JP2003190203A - Laser curing device for ophthalmology - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a laser curing device for ophthalmology, used for many purposes without complicating the configuration of the device. <P>SOLUTION: In this laser curing device for ophthalmology, infrared or near infrared laser light from a laser light source is guided and applied to the eyegrounds of a patient's eyes. The device includes a variable power optical system capable of switching the spot size of the laser light on the eyegrounds in a range including 100 to 3000 μm, and an input means capable of inputting the irradiation time in a range including 0.1 to 60 seconds. <P>COPYRIGHT: (C)2003,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ophthalmic laser treatment apparatus which irradiates a fundus of a patient's eye with laser light to perform photocoagulation treatment or the like.

[0002]

2. Description of the Related Art In ophthalmic laser treatment, the use of laser light has been very widespread and various studies have been conducted. Typically, photocoagulation treatment that causes coagulative necrosis due to heat of the retinal tissue by irradiating the fundus with laser light is known, but recently, for the treatment of age-related macular degeneration, transpupillary hyperthermia is used. (Hereinafter TTT: Transpupillary Therm
otherapy) is being studied. TTT treatment is a non-invasive hyperthermia treatment method that utilizes the atrophy and functional decline of slow-acting cell tissue induced by laser light. A histologically fragile structure such as choroidal neovascularization of age-related macular degeneration is highly sensitive, and can give a slight temperature rise of about 1 ° C to 2 ° C to necrotize the tissue.

[0003]

By the way, the specifications of the conventional apparatus are set according to a specific application, and the specifications have a very narrow range. In order to make it versatile, it has been used as various combo machines, and for example, it has been a suitable apparatus with an optical system added according to a specific application. However, preparing a dedicated optical system for each application has a problem in that the mechanism of the device becomes complicated, resulting in high cost and poor usability.

The present invention has been made in view of the above problems of the prior art.
It is a technical object to provide a laser treatment apparatus that can be used for various purposes without complicating the apparatus configuration.

[0005]

In order to solve the above problems, the present invention is characterized by having the following configuration. (1) In an ophthalmic laser treatment apparatus for guiding and irradiating infrared or near-infrared laser light from a laser light source to the fundus of the patient's eye, the spot size of the laser light is set on the fundus. 100 ~
A variable power optical system capable of switching in a range including 3000 μm,
And an input unit capable of inputting an irradiation time in a range including 0.1 to 60 seconds. (2) In an ophthalmic laser treatment apparatus for guiding and irradiating infrared or near-infrared laser light from a laser light source to the fundus of the patient's eye, the spot size of the laser light is set on the fundus. 100 ~
A variable power optical system capable of switching in a range including 3000 μm,
When the spot size is 1000 μm or less, the irradiation time can be variably input within a range including 0.1 to 0.3 seconds, and when the spot size is 1000 μm or more, the irradiation time includes 60 seconds. And an input means capable of inputting with. (3) The ophthalmic laser treatment apparatus according to (1) or (2) is
Further, an inputtable range changing means for changing the inputtable range of the irradiation condition depending on the application is provided. (4) The ophthalmic laser treatment apparatus according to (1) or (2) is
Warning means for giving a warning to the input contents based on the mutual relation of the input items including the spot size and the irradiation time.

[0006]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. In this embodiment, an apparatus capable of performing both photocoagulation treatment with a narrow spot size and TTT treatment with a wide spot size is taken as an example. FIG. 1 is a diagram showing an external view of the laser treatment apparatus. Reference numeral 1 denotes a laser treatment apparatus main body, in which a treatment semiconductor laser light source 20 and the like are incorporated. Reference numeral 2 denotes an operation panel for setting and inputting laser irradiation output conditions, aiming light output, and the like. A slit lamp delivery 3 is provided with an illumination optical system and an observation optical system, and an irradiation optical system unit 40 for irradiating a patient's eye with a treatment laser beam is attached. Further, 6 is a joystick for moving the slit lamp delivery 3. Reference numeral 7 is a knob for setting the irradiation spot size. Reference numeral 8 is a foot switch for transmitting a laser irradiation trigger signal.

FIG. 2 is a diagram for explaining a schematic optical system of the apparatus. Light (about 810 nm) emitted from the therapeutic semiconductor laser light source 20 arranged in the laser device main body 1 becomes a parallel light flux through the collimating lens 21 and the cylindrical lens 22 and is incident on the dichroic mirror 23. The dichroic mirror 23 is a semiconductor laser 81.
It has a characteristic of transmitting light near 0 nm and reflecting a red laser (light near 633 nm). Reference numeral 24 denotes a semiconductor laser light source for aiming. Aiming light emitted from the laser light source 24 for aiming passes through a collimating lens 27, is reflected by a mirror 25, and then becomes coaxial with a therapeutic laser light by a dichroic mirror 23. The light is condensed on the incident end face 4 a of the optical fiber 4 by the condenser lens 26 and is incident on the optical fiber 4. Reference numeral 28 denotes a safety shutter, and when the foot switch 8 is stepped on and a command to irradiate the treatment laser light is issued, a shutter drive device 28a shown in FIG.
Is driven to allow the laser light to pass therethrough, and is inserted into the optical path to block the laser light when an abnormality occurs.

Each laser light guided by the optical fiber 4 is irradiated by the slit lamp delivery 3 of the irradiation optical system unit 4.
Light is guided to 0. The core diameter of the optical fiber 4 is 200 μm
Is. The emission end 4b of the optical fiber 4 is connected to the upper part of the irradiation optical system unit 40. The irradiation optical system unit 40 includes a collimating lens 41, a zoom lens 42 that is movable in the optical axis direction to change the spot size of the laser light, an objective lens 43, and a reflection mirror 44 that reflects the laser light. An optical system is arranged. The laser light emitted from the optical fiber 4 is reflected by the reflection mirror 44 of the irradiation optical system toward the patient's eye E, and is irradiated onto the affected area via the contact lens 45. The emission end surface 4b of the optical fiber 4 is placed at the back focal position of the collimating lens 41, and the spot size of the laser light irradiated to the fundus via the contact lens 45 and the irradiation optical system is determined by the zoom lens 42. The image of the emission end face 4b of the optical fiber 4 is continuously changed to 0.5 times to 15 times. Thereby, the spot size diameter can be changed to 100 to 3000 μm.

FIG. 3 shows a spot size changing mechanism 100 by moving the zoom lens 42. A rotatable cylindrical cam 103 is provided outside the cylindrical member 115 fixed to the housing of the irradiation optical system unit 40. A gear 101 is press-fitted into the shaft of the spot size setting knob 7, and the gear 101 meshes with a gear 104 formed in the lower portion of the cylindrical cam 103. A gear 105 formed on the upper portion of the cylindrical cam 103 meshes with a gear 121 fixed to the shaft of the potentiometer 120. The zoom lens 42 has a convex lens 42a, a concave lens 42b, a concave lens 42c, and a concave lens 42d. The convex lens 42a is fixed to the holder 110. Concave lenses 42b, 42
c and 42d are fixed to the holder 112. Concave lenses 42b, 42c and 42d are composed of three elements.
This is because spherical aberration that occurs when the magnification changes from 0.5 to 15 times is minimized. The holders 110 and 112 are held by a cylindrical member 115 so as to be vertically movable. A vertical groove 115a is formed in the cylindrical member 115,
The pin 111 fixed to the holder 110 and the pin 113 fixed to the holder 112 are engaged with the vertical groove 115a. Further, the pins 111 and 113 are provided on the cylindrical cam 10.
3 are respectively engaged with cam grooves 106 and 107 formed on the side surface of No. 3. As shown in FIG. 4, the cam grooves 106 and 107
Is a convex lens 42a and concave lenses 42b, 42c, 42d
It is designed so that a zooming optical system for zooming is configured by the amount of displacement in the direction of the optical axis.

With this structure, when the knob 7 is rotated,
The cylindrical cam 103 rotates about the optical axis L, and the rotation of the cylindrical cam 103 applies a vertical movement force to the pins 111 and 113, so that the convex lens 42a and the concave lenses 42b and 42 are formed.
c and 42d move up and down, and the spot size is changed. The spot size can be continuously varied between 100 and 3000 μm. The collimating lens 41 is fixed to the cylindrical member 115 by a holder 116.

During photocoagulation, 100 to 1000 μm is mainly used.
The spot size of m is used, and it is 100 at the time of TTT.
Spot sizes of 0-3000 μm are used. Of course, in order to expand the application range of photocoagulation treatment and TTT treatment, the zoom optical system described above has a wider range, for example, 5
It may be configured so that the magnification can be changed to 0 to 5000 μm.

In FIG. 2, reference numeral 50 denotes an illumination optical system for projecting slit light, which includes an illumination light source 51, a condenser lens 52, a slit 53, a filter 54, a projection lens 55, a semicircular correction lens 56, and a split mirror 57a. , 5
7b etc. Reference numeral 60 denotes an observation optical system, which includes the objective lens 61 and the variable-magnification optical system 6 arranged in the left and right optical paths.
2, imaging lens 63, erecting prism group 64, field stop 6
5, an eyepiece lens 66, a protection filter 67, and the like.

In an apparatus having the above structure,
The operation will be described with reference to the control system block diagram of FIG. The operator observes the fundus illuminated by the illumination light from the illumination optical system 50 through the observation optical system 60. next,
The aiming laser light source 24 is turned on by the aiming switch 2c of the operation panel 2. Reference numeral 2b is an aiming display unit that indicates the brightness of the aiming light. The aiming light is guided to the optical fiber 4 and is applied to the fundus via the irradiation optical system. The operator operates the joystick 6 while observing the aiming light applied to the fundus to perform alignment with the affected area. Also, the spot size of the laser beam is knob 7
Set by rotating. When the knob 7 is rotated, the potentiometer 120 which is interlocked with the knob 7 is rotated, and the signal thereof is transmitted to the control unit 8.
Sent to 0.

The operator switches the time of laser irradiation to 2
f, the laser output is input by the knob 2h. The laser irradiation time is the time during which the laser light is irradiated while the foot switch 8 is kept pressed. Each value is displayed on the display 2e, 2g
Is displayed in. Usually, in photocoagulation treatment, a spot size of 100 to 1000 μm is used, and irradiation time is 0.02.
Variable input is possible for 0.5 seconds. The laser irradiation time for photocoagulation treatment is preferably variably inputtable for at least 0.1 to 0.3 seconds. Further, in the TTT treatment, a spot size of 1000 to 3000 μm is used, and an irradiation time can be variably input within a range of 5 to 600 seconds. It is preferable that an irradiation time of TTT treatment of at least 60 seconds can be input.

The laser irradiation time input in each treatment is compared with the irradiation time input range corresponding to the spot size stored in the memory 81. That is, when the spot size is 100 to 1000 μm, it is compared whether the irradiation time is within the input range of 0.02 to 0.5 seconds for photocoagulation treatment. When the spot size is 1000 to 3000 μm, it is compared whether the irradiation time is the input range of 5 to 600 seconds for TTT treatment.

When the control section 80 receives an input from the output signal from the potentiometer 120 that does not match the irradiation time corresponding to the spot size, the controller 130 gives a warning to the operator by an alarm 130 and displays the error content on the display of the operation panel 2. Display on 2d. That is, the inputtable range of the laser irradiation time is limited according to the spot size for each treatment.

The irradiation energy density also differs between the photocoagulation treatment (spot size 100 to 1000 μm) and the TTT treatment (spot size 1000 to 3000 μm). That is, the value of the irradiation energy density is smaller during the TTT treatment. Therefore, the inputtable range of the irradiation energy density may be similarly limited according to the setting of the spot size. The irradiation energy density can be calculated by the control unit 80 from the spot size and the input value of the laser output.

In the above description, the boundary between the spot sizes of the photocoagulation treatment and the TTT treatment is 1000 μm, but the boundary between the spot sizes can be changed according to the operator's preference. Also, for example, only the lower limit of the spot size boundary of TTT treatment is 100
It is also possible to change from 0 μm to 500 μm by a switch (not shown) on the operation panel 2. In this case, 50
Since the range of 0 to 1000 μm overlaps and the photocoagulation treatment and the TTT treatment cannot be distinguished, the input value of the laser irradiation time is not limited.

Laser irradiation is made possible by a READY switch (not shown), and laser light is irradiated using the foot switch 8. When the foot switch 8 is stepped on, the control unit 80 drives the treatment laser light source 20 and opens the safety shutter 28 via the shutter drive device 28a. Laser light from the therapeutic laser light source 20 passes through the inside of the fiber 4 and is guided to the irradiation optical system unit 40. The laser light emitted from the fiber 4 passes through the collimating lens 41, the zoom lens 42, and the objective lens 43, is then reflected by the reflection mirror 44, and passes through the contact lens 45 and the patient's eye E.
To the affected area.

In the above embodiment, the spot size can be obtained from the output signal from the potentiometer 120 and used as a selection signal for photocoagulation treatment and TTT treatment. In addition, a photocoagulation treatment is provided on the operation panel 2.
The configuration may be such that a TTT treatment selection switch (not shown) is provided. In this case, the control unit 80 limits the inputtable range of the laser output and the spot size related to the energy density, in addition to the laser irradiation time described above, by the signal of the selection switch (the inputtable range is used for selecting the treatment). Depending on). The respective inputtable ranges corresponding to the photocoagulation treatment and the TTT treatment are stored in the memory 81 in advance.
Then, when the irradiation condition input on the operation panel 2 is out of the inputtable range, the control unit 80 causes the alarm 130.
To warn the operator. Further, even if the foot switch 8 is pressed, the laser emission from the laser light source 20 is prohibited. As a result, the operator can perform appropriate laser irradiation according to the application without performing laser irradiation with unintended condition settings.

[0021]

As described above, according to the present invention,
It is possible to realize a laser treatment apparatus that can be used for various purposes without complicating the apparatus configuration. Also, appropriate laser irradiation can be performed according to each application.

[Brief description of drawings]

FIG. 1 is a diagram showing an appearance of a device.

FIG. 2 is a diagram showing an optical system of the apparatus.

FIG. 3 is a diagram showing a spot size changing mechanism.

FIG. 4 is a diagram showing a displacement of a lens of a variable power optical system.

FIG. 5 is a diagram showing a block diagram of a control system.

[Explanation of symbols]

1 device body 2 Operation panel 3 slit lamp delivery 4 optical fiber 20 Laser light source for treatment 42 zoom lens 80 Control unit 100 spot size change mechanism 120 potentiometer 130 alarm

─────────────────────────────────────────────────── ─── Continuation of the front page (51) Int.Cl. ⁷ Identification code FI theme code (reference) G02B 7/04 Z (72) Inventor Kiyomi Iyota 34 Maebama, Tateishi-cho, Gamagori-shi, Aichi 14 Nidek Pick-up Company F term in factory (reference) 2H044 DA02 EF07 4C026 AA03 BB08 FF02 FF33 FF36 HH02 HH12 HH16 HH22 HH23 HH24 4C082 RA08 RE33 RL02 RL12 RL17 RL30

Claims (4)

[Claims] 1. An infrared or near-infrared laser from a laser light source.
In an ophthalmic laser treatment apparatus that guides and irradiates the laser light to the fundus of the patient's eye, the spot size of the laser light is 1 on the fundus.
An ophthalmic laser treatment apparatus comprising: a variable power optical system capable of switching within a range including 00 to 3000 μm; and an input means capable of inputting an irradiation time within a range including 0.1 to 60 seconds. . 2. An infrared or near infrared laser from a laser light source.
In an ophthalmic laser treatment apparatus that guides and irradiates the laser light to the fundus of the patient's eye, the spot size of the laser light is 1 on the fundus.
A variable-magnification optical system that can be switched in the range including 00 to 3000 μm, and when the spot size is 1000 μm or less, the irradiation time can be variably input in the range including 0.1 to 0.3 seconds, and the spot size can be changed. And an input means capable of inputting the irradiation time within a range including 60 seconds when used at 1000 μm or more. 3. The ophthalmic laser treatment apparatus according to claim 1 or 2, further comprising inputtable range changing means for changing the inputtable range of irradiation conditions depending on the application. apparatus. 4. The laser treatment apparatus for ophthalmology according to claim 1 or 2, further comprising: a warning unit that gives a warning to the input content based on the mutual relation of the input items including the spot size and the irradiation time. Laser treatment equipment for ophthalmology.