied to the fixation target projection light source 41. In this case, the brightness of the fixation target projected toward the eye E is changed. Further, the ophthalmic laser surgical apparatus 1 switches between insertion of the movable optical element 48 on the projection optical path and removal of the movable optical element 48 from the projection optical path by driving the optical element movement drive unit 49.
  • the focal length of the fixation target projection optical system can be changed. In this case, the focusing state of the fixation target in the retina of the eye E is changed.
  • the fixation target projection optical system is various optical members provided in a projection optical path extending from the fixation target projection light source 41 to the eye E.
  • the fixation target projection optical system of the present embodiment includes diaphragms 42 and 43, a lens 44, a fixed lens 47, and a movable optical element 48.
  • the method for changing the projection state of the fixation target can be selected as appropriate.
  • the ophthalmic laser surgical apparatus 1 may move the movable optical element 48 in the direction along the projection optical axis (the direction of arrow F in FIG. 3) by driving the optical element movement drive unit 49.
  • the ophthalmic laser surgical apparatus 1 may move the movable stage 45 in a direction along the projection optical axis (in the direction of arrow G in FIG. 3) by driving the fixation target moving drive unit 46.
  • the focal length of the fixation target projection optical system is changed.
  • both the movable optical element 48 and the movable stage 45 may be moved along the projection optical axis.
  • the method of projecting the fixation target can also be changed.
  • a liquid crystal display may be used instead of the point light source.
  • the fixation direction of the eye E is changed by changing the display position of the target in the display area of the liquid crystal display.
  • a method of arranging a plurality of point light sources and switching the point light sources to be turned on can also be adopted.
  • the ophthalmic laser surgical apparatus 1 includes a housing 60 that houses various optical systems and scanning units 6, 10, 18, and the like.
  • a cylindrical portion 61 is provided in a part of the lower portion of the housing.
  • the objective lens 20 described above is fixed inside the cylindrical portion 61.
  • the tube portion 61 serves as an irradiation end for irradiating the eye E with a surgical laser beam.
  • An alignment index projection unit 63 is provided at the lower end of the housing 60.
  • the alignment index projection unit 63 projects the alignment index onto the cornea of the eye E.
  • the alignment index projection unit 63 of the present embodiment includes a plurality of alignment / illumination light sources 64 that are point light sources that emit light of a finite distance.
  • the light emitted from the alignment / illumination light source 64 also serves as an illumination light source for capturing a front image.
  • an illumination light source may be provided separately from the alignment light source.
  • a plurality (eight in this embodiment) of alignment / illumination light sources 64 are arranged in an annular shape around the central axis of the cylindrical portion 61.
  • control unit 50 processes the front image to detect light emitted from the alignment / illumination light source 64 and reflected by the cornea as a bright spot.
  • the control unit 50 detects the position of the eye E with respect to the apparatus main body based on the detected position of the bright spot.
  • the configuration of the alignment index projection unit 63 can be changed as appropriate.
  • an annular light source that projects a continuous ring-shaped index may be employed.
  • the position of the eye E in the direction (XY direction) intersecting the photographing optical axis of the front image is detected by projecting the alignment index with light of finite distance.
  • the ophthalmic laser surgical apparatus 1 projects the position of the eye E in the direction along the imaging optical axis (Z direction) by projecting both an infinite index and a finite target toward the eye E. You may detect with the position in a direction.
  • the position of the eye E in the Z direction is detected based on the relationship between the infinity index reflected in the front image and the finite distance target.
  • the illumination light may be applied to the eye E by a light source different from the light source provided in the ophthalmic laser surgical apparatus 1.
  • the housing 60 includes a coupling drive unit 66.
  • the coupling drive unit 66 couples the interface 90 to the eye E by moving the housing 60 (device main body) and the holding unit 67 (described later) with respect to the eye E.
  • the coupling drive unit 66 of the present embodiment can move the housing 60 and the holding unit 67 in three directions (X, Y, Z directions).
  • the specific method for changing the relative positional relationship between the apparatus main body and the eye E is not limited to the method of moving the housing 60 in three directions.
  • the coupling drive unit may couple the interface 90 to the eye E by moving the subject relative to the apparatus main body.
  • the adjustment driving unit 70 is connected to the housing 60 and the holding unit 67. At least a part of the interface 90 is detachably attached to the holding unit 67.
  • the holding unit 67 holds the mounting interface in a state where at least one of the position and the angle of the mounted interface 90 (hereinafter sometimes referred to as “mounting interface”) with respect to the apparatus main body can be adjusted.
  • the adjustment driving unit 70 of the present embodiment adjusts the position of the mounting interface with respect to the apparatus main body by moving the holding unit 67 in the XY directions with respect to the apparatus main body.
  • the adjustment holding unit may adjust the angle of the mounting interface (details will be described later).
  • the holding portion 67 includes a base portion 68, a first link 71, a second link 72, a lock mechanism 73, a connecting portion 74, a position detection sensor 75, an interface mounting portion 76, and a pressure sensor 77.
  • the holding part 67 includes a nut 80, a pin 81, a feed screw 82, and a motor 83.
  • the base unit 68 is connected to the adjustment driving unit 70 and serves as a base for holding the interface 90.
  • the first link 71 is connected to a part of the upper end of the base portion 68 so as to be rotatable about a horizontal axis.
  • the second link 72 is connected to one end of the first link 71 so as to be rotatable about a horizontal axis.
  • the second link 72 extends in the vertical direction. When the first link 71 rotates, the second link 72 moves in the vertical direction (Z direction). The movement of the second link 72 in the Z direction is guided by a part of the base portion 68.
  • the lock mechanism 73 is connected to a part of the second link 72 (in the vicinity of the lower end in the present embodiment).
  • the lock mechanism 73 can lock and unlock the movement of the second link 72.
  • the connecting portion 74 is fixed to a part of the second link 72 (in the present embodiment, near the center in the vertical direction) and moves in the Z direction together with the second link 72.
  • the connecting part 74 connects the second link 72 and the interface mounting part 76.
  • the position detection sensor 75 can detect the position of the interface 90 in the Z direction by detecting the position of the second link 72 in the Z direction.
  • the interface 90 is detachably mounted on the interface mounting portion 76.
  • a space 78 is formed between the base portion of the interface 90 and the interface mounting portion 76.
  • the pressure sensor (for example, load cell) 77 detects a load applied between the interface mounting portion 76 and the connecting portion 74.
  • the CPU 51 of the control unit 50 can detect the load applied between the interface 90 and the eye E based on the value of the pressure sensor 77. Therefore, the CPU 51 can also detect whether the interface 90 is in contact with the eye E using the pressure sensor 77.
  • the nut 80 is mounted in a hole formed in the base portion 68 so as to be movable in the Z direction.
  • a pin 81 that contacts the first link 71 from below is provided at the upper end of the nut 80.
  • the feed screw 82 is screwed into the nut 80.
  • the motor 83 rotates the feed screw 82.
  • the nut 80 and the pin 81 move in the Z direction.
  • the first link 71 rotates
  • the second link 72, the connecting portion 74, the interface mounting portion 76, and the interface 90 move in the Z direction.
  • the lock mechanism 73 unlocks the second link 72 and the interface 90 is movable upward. It becomes. As a result, the safety for the eye E is improved.
  • the interface 90 will be described with reference to FIGS. 5 and 6.
  • the interface 90 is disposed between the apparatus main body and the eye E among optical paths of various lights (surgical laser light, reference light, observation light, OCT light, and fixation target projection light) extending between the apparatus main body and the eye E. Intervenes and is coupled to eye E.
  • the user can selectively use a plurality of types of interfaces 90 according to the region to be operated, the surgical procedure, and the like.
  • the plurality of types of interfaces 90 in the present embodiment include an immersion interface 91 (see FIG. 5) and an applanation interface 92 (see FIG. 6).
  • a configuration common to the immersion interface 91 and the applanation interface 92 will be described. The details of the configuration described below may be different between the immersion interface 91 and the applanation interface 92.
  • the interface 90 includes a mount 93, a suction path 94, an eye fixing portion 95, and an interface lens (an immersion lens 100 or a contact lens 110).
  • the mount 93 is a member that becomes a base of the interface 90.
  • the mount 93 is mounted on the interface mounting portion 76 (see FIG. 4) of the holding portion 67 and holds the eye fixing portion 95 and the like.
  • the mount 93 is formed with a circular hole penetrating in the Z direction (vertical direction in FIGS. 5 and 6). Various types of light can propagate inside the circular hole.
  • the suction path 94 is provided in the mount 93 and allows gas to flow between a space 96 described later and a pump (not shown).
  • the eye fixing part (suction ring in the present embodiment) 95 is an annular (annular in the present embodiment) member.
  • the eye fixing part 95 of this embodiment is formed in a continuous annular shape.
  • the shape of the eye fixing part 95 may be an open ring shape.
  • An annular eye fixing portion 95 may be formed by arranging a plurality of members in an annular shape.
  • the eye fixing part 95 is provided at the lower part of the mount 93 so as to surround the lower end of the circular hole formed in the mount 93.
  • the eye fixing unit 95 is coupled to the eye E (in this embodiment, the cornea or sclera of the eye E), so that the apparatus main body (specifically, the objective lens 20 provided in the apparatus main body and the surgical laser) The position of the eye E with respect to the light reference axis or the like is fixed.
  • the eye fixing part 95 and the mount 93 are separate members.
  • the eye fixing part 95 is fixed to the mount 93 by fitting, welding, adhesive bonding, or the like.
  • the eye fixing part 95 may be formed integrally with the mount 93.
  • the eye fixing unit 95 may be detachably attached to the mount 93 or an arm portion of the mount 93 by suction or the like.
  • a sealed space 96 is formed between the surface of the eye E and the eye fixing part 95.
  • the gas in the space 96 is discharged through the suction passage 94, the eye fixing portion 95 is sucked and fixed to the eye E.
  • the interface lens (the immersion lens 100 and the contact lens 110) is disposed on the apparatus main body side (above the eye fixing unit 95 in the present embodiment) of the various light paths of the light.
  • the interface lenses 100 and 110 of this embodiment are fixed to the upper part of a circular hole formed in the mount 93 by an adhesive or the like.
  • the interface lenses 100 and 110 and the eye fixing part 95 may be separate members instead of being integrally fixed (details will be described later with reference to FIG. 13).
  • the interface lenses 100 and 110 may be detachably attached to the mount 93 or the arm portion of the mount 93 by suction or the like.
  • the immersion lens 100 of the immersion interface 91 will be described with reference to FIG.
  • a space 103 is generated between the immersion lens 100 and the surface (cornea) of the eye E.
  • a substance for example, a liquid such as water or a viscoelastic substance or an elastic body
  • the refractive index difference between the transparent tissues of the eye E eg, cornea
  • that of air is disposed in the space 103.
  • an injection path (not shown) for injecting liquid into the space 103 is formed in the mount 93.
  • the liquid is injected into the space 103 through the injection path with the immersion interface 91 in contact with the eye E.
  • the method of arranging a substance such as a liquid in the space 103 can be changed as appropriate.
  • the user may place a substance such as a liquid on the eye E from above while the immersion interface 91 is in contact with the eye E, and then attach the immersion lens 100 to the mount 93.
  • the rear surface 101 located on the eye E side and the front surface 102 located on the apparatus main body side are both convex toward the eye E side (lower side). Is curved.
  • the surfaces of the rear surface 101 and the front surface 102 are shaped along a spherical surface.
  • the shapes of the rear surface 101 and the front surface 102 can be changed.
  • at least one of the rear surface 101 and the front surface 102 may be a flat surface.
  • the control unit 50 can also detect the center position of the immersion lens 100 by the light (bright spot) that is irradiated from the alignment index projection unit 63 (see FIG. 4) and reflected by the lens surface. .
  • the control unit 50 performs various processes using the center of the immersion lens 100 detected by the alignment index as the center of the eye fixing unit 95. May be.
  • the lens surface may be curved along an aspheric surface.
  • the contact lens 110 of the applanation interface 92 will be described with reference to FIG.
  • the rear surface 111 of the contact lens 110 comes into contact with the surface of the eye E (including the cornea). That is, the cornea of the eye E is applanated.
  • the shape of the cornea surface is deformed to the shape of the rear surface 111 of the contact lens 110. Therefore, the irradiation position of the surgical laser beam is set appropriately.
  • the contact lens 110 may be applanated by the eye E by sucking the gas between the rear surface 111 of the contact lens 110 and the surface of the eye E.
  • the rear surface 111 located on the eye E side is curved in a convex shape toward the upper side. Therefore, an increase in intraocular pressure during applanation is suppressed as compared with the case where the eye E is applanated by a flat surface.
  • the control unit 50 can detect the center position of the contact lens 110 by the light emitted from the alignment index projection unit 63 (see FIG. 4) and reflected by the rear surface 111.
  • the front surface 112 of the contact lens 110 is curved in a convex shape toward the apparatus main body, similarly to the front surface 102 of the immersion lens 100 described above. Both the rear surface 111 and the front surface 112 are formed in a curved shape along the spherical surface.
  • the shapes of the rear surface 111 and the front surface 102 of the contact lens 110 can be changed in the same manner as the immersion lens 100.
  • the rear surface 111 of the contact lens 110 may be a flat surface.
  • applanation includes not only the meaning of deforming the cornea of the eye E into a flat shape but also the meaning of deforming the cornea of the eye E into a predetermined shape that is not flat.
  • an adjustment operation of an interface 90 (hereinafter sometimes abbreviated as “IF”) to the apparatus main body will be described.
  • the ophthalmic laser surgical apparatus 1 can execute an adjustment operation for adjusting at least one of the position and the angle of the interface 90 with respect to the apparatus main body.
  • the interface adjustment operation is performed before the docking operation (details will be described later) for coupling the interface 90 to the eye E is performed.
  • the IF adjustment operation control process (eye fixation unit reference) shown in FIG. 7 is performed when the instruction to execute the IF adjustment operation with the eye fixation unit 95 as a reference is input to the control unit 50. ) Is executed.
  • the CPU 51 executes the IF adjustment operation control process shown in FIG. 7 according to the program stored in the ROM 52 or the nonvolatile memory.
  • the CPU 51 detects the center of the annular eye fixing unit 95 in the interface 90 (mounting interface) mounted on the holding unit 67 (see FIG. 4) (S1).
  • Various methods can be adopted as a method of detecting the center of the eye fixing unit 95.
  • the CPU 51 can detect the center of the eye fixing unit 95 by processing the image of the eye fixing unit 95 captured by the light receiving element 31 of the front image capturing unit 30.
  • the CPU 51 detects an edge 97 in the annular eye fixing unit 95 by processing an image of the eye fixing unit 95 photographed by the light receiving element 31.
  • the CPU 51 detects the center of the detected edge 97 as the center of the eye fixing unit 95.
  • the edge 97 is a perfect circle, for example, the CPU 51 may detect the positions of at least three points on the edge 97 and may fit (fit) a circle passing through the detected positions. In this case, the center of the fitted circle is detected as the center of the eye fixing unit 95.
  • a mark photographed by the front image photographing unit 30 may be provided at a predetermined position with respect to the center of the eye fixing unit 95 in the eye fixing unit 95.
  • the CPU 51 can detect the center of the eye fixing unit 95 based on the position of the mark shown in the front image. Needless to say, it is not necessary that the entire edge 97 is reflected in the front image, and it is sufficient that the edge 97 is reflected to the extent that the center of the edge 97 can be detected.
  • the method for detecting the center of the eye fixing unit 95 can be changed.
  • the material of the eye fixing unit 95 is a material that transmits light for capturing a cross-sectional image (OCT light in the present embodiment)
  • the CPU 51 determines the eye based on the cross-sectional image of the eye fixing unit 95.
  • the center of may be detected.
  • the CPU 51 may detect the center of the interface lenses 100 and 110 as the center of the eye fixing unit 95.
  • the CPU 51 may detect the center of the alignment index reflected by the lens surfaces of the interface lenses 100 and 110 as the center of the eye fixing unit 95.
  • the eye fixing unit 95 may not enter the imaging region of the front image.
  • the CPU 51 can detect the center of the alignment index reflected by the lens surface of the contact lens 110 (the rear surface 111 in the present embodiment) as the center of the eye fixing unit 95. Further, the CPU 51 may detect the lens center from the cross-sectional images of the interface lenses 100 and 110 and set the detected lens center as the center of the eye fixing unit 95.
  • the CPU 51 detects the center of the eye fixing unit 95 (S1)
  • the CPU 51 displays the detected center position of the eye fixing unit 95 on the display unit 54 (S2).
  • the cross mark 106 that is an X-shaped reticle is superimposed on the front image of the display unit 54, thereby indicating the center position of the eye fixing unit 95.
  • the method of indicating the center position of the eye fixing unit 95 on the display unit 54 can be changed as appropriate.
  • the CPU 51 displays the position of the reference axis on the display unit 54 (S3).
  • the reference axis serves as a reference for determining an appropriate position of the mounting interface.
  • Various axes can be adopted as the reference axis.
  • the position of the optical axis when the optical axis of the surgical laser beam scanned by the XY scanning unit 10 (see FIG. 1) coincides with the center of the scanning range in the XY direction is used as the position of the reference axis. May be.
  • the optical axis of the surgical laser beam when the XY scanning unit 10 is in the initial state (for example, when the mirror of the XY scanning unit 10 is positioned at the zero position) may be used as the reference axis.
  • the optical axis of the objective lens 20 or the physical central axis of the lens barrel that holds the objective lens 20 may be used as the reference axis.
  • the optical axis or the physical axis of the optical element located on the upstream side of the optical path of the surgical laser beam from the interface 90 may be used as the reference axis.
  • an axis that becomes a reference when performing engineering design of the ophthalmic laser surgical apparatus 1 (for example, design and arrangement of each lens) may be used as the reference axis.
  • a jig that can ignore the influence of the manufacturing error may be attached to the holding unit instead of the interface 90, and the position of the reference axis may be set based on the attached jig.
  • the CPU 51 of this embodiment irradiates the reference light from the reference light source 3 with the XY scanning unit 10 in the initial state.
  • the position of the optical axis of the surgical laser beam applied to the eye E is the position of the reference light incident on the light receiving element 31 of the front image capturing unit 30 (that is, the position of the reference light reflected in the front image). ) Is detected. Therefore, in this embodiment, as shown in FIG. 8, the position of the reference light (reference target 108 shown in FIG. 8) reflected in the front image is displayed on the display unit 54 as the position on the XY plane of the reference axis as it is. Is done.
  • a range presentation reticle indicating whether or not the deviation between the center position of the eye fixing unit 95 and the position of the reference axis is within an allowable range. 109 is superimposed and displayed.
  • the center of the cross mark 106 is located inside the annular range presentation reticle 109, it indicates that the positional deviation of the center of the eye fixing portion 95 with respect to the reference axis is within the allowable range.
  • the width of the allowable range may be determined in advance based on experiments or the like, or may be determined according to an operation instruction input by the user.
  • the user when the user manually adjusts the position of the eye fixing unit 95, the user adjusts the position of the eye fixing unit 95 while looking at the range presenting reticle 109, thereby fixing the eye in an appropriate direction by an appropriate distance.
  • the part 95 can be moved.
  • the ophthalmic laser surgical apparatus 1 automatically adjusts the position of the eye fixing unit 95, the user indicates whether or not the position of the eye fixing unit 95 has been appropriately adjusted. 109 can be easily confirmed.
  • the vertical center line 115 and the horizontal center line 116 are superimposed on the front image displayed on the display unit 54 in the present embodiment.
  • a vertical center line 115 indicates the center in the X direction (left-right direction in the figure) in the imaging region.
  • a horizontal center line 116 indicates the center in the Y direction (vertical direction in the figure) in the imaging region. Therefore, the intersection of the vertical center line 115 and the horizontal center line 116 becomes the center of the imaging area of the front image captured by the light receiving element 31.
  • the ophthalmic laser surgical apparatus 1 of the present embodiment can automatically adjust the position of the interface 90 with respect to the apparatus main body. Specifically, the CPU 51 determines whether or not the deviation of the center position of the eye fixing unit 95 from the reference axis is within an allowable range (S5). When the deviation is out of the allowable range (S5: NO), the CPU 51 controls the drive of the adjustment driving unit 70 (see FIG. 4) to move the eye fixing unit 95 in the XY directions, so that the eye fixing unit 95 The center position is brought close to the reference axis (S6). The process returns to S1. If the deviation is within the allowable range (S5: YES), the IF adjustment operation control process ends. When the position of the interface 90 is automatically adjusted, the CPU 51 does not have to display the center of the interface 90 on the display unit 54.
  • IF lens standard interface lenses 100 and 110.
  • FIGS. 9 and 10 an outline of a method for adjusting the position of the interface 90 with reference to the IF lenses 100 and 110 will be described with reference to FIGS. 9 and 10.
  • 9 and 10 the relationship between the front surfaces 102 and 112 that are convex on the eye E side and the reference axis S will be described.
  • the contents described below can also be applied to the lens surface that is convex toward the apparatus main body and the rear surfaces 101 and 111 of the IF lenses 100 and 110.
  • the optical design is performed so that the aberration that can occur in the lens is minimized.
  • the angle of the front surface 102 with respect to the reference axis S is perpendicular at the intersection 122 between the reference axis S and the front surfaces 102 and 112.
  • the reference axis S intersects the center of the lens surfaces of the front surfaces 102 and 112 when viewed from the direction of the reference axis S (that is, on the XY plane). That is, it seems that the positions of the front surfaces 102 and 112 with respect to the reference axis S are appropriate in the XY directions.
  • the angles of the IF lenses 100 and 110 are rotated from the optimum angle (rotated counterclockwise as shown in the figure). In this case, the angle of the front surface 102 with respect to the reference axis S is not perpendicular at the intersection 122 between the reference axis S and the front surfaces 102 and 112. As a result, the aberration generated in the surgical laser beam by the front surfaces 102 and 112 increases.
  • the straight line 120 that passes through the center position 118 of the virtual spherical surface 117 along the front surfaces 102 and 112 and the intersection 122 described above is in the direction in which the reference axis S extends. It is tilted by an angle ⁇ .
  • the straight line 119 that is parallel to the direction in which the reference axis S extends and passes through the center position 118 of the spherical surface 117 is shifted from the reference axis S by the distance ⁇ XY.
  • the ophthalmic laser surgical apparatus 1 has a vertical position 121 (that is, an intersection 121 between the straight line 119 and the front surfaces 102 and 112) that is perpendicular to the direction of the reference axis S among the front surfaces 102 and 112. Approach the reference axis S.
  • the vertical position (not shown) of the rear surfaces 101 and 111 that is perpendicular to the direction of the reference axis S is also close to the reference axis S, similarly to the vertical position 121 of the front surfaces 102 and 112.
  • the ophthalmic laser surgical apparatus 1 brings the vertical position 121 of the front surfaces 102 and 112 close to the reference axis S instead of the vertical position of the rear surfaces 101 and 111.
  • the front surfaces 102 and 112 of this embodiment have a shape along a spherical surface.
  • the straight line passing through the center position 118 of the spherical surface 117 always intersects the front surfaces 102 and 112 perpendicularly. Accordingly, when the positions of the IF lenses 100 and 110 are adjusted so that the straight line 119 coincides with the reference axis S, the vertical position 121 is positioned on the reference axis S. As a result, as shown in FIG. 10, the aberration generated in the surgical laser beam by the front surfaces 102 and 112 is minimized.
  • the ophthalmic laser surgical apparatus 1 can detect the vertical position 121 by detecting the center position 118 of the spherical surface 117 along the lens surface. The above method is employed in the IF adjustment operation control process shown in FIG.
  • the IF adjustment operation control process (lens reference) shown in FIG. 9 is executed by the CPU 51 when an instruction to execute the adjustment operation of the interface 90 with the IF lenses 100 and 110 as a reference is input to the control unit 50.
  • the CPU 51 acquires the position information of at least one point on the front surfaces 102 and 112 of the IF lenses 100 and 110 as lens surface information (S10).
  • the cross-sectional image capturing unit 23 captures a cross-sectional image of a cross section parallel to the optical axis of the OCT light at two or more locations of the IF lenses 100 and 110.
  • the CPU 51 detects the edges of the front surfaces 102 and 112 as lens surface information in each of the plurality of cross-sectional images.
  • the CPU 51 may detect the position of the arc on the edge, or may detect the positions of a plurality of points located on the edge.
  • the length of the arc to be detected or the number of points may be longer than the length or the number required for fitting a circle to the detected arc or a plurality of points. Therefore, when detecting the positions of a plurality of points, the CPU 51 may detect the positions of three or more points necessary for fitting a circle from the edge on each tomographic image.
  • the plurality of cross-sectional images may be parallel to each other. However, the accuracy in detecting the center position 118 of the spherical surface 117 is improved by taking a plurality of cross-sectional images so that at least two cross-sections intersect each other.
  • the CPU 51 detects the center position 118 of the spherical surface 117 along the lens surfaces of the front surfaces 102 and 112 based on the lens surface information acquired in S10 (S11). As an example, the CPU 51 fits a circle to the edge on each tomographic image acquired in S10. The CPU 51 can detect the spherical surface 117 and the center position 118 by fitting the spherical surface 117 that passes through all of the fitted circles.
  • the method for detecting the center position 118 of the spherical surface 117 from the lens surface information can be changed as appropriate.
  • the CPU 51 can fit the spherical surface 117 to the detected four points by detecting the positions of the four points not located on the same plane from the edge.
  • the CPU 51 can also fit the spherical surface 117 by detecting three points on the edge.
  • the CPU 51 displays the detected center position 118 of the spherical surface 117 as the vertical position 121 on the front image of the display unit 54 (S12).
  • the center position 118 and the vertical position 121 coincide.
  • the photographing optical axis of the front image photographing unit 30 is parallel to the reference axis S. Therefore, the center position 118 displayed on the front image coincides with the vertical position 121.
  • the CPU 51 displays the position of the reference axis S on the display unit 54 (S13).
  • the display method of the vertical position 121 and the reference axis S can be selected as appropriate.
  • the CPU 51 may display the vertical position 121 on the front image using the cross mark 106 illustrated in FIG.
  • the CPU 51 may display the position of the reference light reflected in the front image as the position of the reference axis S as it is in FIG.
  • the CPU 51 superimposes and displays a range presentation reticle 109 indicating whether or not the deviation between the vertical position 121 and the reference axis S is within an allowable range on the front image in the same manner as the method illustrated in FIG. Also good.
  • the CPU 51 determines whether or not the deviation of the vertical position 121 with respect to the reference axis S is within an allowable range (S15).
  • the CPU 51 controls the drive of the adjustment drive unit 70 (see FIG. 4) to move the IF lenses 100 and 110 in the XY directions, thereby setting the vertical position 121. It approaches the reference axis S (S16). The process returns to S10. If the deviation is within the allowable range (S15: YES), the IF adjustment operation control process ends. According to the processing shown in FIG. 8, the influence of the aberration and the like can be easily suppressed by adjusting the position of the interface 90 without adjusting the angle of the interface 90.
  • the vertical position 121 is detected by detecting the center position 118 of the spherical surface 117.
  • cross-sectional images of the IF lenses 100 and 110 are taken on two planes parallel to the Z axis and intersecting each other. It is desirable that the angle at which the two cross-sectional directions intersect (that is, the scanning direction of the OCT light for capturing the respective cross-sectional images) is as close to vertical as possible. As the crossing angle is closer to the vertical, the detection accuracy of the vertical position 121 is improved.
  • a cross-sectional image in XZ direction (lower image) and a cross-sectional image in YZ direction (right image) are taken. Three or more cross-sectional images may be taken.
  • three or more points whose positions in the Z direction are all the same may be detected from two cross-sectional images that intersect each other.
  • the detected points need to include three points that are not located on the same straight line.
  • a circle is fitted to three or more detected points, and the XY coordinates of the center of the fitted circle are detected as the XY coordinates of the vertical position 121.
  • the CPU 51 may directly acquire information on the vertical position 121 on the lens surface as lens surface information.
  • the CPU 51 irradiates the lens surface with light having an optical axis parallel to the reference axis S (for example, OCT light in this embodiment) while arbitrarily moving the IF lenses 100 and 110 in the XY directions.
  • a position where light is reflected vertically may be searched.
  • information on the position where light is vertically reflected is directly acquired as lens surface information indicating the XY coordinates of the vertical position 121.
  • the information on the center position on the XY plane of the alignment index reflected by the lens surface may be acquired as the lens surface information indicating the XY coordinates of the vertical position 121.
  • information on one point on the curved lens surface (information on the vertical position 121) is acquired as lens surface information.
  • the CPU 51 may detect the vertical position using another image (for example, a Scheimpflug image or an SLO image).
  • the CPU 51 may determine a reference (for example, the vertical position 121) for adjusting the positions of the front surfaces 102 and 112 on the XY plane with respect to the reference axis S using the lens surface information of the rear surfaces 101 and 111. For example, the CPU 51 detects the center position of the spherical surface along which the rear surfaces 101 and 111 are aligned or the vertical position of the rear surfaces 101 and 111 using the lens surface information of the rear surfaces 101 and 111. The CPU 51 may determine the center position 118 or the vertical position 121 of the spherical surface 117 of the front surfaces 102 and 112 from the center position of the spherical surfaces of the rear surfaces 101 and 111 or the vertical position of the rear surfaces 101 and 111.
  • a reference for example, the vertical position 121
  • the CPU 51 may determine the center position of the spherical surface along which the rear surfaces 101 and 111 are aligned or the vertical position of the rear surfaces 101 and 111 using the lens surface information of the rear surfaces 101 and
  • the CPU 51 considers the angles of the IF lenses 100 and 110 with respect to the reference axis S when determining the center position 118 or the vertical position 121 of the front surfaces 102 and 112 from the lens surface information of the rear surfaces 101 and 111. Good. For example, the CPU 51 determines the angle of the optical axis of the IF lenses 100 and 110 with respect to the reference axis S, the center position or vertical position of the spherical surface along the rear surfaces 101 and 111, and the diameter of the spherical surface 117 along the front surfaces 102 and 112. The center position 118 or the vertical position 121 of the front surfaces 102 and 112 may be determined.
  • the CPU 51 may use information of the lens surface having the smaller curvature radius among the rear surfaces 101 and 111 and the front surfaces 102 and 112. The detection accuracy of the center position 118 and the vertical position 121 is improved as the curvature radius is smaller.
  • the eye fixation unit reference is determined according to the operation content information indicating at least one of the operation target site of the eye E, the type of the wearing interface, and the operation method to be executed. It is determined which one of IF adjustment operation control processing (see FIG. 7) and IF lens reference IF adjustment operation control processing (see FIG. 11) is to be executed.
  • control unit 50 inputs an instruction for specifying the surgical content input by the user, and based on one of the center of the eye fixing unit 95 and the vertical position 121 of the lens surface according to the specified surgical content.
  • the adjustment operation may be controlled. In this case, the influence of the aberration is appropriately suppressed according to the operation content.
  • the eye fixing unit 95 and the IF lenses 100 and 110 are fixed integrally is illustrated.
  • the eye fixing unit 95 and the IF lenses 100 and 110 may be individually adjusted with respect to the apparatus main body.
  • the ophthalmic laser surgical apparatus 1 may adjust the angle of at least one of the entire interface 90, the eye fixing unit 95, and the IF lenses 100 and 110.
  • a holding unit that holds the IF lenses 100 and 110 and a holding unit that holds the eye fixing unit (suction ring) 95 are provided separately.
  • the ophthalmic laser surgical apparatus 1 includes an IF lens adjustment drive unit 128 and a suction adjustment drive unit 129.
  • the IF lens adjustment drive unit 128 can adjust the position and angle of the IF lenses 100 and 110 with respect to the apparatus main body.
  • the suction adjustment driving unit 129 can adjust the position of the eye fixing unit 95 in the X and Y directions with respect to the apparatus main body.
  • the CPU 51 detects the optical axes of the IF lenses 100 and 110 (S20). Various methods can be adopted as a method of detecting the optical axes of the IF lenses 100 and 110. For example, the CPU 51 may detect the vertices of the rear surfaces 101 and 111 and the vertices of the front surfaces 102 and 112 using a cross-sectional image or an alignment index, and detect an axis connecting the two detected vertices as an optical axis.
  • the CPU 51 may detect the center position of the spherical surfaces of the rear surfaces 101 and 111 and the center position of the spherical surfaces of the front surfaces 102 and 112, and detect an axis connecting the two detected center positions as an optical axis.
  • the CPU 51 controls the drive of the IF lens adjustment drive unit 128 and adjusts the angle of the IF lenses 100 and 110 with respect to the apparatus main body, thereby bringing the angle of the optical axis of the IF lenses 100 and 110 closer to the angle of the reference axis S ( S21).
  • the CPU 51 displays the vertical position (in the example shown in FIG. 14, the position of the optical axis of the IF lenses 100 and 110 on the XY plane) on the display unit 54 (S22). Further, the CPU 51 displays the position of the reference axis S on the display unit 54 (S23).
  • the CPU 51 determines whether or not the deviation of the vertical position (optical axis) with respect to the reference axis S is within an allowable range (S25).
  • the CPU 51 controls the drive of the IF lens adjustment drive unit 128 to move the IF lenses 100 and 110 in the XY directions, so that the vertical position is set to the reference axis S. Approach (S26). The process returns to S22. If the deviation is within the allowable range (S25: YES), the process proceeds to S28.
  • the CPU 51 detects the center of the annular eye fixing unit 95 (S28).
  • the detected position of the center of the eye fixing unit 95 is displayed on the display unit 54 (S29). Further, the position of the reference axis S is displayed on the display unit 54 (S30).
  • the CPU 51 determines whether or not the deviation between the center position of the eye fixing unit 95 and the position of the reference axis S is within an allowable range (S32).
  • the CPU 51 controls the drive of the suction adjustment driving unit 129 to move the eye fixing unit 95 in the XY direction, thereby setting the center position of the eye fixing unit 95. It approaches the reference axis S (S33).
  • the process returns to S28. If the deviation falls within the allowable range (S32: YES), the IF adjustment operation control process ends.
  • the ophthalmic laser surgical apparatus 1 can also adjust the angle of the eye fixing portion 95 with respect to the apparatus main body.
  • the ophthalmic laser surgical apparatus 1 may detect the angle of the eye fixing unit 95 with respect to the apparatus main body using, for example, a front image, a cross-sectional image, or a camera that captures the eye fixing unit 95.
  • the ophthalmic laser surgical apparatus 1 controls the drive of the suction adjustment drive unit 129 so that the detected angle of the eye fixing unit 95 approaches the angle of the reference axis S, and adjusts the angle of the eye fixing unit 95. Good.
  • the ophthalmic laser surgical apparatus 1 may adjust the entire angle of the interface 90 with respect to the apparatus main body.
  • the ophthalmic laser surgical apparatus 1 may adjust the angle of the interface 90 on the basis of the angle of the eye fixing unit 95 with respect to the apparatus main body, or on the basis of the angle of the IF lenses 100 and 110 with respect to the apparatus main body.
  • the angle of the interface 90 may be adjusted.
  • the angles of the IF lenses 100 and 110 with respect to the apparatus main body are detected by detecting the optical axes of the IF lenses 100 and 110.
  • the angles of the IF lenses 100 and 110 may be detected using other methods (for example, a camera for detecting the angle).
  • FIG. 15 A docking operation for coupling (docking) the interface 90 to the eye E will be described with reference to FIGS.
  • the docking process shown in FIG. 15 is executed by the CPU 51 (controller) of the control unit 50 before the operation of the eye E with the surgical laser beam is performed.
  • CPU51 performs the docking process shown in FIG. 15 according to the ophthalmologic apparatus control program (ophthalmic surgery control program) memorize
  • the CPU 51 adjusts the positions of the apparatus main body (for example, the casing 60 and the cylinder portion 61) and the interface 90 to the default positions before starting docking (S40).
  • the default position may be a position where the distance between the interface 90 and the eye E is appropriately separated.
  • a default position is set at a position where the distance between the interface 90 and the eye E is about 100 mm. Therefore, while the apparatus main body is in the default position, the user can perform various treatments before the operation of the eye E (for example, opening of the eye E with the eyelid opening device).
  • the CPU 51 sets the light amount of the illumination light source (alignment / illumination light source 64 in the present embodiment) that illuminates the eye E according to the illumination light amount input by the user (S41).
  • the user can input an operation instruction for adjusting the amount of light to the ophthalmic laser surgical apparatus 1 by operating the operation unit 55 (see FIG. 1). That is, the CPU 51 acquires the instructed light amount via the operation unit 55 (light amount receiving unit).
  • the CPU 51 acquires the type of the interface 90 attached to the holding unit 67 and the surgical technique to be performed.
  • the CPU 51 adjusts the magnification and focus of the front image of the eye E captured by the front image capturing unit 30 according to the acquired type and technique of the interface 90 (S42).
  • the ophthalmic laser surgical apparatus 1 may include a sensor (for example, an RFID reader, a barcode reader, or the like) for detecting the type of the interface 90 attached to the holding unit 67. Further, the CPU 51 may recognize the type of the interface 90 corresponding to the technique input to the operation unit 55 as the wearing interface.
  • a sensor for example, an RFID reader, a barcode reader, or the like
  • the method for adjusting the focus to the eye E can also be selected as appropriate.
  • the CPU 51 of the present embodiment performs image processing on the front image while driving the light receiving adjustment unit (at least one of the light receiving adjustment units 33 and 34 shown in FIG. 2) to change the focus state. By doing so, the eye E is focused.
  • the CPU 51 may determine that a state in which the bright spot of the alignment index projected onto the eye E from the alignment index projection unit 63 is the smallest on the front image is a state in which the focus is adjusted on the eye E.
  • the state in which the tissue of the eye E (for example, the iris) reflected in the front image is the clearest may be determined as the state in which the focus is adjusted.
  • the CPU 51 When adjusting the focus based on the focus state of the bright spot or tissue reflected in the front image, the CPU 51 detects a change in the focus state of the bright spot or tissue while controlling the drive of the light receiving adjustment unit. It may be detected whether the drive direction of the light receiving adjustment unit is correct. For example, the CPU 51 controls the driving of the light receiving adjustment unit to move at least one of the light receiving element 31 and the optical member in the first direction while changing the focus state of the bright spot or the tissue on the front image (for example, , Change in the size of the bright spot).
  • the CPU 51 determines whether the light receiving element 31 and the optical member are At least one of them is continuously moved in the first direction.
  • the CPU 51 and the light receiving element 31 and At least one of the optical members is switched to a second direction opposite to the first direction. In this case, the automatic adjustment of the focus state is executed more smoothly.
  • a method for adjusting the magnification of the front image can be selected as appropriate.
  • an appropriate magnification of the front image is determined in advance according to at least one of the type of the wearing interface and the surgical technique to be performed.
  • the ophthalmic laser surgical apparatus 1 drives at least one of the light receiving adjustment units 33, 34, and 36, thereby changing the imaging magnification of the front image according to the type of the wearing interface and the surgical procedure.
  • the magnification can be adjusted to at least one of them.
  • the CPU 51 acquires position information indicating the position of the eye E with respect to the apparatus main body (S43).
  • the position of the eye E in the Z direction) is acquired as position information.
  • the Z-direction position of the eye E is acquired based on the adjustment result of the focus state by the light receiving adjustment units (focus adjustment units) 33 and 34.
  • the focus of the front image is adjusted to the eye E by moving at least one of the light receiving element 31 and the optical member on the photographing optical path along the photographing optical axis.
  • the positions of the light receiving element 31 and the optical member when the focus state is appropriately adjusted are associated in advance with a table, an arithmetic expression, or the like according to the position of the eye E in the Z direction. Therefore, the CPU 51 can acquire the distance between the apparatus main body and the eye E based on the position of at least one of the light receiving element 31 and the optical member in a state where the focus state is adjusted.
  • the method for obtaining the position of the eye E in the Z direction can be changed.
  • the Z-direction position of the eye E may be acquired based on an encoder value that detects the Z-direction position of the apparatus main body.
  • the Z-direction position of the eye E may be acquired from the cross-sectional image of the eye E acquired by the cross-sectional image capturing unit 23 or an interference signal.
  • a camera for detecting the position of the eye E in the Z direction or an ultrasonic transceiver may be used.
  • the position of the eye E in the Z direction may be acquired based on the relationship between the infinity index shown in the front image and the finite target.
  • the ophthalmic laser surgical apparatus 1 of the present embodiment adjusts the focus state of the front image by moving at least one of the light receiving element 31 and the optical member.
  • the method for adjusting the focus state can also be changed.
  • the focus state can be adjusted using a liquid lens or the like that can change the focal length.
  • the CPU 51 can detect the position of the eye E in the Z direction based on the state of the liquid lens or the like.
  • the CPU 51 determines whether or not a docking start instruction has been input (S44).
  • the docking start instruction may be input by operating the operation unit 55 by the user when preparation for docking (for example, opening of the eye E by the eyelider) is completed.
  • the CPU 51 controls the drive of the coupling drive unit 66 to lower the apparatus main body (for example, the housing 60, the cylinder unit 61, etc.) and the holding unit 67. (S46). As a result, the apparatus main body and the eye E are gradually brought closer. Note that the ophthalmic laser surgical apparatus 1 may bring the apparatus main body and the eye E closer by moving the subject.
  • the CPU 51 adjusts the focus of the front image as needed with respect to the eye E that gradually approaches the apparatus body by controlling at least one of the light receiving adjustment units 33 and 34 (S47).
  • the positions of the light receiving element 31 and the optical member when the focus state is appropriately adjusted are associated in advance with a table, an arithmetic expression, or the like according to the position of the eye E in the Z direction. ing.
  • the CPU 51 acquires the Z direction position of the eye E at that time as needed according to the Z direction position of the eye E once acquired at the default position and the movement distance of the apparatus main body after S43 is performed. Can do.
  • the CPU 51 can adjust the focus of the front image while moving the apparatus main body by adjusting the light receiving element 31 and the optical member to a position corresponding to the position of the eye E in the Z direction at that time.
  • a light amount adjustment process (S48), an XY direction alignment process (S49), and a size index display process (S50) are performed.
  • the ophthalmic laser surgical apparatus 1 can adjust the amount of light emitted from the alignment / illumination light source 64 to the eye by executing a light amount adjustment process.
  • the CPU 51 can acquire the position of the eye E in the Z direction based on the adjustment result of the focus state by the light receiving adjustment units (focus adjustment units) 33 and 34.
  • the CPU 51 may acquire the Z direction position of the eye E at that time according to the Z direction position of the eye E acquired by performing focus adjustment at the default position and the subsequent movement distance of the apparatus main body. Good.
  • the CPU 51 may acquire the position in the Z direction of the eye E at that time based on the position of at least one of the light receiving element 31 and the optical member at that time. Further, as described above, it is also possible to acquire the position of the eye E in the Z direction using the cross-sectional image capturing unit 23 or the like.
  • the CPU 51 adjusts the amount of light emitted from the alignment / illumination light source 64 to the eye according to the position information of the eye E (in the present embodiment, the Z direction position) (S61). Specifically, the CPU 51 of this embodiment controls the power supplied to the alignment / illumination light source 64 to adjust the amount of light emitted from the alignment / illumination light source 64 and reaching the eye E.
  • the relationship between the position of eye E in the Z direction (that is, the distance between the apparatus main body and eye E) and the amount of light will be described.
  • a table that associates the position in the Z direction, which is one of the position information of the eye E, with the amount of light is stored in advance in the nonvolatile memory. It is remembered.
  • the table illustrated in FIG. 17 can be created by various methods. For example, in the present embodiment, the luminance of the observation image (front image) is detected while changing the supply voltage with the position of the eye E in the Z direction fixed. A suitable supply voltage is searched for in which the detected luminance is within a certain range.
  • a table is created by plotting the appropriate supply voltage at each position in the Z direction.
  • the table may be created so that the luminance of the reference portion (for example, the iris of the eye E) in the observation image is within a certain range.
  • the table may be created so that the average brightness of the entire observation image is within a certain range.
  • the ophthalmic laser surgical apparatus 1 uses the table, so that even when the relationship between the position of the eye E and the amount of light becomes complicated, both can be associated with each other appropriately.
  • there is a blocking area where at least part of the light emitted from the alignment / illumination light source 64 toward the eye E is blocked by the member (interface 90 in the present embodiment).
  • the member interface 90 in the present embodiment.
  • FIG. 17 the relationship between the position of the eye E and the amount of light becomes complicated.
  • a table is created in consideration of the effect of blocking light, so that the relationship between the position of the eye E and the amount of light is appropriately associated.
  • the CPU 51 can maintain the luminance of the displayed observation image within a certain range regardless of the position of the eye E in the Z direction by adjusting the supply voltage according to the table illustrated in FIG. Further, the CPU 51 adjusts the supply voltage in accordance with the table shown in FIG. 17 to maintain the amount of reflected light reflected by the eye E and incident on the light receiving element 31 within a certain range regardless of the position in the Z direction. be able to. In particular, the CPU 51 of the present embodiment can adjust the light amount in consideration of the influence of vignetting of illumination light by the interface 90.
  • the CPU 51 can adjust the voltage supplied to the alignment / illumination light source 64 in consideration of the illumination light quantity input by the user together with the position information of the eye E.
  • the position of the eye E in the Z direction and the illumination voltage according to the amount of illumination light input by the user are associated.
  • the CPU 51 supplies a voltage corresponding to both the position of the eye E in the Z direction and the amount of illumination light input by the user to the light source.
  • the CPU 51 may adjust the amount of light reaching the eye E using an arithmetic expression for calculating the amount of light from the position information. Further, the CPU 51 may use an arithmetic expression for calculating the light amount based on the position information and the illumination light amount input by the user.
  • the CPU 51 adjusts at least one of the gain and the offset of the observation image (front image) to be displayed while executing the adjustment process (S61) of the power supplied to the alignment / illumination light source 64 (S62). .
  • the CPU 51 may adjust at least one of the gain and the offset so that the luminance of the observation image displayed on the display unit 54 is maintained within a certain range.
  • the CPU 51 may maintain the luminance of the reference portion in the observation image within a certain range by adjusting at least one of the gain and the offset, and the average luminance of the entire observation image within the certain range. May be maintained.
  • the CPU 51 generates observation image data (front image data) of the anterior segment of the eye E based on the light reception signal output when the light receiving element 31 receives the reflected light from the eye E.
  • the CPU 51 displays a front image of the eye E on the display unit 54 based on the generated observation image data.
  • the front image displayed on the display unit 54 is updated (S63). That is, the CPU 51 drives the coupling drive unit 66 while continuously generating observation image data, and couples the interface 90 to the eye E.
  • the process returns to the docking process (see FIG. 15) and proceeds to the XY direction alignment process (see FIG. 18).
  • the ophthalmic laser surgical apparatus 1 can control the coupling operation (docking operation) on the basis of at least one of the components constituting the interface 90 by executing the XY direction alignment process.
  • the ophthalmic laser surgical apparatus 1 according to the present embodiment performs an XY-direction alignment process, and is combined with the center of the eye fixing unit 95 determined by the inner edge 97 (inner diameter) of the eye fixing unit 95 as a reference. The operation can be controlled.
  • the CPU 51 detects the center of the annular eye fixing unit 95 in the interface 90 (S1).
  • the IF adjustment operation control process eye fixing unit reference
  • the IF adjustment operation control process individual adjustment
  • the CPU 51 may use the center of the eye fixing unit 95 that has already been detected as it is.
  • the CPU 51 determines the reference light reflected on the front image (for example, see the reference target 108 shown in FIG. 19).
  • the center of the eye fixing unit 95 may be detected based on the position. If the center of the eye fixing unit 95 is not detected in the IF adjustment operation control process, in S70, the center of the eye fixing unit 95 may be detected by the same process as S1 in FIG. 7 or S28 in S14. Therefore, this description is omitted.
  • the CPU 51 executes eye center detection processing (S71).
  • eye center detection process the center of the eye E is detected. Details of this will be described later with reference to FIGS.
  • FIG. 19 is a diagram illustrating an example of the combining operation in-progress image 131 that is a front image displayed during the combining operation.
  • the iris 132 of the eye E is reflected.
  • a bright spot 133 that is irradiated by the alignment index projection unit 63 (see FIG. 4) and reflected by the cornea is reflected.
  • the center of the eye fixing unit 95 is aligned with the reference axis S in the IF adjustment operation control process described above.
  • the CPU 51 displays the position of the reference visual target 108 indicating the position of the reference axis S as it is as the center position of the eye fixing unit 95.
  • the center position of the eye fixing unit 95 may be displayed in a manner different from the reference visual target 108.
  • the center of the eye E is indicated by the circular eye center mark 135 being superimposed on the image 131 during the combining operation.
  • the CPU 51 causes the range presentation reticle 137 indicating whether or not the deviation between the center position of the eye E and the center position of the eye fixing unit 95 is within an allowable range to be superimposed on the image 131 during the combining operation.
  • the eye center mark 135 is located inside the range presentation reticle 137, it indicates that the positional deviation of the center of the eye E with respect to the center of the eye fixing unit 95 is within an allowable range.
  • the width of the allowable range may be determined in advance based on experiments or the like, or may be determined according to an operation instruction input by the user.
  • the CPU 51 controls the drive of the coupling drive unit 66 (see FIG. 4) to move the apparatus main body to the eye E.
  • the center position of the eye fixing unit 95 is brought closer to the center position of the eye E (S73).
  • the center of the eye fixing unit 95 and the reference axis S may be aligned in advance.
  • the position of the reference axis S is brought close to the center position of the eye E. The process returns to the docking process (see FIG. 15).
  • the center of the eye fixing unit 95 and the center of the eye E are automatically brought close to each other, but the user manually brings the center of the eye fixing unit 95 and the center of the eye E close to each other while viewing the combining operation image 131. Also good.
  • the ophthalmic laser surgical apparatus 1 does not display the center of the eye fixing unit 95 and the center of the eye E on the display unit 54. May be.
  • the CPU 51 detects the center position of the eye E and the projection position of the reference light projected by the reference light source 3 from the image photographed by the light receiving element 31 (see FIG. 2) of the front image photographing unit 30. Also good. Further, the CPU 51 may control the alignment operation of the eye E with respect to the apparatus main body based on the center position of the eye E and the projection position of the reference light. Specifically, the CPU 51 may display the center position of the eye E and the projection position of the reference light on the front image. In addition, the CPU 51 may bring the center position of the eye E closer to the projection position of the reference light by controlling the coupling drive unit 66 and changing the relative positional relationship between the apparatus main body and the eye E. In this case, the eye E is easily fixed at an appropriate position with respect to the reference axis S. For example, when the reference axis S coincides with the center of the eye fixing unit 95, the eye fixing unit 95 is easily fixed at an appropriate position of the eye E.
  • the eye center detection process will be described with reference to FIGS.
  • the ophthalmic laser surgical apparatus 1 can switch the method for detecting the center position of the eye E according to the detection condition when executing the eye center detection process.
  • the distance between the apparatus main body and the eye E that is, the Z direction position of the eye E
  • the detection condition Get as.
  • the detection state of the bright spot 133 on the cornea caused by the projection light from the alignment index projection unit 63 is acquired as a detection condition.
  • the center detection method of the eye E executed in the present embodiment includes a bright spot fitting detection method, a bright spot centroid detection method, and a shape detection method.
  • the CPU 51 processes the front image to detect the bright spot 133 of one or a plurality of alignment indexes reflected by the cornea of the eye E.
  • the CPU 51 detects the center of the circular figure passing through the detected one or more bright spots 133 as the center position of the eye E. That is, an annular figure is fitted to the detected bright spot 133, and the center of the fitted annular figure is detected as the center position of the eye E.
  • the center position of the eye E is detected more accurately than when the bright spot centroid detection method is used.
  • the shape of the annular figure can be selected as appropriate, but as an example, an elliptical figure is used in the present embodiment.
  • the detection state of the bright spot 133 needs to be sufficient to identify (fitting) a circular figure.
  • the number of bright spots 133 necessary for the fitting varies depending on conditions. Specifically, when the number of bright spots 133 is four, ellipse fitting is possible if the four bright spots 133 are the vertices of a specific figure such as a parallelogram, but the vertices of a specific figure are possible. If not, ellipse fitting with four bright spots is impossible. When the number of bright spots 133 is five or more, ellipse fitting is possible.
  • the accuracy of the fitting of the annular figure changes depending on the degree to which the ring-shaped bright spot is detected.
  • the conditions that allow the fitting of a circular figure vary as appropriate depending on the shape of the figure to be fitted, the arrangement of bright spots 133, the type of alignment index, and the like.
  • a determination criterion suitable for the condition may be used. For example, when using a plurality of point light sources for the alignment index projection unit 63, the CPU 51 determines whether fitting is possible depending on whether the number of detected bright spots 133 is equal to or greater than a threshold value. May be. In addition, when a continuous ring-shaped light source is used for the alignment index projection unit 63, the CPU 51 needs at least one of the detected arc-shaped bright spot area, angle, and length for fitting. Whether or not the fitting is possible may be determined based on whether or not the threshold value is greater than or equal to a certain threshold value.
  • the CPU 51 detects the bright spot 133 of one or more alignment indexes reflected by the cornea of the eye E by processing the front image. Next, the CPU 51 detects the center of gravity of the detected one or more bright spots 133 as the center position of the eye E.
  • the center position of the eye E is easily detected even when sufficient bright spots 133 are not detected to fit the circular figure. Even when it is difficult to discriminate between the bright spot 133 and noise, the noise can be recognized as the bright spot 133 and the center of gravity can be detected.
  • the processing load on the CPU 51 when executing the bright spot centroid detection method is smaller than when executing the bright spot fitting detection method.
  • the CPU 51 processes the image photographed by the photographing unit (at least one of the front image photographing unit 30 and the cross-sectional image photographing unit 23), and thereby the shape of the pupil 146 of the eye E (see FIG. 20). At least one of the shape of the cornea, the shape of the iris, and the diameter of the cornea (for example, the outer shape of the cornea when viewed from the front) is detected.
  • the CPU 51 detects at least one of the center of the pupil 146 and the center of the cornea as the center position of the eye E from the detected shape. For example, the CPU 51 may detect the outer edge of the pupil 146 of the eye E (that is, the inner edge of the iris 132) 147 by processing the front image.
  • the CPU 51 may detect a center of the eye E as a center position of the eye E by fitting an annular figure (for example, a circle or an ellipse) to the edge 147. Further, the CPU 51 may detect a vertex position of the cornea by processing a cross-sectional image of the cornea of the eye E, and may detect the detected vertex position of the cornea as a center position of the eye E. According to the shape detection method, the center position of the eye E is detected even when the bright spot 133 of the alignment index is not detected from the front image.
  • an annular figure for example, a circle or an ellipse
  • a plurality of regions are defined according to the distance between the apparatus main body and the eye E (that is, the position of the eye E in the Z direction) in the Z direction along the imaging optical axis of the imaging unit.
  • a long-distance area, an arbitrary area, a blocking area, and a short-distance area are defined in order from the farthest distance from the apparatus main body (in this case, the interface 90).
  • the long-distance area is an area where the distance between the apparatus main body and the eye E is equal to or greater than the first threshold value.
  • the first threshold can be set as appropriate. In the example shown in FIG. 20, the first threshold value is set to 80 mm.
  • the bright spot 133 may not be clearly visible in the front image. In this case, it may be difficult to distinguish between the noise and the bright spot 133.
  • a plurality of bright spots 133 are likely to be concentrated in a narrow area of the cornea, it may be difficult to detect each of the bright spots 133 (see the long-distance area image 141 in FIG. 20).
  • the ophthalmic laser surgical apparatus 1 can perform the coupling operation if the center position can be detected to some extent without accurately detecting the center position of the eye E. Can be executed. Therefore, the CPU 51 of the present embodiment uses a bright spot centroid detection method that can detect the center position of the eye E with a small processing load even when a sufficient bright spot 133 is not detected when the eye E is in a long-distance region. adopt.
  • the arbitrary area is defined between the long distance area and the blocking area. Since the arbitrary region is closer to the apparatus main body than the long-distance region, it is desirable that the center position of the eye E be detected as accurately as possible. However, even in an arbitrary area, it may be difficult to detect the bright spot 133 (see the arbitrary area image 142 in FIG. 20). In addition, an obstacle (for example, an operator's hand) may enter between the alignment index projection unit 63 and the eye E, and the projection light of the alignment index may be blocked.
  • an obstacle for example, an operator's hand
  • the CPU 51 of the present embodiment depending on the detection state of the bright spot 133 on the cornea generated by the projection light from the alignment index projection unit 63, A plurality of (three in this embodiment) center detection methods are used properly.
  • the blocking area is an area where the projection light of the alignment index projected from the alignment index projection unit 63 onto the eye E is blocked by the member (the interface 90 in the present embodiment) (see the blocking area image 143 in FIG. 20).
  • a range of 10 mm to 20 mm from the apparatus main body is defined as the blocking area.
  • the CPU 51 of the present embodiment employs a shape detection method that can detect the center position of the eye E even when the bright spot 133 is not detected when the eye E is in the blocking region.
  • the short distance area is an area where the distance between the apparatus main body and the eye E is equal to or less than the second threshold value.
  • the second threshold value can be set as appropriate, when both the first threshold value and the second threshold value are set, the second threshold value is set to be equal to or lower than the first threshold value.
  • the short distance area is an area immediately before the interface 90 and the eye E are coupled.
  • the ophthalmic laser surgical apparatus 1 desirably couples the interface 90 to the position of the eye E as accurate as possible (see the near field image 144 in FIG. 20). Therefore, the CPU 51 of the present embodiment employs a bright spot fitting detection method that can more accurately detect the center position of the eye E when the eye E is in the short distance region.
  • the CPU 51 of the present embodiment positions the eye E in any region according to the distance between the apparatus main body and the eye E (that is, the position in the Z direction) in the Z direction along the imaging optical axis of the imaging unit. Judgment is made. As described above, the method for obtaining the position of the eye E in the Z direction can be selected as appropriate. As an example, in the present embodiment, the Z direction position of the eye E acquired in the light amount adjustment process (see S60 in FIG. 16) is used.
  • the CPU 51 determines whether or not the region where the eye E is located is in the long-distance region (S81). When the eye E is in the long distance region (S81: YES), it is determined whether or not the bright spot 133 can be detected from the front image (S82). When the bright spot 133 can be detected (S82: YES), the center position of the eye E is detected by the bright spot centroid detection method (S83), and the process returns to the XY direction alignment process (see FIG. 18). If the bright spot 133 cannot be detected (S82: NO), a stop flag indicating that the coupling operation is to be stopped is set to ON (S84), and the process returns to the XY direction alignment process.
  • the eye E When the eye E is not in the long distance area (S81: NO), it is determined whether or not the eye E is in the arbitrary area (S86). When the eye E is in an arbitrary region (S86: YES), it is determined whether or not the annular figure can be fitted to the bright spot 133 (S87). When the fitting is possible (S87: YES), the center position of the eye E is detected by the bright spot fitting detection method (S88).
  • the CPU 51 detects the center position detected by the bright spot fitting detection method. Then, the shift of the center position detected by the shape detection method is detected. In this case, the CPU 51 can detect the same center position by different detection methods in subsequent processing by using the detected deviation.
  • the CPU 51 restricts the relative movement of the eye E in the XY direction with respect to the apparatus main body as a predetermined condition is satisfied (S91).
  • the detection accuracy of the center position of the eye E by the bright spot centroid detection method is likely to be lower than the detection accuracy by other detection methods.
  • the CPU 51 of this embodiment switches the detection method of the center position from another detection method (for example, the bright spot fitting detection method) to the bright spot centroid detection method, and is detected in S90.
  • the movement in the XY directions is restricted on the condition that the center position is located within the specific area.
  • the specific area can be set as appropriate.
  • a predetermined circular area around the reference axis S may be set as the specific area.
  • the detection of the center position by the bright spot centroid detection method itself may be prohibited in order to suppress the influence of switching of the detection method.
  • the shape detection method determines whether or not the shape detection method can be executed (S92). If possible (S92: YES), the center position of the eye E is detected by the shape detection method (S93). If the shape detection method cannot be executed (S92: NO), the stop flag is turned ON (S94).
  • the CPU 51 determines the center position of the eye E based on the center position detected by the shape detection method in S93 and S97 and the shift detected in S88. Specifically, the CPU 51 determines a position shifted by the shift direction and amount detected in S88 from the center position detected by the shape detection method as the center position of the eye E. In this case, the occurrence of problems due to the difference in detection method is suppressed.
  • the size index 150 (see FIG. 23) is an index indicating the size of the eye fixing unit 95.
  • the size index 150 of the present embodiment indicates the size of the outer shape of the portion of the eye fixing unit 95 that contacts the eye E. In the size index display process of the present embodiment, the size index 150 is superimposed and displayed on the front image of the display unit 54.
  • the ophthalmic laser surgical apparatus 1 when the size index display process is started, it is determined whether or not an instruction to turn off the display of the size index 150 is input.
  • the ophthalmic laser surgical apparatus 1 according to the present embodiment superimposes (displays ON) and hides the size index 150 on the front image via an instruction receiving unit (operation unit 55) that receives an operation instruction input by the user.
  • An instruction to switch (display OFF) is input.
  • the CPU 51 can switch between displaying and not displaying the size index 150 in accordance with the input instruction. Specifically, when an instruction to turn off the display of the size index 150 is input (S110: YES), the CPU 51 does not execute the processing for displaying the size index 150 (S114 to S117). The process is returned to the docking process (see FIG. 15). Therefore, the user can easily delete the display of the size index 150 when confirming that the eye E is sufficiently opened.
  • the CPU 51 positions the eye E with respect to the apparatus main body in the Z direction along the optical axis of the imaging optical path of the front image capturing unit 30 ( That is, the Z-direction position) is acquired (S111).
  • the method for obtaining the position of the eye E in the Z direction can be selected as appropriate.
  • the position of the eye E in the Z direction has already been acquired based on the adjustment results of the light receiving adjustment units 33 and 34 (focus adjustment unit). Specifically, in S60 of FIG.
  • the position of the eye E in the Z direction is determined based on the position of at least one of the light receiving element 31 and the optical member in the front image capturing unit 30 in a state where the focus is adjusted to the eye E. Has been acquired.
  • the Z direction position of the eye E acquired in S60 of FIG. 16 is used.
  • the method for obtaining the position of the eye E in the Z direction may be changed.
  • the CPU 51 may acquire the Z direction position of the eye E based on the cross-sectional image of the eye E photographed by the cross-sectional image photographing unit 23.
  • the CPU 51 determines whether or not the distance between the apparatus main body and the eye E in the direction along the optical axis of the photographing optical path of the front image (Z direction) is equal to or greater than a threshold value (S112).
  • a threshold value S112
  • the apparatus main body for example, the interface 90
  • the interface 90 immediately before the interface 90 is coupled to the eye E, it is desirable that information for allowing the user to determine whether or not the alignment of the interface 90 with respect to the eye E in the XY direction is appropriate is sufficiently presented by the front image. . Therefore, when the distance between the apparatus main body and the eye E is less than the threshold value, it is desirable that the size index 150 that is not used for checking the alignment state in the XY directions is not displayed. Therefore, if the distance between the apparatus main body and the eye E is less than the threshold (S112: NO), the CPU 51 docks the process without executing the process for displaying the size index 150 (see FIG. 15). Return to.
  • processing for displaying the size index 150 on the front image is performed (S114 to S117).
  • the threshold value serving as the determination criterion in S112 may be determined in advance or may be changed by the user. Further, the determination in S112 may be omitted so that the size index 150 is displayed regardless of the position of the eye E in the Z direction.
  • the CPU 51 detects the type of the eye fixation unit 95 being used among the plurality of types of eye fixation units 95 (S114).
  • the type of the eye fixing unit 95 of the interface 90 size of the eye fixing unit 95
  • the CPU 51 detects the type of the interface 90 attached to the holding unit 67 (see FIG. 4). Note that the method similar to the method described in S42 of the docking process (see FIG. 15) can be adopted as a method of acquiring the type of the wearing interface.
  • the CPU 51 determines the size of the size index 150 to be superimposed on the front image according to the type of the interface 90 and the position of the eye E in the Z direction (S115).
  • the front image capturing unit 30 in the present embodiment captures a front image of the anterior segment of the eye E at different magnifications according to the distance between the apparatus main body and the eye E (see images 141 to 144 in FIG. 20).
  • the user can observe the eye E at an appropriate magnification according to the distance between the apparatus main body and the eye E.
  • the ophthalmic laser surgical apparatus 1 displays the size index 150 according to the distance between the apparatus main body and the eye E (the position of the eye E in the Z direction), thereby determining the open state by the user. To assist.
  • the size of each of the plurality of types of eye fixing units 95 is stored in advance in a nonvolatile memory or the like.
  • the CPU 51 may calculate the size of the size index 150 to be displayed based on the size of the eye fixing unit 95 used and the position of the eye E in the Z direction. The position in the Z direction of the eye E and the size of the size index 150 to be displayed may be associated in advance with a table or the like.
  • the CPU 51 desirably determines the size of the size index 150 in consideration of a change in the imaging magnification of the front image according to the position in the Z direction.
  • the CPU 51 may set the size index 150 to be slightly larger than the actual size of the eye fixing unit 95 so that the eye fixing unit 95 is more smoothly coupled to the eye E.
  • the CPU 51 detects the position of the eye E in the XY direction (XY position of the eye E) intersecting the optical axis of the photographing optical path of the front image photographing unit 30 (S116).
  • the center position of the eye E detected by the above-described eye center detection process is used in S116 as the XY direction position of the eye E.
  • the CPU 51 superimposes and displays the size index 150 of the size determined in S115 at a position on the front image corresponding to the position in the XY direction of the eye among the front images displayed on the display unit 54 (S117). ).
  • the process returns to the docking process (see FIG. 15).
  • a size index 150 indicating the size of the outer shape of the eye fixing unit 95 is displayed together with the front image of the eye E opened by the eyelid opening device 149.
  • the center of the size index 150 coincides with the eye center mark 135 indicating the center position of the eye E.
  • the annular size index 150 is used, but it goes without saying that the display mode of the size index 150 can be changed as appropriate.
  • the size of the size index 150 may be recognized by the user by changing the color of the image inside and outside the size index 150.
  • the size index display process shown in FIG. 22 is repeatedly executed until the connection between the eye E and the interface 90 is completed (see FIG. 15). Accordingly, the size index displayed in S115 and S117 changes in real time according to the change in the distance between the apparatus main body and the eye E. Further, the position of the size index displayed in S116 and S117 also changes in real time according to the position of the eye E in the XY direction.
  • the ophthalmic laser surgical apparatus 1 automatically adjusts the display position of the size index 150 to the position of the eye E and moves the display position of the size index 150 according to a user operation instruction. Can be switched according to the selection instruction input to the operation unit 55.
  • the CPU 51 receives an operation instruction input for selecting either automatic alignment or manual alignment of the size index 150 via the operation unit 55.
  • the CPU 51 moves the display position of the size index 150 on the front image in the direction specified by the instruction input to the operation unit 55. In this case, the user can move the display position of the size index 150 to a position where the open state can be easily determined.
  • the CPU 51 determines whether or not to stop the docking process (S52). For example, when an error occurs, when a stop instruction is input by the user, or when the stop flag is set to ON in the eye center detection process (see FIG. 21), the CPU 51 stops the docking process. .
  • the CPU 51 stops the lowering operation of the apparatus main body, notifies the user of an error or the like (S53), and ends the process.
  • the CPU 51 manually adjusts the relative positional relationship between the eye E and the apparatus main body in the XY direction to an appropriate positional relationship. You may alert
  • the CPU 51 determines whether the interface 90 is coupled to the eye E (S55). Details of the method for determining the completion of the combination will be described later. If not combined (S55: NO), the process returns to S46, and the processes of S46 to S55 are repeated. When the interface 90 is coupled (S55: YES), a process for changing the projection state of the fixation target is performed (S56), and the docking process is terminated.
  • the reference visual target 108 is continuously projected from the reference light source 3 (see FIG. 1) from the start to the end of the docking process is illustrated.
  • the reference light projected from the reference light source 3 does not always have to be projected during the docking process.
  • the reference light may be projected immediately before the start of the combining operation and after the completion of the combining operation.
  • the imaging state of the fixation target on the fundus of the eye E may change before and after the interface 90 is coupled to the eye E. In this case, the appearance of the fixation target by the subject changes.
  • the shape of the eye E (for example, the shape of the cornea) may change, and the imaging state of the fixation target may change.
  • the interface 90 including the immersion lens 100 (see FIG. 5) or the contact lens 110 (see FIG. 6) exists among the plurality of types of interfaces 90 that can be used.
  • the immersion lens 100 contacts the liquid filled between the lens surface (rear surface 101) located on the eye E side of the immersion lens 100 and the eye E. Further, the contact lens 110 contacts the eye E.
  • the refractive index of the light of the fixation target changes before and after the interface lenses 100 and 110 contact the eye E or the liquid, and the imaging state of the fixation target easily changes.
  • the ophthalmic laser surgical apparatus 1 according to the present embodiment changes the projection state of the fixation target before and after the interface 90 is coupled to the eye E. As a result, by connecting the interface 90 to the eye E, the influence that can occur on the fixation of the subject is appropriately suppressed.
  • the ophthalmic laser surgical apparatus 1 receives an input of an instruction for selecting either automatic coupling detection or manual coupling detection of the interface 90 via the operation unit 55.
  • the CPU 51 detects that the interface 90 is coupled to the eye E by inputting an operation instruction indicating that the coupling is completed to the operation unit 55. .
  • the CPU 51 of the present embodiment automatically detects that the interface 90 is coupled to the eye E based on the change of the bright spot 133 on the front image.
  • the interface 90 is coupled to the eye E, the refraction state of the light projected from the fixation target projection unit 40 onto the eye E and the refraction state of the light reflected by the cornea of the eye E and incident on the front image photographing unit 30 May also change.
  • the refraction of the reflected light incident on the front image photographing unit 30 from the cornea. The state changes greatly.
  • the CPU 51 detects a change in the bright spot 133 formed on the cornea by the alignment index from the front image.
  • the CPU 51 automatically detects the coupling of the interface 90 based on the detected change of the bright spot 133 (for example, disappearance of bright spot 133, change in size, change in brightness, etc.).
  • the CPU 51 may detect the coupling of the interface 90 using an output signal of a pressure sensor 77 (see FIG. 4) that detects a load applied between the interface 90 and the eye E. Further, the CPU 51 may use a change in the front image other than the bright spot 133 (for example, a change in the shape of the tissue of the eye E reflected in the front image). The CPU 51 may use a cross-sectional image captured by the cross-sectional image capturing unit 23.
  • the CPU 51 may detect the coupling of the interface 90 based on the distance between the eye fixing unit 95 and the IF lenses 100 and 110. .
  • the CPU 51 automatically detects that the liquid is filled between the eye E and the immersion lens 100, thereby automatically coupling the immersion interface 91 to the eye E. It may be detected.
  • the CPU 51 may use a sensor or the like that detects that the liquid is filled.
  • the CPU 51 of the present embodiment changes the projection state of the fixation target by executing at least one of changing the light amount of the fixation target projection light and changing the focal length of the fixation target projection optical system. Can do. Details of these methods have already been described in the description of the fixation target projection unit 40 shown in FIG.
  • the connection of the interface 90 to the eye E may deteriorate the imaging state of the fixation target light on the fundus of the eye E.
  • the CPU 51 may increase the amount of fixation target projection light.
  • the brightness difference of the fixation target recognized by the user is reduced before and after the interface 90 is coupled.
  • the CPU 51 desirably changes the light amount after the imaging state of the fixation target on the fundus actually changes (for example, after the IF lenses 100 and 110 actually contact the liquid or the eye E). .
  • the CPU 51 may change the focal length of the fixation target projection optical system so that the change in the imaging state of the fixation target on the fundus is suppressed before and after the interface 90 is coupled to the eye E. Good.
  • the CPU 51 of the present embodiment can change the rate of changing the projection state of the fixation target according to the type of the interface 90 used (that is, the interface 90 attached to the holding unit 67). it can. Therefore, the CPU 51 can appropriately change the projection state of the fixation target according to the type of the interface 90.
  • the method similar to the method described in S42 of the docking process may be adopted as a method of acquiring the type of the interface 90 being used.
  • the irradiation position of the surgical laser light may be determined based on the front image captured by the front image capturing unit 30. In this case, if the correspondence between the imaging region imaged by the light receiving element 31 and the position where the surgical laser beam is actually irradiated changes, it may be difficult to irradiate the surgical laser beam at an accurate position. There is.
  • FIG. 24 is an example of a front image of the eye E (combination completion image 160) when the combining operation of the interface 90 with the eye E is completed.
  • the projection position of the reference visual target 108 projected by the reference light source 3 coincides with the intersection 162 of the vertical center line 115 and the horizontal center line 116 that are the center of the imaging area of the front image.
  • various members such as the light receiving element 31 are arranged.
  • the light receiving surface of the light receiving element 31 is adjusted to have a predetermined angle with respect to the optical axis of the reflected light reflected by the eye E and incident on the light receiving element 31 (that is, the photographing optical axis of the front image). Yes.
  • the photographing optical axis of the front image may be displaced, and the center 162 of the photographing region of the front image and the projection position of the reference target 108 may be displaced in the XY directions.
  • the angle of the light receiving surface of the light receiving element 31 may be inclined from a predetermined angle with respect to the photographing optical axis of the front image. In these cases, the correspondence between the imaging region of the front image and the irradiation position of the surgical laser light changes.
  • the ophthalmic laser surgical apparatus 1 of the present embodiment includes light receiving adjustment units 33, 34, and 36 (see FIG. 2) that adjust the light receiving state (at least one of the focus state and the magnification) of the light receiving element 31.
  • the above correspondence relationship is more likely to change.
  • the ophthalmic laser surgical apparatus 1 of the present embodiment can suppress the influence of the change in the correspondence relationship and irradiate surgical laser light at a more accurate position.
  • the irradiation control data creation process will be described with reference to FIG.
  • the irradiation control data creation process is executed by the CPU 51 of the control unit 50 after the docking process (see FIG. 15) ends.
  • CPU51 performs irradiation control data creation processing according to the ophthalmic surgery control program memorize
  • the irradiation control data is data that is referred to by the CPU 51 in order to control the driving of the scanning units 6, 10, 18, etc. when performing laser surgery using surgical laser light.
  • the CPU 51 creates temporary data of irradiation control data based on the position of the eye E on the front image photographed by the light receiving element 31 (S120).
  • temporary data is created with reference to a reference position that is predetermined in the shooting area, regardless of whether the shooting area of the front image is the correct area.
  • the center 162 of the imaging area of the front image is used as the reference position.
  • the CPU 51 projects the reference light (reference target 108) from the reference light source 3 onto the light receiving element 31 (S121).
  • the CPU 51 has a reference position 162 that is set in advance in the image capturing area of the image captured by the light receiving element 31, and a reference target 108 included in the image.
  • a deviation from the projection position is detected (S122).
  • the CPU 51 detects the inclination of the light receiving surface of the light receiving element 31 with respect to the photographing optical axis of the front image based on the reference light projected on the light receiving element 31 (S123).
  • the CPU 51 of the present embodiment detects the inclination of the light receiving surface based on the shape of the reference target 108 photographed by the light receiving element 31.
  • the method for detecting the inclination of the light receiving surface can be changed.
  • the ophthalmic laser surgical apparatus 1 may project a plurality of reference targets on the light receiving element 31 and detect the inclination of the light receiving surface based on the positions of the plurality of captured reference targets.
  • the CPU 51 corrects the temporary data created in S120 based on the deviation between the reference position 162 and the reference target 108 in the front image and the inclination of the light receiving surface of the light receiving element 31.
  • the CPU 51 scans the scanning units 6 and 10 so as to eliminate the mismatch in the correspondence between the imaging region and the irradiation position of the surgical laser beam due to the shift (positional deviation and angular deviation) of the imaging region of the front image. , 18 and the like are generated.
  • the CPU 51 controls the driving of the scanning units 6, 10, 18 and the like according to the irradiation control data created by the irradiation control data creation process.
  • the driving of the scanning units 6, 10, and 18 is controlled based on the image of the eye E taken by the light receiving element 31 and the reference light projected on the light receiving element 31. Therefore, the accuracy of irradiation with surgical laser light is improved.
  • the CPU 51 temporarily creates temporary data (S120), and corrects the created temporary data based on the positional deviation and the angular deviation (S121 to S124). However, the CPU 51 may create irradiation control data based on one of the positional deviation and the angular deviation. In addition to the position of the eye E on the front image, the CPU 51 may directly create the irradiation control data without creating temporary data in consideration of at least one of positional deviation and angular deviation in advance. Further, the CPU 51 may correct the captured image data of the front image captured by the light receiving element 31 based on at least one of the positional deviation and the angular deviation. In this case, a front image in a state where the deviation is corrected is displayed on the display unit 54 or the like.
  • ⁇ Adjusting the interface to the main unit> at least one of the position and the angle of the interface with respect to the apparatus main body may be shifted due to an interface manufacturing error, an interface mounting error with respect to the apparatus, or the like. In this case, for example, inconveniences such as generation of aberrations and fluctuations in the irradiation range of the surgical laser light may occur.
  • the ophthalmic laser surgical apparatus 1 detects at least one of the position and the angle of the mounting interface mounted on the holding unit 67.
  • the ophthalmic laser surgical apparatus 1 controls the adjustment operation based on at least one of the detected position and angle.
  • the adjustment operation is an operation executed to adjust the mounting state of the mounting interface.
  • the mounting state of the mounting interface is adjusted with higher accuracy than when the user visually adjusts the mounting state of the mounting interface. As a result, the influence of the displacement of the mounting interface with respect to the apparatus main body is more appropriately suppressed.
  • the interface 90 of the above embodiment includes an annular eye fixing unit 95 that fixes the position of the eye E.
  • the CPU 51 detects the center of the eye fixing unit 95 and controls the adjustment operation based on the detected center position.
  • the center of the eye fixing part 95 is adjusted to an appropriate position with respect to the optical path of the surgical laser light.
  • the position of the eye E fixed by the eye fixing unit 95 is an appropriate position with respect to the optical path of the surgical laser light.
  • aberrations caused by the cornea can be suppressed.
  • the ophthalmic laser surgical apparatus 1 includes an imaging unit capable of imaging the eye fixing unit 95.
  • the CPU 51 detects the center of the eye fixing unit 95 by processing the image of the eye fixing unit 95 imaged by the imaging unit. Specifically, the CPU 51 detects an edge in the annular eye fixing unit 95 by processing an image of the eye fixing unit 95 photographed by the photographing unit, and uses the center of the detected edge as the center of the eye fixing unit 95. To detect. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can appropriately detect the center of the eye fixing unit 95.
  • the CPU 51 of the above embodiment can display the position of the center of the eye fixing unit 95 and the position of the reference axis S serving as a reference for determining the appropriate position of the wearing interface on the display unit 54. Therefore, the user can confirm by the display unit 54 whether or not the eye fixing unit 95 is disposed at an appropriate position with respect to the optical path of the surgical laser beam. Further, the user can manually change the position of the eye fixing unit 95 to an appropriate position while looking at the display unit 54.
  • the CPU 51 of the above embodiment controls the drive of the adjustment driving unit 70 (see FIG. 4) or the suction adjustment driving unit 129 (see FIG. 13) to bring the center position of the eye fixing unit 95 closer to the reference axis S. Can do. Therefore, the ophthalmic laser surgical apparatus 1 of the above embodiment can automatically and accurately arrange the eye fixing portion 95 at an appropriate position with respect to the optical path of the surgical laser light.
  • the interface 90 of the above embodiment includes IF lenses 100 and 110 (see FIGS. 5 and 6).
  • the CPU 51 detects at least one of the position and the angle of the IF lenses 100 and 110 and controls the adjustment operation based on the detection result. In this case, since the mounting state of the IF lenses 100 and 110 is adjusted to an appropriate state, occurrence of a defect due to the displacement of the IF lenses 100 and 110 with respect to the apparatus main body (for example, generation of aberration due to the IF lenses 100 and 110, etc.) ) Is suppressed.
  • the CPU 51 of the above embodiment acquires information on at least one point on the curved lens surface as lens surface information, and detects at least one of the positions and shapes of the IF lenses 100 and 110 based on the acquired lens surface information. .
  • the state of the IF lenses 100 and 110 is acquired directly from the lens surfaces of the IF lenses 100 and 110. Therefore, the mounting state of the IF lenses 100 and 110 is adjusted more accurately.
  • the CPU 51 of the above embodiment controls the adjustment operation based on lens surface information of at least the front surfaces 102 and 112 of the IF lenses 100 and 110. Since the rear surfaces 101 and 111 of the IF lenses 100 and 110 in the above embodiment are in contact with the eye E, liquid, or elastic body, the rear surfaces 101 and 111 are less susceptible to aberrations than the front surfaces 102 and 112. In the above-described embodiment, the adjustment operation is performed based on the lens surface information of the front surfaces 102 and 112 where aberrations are more likely to occur than the rear surfaces 101 and 111. Therefore, the adjustment operation is performed based only on the lens surface information of the rear surfaces 101 and 111. The aberration is suppressed more efficiently than in the case where the error occurs.
  • the CPU 51 of the above embodiment has a vertical position 121 that is perpendicular to the direction of the reference axis S among at least one of the front surfaces 102 and 112 and the rear surfaces 101 and 111 (see FIGS. 9, 10, and 12). Is detected.
  • the CPU 51 controls the adjustment operation based on the detected vertical position 121.
  • the optical design is performed so that the optical performance is improved when the reference axis S and the vertical position 121 intersect. Therefore, the optical performance is appropriately improved by performing the adjustment operation based on the vertical position 121.
  • the CPU 51 of the above-described embodiment detects the vertical position 121 by detecting the center 118 of the spherical surface 117 along which the lens surface extends from the information on the position of at least three points of the lens surface. In this case, a straight line passing through the center 118 of the spherical surface 117 along the lens surface is always perpendicular to the lens surface. Therefore, the CPU 51 can detect the vertical position 121 more accurately and easily.
  • the CPU 51 of the above embodiment can display the vertical position 121 on the lens surface and the position of the reference axis S of the apparatus on the display unit 54. Therefore, the user can confirm whether or not the IF lenses 100 and 110 are disposed at appropriate positions with respect to the optical path of the surgical laser beam by the display unit 54. Further, the user can manually change the positions of the IF lenses 100 and 110 to appropriate positions while looking at the display unit 54.
  • the CPU 51 of the above embodiment controls the drive of the adjustment drive unit 70 (see FIG. 4) or the IF lens adjustment drive unit 128 (see FIG. 13) to bring the vertical position 121 on the lens surface closer to the reference axis S. Can do. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can automatically and accurately place the IF lenses 100 and 110 at appropriate positions with respect to the optical path of the surgical laser light.
  • the CPU 51 of the above-described embodiment detects the angle of the IF lenses 100 and 110 with respect to the apparatus main body, and controls the drive of the adjustment driving unit based on the detected angle, so that the optical axis and the reference axis S of the IF lenses 100 and 110 are controlled. And make them close to parallel. Therefore, the ophthalmic laser surgical apparatus 1 according to the embodiment can appropriately suppress the influence of the angular deviation of the IF lenses 100 and 110.
  • the ophthalmic laser surgical apparatus 1 may perform the adjustment operation by providing the user with information for manually adjusting the interface 90.
  • the ophthalmic laser surgical apparatus 1 may allow the user to manually adjust the interface 90 by notifying the user of at least one of the moving direction and the rotating direction of the interface 90 using the display unit 54 or the like.
  • the ophthalmic laser surgical apparatus 1 may not display the center position of the eye fixing unit 95 or the vertical position 121 of the IF lenses 100 and 110.
  • the vertical position 121 of the lens surface having a shape along the spherical surface is brought close to the reference axis S.
  • at least a part of the technique exemplified in the above embodiment can be applied to the case where the IF lenses 100 and 110 having an aspheric lens surface are used.
  • ⁇ Light intensity adjustment> When receiving the reflected light reflected by the eye and processing the received light signal, various conditions can affect the processing. For example, when the position of the eye with respect to the apparatus main body of the ophthalmologic apparatus changes, the amount of light reaching the eye E may change, or the amount of light reflected by the eye and received by the light receiving element may change. . In this case, the processing result of the received light signal may vary depending on the positional relationship between the apparatus main body and the eyes. For example, when the received light signal is processed to generate an eye image, the brightness of the image may fluctuate.
  • the ophthalmic laser surgical apparatus (ophthalmic apparatus) 1 of the above embodiment adjusts the amount of light that reaches the eye E by being irradiated from the alignment / illumination light source 64 according to the position of the eye E with respect to the apparatus main body. Therefore, the ophthalmic laser surgical apparatus 1 can suppress the influence of the change in the position of the eye E relative to the apparatus main body on the processing of the received light signal.
  • the ophthalmic laser surgical apparatus 1 treats the eye E by condensing the pulsed laser light in the tissue of the eye E.
  • an ophthalmic laser surgical apparatus it is desirable for an ophthalmic laser surgical apparatus to perform an operation in a state where the position of the eye E with respect to the apparatus main body is fixed by an eye fixing unit.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment appropriately positions the eye E based on an observation image (at least one of a front image and a cross-sectional image) in which the influence of the relative position change between the apparatus main body and the eye E is suppressed.
  • the coupling drive unit 66 can be driven in a state that can be confirmed. Therefore, the eye fixing part 95 is coupled to the eye E with better accuracy.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment includes light receiving adjustment units 33 and 34 (focus adjustment units) that adjust the focus state of reflected light.
  • the CPU 51 acquires the distance between the apparatus main body and the eye E in the direction along the optical path of the reflected light extending to the light receiving element 31 based on the focus state adjustment result.
  • the ophthalmic laser surgical apparatus 1 can easily acquire the distance between the apparatus main body and the eye E using the adjustment result of the focus state. It is also conceivable to obtain the distance between the apparatus main body and the eye E by projecting both a finite target and an infinite index onto the cornea.
  • the ophthalmic laser surgical apparatus 1 can adjust the focus state by moving at least one of the light receiving element 31 and the optical member on the optical path.
  • the CPU 51 acquires the distance between the apparatus main body and the eye E based on the position of at least one of the light receiving element 31 and the optical member in a state where the focus state is adjusted. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can more appropriately execute the adjustment of the focus state and the acquisition of the distance from the eye E.
  • the ophthalmic laser surgical apparatus 1 adjusts the amount of light reaching the eye E by controlling the power supplied to the alignment / illumination light source 64. Accordingly, the ophthalmic laser surgical apparatus 1 can adjust the amount of light reaching the eye E with a simple configuration.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment maintains the amount of reflected light incident on the light receiving element 31 within a certain range regardless of the position of the eye E with respect to the apparatus main body. Therefore, the ophthalmic laser surgical apparatus 1 can appropriately control the influence of the change in the position of the eye E relative to the apparatus main body on the processing of the received light signal.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment maintains the luminance of the observation image displayed by the observation image data within a certain range regardless of the position of the eye E with respect to the apparatus main body. Therefore, the ophthalmic laser surgical apparatus 1 can generate image data in which a change in luminance is suppressed even when the position of the eye E with respect to the apparatus main body changes.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment adjusts the amount of light reaching the eye E using a table that associates position information with the amount of light, or an arithmetic expression that calculates the amount of light from the position information. Therefore, the ophthalmic laser surgical apparatus 1 can adjust the light amount to a more appropriate value.
  • the ophthalmic laser surgical apparatus 1 adjusts the amount of light reaching the eye E according to position information indicating the position of the eye E with respect to the apparatus body and a light amount adjustment instruction input by the user. . Therefore, the ophthalmic laser surgical apparatus 1 can irradiate the eye E with a light amount desired by the user while suppressing the influence of the change in the position of the eye E on the apparatus main body on the processing of the received light signal.
  • the ophthalmic laser surgical apparatus 1 acquires position information indicating the position of the eye E with respect to the apparatus main body. According to the acquired position information, at least one of the gain and offset of the photographed front image is adjusted. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can appropriately suppress the influence of the change in the position of the eye E relative to the apparatus main body on the front image.
  • the technique relating to the light amount adjustment exemplified in the above embodiment can be applied to an ophthalmic apparatus other than an ophthalmic laser surgical apparatus using an ultrashort pulse laser.
  • the technology exemplified in the above embodiment is a laser surgery device for an ophthalmologic that performs a laser coagulation operation by irradiating the fundus of the eye E with a laser, and a laser on the trabecular body, iris, vitreous body, and the like of the eye E.
  • the present invention can also be applied to an ophthalmic laser surgical apparatus that emits light.
  • an ophthalmic apparatus other than a surgical apparatus (for example, a visual acuity measuring apparatus, an intraocular pressure measuring apparatus, a fundus camera, a tomographic imaging apparatus, a corneal endothelial cell imaging apparatus, a corneal shape measuring apparatus, etc.). Is also applicable.
  • a surgical apparatus for example, a visual acuity measuring apparatus, an intraocular pressure measuring apparatus, a fundus camera, a tomographic imaging apparatus, a corneal endothelial cell imaging apparatus, a corneal shape measuring apparatus, etc.
  • the amount of light applied to the eye E is adjusted by adjusting the power supplied to the alignment / illumination light source 64.
  • a method for adjusting the amount of light applied to the eye E can be selected as appropriate.
  • the ophthalmologic apparatus may include a light source that can move with respect to the eye E.
  • the ophthalmologic apparatus may adjust the amount of light emitted to the eye E by adjusting the distance between the eye E and the light source.
  • the ophthalmologic apparatus may include a plurality of light sources.
  • the ophthalmologic apparatus may adjust the amount of light emitted to the eye E by changing at least one of the number and position of the light sources to be turned on. Further, the ophthalmologic apparatus may include a light shielding plate between the light source and the eye E. In this case, the ophthalmologic apparatus may adjust the amount of light reaching the eye E by adjusting the light shielding amount by the light shielding plate.
  • the reflected light of the diffused light emitted from the alignment / illumination light source 64 is received by the light receiving element 31. Accordingly, the amount of light is adjusted based on the alignment / illumination light source 64 fixed to the apparatus main body and the distance between the eyes E. However, the ophthalmic laser surgical apparatus 1 may adjust the amount of light based on the distance between the eye E and the light receiving element 31.
  • the amount of light emitted from the alignment / illumination light source 64 is determined by a table or an arithmetic expression.
  • the ophthalmic laser surgical apparatus 1 may determine the luminance of the observation image displayed on the display unit 54 in real time, and determine the amount of light so that the change in luminance is within an allowable range.
  • the light receiving element 31 employed in the above embodiment is used to capture a front image of the eye E.
  • the technique relating to the light amount adjustment exemplified in the above embodiment can also be applied to other light receiving elements (for example, the light receiving element of the cross-sectional image photographing unit 23, the light receiving element for detecting the interference signal of light).
  • the light receiving element 31 of the above embodiment is a two-dimensional light receiving element.
  • the technique exemplified in the above embodiment can be applied.
  • the position in the Z direction of the eye E with respect to the apparatus main body is acquired as position information serving as a reference for adjusting the light amount.
  • the ophthalmic laser surgical apparatus 1 may acquire the position of the eye E in the XY direction as position information.
  • both the light quantity with which the eye E is irradiated, and the gain offset of an observation image are adjusted.
  • the ophthalmic laser surgical apparatus 1 can adjust only one of the light amount and the gain / offset.
  • the suction ring may be aligned while the positional relationship between the annular suction ring and the axis of the eyeball is compared.
  • the optimal position of the suction ring with respect to the eye is not uniquely determined, it is difficult to perform alignment with high accuracy. If the coupling position of the eye fixing portion 95 with respect to the eye is shifted, aberration may occur or undesirable eye deformation may occur.
  • the ophthalmic laser surgical apparatus 1 detects the center of the annular eye fixing unit 95 and uses the detected center of the eye fixing unit 95 as a reference for determining the coupling position of the eye fixing unit 95 with respect to the eye E. And Therefore, in the ophthalmic laser surgical apparatus 1 of the above embodiment, the annular eye fixing unit 95 is coupled to an appropriate position of the eye E with higher accuracy.
  • the CPU 51 of the above-described embodiment detects the center of the eye fixing unit 95 by processing the captured image of the eye fixing unit 95. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can easily detect the center of the actual eye fixing unit 95. Specifically, the CPU 51 of the above-described embodiment detects the position of the inner edge 97 in the annular eye fixing unit 95 by processing a captured image of the eye fixing unit 95, and fixes the center of the detected edge 97 to the eye. It is detected as the center of the unit 95. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can detect the center of the eye fixing unit 95 with high accuracy based on the position of the edge 97.
  • the CPU 51 of the above-described embodiment can display the image of the photographed eye E and the detected center position of the eye fixing unit 95 on the display unit 54. Therefore, the user can confirm whether or not the eye fixing unit 95 is coupled to an appropriate position of the eye E by viewing the image displayed on the display unit 54. Further, the user manually couples the eye fixing unit 95 to an appropriate position of the eye E by changing the relative position of the eye E and the eye fixing unit 95 while viewing the image displayed on the display unit 54. It is also possible to make it.
  • the CPU 51 of the above embodiment controls the driving of the coupling driving unit 66 so that the eye fixing unit 95 is placed on the eye E in a state where the distance between the center of the eye fixing unit 95 and the center of the eye E is within an allowable range. Can be combined. Therefore, the ophthalmic laser surgical apparatus 1 according to the embodiment can automatically and accurately couple the eye fixing unit 95 to an appropriate position of the eye E.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can detect the center of the eye E based on the alignment index projected onto the cornea of the eye E.
  • the ophthalmic laser surgical apparatus 1 according to the embodiment can also detect the center of the eye E based on the cross-sectional image of the eye E. Therefore, the ophthalmic laser surgical apparatus 1 can easily detect the center of the eye E.
  • the eye fixing part 95 of the above embodiment is detachably attached to the holding part 67.
  • the eye fixing part 95 can be easily replaced.
  • the position of the eye fixing part 95 with respect to the apparatus main body tends to become unstable due to variations in the mounting position of the eye fixing part 95 with respect to the holding part 67 or manufacturing errors of the eye fixing part 95.
  • the eye fixing unit 95 is coupled to an appropriate position of the eye E with higher accuracy regardless of the position of the eye fixing unit 95 with respect to the apparatus main body. Therefore, it is easy to perform good surgery.
  • the technique exemplified in the above embodiment can also be applied when the eye fixing unit 95 is not detachable from the holding unit 67.
  • the XY alignment technology exemplified in the above embodiment can be applied to an ophthalmic apparatus other than an ophthalmic laser surgical apparatus using an ultrashort pulse laser.
  • the technology exemplified in the above embodiment is a laser surgery device for an ophthalmologic that performs a laser coagulation operation by irradiating the fundus of the eye E with a laser, and a laser on the trabecular body, iris, vitreous body, and the like of the eye E.
  • the present invention can also be applied to an ophthalmic laser surgical apparatus that emits light.
  • the center position of the eye fixing unit 95 is detected every time the docking process is performed.
  • the timing for detecting the center position of the eye fixing unit 95 can be changed as appropriate.
  • the CPU 51 may detect that the interface 90 is mounted on the holding unit 67 and may detect the center of the eye fixing unit 95 in the mounted interface 90 each time the interface 90 is mounted.
  • the accuracy of the detectable eye position or the required eye position detection method may vary depending on various conditions.
  • the position of the eye is detected by a single method regardless of various conditions.
  • the ophthalmic laser surgical apparatus 1 performs center detection processing for detecting the center position of the eye E in the XY directions by processing an anterior eye image (at least one of a front image and a cross-sectional image). To do. Furthermore, the ophthalmic laser surgical apparatus 1 according to the above-described embodiment switches the method for detecting the center position of the eye E according to the detection condition when performing the center detection process. Therefore, according to the above-described embodiment, even when the accuracy of the detectable position of the eye E or the required detection method of the position of the eye E changes to the detection condition, the eye can be detected by an appropriate method according to the detection condition. The position of E is detected.
  • the ophthalmic laser surgical apparatus 1 projects an alignment index onto the cornea of the eye E and captures a front image of the anterior segment of the eye E. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can detect the center position of the eye E using the bright spot 133 formed by the projected alignment index.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can execute at least the bright spot centroid detection method and the bright spot fitting detection method.
  • the bright spot centroid detection method the centroid of the bright spot 133 of the alignment index is detected as the center position of the eye E. In this case, even when the number or area of the detected bright spots 133 is small, the center position of the eye E is detected by a simple process.
  • the bright spot fitting detection method the center of the annular figure passing through the bright spot 133 is detected as the center position of the eye E. In this case, the center position of the cornea is more accurately detected as the center position of the eye E. Therefore, in the ophthalmic laser surgical apparatus 1 according to the above-described embodiment, the position of the eye E is detected by an appropriate method according to the detection condition.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment uses a bright spot fitting detection method that can more accurately detect the center position of the eye E when an annular figure passing through one or a plurality of bright spots 133 can be specified.
  • the ophthalmic laser surgical apparatus 1 uses a bright spot centroid detection method that can detect the center position of the eye E by simple processing when an annular figure passing through one or a plurality of bright spots 133 cannot be specified. Therefore, the position of the eye E is detected by an appropriate method according to the detection condition.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can switch the method for detecting the center position of the eye E according to the distance between the apparatus main body and the eye E. Therefore, even when the accuracy of the detectable position of the eye E or the required method of detecting the position of the eye E changes according to the distance between the apparatus main body and the eye E, the appropriate position according to the detection condition is appropriate.
  • the position of the eye E is detected by the method.
  • the ophthalmic laser surgical apparatus 1 detects the center position of the eye E by the bright spot centroid detection method when the distance between the apparatus main body and the eye E is equal to or greater than the first threshold. Therefore, when the position of the eye E with respect to the apparatus main body is far away and it is sufficient that the center position of the eye E can be detected to some extent, the ophthalmic laser surgical apparatus 1 of the above embodiment can detect the center position of the eye E with a simple process. can do.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment detects the center position of the eye E by the bright spot fitting detection method when the distance between the apparatus main body and the eye E is equal to or less than the second threshold value. Therefore, when the position of the eye E is close to the apparatus main body and it is desirable to detect the center of the eye E as accurately as possible, the ophthalmic laser surgical apparatus 1 according to the above embodiment can more accurately detect the center of the eye E. The position can be detected.
  • the detection accuracy of the center position of the eye E by the bright spot centroid detection method tends to be lower than the detection precision by other detection methods (for example, bright spot fitting detection method).
  • the detection precision by other detection methods for example, bright spot fitting detection method.
  • the apparatus main body which has been aligned with the eye E with high accuracy, move in the XY directions with reference to the center position detected with low accuracy.
  • the center position detection method when the center position detection method is switched to the bright spot centroid detection method, the center position detected by the luminescent spot centroid detection method is located within a specific region. Then, the movement of the apparatus main body in the XY directions is restricted (for example, prohibited, the movement speed is reduced, the movement range is reduced, etc.) Therefore, adverse effects when the center position detection method is switched are suppressed.
  • the ophthalmic laser surgical apparatus 1 processes an image photographed by the photographing unit (the front image photographing unit 30 or the cross-sectional image photographing unit 23), so that the tissue of the anterior eye part of the eye E (for example, the pupil) 146, corneal shape, and iris shape) can be detected.
  • the ophthalmic laser surgical apparatus 1 can detect at least one of the pupil center, the cornea center, and the iris center as the center position of the eye E from the detected anterior eye portion of the eye E (shape detection method). That is, the ophthalmic laser surgical apparatus 1 according to the above-described embodiment can execute both the detection of the center position using the bright spot 133 and the detection of the center position based on the shape.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can detect the center position of the eye E by the shape detection method when the center position of the eye E cannot be detected by the bright spot 133 of the alignment index. Therefore, for example, even when the projection light projected from the alignment index projection unit 63 to the eye E is temporarily blocked by various members (in the present embodiment, the eye fixing unit 95) or the user's hand, the above-described embodiment.
  • the ophthalmic laser surgical apparatus 1 can appropriately detect the center position of the eye E.
  • the ophthalmic laser surgical apparatus 1 uses the shape detection method to detect the eye E when the eye E is located in a blocking area where the projection light projected from the alignment index projection unit 63 onto the eye E is blocked by the member.
  • the center position of can be detected. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can detect the center position of the eye E even when the eye E is located in the blocking region.
  • the detected center position may change even though the position of the eye E with respect to the apparatus main body has not changed.
  • the ophthalmic laser surgical apparatus can detect a shift of a plurality of center positions detected by different methods, and can determine the center position of the eye E based on the detected shifts. Therefore, the occurrence of inconvenience due to the difference in detection method is suppressed.
  • the CPU 51 of the above embodiment detects a deviation between the center position detected by the bright spot fitting detection method and the center position detected by the shape detection method.
  • the CPU 51 can determine the center position of the eye E based on the center position detected by the shape detection method and the deviation. In this case, even when the center position detected by the bright spot fitting detection method (for example, the center of the cornea) and the center position detected by the shape detection method (for example, the center of the pupil) are different, inconvenience occurs due to the difference in the detection method. It is suppressed.
  • the technique relating to the center detection of the eye E exemplified in the above embodiment can be applied to an ophthalmologic apparatus other than an ophthalmic laser surgical apparatus using an ultrashort pulse laser.
  • the technology exemplified in the above embodiment is a laser surgery device for an ophthalmologic that performs a laser coagulation operation by irradiating the fundus of the eye E with a laser, and a laser on the trabecular body, iris, vitreous body, and the like of the eye E.
  • the present invention can also be applied to an ophthalmic laser surgical apparatus that emits light.
  • the technique exemplified in the above embodiment can be applied to an ophthalmologic apparatus other than the surgical apparatus, similarly to the other techniques described above.
  • the method for detecting the center position of the eye E is switched based on the position of the eye E in the Z direction and the detection state of the bright spot 133.
  • the ophthalmic laser surgical apparatus 1 may switch the center position detection method based on other conditions.
  • the center position detection method may be switched according to the technique to be executed.
  • ⁇ Display size index> When the eye fixing unit is coupled to the eye, it may be difficult to couple the eye coupling unit to the eye unless the subject's eyes are sufficiently opened. Various inconveniences can occur when it is not easy to determine whether or not the eye E is sufficiently opened. For example, when the eye fixing part and the eye are once combined and the eye opening is found to be insufficient, the user needs to open the eye again and try again.
  • the ophthalmic laser surgical apparatus 1 captures a front image of the anterior segment of the eye E at a different magnification depending on the distance between the apparatus main body and the eye E, and displays the front image on the display unit 54.
  • the ophthalmic laser surgical apparatus 1 can superimpose and display a size index 150 indicating the size of the eye fixing unit 95 on the front image.
  • the user can observe the eye E at an appropriate magnification according to the distance between the apparatus main body and the eye E.
  • the user can easily determine whether or not sufficient eye opening is performed to fix the eye fixing unit 95 to the eye E by comparing the eye E displayed on the front image with the size index 150. Can be judged.
  • the ophthalmic laser surgical apparatus 1 superimposes and displays the size index 150 indicating the size of the outer shape of the portion of the eye fixing unit 95 in contact with the eye E on the front image.
  • the user can compare the size of the part of the eye fixing unit 95 that contacts the eye E with the size of the opened eye E on the same front image. Therefore, the user can more appropriately determine whether or not sufficient opening has been performed.
  • the ophthalmic laser surgical apparatus 1 superimposes and displays a size index 150 indicating the size of the eye fixing unit 95 in the Z direction position on the front image according to the Z direction position of the eye E with respect to the apparatus main body.
  • the size of the size index 150 also changes according to the size of the eyes on the front image. Therefore, the user can appropriately determine whether or not sufficient eye opening is performed regardless of the position of the eye E in the Z direction.
  • the ophthalmic laser surgical apparatus 1 includes focus adjustment units (light reception adjustment units) 33 and 34 that adjust the focus of the front image to the eye E.
  • the CPU 51 acquires the position of the eye E in the Z direction based on the adjustment result of the focus state. In this case, the ophthalmic laser surgical apparatus 1 can easily acquire the position of the eye E in the Z direction using the adjustment result of the focus state.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can adjust the focus of the front image by moving at least one of the light receiving element 31 and the optical member on the imaging optical path.
  • the CPU 51 obtains the position of the eye E in the Z direction based on the position of at least one of the light receiving element 31 and the optical member in a state where the focus of the front image is adjusted to the eye E. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can more appropriately execute the focus adjustment of the front image and the acquisition of the position of the eye E in the Z direction.
  • the ophthalmic laser surgical apparatus 1 according to the above-described embodiment can also acquire the position of the eye E in the Z direction based on the cross-sectional image of the eye E. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can appropriately detect the position of the eye E in the Z direction.
  • the ophthalmic laser surgical apparatus 1 detects the XY direction position, which is the position of the eye E in the XY direction, and superimposes and displays the size index 150 at a position on the front image corresponding to the detected XY direction position. Can do. In this case, in the front image, the size index 150 is displayed at a position corresponding to the position of the photographed eye E. Therefore, the user can more easily determine whether or not sufficient opening has been performed.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can switch between displaying and not displaying the size index 150 on the front image.
  • the ophthalmic laser surgical apparatus 1 can switch between displaying and not displaying the size index 150 according to the necessity of displaying the size index 150.
  • the ophthalmic laser surgical apparatus 1 may hide the size index 150 when an operation instruction indicating that it has been confirmed that a sufficient opening has been performed is input.
  • the ophthalmic laser surgical apparatus 1 has the size index 150 to be superimposed and displayed on the front image in accordance with the size of the eye fixing unit 95 being used among the plurality of types of eye fixing units 95. Can be changed. Therefore, the user can easily determine whether or not sufficient eye opening is performed regardless of the type of eye fixation unit 95 to be used.
  • the technique related to the display of the size index exemplified in the above embodiment can be applied to an ophthalmic apparatus other than an ophthalmic laser surgical apparatus using an ultrashort pulse laser.
  • the technology exemplified in the above embodiment is a laser surgery device for an ophthalmologic that performs a laser coagulation operation by irradiating the fundus of the eye E with a laser, and a laser on the trabecular body, iris, vitreous body, and the like of the eye E.
  • the present invention can also be applied to an ophthalmic laser surgical apparatus that emits light.
  • the technique exemplified in the above embodiment can be applied to an ophthalmologic apparatus other than the surgical apparatus, similarly to the other techniques described above.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can change the size of the size index 150 to be superimposed and displayed while changing the distance (Z direction position) of the eye E to the apparatus main body.
  • the size index 150 may be displayed with the position of the eye E in the Z direction fixed.
  • the ophthalmic laser surgical apparatus 1 displays the size index 150 in a state where the position of the eye E in the Z direction is fixed, and after the user confirms that the eye opening is sufficient, the display of the size index 150 is erased. Then, the coupling operation may be started.
  • the imaging state of the fixation target projected from the ophthalmic apparatus on the fundus may change before and after the interface is coupled to the eye. In this case, the appearance of the fixation target by the subject changes. As a result, for example, the possibility that it becomes difficult for the target person to determine the position of the fixation target increases.
  • the ophthalmic laser surgical apparatus 1 includes the fixation target projection unit 40, the interface 90, and the CPU 51.
  • the fixation target projection unit 40 projects a fixation target that guides the line of sight of the eye of the subject onto the eye E.
  • the interface 90 is interposed between the apparatus main body and the eye E in the optical path of the fixation target, and is coupled to the eye E.
  • the CPU 51 changes the projection state of the fixation target from the fixation target projection unit 40 to the eye E before and after the interface 90 is coupled to the eye E. Therefore, the ophthalmic laser surgical apparatus 1 according to the above-described embodiment can appropriately suppress the influence that may occur on the fixation of the subject by coupling the interface 90 to the eye E.
  • the ophthalmic laser surgical apparatus 1 changes the projection state of the fixation target by changing the light amount of the fixation target projected onto the eye E. In this case, even if the imaging state of the fixation target on the fundus changes, the ophthalmic laser surgical apparatus 1 suppresses the density change of the light amount of the fixation target on the fundus by changing the light amount. Can do. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can appropriately suppress the change in the brightness of the fixation target recognized by the subject before and after the interface 90 is coupled to the eye E. it can.
  • the ophthalmic laser surgical apparatus 1 includes a focal length changing unit (a fixation target movement driving unit 46 and an optical element movement driving unit) that changes the focal length of a fixation target projection optical system provided in the optical path of the fixation target. 49).
  • the CPU 51 can change the projection state of the fixation target by changing the focal length of the fixation target projection optical system.
  • the ophthalmic laser surgical apparatus 1 can appropriately suppress a change in the imaging state of the fixation target on the fundus.
  • the ophthalmic laser surgical apparatus 1 can change the rate of changing the projection state of the fixation target according to the type of interface used.
  • the change state of the imaging state of the fixation target on the fundus may be different.
  • the ophthalmic laser surgical apparatus 1 according to the above-described embodiment can appropriately suppress the influence that can occur on the fixation of the subject according to the type of the interface 90 even when a plurality of types of interfaces 90 are used.
  • the ophthalmic laser surgical apparatus 1 includes an alignment index projection unit 63 that projects an alignment index and an imaging unit that captures an anterior eye image.
  • the CPU 51 can detect a change in the bright spot 133 formed on the cornea based on the alignment index, and can detect whether the interface 90 is coupled based on the detected change in the bright spot 133. That is, in the above embodiment, when the interface 90 is coupled to the eye E, the refraction state of light incident on the photographing unit from the eye E and the refraction state of light projected onto the eye E from the fixation target projection unit 40 Both change.
  • the ophthalmic laser surgical apparatus 1 according to the embodiment can appropriately detect the coupling of the interface 90 based on a change in the bright spot 133 imaged by the imaging unit.
  • the ophthalmic laser surgical apparatus 1 can detect that the interface 90 is coupled to the eye E when an operation instruction is input to the operation unit 55. In this case, the projection state of the fixation target on the eye E from the fixation target projection unit 40 is changed at an appropriate timing desired by the user.
  • the interface 90 of the above embodiment includes the contact lens 110 that contacts the eye E or the immersion lens 100 that contacts the liquid.
  • the refractive index of the light of the fixation target projected from the fixation target projection unit 40 changes before and after the IF lenses 100 and 110 contact the eye E or the liquid, and the imaging state of the fixation target changes.
  • the ophthalmic laser surgical apparatus 1 according to the embodiment changes the projection state of the fixation target from the fixation target projection unit 40 to the eye E before and after the interface 90 is coupled to the eye E. Therefore, even when the contact lens 110 or the immersion lens 100 is used, the influence that can occur on the fixation of the subject is appropriately suppressed.
  • the technique exemplified in the above embodiment can also be applied to the case where an interface that does not include the IF lenses 100 and 110 is used.
  • the technique relating to the fixation target projection exemplified in the above embodiment can be applied to an ophthalmic apparatus other than an ophthalmic laser surgical apparatus using an ultrashort pulse laser.
  • the technology exemplified in the above embodiment is a laser surgery device for an ophthalmologic that performs a laser coagulation operation by irradiating the fundus of the eye E with a laser, and a laser on the trabecular body, iris, vitreous body, and the like of the eye E.
  • the present invention can also be applied to an ophthalmic laser surgical apparatus that emits light.
  • the technique exemplified in the above embodiment can be applied to an ophthalmologic apparatus other than the surgical apparatus, similarly to the other techniques described above.
  • the ophthalmic laser surgical apparatus 1 projects reference light onto the light receiving element 31 that captures an image of the eye E along an optical axis whose relationship with the optical axis of the surgical laser light is predetermined. Can do.
  • the ophthalmic laser surgical apparatus 1 or the user is projected onto the light receiving element 31 even if the correspondence between the imaging region photographed by the light receiving element 31 and the position where the surgical laser light is actually irradiated changes.
  • the irradiation position of the surgical laser light can be determined based on the reference light. As a result, the surgical laser beam is irradiated to a more accurate position.
  • the CPU 51 of the above embodiment controls the driving of the scanning units 6, 10, and 18 based on the captured image of the eye E and the reference light projected on the light receiving element 31.
  • the CPU 51 more appropriately grasps the relationship between the optical axis of the surgical laser beam and the light receiving element 31 as compared with the case of controlling the driving of the scanning units 6, 10, and 18 without using the reference light.
  • the irradiation control of the surgical laser light based on the photographed image can be performed. Therefore, the ophthalmic laser surgical apparatus 1 can irradiate the surgical laser beam at a more accurate position.
  • the ophthalmic laser surgical apparatus 1 includes light receiving adjustment units 33, 34, and 36 that adjust the light receiving state of the reflected light from the eye E in the light receiving element 31.
  • the ophthalmologic laser surgical apparatus 1 can perform at least one of focus adjustment of a captured image, change of magnification of the captured image, and the like. Therefore, a more appropriate image is taken.
  • the relationship (at least one of position and angle) between the light receiving element 31 and the optical axis of the reflected light extending from the eye E to the light receiving element 31 is likely to change. As a result, the correspondence between the imaging region and the position where the surgical laser light is actually irradiated is likely to change.
  • the irradiation position of the surgical laser light is determined based on the reference light projected on the light receiving element 31. Therefore, the ophthalmic laser surgical apparatus 1 according to the above embodiment can improve the accuracy of irradiation of the surgical laser light while capturing an appropriate image of the eye E.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment inserts reference light coaxially with the optical axis of the surgical laser light from the upstream side of the scanning units 6, 10, and 18. Further, the ophthalmic laser surgical apparatus 1 according to the above embodiment branches the optical axis of the reference light from the optical axis of the surgical laser light on the downstream side of the scanning units 6, 10, and 18 to receive the reference light as a light receiving element. 31 is projected. In this case, even when the states of the scanning units 6, 10, and 18 change, the relationship between the optical axis of the surgical laser beam and the optical axis of the reference light is maintained. Therefore, the relationship between the optical axis of the surgical laser light and the optical axis of the reference light is more accurately maintained.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment can project a visual target having a predetermined shape onto the light receiving element 31.
  • the projection position of the reference light on the light receiving element 31 is more easily recognized.
  • the CPU 51 can easily detect the inclination of the light receiving surface of the light receiving element 31 with respect to the optical axis of the reflected light from the eye E (that is, the photographing optical axis).
  • the ophthalmic laser surgical apparatus 1 of the above embodiment detects the inclination of the light receiving surface of the light receiving element 31 with reference light, and based on the detected inclination, drive control of the scanning units 6, 10, 18, and captured image data At least one of the inclination correction is executed. As a result, the surgical laser beam is irradiated to a more accurate position.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment fixes the position of the eye E relative to the apparatus main body by the eye fixing unit 95. Therefore, the ophthalmic laser surgical apparatus 1 can perform a stable operation as compared with a case where the operation is performed in a state where the position of the eye E is not fixed. Furthermore, the CPU 51 of the above-described embodiment detects a deviation between the reference position 162 in the imaging region and the projection position of the reference light in a state where the eye fixing unit 95 is coupled to the eye E. The CPU 51 controls the driving of the scanning units 6, 10, and 18 based on the detected deviation.
  • the ophthalmic laser surgical apparatus 1 is configured even when the eye fixing unit 95 is coupled to the eye E without considering the correspondence between the imaging region and the position where the surgical laser light is actually irradiated.
  • the accuracy of irradiation with the surgical laser beam can be improved.
  • the ophthalmic laser surgical apparatus 1 of the above embodiment includes an irradiation position detection unit 26 that detects an irradiation position of the surgical laser light on an optical path branched from the optical path of the surgical laser light.
  • the optical path of the reference light in the above embodiment has an optical path that is common to at least a part of the optical path extending from the surgical laser light source 2 to the irradiation position detection unit 26. In this case, the ophthalmic laser surgical apparatus 1 can appropriately grasp the irradiation position of the surgical laser beam by the irradiation position detection unit 26.
  • the ophthalmic laser surgical apparatus 1 allows the reference light to pass through at least a part of the optical path of the surgical laser light whose irradiation position is grasped, so that the irradiation position of the surgical laser light is reflected in the captured image. Appropriately grasped by light.
  • the ophthalmic laser surgical apparatus 1 controls the alignment operation of the eye E with respect to the apparatus body based on the center position of the eye E and the projection position of the reference light.
  • the eye E is easily fixed at an appropriate position with respect to the reference axis.
  • the eye fixing unit 95 is easily fixed at an appropriate position of the eye E.
  • the reference light projection unit of the present embodiment projects the reference light onto the light receiving element 31 along an optical axis whose relationship with the photographing optical axis of the cross-sectional image photographing unit 23 is predetermined.
  • the imaging region of the front image captured by the light receiving element 31 and the imaging region of the cross-sectional image captured by the cross-sectional image capturing unit 23 in this embodiment, the OCT scanned by the scanning unit of the cross-sectional image capturing unit 23. Even if the correspondence relationship with the light scanning range) changes, the correspondence relationship between the two is determined based on the reference light. As a result, the surgical laser beam is irradiated to a more accurate position.
  • the technique relating to the reference light exemplified in the above embodiment can be applied to ophthalmologic apparatuses other than ophthalmic laser surgical apparatus using an ultrashort pulse laser.
  • the temporary data of the irradiation control data is corrected based on the deviation between the reference visual target 108 and the reference position 162 on the front image.
  • the ophthalmic laser surgical apparatus 1 can use the reference light for other purposes.
  • the ophthalmic laser surgical apparatus 1 may move the position of the light receiving element 31 relative to the apparatus main body so that the position of the reference light reflected on the front image matches the reference position 162 on the front image. .
  • the ophthalmic laser surgical apparatus 1 may adjust the angle of the light receiving element 31 so that the angle of the light receiving surface of the light receiving element 31 detected by the reference light becomes an appropriate angle. Furthermore, the ophthalmic laser surgical apparatus 1 may create irradiation control data by causing the user to input the irradiation position of the surgical laser light in a state where the front image is displayed on the display unit 54.
  • the ophthalmic laser surgical apparatus 1 and the ophthalmic surgery control program of the above embodiment can also be expressed as follows.
  • An ophthalmic laser surgical apparatus that treats the eye by irradiating the eye of the subject with a surgical laser beam, the interface interposed between the apparatus main body and the eye in the optical path of the surgical laser light And a holding unit for holding at least a part of the interface in a detachable manner and holding the attachment interface as the attached interface in a state in which at least one of the position and the angle with respect to the apparatus main body is adjustable.
  • a controller that controls the operation of the ophthalmic laser surgical apparatus, and the controller detects at least one of a position and an angle of the mounting interface with respect to the apparatus main body, and a mounting state of the mounting interface
  • the adjustment operation which is the operation executed to adjust the Controlled based on either also.
  • An ophthalmologic apparatus comprising: a light source that irradiates light to a subject's eye; a light receiving element that receives reflected light reflected by the eye; and a control unit that controls an operation of the ophthalmologic apparatus, wherein the control The unit acquires position information indicating the position of the eye with respect to the apparatus main body, and adjusts the amount of light emitted from the light source to the eye according to the acquired position information.
  • An ophthalmologic apparatus that captures a front image of the anterior segment of the eye by receiving a light source that is fixed to the apparatus body and that irradiates light on the subject's eyes and reflected light reflected by the eyes
  • a front image capturing unit and a control unit that controls the operation of the ophthalmologic apparatus, wherein the control unit acquires position information indicating the position of the eye with respect to the apparatus body, and according to the acquired position information Then, at least one of a gain and an offset of the front image captured by the front image capturing unit is adjusted.
  • An ophthalmologic apparatus control program for controlling an ophthalmologic apparatus, the ophthalmologic apparatus comprising: a light source that irradiates light to a subject's eye; and a light receiving element that receives reflected light reflected by the eye;
  • the ophthalmologic apparatus control program is executed by the processor of the ophthalmologic apparatus, so that an acquisition step of acquiring position information indicating the position of the eye with respect to the apparatus main body, and the eye from the light source according to the acquired position information
  • a light amount adjustment step for adjusting the light amount of light irradiated on the ophthalmic apparatus.
  • An ophthalmic laser surgical apparatus that treats the eye by irradiating the eye of the subject with a surgical laser beam, and is an annular ocular fixation that fixes the position of the eye with respect to the apparatus body by being coupled to the eye And a light receiving element that captures an image of the eye, and a control unit that controls the operation of the ophthalmic laser surgical apparatus, and the control unit detects and detects the center of the annular eye fixing unit Based on the center of the eye fixing unit, the connecting operation performed to connect the eye fixing unit to the eye is controlled.
  • An ophthalmic surgical control program for controlling an ophthalmic laser surgical apparatus, wherein the ophthalmic laser surgical apparatus is coupled to an eye of a subject to thereby fix the position of the eye with respect to the apparatus main body.
  • a center detecting step for detecting the center of the annular eye fixing unit, and the detected center of the eye fixing unit by executing the ophthalmic surgery control program by the processor of the ophthalmic laser surgical apparatus.
  • the ophthalmic laser surgical apparatus is caused to perform a coupling operation step for controlling a coupling operation performed to couple the eye fixing unit to the eye.
  • An ophthalmic apparatus comprising: an imaging unit that captures an image of an anterior segment of an eye of a subject; and a control unit that controls the operation of the ophthalmic apparatus, wherein the control unit is captured by the imaging unit
  • a center detection process for detecting the center position of the eye in the XY direction intersecting the imaging optical axis of the imaging unit is executed, and according to a detection condition when the center detection process is executed. Then, the method for detecting the center position is switched.
  • An ophthalmologic apparatus control program for controlling an ophthalmologic apparatus, wherein the ophthalmologic apparatus includes an imaging unit that captures an image of an anterior segment of an eye of a subject, and the ophthalmic apparatus control program is executed by a processor of the ophthalmic apparatus.
  • the ophthalmic apparatus control program is executed by a processor of the ophthalmic apparatus.
  • a front image capturing unit that captures a front image of the anterior segment of the eye at a different magnification according to the distance between the apparatus main body and the subject's eye, and an ophthalmic apparatus
  • An eye fixing unit that fixes the position of the eye with respect to the apparatus main body
  • a control unit that controls the operation of the ophthalmic apparatus.
  • the control unit displays the front image on a display unit, and the eye fixing unit.
  • a size index indicating the size of the image is superimposed and displayed on the front image of the display unit.
  • An ophthalmologic apparatus control program for controlling an ophthalmologic apparatus, wherein the ophthalmologic apparatus captures a front image of an anterior ocular segment of the eye at a different magnification according to a distance between the apparatus main body and a subject's eye.
  • a front image capturing unit and an eye fixing unit that fixes the position of the eye with respect to the apparatus body by being coupled to the eye, and the ophthalmic apparatus control program is executed by the processor of the ophthalmic apparatus,
  • the ophthalmologic apparatus is caused to execute a size target display step of superimposing and displaying a size target indicating the size of the eye fixing unit on the front image displayed on the display unit.
  • a fixation target projecting unit that projects a fixation target that guides the line of sight of the eye of the subject onto the eye, and an optical path of the fixation target that is projected by the fixation target projection unit,
  • An interface interposed between the apparatus main body and the eye and coupled to the eye; and a control unit for controlling the operation of the ophthalmic apparatus, the control unit having the interface coupled to the eye
  • the projection state of the fixation target from the fixation target projection unit to the eye is changed before and after the operation.
  • An ophthalmologic apparatus control program for controlling an ophthalmologic apparatus, wherein the ophthalmologic apparatus projects a fixation target that guides a line of sight of a subject's eye to the eye, and the fixation target projection An optical path of the fixation target projected by a unit, and an interface interposed between the apparatus main body and the eye and coupled to the eye, and the ophthalmic apparatus control program is executed by the processor of the ophthalmic apparatus And a projection state changing step for changing a projection state of the fixation target from the fixation target projection unit to the eye before and after the interface is coupled to the eye. Let it run.
  • An ophthalmic laser surgical apparatus that treats the eye by irradiating the eye of the subject with a surgical laser beam, the controller controlling the operation of the ophthalmic laser surgical apparatus, and the reflection reflected by the eye
  • a light receiving element that captures an image of the eye by receiving light; a surgical laser light source that emits the surgical laser light; a scanning unit that scans a spot on which the surgical laser light is collected;
  • a reference light projection unit that projects reference light onto the light receiving element along an optical axis that has a predetermined relationship with the optical axis of the surgical laser light applied to the eye.

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

Abstract

L'objectif de la présente invention est de proposer un dispositif laser pour chirurgie ophtalmologique dans lequel l'influence du déplacement de la position et/ou de l'angle d'une interface par rapport au corps du dispositif peut être atténuée. Le dispositif laser pour chirurgie ophtalmologique selon la présente invention est pourvu d'une interface, d'une unité de support et d'une unité de commande. L'interface est disposée entre le corps du dispositif et l'œil sur le trajet optique de la lumière laser chirurgicale. Au moins une partie de l'interface est fixée de manière amovible à l'unité de support qui maintient l'interface dans un état permettant le réglage de la position et/ou de l'angle de celle-ci par rapport au corps du dispositif. L'unité de commande détecte la position et/ou l'angle de l'interface ainsi fixée par rapport au corps du dispositif. L'unité de commande, sur la base de la position et/ou de l'angle détecté, commande une opération de réglage effectuée pour ajuster l'état de fixation de l'interface ainsi fixée par rapport au corps du dispositif.
PCT/JP2016/060858 2015-03-31 2016-03-31 Dispositif laser pour chirurgie ophtalmologique, dispositif ophtalmologique, programme de commande de dispositif ophtalmologique, et programme de commande pour chirurgie ophtalmologique WO2016159331A1 (fr)

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
JP2015-073995 2015-03-31
JP2015-073991 2015-03-31
JP2015073995A JP2016193032A (ja) 2015-03-31 2015-03-31 眼科装置および眼科装置制御プログラム
JP2015073991A JP2016193028A (ja) 2015-03-31 2015-03-31 眼科用レーザ手術装置
JP2015073992A JP2016193029A (ja) 2015-03-31 2015-03-31 眼科装置および眼科装置制御プログラム
JP2015-073992 2015-03-31
JP2015-073993 2015-03-31
JP2015073993A JP2016193030A (ja) 2015-03-31 2015-03-31 眼科用レーザ手術装置および眼科手術制御プログラム

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