WO2023068359A1 - 眼内照明機器、眼内照明用アタッチメント - Google Patents
眼内照明機器、眼内照明用アタッチメント Download PDFInfo
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- WO2023068359A1 WO2023068359A1 PCT/JP2022/039240 JP2022039240W WO2023068359A1 WO 2023068359 A1 WO2023068359 A1 WO 2023068359A1 JP 2022039240 W JP2022039240 W JP 2022039240W WO 2023068359 A1 WO2023068359 A1 WO 2023068359A1
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- Prior art keywords
- fiber
- holder
- intraocular illumination
- eye
- illumination device
- Prior art date
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- 238000005286 illumination Methods 0.000 title claims abstract description 183
- 239000000835 fiber Substances 0.000 claims abstract description 109
- 238000001356 surgical procedure Methods 0.000 claims abstract description 17
- 230000003287 optical effect Effects 0.000 claims description 28
- 229910052736 halogen Inorganic materials 0.000 claims description 7
- 150000002367 halogens Chemical class 0.000 claims description 7
- 238000000034 method Methods 0.000 claims description 7
- 229910052724 xenon Inorganic materials 0.000 claims description 7
- FHNFHKCVQCLJFQ-UHFFFAOYSA-N xenon atom Chemical compound [Xe] FHNFHKCVQCLJFQ-UHFFFAOYSA-N 0.000 claims description 7
- 238000007689 inspection Methods 0.000 abstract 1
- 210000001508 eye Anatomy 0.000 description 94
- 238000010586 diagram Methods 0.000 description 6
- 210000004087 cornea Anatomy 0.000 description 3
- 238000004519 manufacturing process Methods 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 230000002093 peripheral effect Effects 0.000 description 3
- 229910001369 Brass Inorganic materials 0.000 description 2
- 239000010951 brass Substances 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 239000011347 resin Substances 0.000 description 2
- 229920005989 resin Polymers 0.000 description 2
- 230000002146 bilateral effect Effects 0.000 description 1
- 210000005252 bulbus oculi Anatomy 0.000 description 1
- 239000000470 constituent Substances 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000004709 eyebrow Anatomy 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 239000013307 optical fiber Substances 0.000 description 1
- 210000003786 sclera Anatomy 0.000 description 1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
- A61F9/007—Methods or devices for eye surgery
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F21—LIGHTING
- F21S—NON-PORTABLE LIGHTING DEVICES; SYSTEMS THEREOF; VEHICLE LIGHTING DEVICES SPECIALLY ADAPTED FOR VEHICLE EXTERIORS
- F21S2/00—Systems of lighting devices, not provided for in main groups F21S4/00 - F21S10/00 or F21S19/00, e.g. of modular construction
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B21/00—Microscopes
- G02B21/06—Means for illuminating specimens
-
- G—PHYSICS
- G02—OPTICS
- G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
- G02B6/00—Light guides; Structural details of arrangements comprising light guides and other optical elements, e.g. couplings
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F21—LIGHTING
- F21Y—INDEXING SCHEME ASSOCIATED WITH SUBCLASSES F21K, F21L, F21S and F21V, RELATING TO THE FORM OR THE KIND OF THE LIGHT SOURCES OR OF THE COLOUR OF THE LIGHT EMITTED
- F21Y2101/00—Point-like light sources
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F21—LIGHTING
- F21Y—INDEXING SCHEME ASSOCIATED WITH SUBCLASSES F21K, F21L, F21S and F21V, RELATING TO THE FORM OR THE KIND OF THE LIGHT SOURCES OR OF THE COLOUR OF THE LIGHT EMITTED
- F21Y2115/00—Light-generating elements of semiconductor light sources
- F21Y2115/10—Light-emitting diodes [LED]
Definitions
- the present disclosure relates to an intraocular illumination device and an attachment for intraocular illumination.
- JP-A-2005-230558 a light source is placed inside the microscope at a position opposite to the eye with respect to the objective lens, and the light passing through the objective lens illuminates the inside of the eye from outside the eye.
- techniques have been proposed.
- the light source is positioned on the opposite side of the eye with respect to the objective lens, and the light enters the eye through the objective lens. It was difficult to obtain intraocular illumination.
- the light source is arranged inside the microscope, it is necessary to purchase a new microscope with such a special structure, which is inconvenient in that existing microscopes cannot be used.
- a technology that can provide intraocular illumination from outside the eye with sufficient light intensity and range is desired. Also, a technique that can realize intraocular illumination from outside the eye while using an existing microscope is desired.
- An intraocular illumination device includes: a fiber for guiding light from a light source; a holder that is placed between a microscope objective lens and the eye during surgery or examination of the eye and supports the tip of the fiber; with The distal end of the fiber is provided with a reflector that reflects the light guided through the fiber into the eye.
- An intraocular illumination attachment includes: An intraocular illumination attachment placed between a microscope objective and the eye during surgery or examination of the eye, comprising: an illumination unit that includes a mirror attached to the tip of a fiber that guides light from a light source and that reflects light directed through the fiber into the eye; a holder that supports the lighting unit; Prepare.
- FIG. 1 is a schematic diagram showing the positional relationship between an intraocular illumination device, an objective lens of a microscope, and an eye according to an embodiment.
- FIG. 2 is an enlarged perspective view of an intraocular illumination device.
- FIG. 3 is a plan view of the intraocular illumination device when viewed from the eye side.
- FIG. 4 is a perspective view of the holder of the intraocular illumination attachment when viewed from the objective lens side of the microscope.
- FIG. 5 is a perspective view of the holder of the intraocular illumination attachment when viewed from the eye side.
- FIG. 6 is an enlarged perspective view of the illumination unit attached to the tip of the fiber.
- FIG. 7A is a vertical cross-sectional view of the lighting unit.
- FIG. 7B is a perspective view of the lighting unit.
- FIG. 8 is a photograph of the fundus taken when the fundus was actually observed using the intraocular illumination device.
- FIG. 9 is an enlarged perspective view of an intraocular illumination device according to a modified example.
- FIG. 10 is a plan view of an intraocular illumination device according to a modification when viewed from the eye side.
- FIG. 11 is a perspective view of a holder of an intraocular illumination attachment according to a modified example when viewed from the objective lens side of a microscope.
- FIG. 12 is a perspective view of a holder of an intraocular illumination attachment according to a modified example when viewed from the eye side.
- FIG. 13 is a schematic diagram showing a positional relationship between an intraocular illumination device, an objective lens of a microscope, and an eye according to a modified example.
- FIG. 14 is a schematic diagram showing the positional relationship between an intraocular illumination device, an objective lens of a microscope, and an eye according to a modified example.
- FIG. 15 is a diagram showing specific dimensions of the holder of the intraocular illumination device actually used in the examples.
- FIG. 16 is a diagram showing specific dimensions of the cylindrical portion of the illumination unit of the intraocular illumination device actually used in the examples.
- An intraocular illumination device comprises: a fiber for guiding light from a light source; a holder that is placed between a microscope objective lens and the eye during surgery or examination of the eye and supports the tip of the fiber; with The tip of the fiber is provided with a reflector that reflects the light guided through the fiber into the eye.
- the tip of the fiber that guides the light from the light source is supported by the holder between the objective lens of the microscope and the eye, and the tip of the fiber has a light guide through the fiber. Since the reflecting portion is provided to reflect the light received into the eye, it is possible to irradiate the light into the eye from a position sufficiently close to the eye without passing through the lens. Therefore, it is possible to obtain intraocular illumination from outside the eye with a sufficient amount of light and a sufficient range. In addition, since the distal end of the fiber is supported by the holder so that it does not move, the operator can operate the surgical instrument with both hands, ie, the bilateral technique can be practiced.
- An intraocular illumination device is the intraocular illumination device according to the first aspect,
- An illumination unit is attached to the tip of the fiber and includes a mirror that reflects the light guided through the fiber into the eye, The reflecting section is composed of the mirror.
- An intraocular illumination device is the intraocular illumination device according to the first aspect,
- the end surface of the tip of the fiber is obliquely polished so as to reflect the light guided through the fiber toward the inside of the eye,
- the reflecting portion is composed of the end surface of the fiber.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to third aspects,
- the holder has a thickness of 10 mm or less.
- the holder can be easily arranged in a narrow space between the objective lens of the microscope and the eye.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to fourth aspects,
- the holder supports a plurality of the distal ends of the fibers.
- the holder supports a plurality of the distal ends of the fibers, thereby increasing the light amount and range of the intraocular illumination.
- An intraocular illumination device is the intraocular illumination device according to the fifth aspect, A plurality of reflecting portions respectively provided at a plurality of tip portions are arranged in the holder so as to be arranged at regular intervals along a circumferential direction about the optical axis of the microscope.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to sixth aspects,
- the holder is provided with an attachment portion that can be attached to the lens unit of the microscope.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to sixth aspects,
- the holder is integrated with the lens unit of the microscope.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to eighth aspects, A through hole is formed in the holder coaxially with the optical axis of the microscope, and a groove or hole is formed so as to extend outward from the vicinity of the through hole in plan view, and the The tip is inserted into and supported by the groove or hole formed in the holder.
- the through hole is formed in the holder coaxially with the optical axis of the microscope, a bright field of view can be obtained when observing with the microscope.
- the tip of the fiber is supported by being inserted into the groove or hole formed in the holder, the configuration for supporting the tip of the fiber can be realized with a very simple structure, and the manufacturing cost of the holder can be reduced. can be reduced.
- An intraocular illumination device is the intraocular illumination device according to the ninth aspect,
- the tip of the fiber is positionally adjustable along the groove or hole while supported by the holder.
- the brightness of the fundus and the condition of the spot (illuminated portion) can be easily adjusted by adjusting the position of the tip of the fiber.
- An intraocular illumination device is the intraocular illumination device according to the tenth aspect,
- the tip of the fiber can be aligned along the groove or hole to bring the reflector closer to within 5 mm of the optical axis of the microscope.
- the window can be brought close to within 5 mm from the optical axis of the microscope. It is possible to efficiently enter the light from the black part of the eye into the eye.
- An intraocular illumination device is the intraocular illumination device according to any one of the ninth to eleventh aspects,
- the number of the tip portions of the fiber is four, and the holder is formed with four grooves or holes. , 0°, 90°, 180° and 270°.
- An intraocular illumination device is the intraocular illumination device according to any one of the ninth to eleventh aspects,
- the number of the tip portions of the fiber is four, and the holder is formed with four grooves or holes. , extending in the direction of 0° from the position of 0°, the second groove or hole is formed to extend in the direction of 180° from the position of 180°, and the third groove or hole is formed to extend in the direction of 180° from the position of 180°.
- the hole is formed to extend in the 0° or 180° direction from the 90° position, and the fourth groove or hole is formed to extend in the 0° or 180° direction from the 270° position. ing.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to thirteenth aspects,
- the exit side NA of the fiber is less than or equal to 0.55.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to fourteenth aspects,
- the fiber is branched from the light source to the lighting unit.
- the number of lighting units can be increased without increasing the number of light sources.
- An intraocular illumination device is the intraocular illumination device according to any one of the first to fifteenth aspects,
- the light source is at least one of a xenon lamp, a halogen lamp and an LED.
- the xenon lamp, halogen lamp, or LED already installed in the operating room or examination room can be used as the light source, which is convenient because there is no need to prepare a new light source.
- An intraocular illumination attachment comprises: An intraocular illumination attachment placed between a microscope objective and the eye during surgery or examination of the eye, comprising: an illumination unit that includes a mirror attached to the tip of a fiber that guides light from a light source and that reflects light directed through the fiber into the eye; a holder that supports the lighting unit; Prepare.
- the intraocular illumination attachment is placed between the microscope objective lens and the eye, i.e. outside the microscope, during surgery or examination of the eye, thus making use of the existing microscope.
- Intraocular illumination from the outside of the eye can be realized.
- an illumination unit containing a mirror that reflects light guided through the fiber into the eye is supported by a holder between the microscope objective and the eye, so that the light can be seen through the lens from a position sufficiently close to the eye. It is possible to irradiate light into the eye without Therefore, it is possible to obtain intraocular illumination from outside the eye with a sufficient amount of light and a sufficient range.
- the lighting unit is supported by the holder so as not to move, the operator can operate the surgical instrument with both hands, ie, practice bimanual techniques.
- An intraocular illumination attachment according to an eighteenth aspect of the embodiment is the intraocular illumination attachment according to the seventeenth aspect,
- the holder has a thickness of 10 mm or less.
- the holder can be easily arranged in a narrow space between the objective lens of the microscope and the eye.
- An intraocular illumination attachment is an intraocular illumination attachment according to the seventeenth or eighteenth aspect,
- the holder supports a plurality of lighting units.
- the holder supports a plurality of illumination units, so that the light amount and range of intraocular illumination can be increased.
- An intraocular illumination attachment is an intraocular illumination attachment according to the nineteenth aspect,
- the plurality of illumination units are arranged such that windows through which the light reflected by the mirrors is emitted are arranged at regular intervals along the circumferential direction around the optical axis of the microscope.
- An intraocular illumination attachment is an intraocular illumination attachment according to any one of the seventeenth to twentieth aspects,
- the holder is provided with an attachment portion that can be attached to the lens unit of the microscope.
- the holder can be easily fixed to the lens unit so as not to move.
- An intraocular illumination attachment is an intraocular illumination attachment according to any one of the seventeenth to twenty-first aspects,
- a through hole is formed in the holder coaxially with the optical axis of the microscope, and a groove or a hole is formed so as to extend outward from the vicinity of the through hole in plan view, and the tip of the fiber is formed.
- the lighting unit attached to the part is inserted into and supported by the groove or hole formed in the holder.
- the through hole is formed in the holder coaxially with the optical axis of the microscope, a bright field of view can be obtained when observing with the microscope.
- the lighting unit is supported by being inserted into the groove or hole formed in the holder, the structure for supporting the lighting unit can be realized with a very simple structure, and the manufacturing cost of the holder can be reduced. It becomes possible.
- An intraocular illumination attachment is the intraocular illumination attachment according to the twenty-second aspect, 7.
- the brightness of the fundus and the condition of the spot (illuminated portion) can be easily adjusted by adjusting the position of the illumination unit.
- An intraocular illumination attachment is an intraocular illumination attachment according to the twenty-third aspect,
- the illumination unit attached to the tip of the fiber is positioned along the groove or hole so that the window for emitting the light reflected by the mirror is within 5 mm from the optical axis of the microscope. can be brought close to the range of
- the window can be placed within 5 mm from the optical axis of the microscope. It can be efficiently put into the eye from the black part of the eye.
- An intraocular illumination attachment is an intraocular illumination attachment according to any one of the twenty-second to twenty-fourth aspects,
- the number of the illumination units is four
- the holder is formed with four grooves or holes, and each of the four grooves or holes is 0° in polar coordinates centered on the optical axis of the microscope. , 90°, 180° and 270°.
- An intraocular illumination attachment is an intraocular illumination attachment according to any one of the twenty-second to twenty-fourth aspects,
- the number of the illumination units is four
- the holder is formed with four grooves or holes. is formed to extend in the direction of 0° from the position of
- the second groove or hole is formed to extend in the direction of 180° from the position of 180°
- the third groove or hole is formed to: It is formed to extend in the 0° or 180° direction from the 90° position
- the fourth groove or hole is formed to extend in the 0° or 180° direction from the 270° position.
- An intraocular illumination attachment is an intraocular illumination attachment according to any one of the seventeenth to twenty-sixth aspects, The intraocular illumination attachment is disposable.
- the attachment for intraocular illumination is disposed between the objective lens of the microscope and the eye during eye surgery or examination, and is easily soiled. convenient.
- An intraocular illumination attachment according to a twenty-eighth aspect of the embodiment is an intraocular illumination attachment according to any one of the seventeenth to twenty-seventh aspects,
- the exit side NA of the fiber is less than or equal to 0.55.
- An intraocular illumination attachment according to a twenty-ninth aspect of the embodiment is an intraocular illumination attachment according to any one of the seventeenth to twenty-eighth aspects,
- the number of lighting units can be increased without increasing the number of light sources.
- An intraocular illumination attachment is an intraocular illumination attachment according to any one of the seventeenth to twenty-ninth aspects,
- the light source is at least one of a xenon lamp, a halogen lamp and an LED.
- the xenon lamp, halogen lamp, or LED already installed in the operating room or examination room can be used as the light source, which is convenient because there is no need to prepare a new light source.
- an intraocular illumination device In an intraocular illumination device according to a thirty-first aspect of the embodiment, An intraocular illumination attachment according to any one of the seventeenth to thirtieth aspects, and the fiber.
- An ophthalmic surgical or examination microscope comprises: An intraocular illumination device according to any one of aspects 1 to 16 and 31 is provided.
- FIG. 1 is a schematic diagram showing the positional relationship between an intraocular illumination device 1, an objective lens 31 of a microscope, and an eye 20 according to one embodiment.
- FIG. 2 is an enlarged perspective view of the intraocular illumination device 1.
- FIG. 3 is a plan view of the intraocular illumination device 1 when viewed from the eye 20 side.
- the intraocular illumination device 1 has a fiber (optical fiber) 13 for guiding light from a light source 15 and an intraocular illumination attachment 10 attached to the tip of the fiber 13. ing.
- the intraocular illumination attachment 10 is arranged between the objective lens 31 of the microscope and the eye 20 during surgery or examination of the eye 20, as shown in FIG. Since the intraocular illumination attachment 10 is arranged between the objective lens 31 and the eye 20 and easily gets dirty, it may be disposable in consideration of hygiene.
- An objective lens 31 of the microscope is housed inside the lens unit 30 .
- the intraocular illumination attachment 10 has an illumination unit 11 attached to the tip of the fiber 13 and a holder 12 supporting the illumination unit 11. As shown in FIGS. 1 to 3, the intraocular illumination attachment 10 has an illumination unit 11 attached to the tip of the fiber 13 and a holder 12 supporting the illumination unit 11. As shown in FIGS. 1 to 3, the intraocular illumination attachment 10 has an illumination unit 11 attached to the tip of the fiber 13 and a holder 12 supporting the illumination unit 11. As shown in FIGS.
- FIG. 6 is an enlarged perspective view showing the illumination unit 11 attached to the tip of the fiber 13.
- FIG. 7A is a longitudinal sectional view of the lighting unit 11
- FIG. 7B is a perspective view of the lighting unit 11.
- the lighting unit 11 includes a cylindrical portion 110 having a cylindrical shape with a tip portion cut obliquely (for example, at an angle of 45°), and a cut surface of the cylindrical portion 110. and a mirror 111 mounted over the exposed aperture.
- the material of cylindrical portion 110 is, for example, brass.
- a window portion 112 is formed on the outer peripheral surface of the cylindrical portion 110 so as to correspond to the reflecting surface of the mirror 111 .
- the distal end portion of the fiber 13 is fixed to the tubular portion 110 while being inserted from the proximal end portion of the tubular portion 110 .
- the light emitted from the tip of the fiber 13 is reflected by the reflecting surface of the mirror 111 in the direction of 90°, and then emitted to the outside through the window 112 . That is, in this embodiment, the mirror 111 of the illumination unit 11 is provided at the tip of the fiber 13 and reflects the light guided through the fiber 13 into the eye 20 .
- FIG. 4 is a perspective view of the holder 12 viewed from the objective lens 31 side of the microscope.
- FIG. 5 is a perspective view of the holder 12 viewed from the eye 20 side.
- the holder 12 has a substantially disk shape.
- the thickness T (the length in the direction of the optical axis A of the microscope) of the holder 12 may be, for example, 10 mm or less, 9 mm or less, or 8 mm or less.
- the thickness of the holder 12 is sufficiently thin so that the holder 12 can be easily placed in the narrow space between the microscope objective lens 23 and the eye 20 during surgery or examination of the eye 20 .
- the diameter W0 of holder 12 may be, for example, 40-50 mm.
- the material of holder 12 is, for example, resin.
- the holder 12 is provided with an attachment portion 14 that can be attached to the lens unit 30 of the microscope.
- the mounting portion 14 has a substantially cylindrical shape and is provided on the surface of the holder 12 so as to be coaxial with the optical axis A of the microscope.
- the diameter of the mounting portion 14 is, for example, 20-25 mm, and the height of the mounting portion 14 is, for example, 10-15 mm.
- a screw hole is formed on the outer peripheral surface of the mounting portion 14 .
- the holder 12 is moved relative to the lens unit 30 by tightening the screw inserted into the screw hole while the lens unit 30 of the microscope is inserted inside the mounting portion 14 . It is designed to be fixed so that it is not
- the holder 12 has a through hole 121 coaxial with the optical axis A of the microscope. As a result, the periphery of the optical axis A of the microscope is not blocked by the holder 12, so that a bright field of view can be obtained when observing with the microscope.
- the holder 12 is formed with a groove or hole 122 extending outward from the vicinity of the through hole 121 in plan view.
- the “groove or hole” has a groove shape (cross-sectional outline is open) near the through hole 121, but a hole shape (cross-sectional outline is closed) away from the through hole 121.
- the diameter of the groove or hole 122 is approximately the same as the diameter of the cylindrical portion 110 of the lighting unit 11, and the lighting unit 11 attached to the tip of the fiber 13 is inserted into the groove or hole 122 formed in the holder 12. It is supported by Thereby, the configuration for supporting the lighting unit 11 can be realized with a very simple structure, and the manufacturing cost of the holder 12 can be reduced.
- the lighting unit 11 attached to the tip of the fiber 13 can be positioned along the groove or hole 122 while being supported by the holder 12. there is By adjusting the position of the illumination unit 11, it is possible to easily adjust the brightness of the fundus and the condition of the spot (illuminated portion).
- the illumination unit 11 attached to the tip of the fiber 13 is positioned along the groove or hole 122 so that the window 112 through which the light reflected by the mirror 111 exits is brought closer to the optical axis A of the microscope. It is possible to Referring to FIG. 3, the distance D between the optical axis A of the microscope and the window 112 may be close to within 5 mm, for example. While the diameter of the iris 21 of the eye 20 is usually 10 to 12 mm, the window 112 is brought close to the optical axis A of the microscope within 5 mm, so that the light emitted from the window 112 can be seen in the iris 21. It is possible to enter the eye 20 efficiently from the part.
- a small groove 122a for restricting rotation may be formed adjacent to the groove or hole 122 for inserting the lighting unit 11.
- a projection (not shown) corresponding to the small groove 122 a is provided on the outer peripheral surface of the cylindrical portion 110 of the lighting unit 11 , and when the cylindrical portion 110 of the lighting unit 11 is inserted into the groove or hole 122 of the holder 12 , the cylindrical portion 110 By inserting the projection along the small groove 122a, it is possible to prevent the illumination unit 11 from rotating around the axis of the fiber 13, and prevent the light emitted from the window 112 from moving. It can be fixed.
- Only one groove or hole 122 may be formed in the holder 12 to support only one lighting unit 11, or a plurality of grooves or holes 122 may be formed to support a plurality of lighting units. 11.
- the holder 12 is formed with four grooves or holes 122 to support four lighting units 11, but is not limited to this.
- the holder 12 may have 6 or 8 grooves or holes to support 6 or 8 lighting units 11 .
- windows 112 through which light reflected by mirrors 111 is emitted are arranged at regular intervals along the circumferential direction around the optical axis A of the microscope.
- the four illumination units 11 are positioned at 0°, 90°, 180° and 270° in polar coordinates centered on the optical axis A of the microscope.
- the holder 12 has four grooves or holes 122 at 0°, 90°, and 180°, respectively, in polar coordinates centered on the optical axis A of the microscope. , 270°.
- the four fibers 13 with the illumination unit 11 attached to their tips are inserted and supported in the grooves or holes 122 from different directions of 0°, 90°, 180°, and 270°. ing.
- holder 12 is positioned between microscope objective 31 and eye 20, and illumination unit 11 attached to the tip of fiber 13 is inserted into groove or hole 122 of holder 12.
- the window 112 of the illumination unit 11 is oriented to face the inside of the eye 20 (see FIG. 3), and the light L emitted from the tip of the fiber 13 is directed to the illumination unit 11. is reflected into the eye 20 by the mirror 111 .
- the illuminance of the light L emitted from the illumination unit 11 into the eye 20 can be appropriately set according to the microscope used.
- the definition of illuminance is according to JIS Z9110:2010.
- the numerical aperture (NA) of the exit side of the fiber 13 may be 0.55 or less, 0.50 or less, 0.45 or less, or 0.40 or less.
- the numerical aperture (NA) is represented by n sin ⁇ , where 2 ⁇ is the angle of the vertex of the maximum conical ray emitted from the core of the fiber 13, and n is the refractive index of the medium in which the fiber 13 exists. It is a value that conforms to the definition of JIS C6820:2018.
- the small numerical aperture (NA) of the fiber 13 allows a sufficiently directional light to be directed into the eye, thereby increasing the amount and range of intraocular illumination. Become.
- the fiber 13 may be branched into a plurality of fibers between the light source 15 and each lighting unit 11.
- one fiber 13 extending from one light source 15 may be branched into four and then connected to the four lighting units 11.
- One fiber 13 extending from one light source 15 is branched into two and then connected to two lighting units 11, and another one fiber 13 extending from another light source 15 is also branched into two. After that, it may be connected to the remaining two lighting units 11 .
- the number of the lighting units 11 can be increased without increasing the number of the light sources 15 .
- the light source 15 may be at least one of a xenon lamp, a halogen lamp and an LED (light emitting diode).
- a xenon lamp, a halogen lamp, or an LED already installed in the operating room or examination room can be used as the light source 15, which is convenient because there is no need to prepare a new light source.
- the intraocular illumination attachment 10 is arranged between the objective lens 31 of the microscope and the eye 20 during surgery or examination of the eye 20, that is, arranged outside the microscope. Therefore, intraocular illumination from outside the eye can be realized while using an existing microscope.
- the illumination unit 11 which includes a mirror 111 that reflects the light guided through the fiber 13 into the eye, is positioned between the microscope objective lens 31 and the eye 20 by the holder 12. Since it is supported, it is possible to irradiate light into the eye from a position sufficiently close to the eye 20 without going through the lens. Therefore, it is possible to obtain intraocular illumination from outside the eye with a sufficient amount of light and a sufficient range.
- the illumination unit 11 is supported by the holder 12 so as not to move, it is possible for the operator to operate the surgical instrument with both hands. It becomes possible.
- the holder 12 is provided with the mounting portion 14, and the holder 12 is fixed to the lens unit 30 of the microscope via the mounting portion 14 so as not to move.
- the holder 12 is not provided with the mounting portion 14, and the holder 12 is attached to the lens unit 30 using a support jig (for example, a stand with a clamp) (not shown). You may support it so that it does not move against it.
- the holder 12 may be configured integrally with the lens unit 30 of the microscope (non-detachable with respect to the lens unit 30).
- the holder 12 is arranged adjacent to the outside of the lens unit 30, but this is not a limitation. 12 may be arranged inside the lens unit 30 .
- the holder 12 has four grooves or holes 122 at 0° and 90°, respectively, in polar coordinates centered on the optical axis A of the microscope. , 180°, and 270°, and the four fibers 13 with the illumination unit 11 attached to their tips are arranged in different directions of 0°, 90°, 180°, and 270°, respectively. Although it is inserted into the groove or hole 122 to be supported, it is not limited to such a mode.
- FIG. 9 is an enlarged perspective view showing an intraocular illumination device 1 according to a modified example
- FIG. 10 is a plan view of the intraocular illumination device 1 viewed from the eye 20 side
- FIG. 11 is a perspective view of the holder 12 of the intraocular illumination attachment 10 according to a modified example when viewed from the objective lens 31 side of the microscope.
- FIG. 12 is a perspective view of the holder 12 of the intraocular illumination attachment 10 according to a modified example when viewed from the eye 20 side.
- the holder 12 has a substantially rectangular parallelepiped shape.
- the thickness T of the holder 12 (the length in the direction of the optical axis A of the microscope) may be, for example, 10 mm or less, 9 mm or less, or 8 mm or less.
- the thickness of the holder 12 is sufficiently thin so that the holder 12 can be easily placed in the narrow space between the microscope objective lens 23 and the eye 20 during surgery or examination of the eye 20 .
- the length W1 in the long side direction of the holder 12 may be, for example, 40 to 50 mm, and the length W2 in the short side direction may be, for example, 20 to 30 mm.
- the material of holder 12 is, for example, resin.
- the holder 12 is formed with four grooves or holes 1221-1224 for supporting the four lighting units 11.
- FIG. 10 the holder 12 is formed with four grooves or holes 1221-1224 for supporting the four lighting units 11.
- the long side direction of the holder 12 is 0° and 180°
- the short side direction of the holder 12 is 90° and 270°
- a hole 1221 is formed to extend in the 0° direction from the 0° position
- a second groove or hole 1222 is formed to extend in the 180° direction from the 180° position.
- the third groove or hole 1223 is formed to extend from the 90° position to the 180° direction (that is, parallel to the first groove or hole 1221), and the fourth groove or hole 1224 is , 270° in the 0° direction (that is, parallel to the second groove or hole 1222).
- two of the four fibers 13 with the illumination unit 11 attached to their tips are arranged in the first and fourth grooves or holes from the same 0° direction. 1221 and 1224 and the remaining two fibers 13 are inserted and supported in second and third grooves or holes 1222 and 1223 from the same 180° direction. It has become so.
- the fiber 13 only needs to be routed from two directions of 0° and 180°, and it is not necessary to route it from four directions. It is possible to prevent the presence of fiber 13 from interfering during eye surgery or examination.
- the length W2 of the holder 12 in the short side direction can be reduced. This makes it possible to set the length W2 of the holder 12 in the short side direction to a size that fits in the recess between the patient's eyebrows and cheeks. Arranging the holder 12 in a narrow space between the eye 20 becomes easier.
- the small groove 1224a for restricting rotation formed adjacent to the fourth groove or hole 1224 may have a fan-shaped cross section.
- the illumination unit 11 attached to the tip of the fiber 13 is inserted into the fourth groove or hole 1224 and supported, and the illumination unit 11 is rotated around the axis of the fiber 13 at a small angle (for example, 5° to 10°), and as shown in FIG. ) can be adjusted.
- a rotation restricting small groove (not shown) formed adjacent to the third groove or hole 1223 may also have a fan-shaped cross section.
- the illumination unit 11 attached to the tip of the fiber 13 is inserted into the third groove or hole 1223 and supported, and the illumination unit 11 is rotated around the axis of the fiber 13 at a small angle (for example, 5° to 10°), and as shown in FIG. ) can be adjusted.
- the third groove or hole 1223 is formed to extend from the 90° position in the 0° direction (that is, parallel to the second groove or hole 1222).
- the fourth groove or hole 1224 may be formed to extend from the 270° position to the 180° direction (that is, parallel to the first groove or hole 1221).
- the inventor actually observed the fundus of a simulated eye and a pig's eye using the intraocular illumination device 1 according to the above-described embodiment.
- the holder 12 of the intraocular illumination device 1 used was manufactured by a 3D printer, and its specific dimensions were as shown in FIG.
- the cylindrical portion 110 of the illumination unit 11 of the intraocular illumination device 1 used was made of brass, and its specific dimensions were as shown in FIG.
- FIG. 8 shows a photograph of the fundus taken when the fundus was actually observed with a simulated eye (the diameter of the eyeball is 24 mm and the diameter of the cornea is 12 mm).
- FIG. 8 shows a photograph of the fundus taken when the fundus was actually observed with a simulated eye (the diameter of the eyeball is 24 mm and the diameter of the cornea is 12 mm).
- FIG. 8 shows a photograph of the fundus taken when the fundus was actually observed with a simulated eye (the diameter of the eyeball is 24 mm and the diameter of the cornea is 12 mm).
- the reflector provided at the tip of the fiber 13 and reflecting the light guided through the fiber 13 toward the inside of the eye 20 is composed of the mirror 111 of the illumination unit 11.
- the reflecting part provided at the tip of the fiber 13 and reflecting the light guided through the fiber 13 into the eye 20 is composed of the end face 131 of the tip of the fiber 13 .
- the inventor of the present invention obliquely polished the end face of the tip of a multimode fiber (SI-MMF400, NA 0.39) with an SMA connector manufactured by Thorlabs by laser processing, and produced a third fiber having an end face angle of 55.7°.
- One sample and a second sample having an end face angle of 55.1° were produced.
- the end face angle is the angle between the plane perpendicular to the optical axis of the fiber 13 and the end face 131 .
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Abstract
Description
光源からの光を導くファイバと、
眼の手術時または検査時に顕微鏡の対物レンズと眼との間に配置され、前記ファイバの先端部を支持するホルダと、
を備え、
前記ファイバの前記先端部には、前記ファイバを通って導かれる光を眼内に向けて反射する反射部が設けられている。
眼の手術時または検査時に顕微鏡の対物レンズと眼との間に配置される眼内照明用アタッチメントであって、
光源からの光を導くファイバの先端部に取り付けられ、前記ファイバを通って導かれる光を眼内に向けて反射するミラーを含む照明ユニットと、
前記照明ユニットを支持するホルダと、
を備える。
光源からの光を導くファイバと、
眼の手術時または検査時に顕微鏡の対物レンズと眼との間に配置され、前記ファイバの先端部を支持するホルダと、
を備え、
前記ファイバの前記先端部には、前記ファイバを通って導かれる光を眼内に向けて反射する反射部が設けられている。
前記ファイバの先端部には、前記ファイバを通って導かれる光を眼内に向けて反射するミラーを含む照明ユニットが取り付けられており、
前記反射部は、前記ミラーから構成されている。
前記ファイバの前記先端部の端面は、前記ファイバを通って導かれる光を眼内に向けて反射するように斜めに研磨加工されており、
前記反射部は、前記ファイバの前記端面から構成されている。
前記ホルダの厚みは、10mm以下である。
前記ホルダは、前記ファイバの前記先端部を複数支持する。
複数の先端部に各々設けられている複数の反射部は、前記ホルダ内において、前記顕微鏡の光軸を中心とする周方向に沿って等間隔に並ぶように配置されている。
前記ホルダには、前記顕微鏡のレンズユニットに対して取り付け可能な取付部が設けられている。
前記ホルダは、前記顕微鏡のレンズユニットと一体に構成されている。
前記ホルダには、前記顕微鏡の光軸と同軸状に貫通孔が形成されており、平面視で前記貫通孔の近傍から外向きに延びるように溝または穴が形成されており、前記ファイバの前記先端部は、前記ホルダに形成された前記溝または穴に挿入されて支持されている。
前記ファイバの前記先端部は、前記ホルダに支持された状態で、前記溝または穴に沿って位置調整可能である。
前記ファイバの前記先端部は、前記溝または穴に沿って位置調整されることで、前記反射部を、前記顕微鏡の光軸から5mm以内の範囲まで近接させることが可能である。
前記ファイバの前記先端部の数は4つであり、前記ホルダには、前記溝または穴が4つ形成されており、前記顕微鏡の光軸を中心とする極座標で、4つの溝または穴はそれぞれ、0°、90°、180°、270°の方向に延びるように形成されている。
前記ファイバの前記先端部の数は4つであり、前記ホルダには、前記溝または穴が4つ形成されており、前記顕微鏡の光軸を中心とする極座標で、第1の溝または穴は、0°の位置から0°の方向に延びるように形成されており、第2の溝または穴は、180°の位置から180°の方向に延びるように形成されており、第3の溝または穴は、90°の位置から0°または180°の方向に延びるように形成されており、第4の溝または穴は、270°の位置から0°または180°の方向に延びるように形成されている。
前記ファイバの射出側のNAは、0.55以下である。
前記ファイバは、前記光源から前記照明ユニットまでの間に分岐されている。
前記光源は、キセノンランプ、ハロゲンランプおよびLEDのうちの少なくとも1つである。
眼の手術時または検査時に顕微鏡の対物レンズと眼との間に配置される眼内照明用アタッチメントであって、
光源からの光を導くファイバの先端部に取り付けられ、前記ファイバを通って導かれる光を眼内に向けて反射するミラーを含む照明ユニットと、
前記照明ユニットを支持するホルダと、
を備える。
前記ホルダの厚みは、10mm以下である。
前記ホルダは、前記照明ユニットを複数支持する。
複数の照明ユニットは、前記ミラーで反射された光を射出させる窓部が前記顕微鏡の光軸を中心とする周方向に沿って等間隔に並ぶように配置されている。
前記ホルダには、前記顕微鏡のレンズユニットに対して取り付け可能な取付部が設けられている。
前記ホルダには、前記顕微鏡の光軸と同軸状に貫通孔が形成されており、平面視で前記貫通孔の近傍から外向きに延びるように溝または穴が形成されており、前記ファイバの先端部に取り付けられた前記照明ユニットは、前記ホルダに形成された前記溝または穴に挿入されて支持されている。
前記ファイバの先端部に取り付けられた前記照明ユニットは、前記ホルダに支持された状態で、前記溝または穴に沿って位置調整可能である、請求項6に記載の眼内照明用アタッチメント。
前記ファイバの先端部に取り付けられた前記照明ユニットは、前記溝または穴に沿って位置調整されることで、前記ミラーで反射された光を射出させる窓部を、前記顕微鏡の光軸から5mm以内の範囲まで近接させることが可能となる。
前記照明ユニットの数は4つであり、前記ホルダには、前記溝または穴が4つ形成されており、前記顕微鏡の光軸を中心とする極座標で、4つの溝または穴はそれぞれ、0°、90°、180°、270°の方向に延びるように形成されている。
前記照明ユニットの数は4つであり、前記ホルダには、前記溝または穴が4つ形成されており、前記顕微鏡の光軸を中心とする極座標で、第1の溝または穴は、0°の位置から0°の方向に延びるように形成されており、第2の溝または穴は、180°の位置から180°の方向に延びるように形成されており、第3の溝または穴は、90°の位置から0°または180°の方向に延びるように形成されており、第4の溝または穴は、270°の位置から0°または180°の方向に延びるように形成されている。
前記眼内照明用アタッチメントは使い捨てである。
前記ファイバの射出側のNAは、0.55以下である。
前記ファイバは、前記光源15から前記照明ユニットまでの間に分岐されている。
前記光源は、キセノンランプ、ハロゲンランプおよびLEDのうちの少なくとも1つである。
第17~30のいずれかの態様に係る眼内照明用アタッチメントと、前記ファイバと、を備える。
第1~16、31のいずれかの態様に係る眼内照明機器を備える。
Claims (20)
- 光源からの光を導くファイバと、
眼の手術時または検査時に顕微鏡の対物レンズと眼との間に配置され、前記ファイバの先端部を支持するホルダと、
を備え、
前記ファイバの前記先端部には、前記ファイバを通って導かれる光を眼内に向けて反射する反射部が設けられている、
眼内照明機器。 - 前記ファイバの先端部には、前記ファイバを通って導かれる光を眼内に向けて反射するミラーを含む照明ユニットが取り付けられており、
前記反射部は、前記ミラーから構成されている、請求項1に記載の眼内照明機器。 - 前記ファイバの前記先端部の端面は、前記ファイバを通って導かれる光を眼内に向けて反射するように斜めに研磨加工されており、
前記反射部は、前記ファイバの前記端面から構成されている、請求項1に記載の眼内照明機器。 - 前記ホルダの厚みは、10mm以下である、請求項1~3のいずれかに記載の眼内照明機器。
- 前記ホルダは、前記ファイバの前記先端部を複数支持する、請求項1~4のいずれかに記載の眼内照明機器。
- 複数の先端部に各々設けられている複数の反射部は、前記ホルダ内において、前記顕微鏡の光軸を中心とする周方向に沿って等間隔に並ぶように配置されている、請求項5に記載の眼内照明機器。
- 前記ホルダには、前記顕微鏡のレンズユニットに対して取り付け可能な取付部が設けられている、請求項1~6のいずれかに記載の眼内照明機器。
- 前記ホルダは、前記顕微鏡のレンズユニットと一体に構成されている、請求項1~6のいずれかに記載の眼内照明機器。
- 前記ホルダには、前記顕微鏡の光軸と同軸状に貫通孔が形成されており、平面視で前記貫通孔の近傍から外向きに延びるように溝または穴が形成されており、前記ファイバの前記先端部は、前記ホルダに形成された前記溝または穴に挿入されて支持されている、請求項1~8のいずれかに記載の眼内照明機器。
- 前記ファイバの前記先端部は、前記ホルダに支持された状態で、前記溝または穴に沿って位置調整可能である、請求項9に記載の眼内照明機器。
- 前記ファイバの前記先端部は、前記溝または穴に沿って位置調整されることで、前記反射部を、前記顕微鏡の光軸から5mm以内の範囲まで近接させることが可能である、請求項10に記載の眼内照明機器。
- 前記ファイバの前記先端部の数は4つであり、前記ホルダには、前記溝または穴が4つ形成されており、前記顕微鏡の光軸を中心とする極座標で、4つの溝または穴はそれぞれ、0°、90°、180°、270°の方向に延びるように形成されている、請求項9~11のいずれかに記載の眼内照明機器。
- 前記ファイバの前記先端部の数は4つであり、前記ホルダには、前記溝または穴が4つ形成されており、前記顕微鏡の光軸を中心とする極座標で、第1の溝または穴は、0°の位置から0°の方向に延びるように形成されており、第2の溝または穴は、180°の位置から180°の方向に延びるように形成されており、第3の溝または穴は、90°の位置から0°または180°の方向に延びるように形成されており、第4の溝または穴は、270°の位置から0°または180°の方向に延びるように形成されている、請求項9~11のいずれかに記載の眼内照明機器。
- 前記ファイバの射出側のNAは、0.55以下である、請求項1~13のいずれかに記載の眼内照明機器。
- 前記ファイバは、前記光源から前記照明ユニットまでの間に分岐されている、請求項1~14のいずれかに記載の眼内照明機器。
- 前記光源は、キセノンランプ、ハロゲンランプおよびLEDのうちの少なくとも1つである、請求項1~15のいずれかに記載の眼内照明機器。
- 眼の手術時または検査時に顕微鏡の対物レンズと眼との間に配置される眼内照明用アタッチメントであって、
光源からの光を導くファイバの先端部に取り付けられ、前記ファイバを通って導かれる光を眼内に向けて反射するミラーを含む照明ユニットと、
前記照明ユニットを支持するホルダと、
を備えた眼内照明用アタッチメント。 - 前記眼内照明用アタッチメントは使い捨てである、請求項17に記載の眼内照明用アタッチメント。
- 請求項17または18に記載の眼内照明用アタッチメントと、前記ファイバと、を備えた眼内照明機器。
- 請求項1~16、19のいずれかに記載の眼内照明機器を備えた眼の手術用または検査用顕微鏡。
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Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
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JPH06205741A (ja) * | 1993-01-11 | 1994-07-26 | Kowa Co | 眼科装置 |
JP2005230558A (ja) | 2001-06-13 | 2005-09-02 | Topcon Corp | 手術用顕微鏡 |
JP2010175672A (ja) * | 2009-01-28 | 2010-08-12 | Nikon Corp | 顕微鏡装置及びそれに用いられるミラーユニット |
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Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPH06205741A (ja) * | 1993-01-11 | 1994-07-26 | Kowa Co | 眼科装置 |
JP2005230558A (ja) | 2001-06-13 | 2005-09-02 | Topcon Corp | 手術用顕微鏡 |
JP2010175672A (ja) * | 2009-01-28 | 2010-08-12 | Nikon Corp | 顕微鏡装置及びそれに用いられるミラーユニット |
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