JP5491142B2 - Ophthalmic surgery microscope - Google Patents

Description

  The present invention relates to an ophthalmic surgical microscope used in ophthalmic surgery. In particular, the present invention relates to an ophthalmic surgical microscope capable of selectively using a plurality of observation modes.

  As an observation mode of the microscope for ophthalmologic surgery, there are a normal observation mode, a toric IOL transplantation mode, an intraocular observation mode, and the like. The normal observation mode is used for observing the anterior segment of the patient's eye, for example, in cataract surgery. The toric IOL transplantation mode is used in a transplant operation of toric IOL (Intracular Lens), and allows the patient's eye to be observed while measuring the astigmatic axis direction of the patient's eye or presenting the measurement result. The intraocular observation mode is used for observing the inside of a patient's eye, for example, in retinal surgery or vitreous surgery.

  The toric IOL transplant mode will be described. The toric IOL is an intraocular lens for correcting astigmatism (see, for example, Patent Documents 1 and 2). In astigmatism correction, not only the intensity of astigmatism (astigmatism power) but also its direction (astigmatism axis direction) is important. Therefore, when transplanting a toric IOL, attention must be paid to the lens arrangement direction. That is, in order to exert the correction effect of the toric IOL, it is necessary to match the strong main meridian direction of the cornea of the patient's eye with the weak main meridian direction of the lens as much as possible. It is known that when both are shifted by 10 degrees, the correction effect is reduced to about 65%, and when they are shifted by 30 degrees, the correction effect is almost zero. Thus, when transplanting a toric IOL, it is necessary to adjust the direction of the toric IOL with high accuracy in accordance with the corneal shape (astigmatic axis direction) of the patient's eye.

  Patent Document 3 discloses a technique for measuring the corneal shape of a patient's eye during surgery. In this technique, a placido ring illuminator is attached to the lower part of a lens barrel of a microscope, a concentric pattern is projected onto the cornea of a patient's eye, and a reflection image is photographed to obtain a corneal shape. When this technique is applied to a toric IOL transplantation operation, it is possible to obtain the corneal shape during the operation and display it on the screen, but to present the astigmatic axis direction of the patient's eye actually observed to the surgeon. I can't. Therefore, the surgeon cannot grasp the orientation in which the toric IOL should be arranged. The present applicant has solved this problem by developing a technique for presenting the astigmatic axis direction of the patient's eye being observed to the surgeon (see Japanese Patent Application No. 2009-210681).

  In the intraocular observation mode, a front lens is disposed between the patient's eye and the objective lens (see, for example, Patent Document 4).

JP-A-5-344990 JP 2006-136714 A JP-A-8-66369 JP 2005-161099 A

  When measuring the astigmatism axis direction and presenting the measurement result in the toric IOL transplantation operation, it is necessary to accurately match the corneal center of the patient's eye with the visual field center of the microscope. However, in the conventional ophthalmic surgical microscope, the horizontal movement speed of the lens barrel is set so as to be optimal in the normal observation mode. Therefore, in the IOL transplantation mode, the movement speed is too high, and the positions of the cornea center and the visual field center are The alignment could not be performed with high accuracy. Therefore, when switching to the IOL porting mode, the moving speed is manually reset each time.

  Further, when using the intraocular observation mode, the operator needs to carefully move the microscope barrel up and down so that the front lens does not contact the patient's eye. However, in the conventional ophthalmic surgical microscope, the vertical movement speed of the lens barrel is set so as to be optimal in the normal observation mode. Therefore, the movement speed is too high in the intraocular observation mode, and the front lens for the patient's eye is It was not easy to avoid contact. For this reason, each time the mode is switched to the intraocular observation mode, the movement speed is manually reset.

  As described above, the conventional microscope for ophthalmic surgery requires troublesome manual work when switching to the IOL transplantation mode or the intraocular observation mode.

  The present invention has been made to solve such problems, and an object thereof is to provide an ophthalmic surgical microscope that does not require manual resetting of the moving speed of the lens barrel when switching the observation mode. There is.

In order to achieve the above object, the invention described in claim 1 includes a lens barrel portion storing at least a part of an optical system having an objective lens, and the lens barrel in a horizontal direction perpendicular to the optical axis of the objective lens. A moving mechanism for moving a part, a detecting means for detecting an observation mode currently selected from a plurality of observation modes provided in advance, and a detection result of the observation mode by the detecting means, And a control means for changing a moving speed of the lens barrel.
The invention of claim 2 is an ophthalmologic surgical microscope according to claim 1, before Symbol plurality of observation modes, a normal observation mode to be used for observing the anterior segment of the patient's eye , and a toric IOL implantation mode used in toric IOL implantation surgery, when that previous SL toric IOL implantation mode is selected is detected by the detecting means, the control means, for the normal observation mode controlling said moving mechanism to move said barrel with less than the moving speed the moving speed of the for toric IOL implantation mode, characterized in that.
The invention described in Claim 3 is the ophthalmologic surgical microscope according to claim 1, before Symbol plurality of observation modes, a normal observation mode to be used for observing the anterior segment of the patient's eye , and a toric IOL implantation mode used in toric IOL implantation surgery, when that previous SL is switched from the normal observation mode to the toric IOL implantation mode detected by said detection means, said control means, said It controls the moving mechanism so as to reduce the moving speed of the lens-barrel portion, characterized in that.
The invention described in claim 4 is the microscope for ophthalmic surgery according to claim 2 or claim 3, further comprising a projecting means for forming a bright spot image on the patient's eye in the toric IOL transplantation mode. The detecting means includes a first sensor for detecting that the projection means is disposed at a predetermined use position, and the first sensor indicates that the projection means is disposed at a predetermined use position. when it is detected, the control means, the change of the moving speed of controlling the moving mechanism the barrel, characterized in that.
The invention according to claim 5 is the ophthalmic surgical microscope according to claim 2 or claim 3, wherein the detection means is obtained by an imaging means for imaging a patient's eye and the imaging means. And determining means for analyzing whether or not the bright spot image is drawn by analyzing the image of the patient's eye, and when the judgment means determines that the bright spot image is drawn, the control means the change of the moving speed of controlling the moving mechanism the barrel, characterized in that.
The invention according to claim 6 is the ophthalmic surgical microscope according to any one of claims 2 to 5, wherein the moving speed in the toric IOL transplantation mode is 1.5 to 2.5 per second. It is characterized by being within a range of 3.0 mm.
The invention according to claim 7 is the microscope for ophthalmic surgery according to claim 6, wherein the moving speed in the normal observation mode is in a range of 4.0 to 6.0 mm per second. It is characterized by that .

  An ophthalmic surgical microscope according to the present invention includes a moving mechanism that moves a lens barrel portion in which at least a part of an optical system is stored, a detection unit that detects an observation mode that is currently selected, and a detection result of the observation mode. And a control means for changing the moving speed of the lens barrel portion by the moving mechanism. Accordingly, the moving speed of the lens barrel can be automatically changed according to the change of the observation mode. This eliminates the need to manually reset the moving speed of the lens barrel when switching the observation mode.

It is the schematic showing an example of the external appearance structure of embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of the structure of the projection image formation part in embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of the structure of the projection image formation part in embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of a structure of the optical system in embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of a structure of the optical system in embodiment of the microscope for ophthalmic surgery concerning this invention. It is a schematic block diagram showing an example of the structure of the control system in embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of the external appearance structure of embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of a structure of the periphery of the front lens in embodiment of the microscope for ophthalmic surgery concerning this invention. It is the schematic showing an example of a structure of the periphery of the front lens in embodiment of the microscope for ophthalmic surgery concerning this invention. It is a schematic block diagram showing an example of the structure of the control system in embodiment of the microscope for ophthalmic surgery concerning this invention.

  An embodiment of the microscope for ophthalmic surgery according to the present invention will be described in detail with reference to the drawings.

  The microscope for ophthalmic surgery according to the present invention can selectively use a plurality of observation modes. Observation mode refers to the type of ophthalmic surgery microscope used according to the observation target (cornea, vitreous, retina, etc.) and the type of surgery (normal cataract surgery, IOL transplantation surgery, vitreous surgery, retinal surgery, etc.) It means an operation form.

  Hereinafter, two embodiments of the present invention will be described in detail. In the first embodiment, an ophthalmic surgical microscope capable of selectively using a normal observation mode and a toric IOL transplantation mode will be described. In the second embodiment, an ophthalmic surgical microscope capable of selectively using the normal observation mode and the intraocular observation mode will be described.

  The microscope for ophthalmic surgery according to the present invention is not limited to the following embodiments, and any microscope that can selectively use a plurality of observation modes provided in advance may be used. For example, the configuration according to the present invention can be applied to an ophthalmic surgical microscope that can selectively use three observation modes of a normal observation mode toric IOL transplantation mode and an intraocular observation mode. Moreover, it is also possible to apply the structure which concerns on this invention with respect to the microscope for ophthalmic surgery which has observation modes other than these.

<First Embodiment>
The microscope for ophthalmic surgery according to this embodiment can selectively use the normal observation mode and the toric IOL transplantation mode. As described above, the normal observation mode is used for observing the anterior segment of the patient's eye. The toric IOL transplantation mode is used in a toric IOL transplantation operation, and measures the astigmatic axis direction of the patient's eye and makes it possible to observe the patient's eye while presenting the measurement result.

[Constitution]
[Appearance structure]
An appearance configuration of the microscope for ophthalmologic surgery 1 according to this embodiment will be described with reference to FIG. The microscope for ophthalmologic surgery 1 includes a support 2, a first arm 3, a second arm 4, a driving device 5, a microscope 6 and a foot switch 8 as in the conventional art.

  The drive device 5 includes an actuator such as a motor. The drive device 5 moves the microscope 6 in the vertical direction and the horizontal direction according to the operation using the operation lever 8a of the foot switch 8. Thereby, the microscope 6 can be moved three-dimensionally.

  Various optical systems and drive systems are accommodated in the lens barrel 10 of the microscope 6. An inverter unit 12 is provided on the upper portion of the lens barrel unit 10. When the observation image of the patient's eye E is obtained as an inverted image, the inverter unit 12 converts the observation image into an erect image. A pair of left and right eyepieces 11 </ b> L and 11 </ b> R are provided on the upper portion of the inverter unit 12. An observer (operator or the like) can view the patient's eye E binocularly by looking into the left and right eyepieces 11L and 11R.

  The microscope for ophthalmologic surgery 1 includes a projection image forming unit 13 as a characteristic configuration. The projection image forming unit 13 projects a light beam onto the patient's eye E to form a predetermined projection image on the patient's eye E. The projection image forming unit 13 is an example of the “projection unit” of the present invention.

  A configuration example of the projection image forming unit 13 is shown in FIGS. Reference numeral 14 in FIG. 2 represents a photographing unit. The photographing unit 14 stores a TV camera 56 described later. FIG. 3 shows a configuration when the head portion 131 of the projection image forming unit 13 is viewed from below (that is, the patient's eye E side, in other words, the opposite side of the lens barrel unit 10).

  As shown in FIGS. 2 and 3, the head portion 131 is a disk-shaped member. As shown in FIG. 3, a plurality of LEDs 131-i (i = 1 to N) are provided on the lower surface of the head portion 131. The LED group 131-i is arranged in an annular shape. In this embodiment, 36 LEDs 131-i are provided at equal intervals (N = 36). That is, the LED group 131-i is disposed at an angle of 10 degrees with respect to the center position of the LED group 131-i. In other words, considering the line segment connecting each LED 131-i and the center position, the line segments related to the two adjacent LEDs 131-i, 131- (i + 1) intersect at an angle of 10 degrees at the center position. .

  Among the LED groups 131-i, one corresponding to the horizontal direction and the vertical direction can be configured to output a color different from that corresponding to the other direction. In other words, the LEDs at positions corresponding to the astigmatism axis direction (astigmatism axis angle) of 0 degrees, 90 degrees, 180 degrees, and 270 degrees (LEDs 131-1, 131-10, 131-19, and 131-28, respectively) It can be configured to output a light flux of a different color from the LED 131-i (i ≠ 1, 10, 19, 28). For example, red LEDs can be used as the LEDs 131-1, 131-10, 131-19, 131-28, and green LEDs can be used as the other LEDs 131-i (i ≠ 1, 10, 19, 28). Thereby, it is possible to easily recognize the horizontal direction and the vertical direction of the astigmatic axis.

  Further, only some of the LEDs 131-1, 131-10, 131-19, and 131-28 may output a light flux having a color different from that of the other LEDs. For example, only the LED 131i corresponding to an angle of 0 degrees can be configured to output a different color from other LEDs (i ≠ 1).

  Further, it is not necessary to configure all of the LEDs 131-1, 131-10, 131-19, and 131-28 to output a light beam of the same color (red in the above example). For example, a red LED is used as each LED 131-1, 131-19, a white LED is used as each LED 131-10, 131-28, and a green LED is used as another LED 131-i (i ≠ 1, 10, 19, 28). Can be used. Thereby, it is possible to easily identify the horizontal direction and the vertical direction.

  In addition, instead of making the horizontal direction and the vertical direction recognizable according to the output color of the light source as described above, the same effect can be achieved with other configurations. For example, the direction can be identified by changing the brightness of the output light.

  The light source used for the projection means of the present invention does not have to be an LED, and may be any device that can output a light beam. Moreover, these light sources do not need to be arrange | positioned at equal intervals. Since FIG. 3 is a bottom view, the arrangement order of the LED groups 131-i is set in the opposite direction (reverse direction) to the general astigmatic axis setting direction. Thereby, the corneal reflection light (Purkinje image) of the light beam output from the LED group 131-i is observed or photographed as a general astigmatic axis setting direction.

  In this embodiment, 36 light sources are provided, but the number of light sources to be installed is also arbitrary. However, when measuring the astigmatic axis direction of the patient's eye E based on the Purkinje image of the luminous flux output from the LED group 131-i, there are provided as many light sources as possible to ensure the accuracy and accuracy of the measurement. It is desirable. In the case of adopting a configuration that does not perform measurement in the astigmatic axis direction, there is no restriction on the number of light sources.

  In addition, the number of light sources can be appropriately set according to the accuracy required when the operator visually recognizes the astigmatic axis direction and the arrangement direction of the main meridian of the toric IOL. For example, since the light sources are arranged at intervals of 10 degrees in this embodiment, the astigmatic axis direction can be presented in units of at least 10 degrees. In order to present the astigmatic axis direction and the like with higher accuracy, the number of light sources corresponding to the accuracy (for example, 72 in the case of 5 degree units) is provided. The same is true for lower accuracy.

  In this embodiment, a plurality of individually configured light sources (LED groups 131-i) are provided, but the present invention is not limited to this. For example, it is possible to obtain a similar function by providing a display device (for example, an LCD (liquid crystal display)) on the lower surface of the head portion 131 and displaying a plurality of bright spots with this display device. In this case, each bright spot corresponds to a “light source”.

  An objective lens unit 16 is provided at the lower end of the lens barrel unit 10. The objective lens unit 16 stores the dictated objective lens 15. A support member 17 is provided in the vicinity of the objective lens unit 16. The support member 17 is formed from the objective lens portion 16 toward the side.

  A through-hole extending in the vertical direction is formed in the distal end portion 17 a of the support member 17. An arm 133 is inserted into the through hole. The arm 133 is slidable in the through hole. Thereby, the arm 133 can be moved in the vertical direction (the direction indicated by the double-sided arrow A in FIG. 2) with respect to the distal end portion 17a. Here, the microscope 6 side is the upward direction, and the patient's eye E side is the downward direction.

  A drop prevention part 134 is provided at the upper end of the arm 133. The fall prevention part 134 is a plate-like member having a diameter larger than the diameter of the through hole. Thereby, the fall prevention unit 134 prevents the arm 133 from falling off the tip portion 17a.

  A head connection portion 132 is provided at the lower end of the arm 133. The head connection part 132 connects the head part 131 to the arm 133 so that the surface on which the LED 131-i is provided faces downward.

  With such a configuration, the head part 131, the head connection part 132, the arm 133, and the fall prevention part 134 (that is, the projection image forming part 13) are movable in the vertical direction with respect to the tip part 17a. For example, the user moves the projection image forming unit 13 by holding the arm 133 or the like. It is also possible to configure the projection image forming unit 13 to be moved electrically by using a driving means such as a motor.

  A connecting hook 18 is provided on the lower surface of the support member 17. The connecting hook 18 is configured to be engageable with an engaging portion (not shown) of the projection image forming portion 13. This engaging part is provided in the head connection part 132, for example. When the projection image forming unit 13 is moved upward, the engaging unit and the connecting hook 18 are engaged to prohibit the vertical movement of the projection image forming unit 13. This engagement relationship can be released by a predetermined operation (for example, pressing a predetermined button). The configuration of the connecting hook 18 and the engaging portion is arbitrary.

  With the above configuration, the LED group 131-i is held so as to be movable along the optical axis direction of the objective lens 15.

[Configuration of optical system]
Next, the optical system of the microscope for ophthalmologic surgery 1 will be described with reference to FIGS. 4 and 5. Here, FIG. 4 is a view of the optical system viewed from the left side as viewed from the operator. FIG. 5 is a view of the optical system viewed from the operator side. In addition to the configuration shown in FIGS. 4 and 5, an optical system (assistant microscope) for the operator's assistant to observe the patient's eye E can be provided.

  In this embodiment, the directions such as up and down, left and right, and front and rear are directions seen from the operator side unless otherwise specified. In addition, about the up-down direction, let the direction which goes to the observation object (patient eye E) from the objective lens 15 be a downward direction, and let this opposite direction be an upper direction. Generally, since a patient undergoes surgery in a supine state, the vertical direction and the vertical direction are the same.

  The aforementioned LED group 131-i is provided at a position below the objective lens 15 (position between the objective lens 15 and the patient's eye E). 4 and 5, only the LEDs 131-i and 131-j (i, j = 1 to N, i ≠ j) located at both ends when viewed from the viewpoint direction are described.

  The term “between the objective lens 15 and the patient's eye E” means between the position (height position) of the objective lens and the position (height position) of the patient eye E in the vertical direction (that is, The position in the front-rear direction is not considered). The LED group 131-i is arranged in an annular shape, but if the projection image (bright spot image) arranged in a substantially annular shape can be formed on the cornea of the patient's eye E, the diameter of the annular shape is Can be set arbitrarily.

  The observation optical system 30 will be described. As shown in FIG. 5, the observation optical system 30 is provided in a pair of left and right. The left observation optical system 30L is called a left observation optical system, and the right observation optical system 30R is called a right observation optical system. Symbol OL indicates the optical axis (observation optical axis) of the left observation optical system 30L, and symbol OR indicates the optical axis (observation optical axis) of the right observation optical system 30R. The left and right observation optical systems 30L and 30R are disposed so as to sandwich the optical axis O of the objective lens 15.

  As in the conventional case, the left and right observation optical systems 30L and 30R are respectively a zoom lens system 31, a beam splitter 32 (only the right observation optical system 30R), an imaging lens 33, an image erecting prism 34, and an eye width adjustment prism 35. A field stop 36 and an eyepiece 37.

  The zoom lens system 31 includes a plurality of zoom lenses 31a, 31b, and 31c. Each of the zoom lenses 31a to 31c can be moved in a direction along the observation optical axis OL (or the observation optical axis OR) by a zoom mechanism 81 (see FIG. 6) described later. Thereby, the magnification at the time of observing or photographing the patient's eye E is changed.

  The beam splitter 32 of the right observation optical system 30R separates part of the observation light guided from the patient's eye E along the observation optical axis OR and guides it to the TV camera imaging system. The TV camera imaging system includes an imaging lens 54, a reflection mirror 55, and a TV camera 56. The television camera imaging system is stored in the imaging unit 14.

  The TV camera 56 includes an image sensor 56a. The image pickup device 56a is configured by, for example, a charge coupled devices (CCD) image sensor, a complementary metal oxide semiconductor (CMOS) image sensor, or the like. As the image sensor 56a, an element having a two-dimensional light receiving surface (area sensor) is used.

  When the ophthalmic surgical microscope 1 is used, the light receiving surface of the imaging device 56a is, for example, a position optically conjugate with the surface of the cornea of the patient's eye E, or a depth from the apex of the cornea by ½ of the corneal curvature radius. It is arranged at a position optically conjugate with a position away in the direction.

  The image erecting prism 34 converts the inverted image into an erect image. The eye width adjustment prism 35 is an optical element for adjusting the distance between the left and right observation lights according to the eye width of the operator (the distance between the left eye and the right eye). The field stop 36 blocks the peripheral region in the cross section of the observation light and limits the operator's visual field.

  Next, the illumination optical system 20 will be described. As shown in FIG. 4, the illumination optical system 20 includes an illumination light source 21, an optical fiber 21a, an exit aperture stop 26, a condenser lens 22, an illumination field stop 23, a slit plate 24, a collimator lens 27, and an illumination prism 25. Is done.

  The illumination field stop 23 is provided at a position optically conjugate with the front focal position of the objective lens 15. The slit hole 24a of the slit plate 24 is formed at a position optically conjugate with the front focal position.

  The illumination light source 21 is provided outside the lens barrel 10 of the microscope 6. One end of an optical fiber 21 a is connected to the illumination light source 21. The other end of the optical fiber 21 a is disposed at a position facing the condenser lens 22 in the lens barrel 10. The illumination light output from the illumination light source 21 is guided by the optical fiber 21 a and enters the condenser lens 22.

  An exit aperture stop 26 is provided at a position facing the exit port (fiber end on the condenser lens 22 side) of the optical fiber 21a. The exit aperture stop 26 acts to shield a partial region of the exit port of the optical fiber 21a. When the shielding area by the exit aperture stop 26 is changed, the emission area of the illumination light is changed. Thereby, the irradiation angle by the illumination light, that is, the angle formed by the incident direction of the illumination light with respect to the patient's eye E and the optical axis O of the objective lens 15 can be changed.

  The slit plate 24 is formed of a disk-shaped member having a light shielding property. The slit plate 24 is provided with a light-transmitting portion including a plurality of slit holes 24 a having a shape corresponding to the shape of the reflecting surface 25 a of the illumination prism 25. The slit plate 24 is moved in a direction perpendicular to the illumination optical axis O ′ (direction of a double-headed arrow B shown in FIG. 4) by a driving mechanism (not shown). As a result, the slit plate 24 is inserted into and removed from the illumination optical axis O ′.

  The collimator lens 27 converts the illumination light that has passed through the slit hole 24a into a parallel light flux. The illumination light that has become a parallel light beam is reflected by the reflecting surface 25 a of the illumination prism 25 and projected onto the patient's eye E via the objective lens 15. Illumination light (a part) projected onto the patient's eye E is reflected by the cornea. Reflected light (sometimes referred to as observation light) of illumination light by the patient's eye E enters the observation optical system 30 via the objective lens 15. With such a configuration, an operator can observe an enlarged image of the patient's eye E.

[Control system configuration]
A control system of the microscope for ophthalmic surgery 1 will be described with reference to FIG. In FIG. 6, a part of the control system is omitted. The omitted portion includes a drive mechanism for the slit plate 24.

(Control part)
The control system of the microscope for ophthalmic surgery 1 is configured with a control unit 60 as a center. The control unit 60 is provided at any part of the microscope for ophthalmic surgery 1 shown in FIG. Further, a computer may be provided separately from the configuration shown in FIG. 1 and used as the control unit 60.

  The control unit 60 controls each part of the microscope for ophthalmic surgery 1. In particular, the control unit 60 controls the driving device 5, the illumination light source 21, the zoom mechanism 81, the LED group 131-i, and the like. As described above, the driving device 5 moves the microscope 6 three-dimensionally. Thereby, the lens barrel 10 is moved in the horizontal direction (direction perpendicular to the optical axis of the objective lens 15). The driving device 5 is an example of the “first moving mechanism” of the present invention. The movement control unit 61 executes control of the driving device 5. The zoom mechanism 81 moves the zoom lenses 31a, 31b, and 31c of the zoom lens system 31. The driving device 5 and the zoom mechanism 81 are provided with, for example, a pulse motor. The controller 60 transmits a pulse signal to each pulse motor to control its operation (rotation angle, rotation speed, etc.).

  The control unit 60 includes a microprocessor and a storage device in the same manner as a normal computer. The control unit 60 (particularly the movement control unit 61) is an example of the “control unit” of the present invention. The moving speed specifying unit 62 will be described later.

(Memory part)
The storage unit 70 stores various information. In particular, the storage unit 70 stores movement speed information 71 in advance. The moving speed information 71 is, for example, table information that associates each observation mode that can be performed by the microscope for ophthalmic surgery 1 with the moving speed of the microscope 6 (lens barrel part 10). Here, the moving speed information 71 may associate the moving direction (horizontal direction, vertical direction, etc.) with the moving speed for each observation mode.

  The microscope for ophthalmologic surgery 1 of this embodiment can implement at least the normal observation mode and the toric IOL transplantation mode. The moving speed information 71 of this embodiment records at least the moving speed in the horizontal direction of the microscope 6 in each of the normal observation mode and the toric IOL transplant mode.

  The moving speed in the horizontal direction in the toric IOL transplantation mode is set smaller than that in the normal observation mode. As a specific example, the movement speed in the normal observation mode is in the range of 4.0 to 6.0 mm / second, and the movement speed in the toric IOL transplantation mode is in the range of 1.5 to 3.0 mm / second (for example, 2.0 to 2.0 / second). About 2.5 mm). The moving speed in the horizontal direction in the toric IOL transplant mode can be appropriately set so that the alignment between the corneal center and the visual field center can be performed with high accuracy. Note that it is not preferable that the moving speed is too small in consideration of the prolonged operation time and operability.

  The operation unit 82 is used by an operator or the like to operate the microscope 1 for ophthalmic surgery. The operation unit 82 includes various hardware keys (buttons, switches, etc.) provided on the housing of the microscope 6 and the foot switch 8. When a touch panel display is provided, the operation unit 82 includes various software keys displayed on the touch panel display.

  In particular, the operation unit 82 includes an operation device for operating the driving device 5 to move the microscope 6 in the horizontal direction. This operation device is, for example, the operation lever 8a of the foot switch 8 (see FIG. 1).

(Mode detector)
The mode detector 83 detects the observation mode that is currently selected from the plurality of observation modes. The mode detector 83 is an example of the “detector” of the present invention.

  The observation mode may be selected manually by the user or automatically by the control unit 60. As an example of selecting the observation mode manually, when a member used in a desired mode is attached to a predetermined part, when the member is disposed at a predetermined position, when an observation mode is specified using the operation unit 82, etc. is there. Further, as an example of automatic selection of the observation mode, there is a case where the observation mode is automatically selected based on the contents of the operation performed on the patient's eye in the past, the disease name of the patient's eye, or the like. The mode detector 83 is particularly effective when manually selecting.

  A configuration example of the mode detection unit 83 for detecting that the toric IOL transplant mode has been selected will be described. As a first configuration example, a sensor is provided to detect that the head portion 131 (LED group 131-i) is disposed at a predetermined use position. This sensor is, for example, a microsensor provided on the lower surface of the fall prevention unit 134 or the upper surface of the tip portion 17a. This microsensor detects that the fall prevention part 134 and the front-end | tip part 17a contacted, ie, LED group 131-i was moved to the patient's eye E vicinity. Thus, the position of the LED group 131-i in the state of being moved downward is the “predetermined use position”. This microsensor is an example of the “first sensor” of the present invention.

  As a second configuration example of the mode detection unit 83, a TV camera 56 and a microprocessor are used. The TV camera 56 functions as “imaging means” of the present invention, and images the patient's eye E. The microprocessor functions as the “determination means” of the present invention, analyzes the image of the patient's eye E obtained by the TV camera 56, and describes a plurality of bright spot images based on the luminous flux from the LED group 131-i. Judge whether or not. This analysis process can be easily performed based on, for example, pixel values (luminance values, etc.) of pixels constituting the image. The microprocessor may be the same as that of the control unit 60 or may be provided separately.

  Instead of detecting the observation mode based on information obtained from the outside of the control unit 60 as described above, the observation mode may be specified according to the control content by the control unit 60. For example, as described above, the control unit 60 controls the LED group 131-i. Therefore, the control unit 60 can specify that the toric IOL transplant mode has been selected in response to lighting the LED group 131-i.

  The control unit 60 can store the detection results by the mode detection unit 83 in time series. For example, the control unit 60 can store on / off of the above-described microswitch in time series, and can store the presence or absence of a plurality of bright spot images in the image of the patient's eye E in time series. Thereby, the control unit 60 can recognize the switching of the observation mode. For example, when the microswitch is turned on from the off state, it can be recognized that the normal observation mode is switched to the toric IOL transplantation mode. On the other hand, when the microswitch is turned off from the on state, it can be recognized that the toric IOL transplant mode has shifted to the normal observation mode.

  The detection result by the mode detection unit 83 is sent to the movement speed specifying unit 62. The moving speed specifying unit 62 specifies the speed when moving the microscope 6 based on the detection result and the moving speed information 71. In this embodiment, the moving speed in the horizontal direction is specified. This process only selects the movement speed corresponding to the observation mode detected by the mode detection unit 83 from the movement speed information 71.

  When an operation instruction in the horizontal direction is given using the operation unit 82 (the operation lever 8a of the foot switch 8), the movement control unit 61 moves the microscope 6 in the horizontal direction at the speed specified by the movement speed specifying unit 62. The drive device 5 is controlled so that

(Calculation processing part)
The arithmetic processing unit 84 executes various arithmetic processes. For example, the arithmetic processing unit 84 calculates the astigmatic axis direction of the patient's eye E based on the captured image of the patient's eye E in a state where the light flux from the LED group 131-i is projected onto the cornea. This calculation process can be executed in the same manner as a conventional keratometer or the like. In this way, instead of obtaining the astigmatism axis direction of the patient's eye E, it may be obtained from the outside.

  The control unit 60 identifies the LED 131-j at a position corresponding to the astigmatic axis direction of the patient's eye E, and lights it in a manner different from the other LEDs 131-i (i ≠ j). Thereby, it becomes possible to present the astigmatic axis direction of the patient's eye E to an operator who observes the patient's eye E with the microscope 6. Note that the measurement and presentation in the astigmatic axis direction using the LED group 131-i is described in detail in Japanese Patent Application No. 2009-210681 by the present inventor.

[Action / Effect]
The operation and effect of the microscope for ophthalmologic surgery 1 will be described.

  The microscope for ophthalmologic surgery 1 detects an observation mode that is currently selected from a plurality of observation modes that are provided in advance, and the horizontal direction of the lens barrel 10 (microscope 6) is detected based on the detection result of the observation mode. It works to change the moving speed.

  A specific example of this action will be described. When the mode detection unit 83 detects that the toric IOL transplant mode is selected, the control unit 60 determines the toric that is smaller than the moving speed for the normal observation mode (for example, about 4.0 to 6.0 mm per second). The drive unit 5 is controlled to move the lens barrel 10 in the horizontal direction at a moving speed for the IOL transplant mode (for example, 1.5 to 3.0 mm per second). The movement in the horizontal direction is executed according to an operation using the operation unit 82.

  As another effect, when the mode detection unit 83 detects that the normal observation mode is switched to the toric IOL transplantation mode, the control unit 60 reduces the moving speed of the lens barrel unit 10 in the horizontal direction ( For example, the driving device 5 is controlled so as to change from about 4.0 to 6.0 mm per second to 1.5 to 3.0 mm per second.

  Conversely, when the mode detector 83 detects that the mode has been switched from the toric IOL transplant mode to the normal observation mode, the controller 60 increases the moving speed of the lens barrel 10 in the horizontal direction (for example, every second). The driving device 5 may be controlled to change from about 1.5 to 3.0 mm to 4.0 to 6.0 mm per second.

  According to the microscope 1 for ophthalmic surgery, since the moving speed of the lens barrel 10 can be automatically changed according to the change of the observation mode, the moving speed of the lens barrel 10 is changed when the observation mode is switched. Eliminates the need for manual reconfiguration. In addition to the moving speed in the horizontal direction, the moving speed in the vertical direction may be changed. The specific aspect is the same as that of the following 2nd Embodiment, for example.

<Second Embodiment>
An embodiment in which the normal observation mode and the intraocular observation mode can be selectively used will be described. The microscope for ophthalmic surgery according to this embodiment has substantially the same configuration as that of the first embodiment. Hereinafter, the same components as those in the first embodiment will be described using the same reference numerals.

[Constitution]
An example of the configuration of the microscope for ophthalmic surgery according to this embodiment will be described with reference to FIGS. The ophthalmic surgical microscope 100 shown in FIG. 7 has an appearance configuration substantially similar to that of the first embodiment. The ophthalmic surgical microscope 100 has the same optical system as that of the first embodiment (see FIGS. 4 and 5).

  A difference of the microscope for ophthalmic surgery 100 from the first embodiment is that a front lens 113 and a holding arm 114 are provided instead of the projection image forming unit 13. The front lens 113 is used when observing the inside of the patient's eye E (retina, vitreous body, etc.).

  As shown in FIG. 8, the upper end of the holding arm 114 is connected to the microscope 6. A front lens 113 is held at the lower end of the holding arm 114. The front lens 113 illuminates the inside of the patient's eye E by focusing the illumination light. As the front lens 113, a plurality of lenses having different refractive powers (for example, 40D, 80D, 120D, etc.) are prepared. These lenses are alternatively mounted on the holding arm 114 and used as the front lens 113.

  The upper end of the holding arm 114 is pivoted so that it can be rotated in the vertical direction. Thereby, the front lens 113 can be inserted into and removed from the position between the patient's eye E and the objective lens 15. The position (use position) where the front lens 113 is inserted is a position on the optical axis of the objective lens 15 and a position between the front focal position of the objective lens 15 and the patient's eye E.

  The front lens 113 is held by a holding plate 141a formed so as to surround the periphery thereof. The holding plate 141a is connected to the arm portion 141 via the pivot 141b, and is rotatable about the pivot 141b. An inclined portion 141c is formed on the holding plate 141a.

  A coil spring 154 is wound around the upper end portion of the arm portion 141. The upper end of the arm portion 141 is pivoted to one end of the storage portion 174 by a pivot 174a. The arm portion 141 is provided with an operation knob (not shown). The operator switches the position of the front lens 113 between the use position and the storage position by holding the operation knob and turning the holding arm 114 about the pivot 174a.

  A driving unit 175 is provided in the main body 6 a of the microscope 6. A lift arm 171 is connected to the drive unit 175 via a support member 176. A fringe portion 171 a is formed at the upper end of the elevating arm 171 to prevent the elevating arm 171 from dropping from the support member 176. The drive unit 175 moves the lifting arm 171 in the vertical direction together with the support member 176. At this time, the front lens 113 is also moved together with the lifting arm 171.

  A connecting portion 171 b is provided at the lower end of the lifting arm 171. A rise restricting member 172 is connected to the connecting portion 171b. The rise restricting member 172 contacts the rise restricting member 177 on the main body 6a side when the elevating arm 171 is raised to a predetermined position. As a result, the rise restricting members 172 and 177 act so that the elevating arm 171 does not move upward from a predetermined position.

  A connecting knob 173 is provided on the connecting portion 171b. When the connecting knob 173 is rotated in a predetermined direction, the tip of a rotating screw (not shown) is inserted into the connecting hole 177a. Accordingly, the front lens 113, the holding arm 114, the storage portion 174, and the like are connected to the main body portion 6a. In this connected state, the movement of the front lens 113 or the like is prohibited.

  A storage portion 174 is connected to the rise restricting member 172. The storage unit 174 stores the holding arm 114 (and the front lens 113). FIG. 9 shows a state in which the holding arm 114 is stored. On the lower surface side of the storage portion 174, a concave storage groove is formed along the longitudinal direction of the storage portion 174. The holding arm 114 is housed in the housing groove by being pivoted about the pivot 174a.

  In the state where the holding arm 114 is housed, as shown in FIG. 9, the lens surface of the front lens 113 faces in the up-down direction. This is due to the action of the inclined portion 141c of the holding plate 141a and the contact member 174b attached to the end of the storage portion 174. That is, when the arm portion 141 is pivoted upward about the pivot 174a, the inclined portion 141c comes into contact with the contact member 174b and is guided by the inclined portion 141c so that the holding plate 141a rotates about the pivot 141b. Thereby, the front lens 113 is disposed at the storage position in a state as shown in FIG.

  On the other hand, FIG. 8 shows a state where the front lens 113 is disposed at a position between the patient's eye E and the objective lens 15, that is, at a use position. When the front lens 113 is stored from this state, the surgeon holds the operation knob described above and pivots the holding arm 114 upward to store the holding arm 114 in the storage unit 174. Further, by rotating the holding arm 114 downward in the reverse manner, the stored front lens 113 can be placed at the use position.

  The storage portion 174 is formed to be attachable to and detachable from the ascending restriction member 172. This is because the front lens 113 and the holding arm 114 are removed from the microscope 6 when sterilizing. The storage portion 174 to the front lens 113 are integrally configured. In a state where the front lens 113 is removed, the ophthalmic surgical microscope 100 can be used as a normal ophthalmic surgical microscope without the front lens 113. That is, in the intraocular observation mode, the front lens 113 is disposed at the use position, and in the normal observation mode, the front lens 113 is retracted from the use position (including both the storage state and the removal state).

  A control system of the ophthalmic surgical microscope 100 will be described with reference to FIG. The control system of the microscope for ophthalmic surgery 100 has substantially the same configuration as that of the first embodiment (see FIG. 6). However, in the second embodiment, the LED group 131-i and the arithmetic processing unit 84 are unnecessary.

  The control system of the microscope for ophthalmic surgery 100 includes a vertical movement mechanism 7 shown in FIG. The vertical movement mechanism 7 is connected to the drive device 5 and is moved three-dimensionally by the drive device 5. Further, the vertical movement mechanism 7 is connected to a slide plate 9. The slide plate 9 is fixed to the microscope 6. The vertical movement mechanism 7 moves the slide plate 9 in the vertical direction. Thereby, the microscope 6 is also moved up and down.

  The unit movement distance in the vertical direction by the vertical movement mechanism 7 is set to be smaller than that of the driving device 5. In other words, the driving device 5 is used for coarse vertical movement, and the vertical movement mechanism 7 is used for fine vertical movement. The vertical movement mechanism 7 is configured to include an actuator such as a pulse motor, similarly to the driving device 5. The operation of the vertical movement mechanism 7 is controlled by the control unit 60. The vertical movement mechanism 7 is an example of the “second movement mechanism” of the present invention. The driving device 5 can also be used as the second moving mechanism.

  In the moving speed information 71 of this embodiment, at least the moving speed in the vertical direction of the microscope 6 in each of the normal observation mode and the intraocular observation mode is recorded. The vertical direction is a direction orthogonal to the horizontal direction in the first embodiment and is a direction along the optical axis of the objective lens 15.

  The moving speed in the vertical direction in the intraocular observation mode is set smaller than that in the normal observation mode. As a specific example, the movement speed in the normal observation mode is in the range of 4.0 to 6.0 mm / second, and the movement speed in the intraocular observation mode is in the range of 0.5 to 3.0 mm / second (for example, 1.0 to 2.5 mm / second). About 1.5 mm). The movement speed in the vertical direction in the intraocular observation mode can be appropriately set so that the front lens 113 does not contact the patient's eye E during the movement in the vertical direction. Note that it is not preferable that the moving speed is too small in consideration of the prolonged operation time and operability.

  The operation unit 82 is provided with an operation device for operating the vertical movement mechanism 7, that is, for performing fine vertical movement. This operation device is, for example, the operation lever 8a of the foot switch 8 (see FIG. 7).

  A configuration example of the mode detection unit 83 for detecting that the intraocular observation mode is selected will be described. The mode detector 83 includes a sensor that detects that the front lens 113 is disposed at the use position described above. This sensor is, for example, a microsensor, and is provided in the storage groove of the storage unit 174. This microsensor detects that the storage portion 174 and the holding arm 114 are in contact, that is, that the front lens 113 is disposed at the storage position. That is, the mode detection unit 83 detects that the front lens 113 is disposed at the use position when the microsensor is turned off. This microsensor is an example of the “second sensor” of the present invention.

  As another configuration example, it is possible to detect that the front lens 113 is disposed at the use position. For this purpose, for example, a sensor for detecting a rotational position with respect to the pivot 174a and the pivot 141b is provided. As this sensor, for example, a rotary potentiometer is used. The mode detection unit 83 detects that the front lens 113 is disposed at the use position in response to the rotary potentiometer detecting a predetermined rotation position (a rotation position corresponding to the use position). This rotary potentiometer is an example of the “second sensor” of the present invention.

  Similarly to the first embodiment, the observation mode may be specified according to the control content by the control unit 60. Further, the detection result by the mode detection unit 83 may be stored in time series to recognize the observation mode switching.

  The detection result by the mode detection unit 83 is sent to the movement speed specifying unit 62. The moving speed specifying unit 62 specifies the speed when moving the microscope 6 based on the detection result and the moving speed information 71. In this embodiment, the moving speed in the vertical direction, in particular, the moving speed by the vertical moving mechanism 7 is specified.

  When an operation instruction in the vertical direction is made using the operation unit 82 (the operation lever 8a of the foot switch 8), the movement control unit 61 moves the microscope 6 in the vertical direction at the speed specified by the movement speed specifying unit 62. The drive device 5 is controlled so that

[Action / Effect]
The operation and effect of the microscope 100 for ophthalmic surgery will be described.

  The microscope for ophthalmic surgery 100 detects an observation mode that is currently selected from a plurality of observation modes that are provided in advance, and based on the detection result of this observation mode, the microscope unit 10 (microscope 6) in the vertical direction. It works to change the moving speed.

  A specific example of this action will be described. When the mode detection unit 83 detects that the intraocular observation mode is selected, the control unit 60 sets the eye smaller than the moving speed for the normal observation mode (for example, about 4.0 to 6.0 mm per second). The driving device 5 is controlled so as to move the lens barrel 10 in the vertical direction at a moving speed for the internal observation mode (for example, 0.5 to 3.0 mm per second). Note that the movement in the vertical direction is executed in accordance with an operation using the operation unit 82.

  As another action, when the mode detection unit 83 detects that the normal observation mode is switched to the intraocular observation mode, the control unit 60 reduces the moving speed of the lens barrel unit 10 in the vertical direction ( For example, the driving device 5 is controlled so as to change from about 4.0 to 6.0 mm per second to 0.5 to 3.0 mm per second.

  Conversely, when the mode detection unit 83 detects that the intraocular observation mode is switched to the normal observation mode, the control unit 60 increases the moving speed of the lens barrel unit 10 in the vertical direction (for example, every second). The driving device 5 may be controlled to change from about 0.5 to 3.0 mm to about 4.0 to 6.0 mm per second.

  According to the microscope 1 for ophthalmic surgery, since the moving speed of the lens barrel 10 can be automatically changed according to the change of the observation mode, the moving speed of the lens barrel 10 is changed when the observation mode is switched. Eliminates the need for manual reconfiguration. In addition to the moving speed in the vertical direction, the moving speed in the horizontal direction may be changed. The specific aspect is the same as that of the following 1st Embodiment, for example.

  The configurations described in the first and second embodiments are merely examples for implementing the ophthalmic surgical microscope according to the present invention. A person who intends to implement the present invention can make arbitrary modifications within the scope of the gist of the present invention.

DESCRIPTION OF SYMBOLS 1,100 Ophthalmic surgery microscope 5 Drive apparatus 6 Microscope 7 Vertical movement mechanism 8 Foot switch 8a Operation lever 10 Lens barrel part 13 Projection image formation part 15 Objective lens 60 Control part 61 Movement control part 62 Movement speed specification part 70 Storage part 71 Movement speed information 83 Mode detector E Patient eye

Claims (7)

A lens barrel portion storing at least a part of an optical system having an objective lens ;
A moving mechanism for moving the lens barrel in a horizontal direction perpendicular to the optical axis of the objective lens ;
Detecting means for detecting the currently selected observation mode among a plurality of observation modes provided in advance;
Control means for changing the moving speed of the lens barrel by the moving mechanism based on the detection result of the observation mode by the detecting means;
A microscope for ophthalmic surgery, comprising: Before SL plurality of observation modes, including a normal observation mode to be used for observing the anterior segment of the patient's eye, the toric IOL implantation mode used in toric IOL implantation surgery,
When that prior Symbol toric IOL implantation mode is selected is detected by the detecting means, the control means, the mobile speed of the for the normal the toric IOL implantation mode smaller than the moving speed of the observation mode wherein controlling the moving mechanism to move the lens barrel,
The microscope for ophthalmologic surgery according to claim 1. Before SL plurality of observation modes, including a normal observation mode to be used for observing the anterior segment of the patient's eye, the toric IOL implantation mode used in toric IOL implantation surgery,
When it has been switched from the previous SL normal observation mode to the toric IOL implantation mode detected by said detection means, said control means controls the moving mechanism so as to reduce the moving speed of the barrel To
The microscope for ophthalmologic surgery according to claim 1. In the toric IOL transplant mode, further comprising a projection means for forming a bright spot image on the patient's eye,
The detection means includes a first sensor that detects that the projection means is disposed at a predetermined use position,
When said projecting means is disposed at a predetermined position of use has been detected by said first sensor, said control means changes the moving speed of the barrel by controlling the moving mechanism,
The microscope for ophthalmic surgery according to claim 2 or claim 3, wherein The detection means includes imaging means for imaging a patient's eye, and determination means for determining whether the bright spot image is depicted by analyzing an image of the patient's eye obtained by the imaging means,
When it is determined by the determining means and the luminescent spot image is depicted, wherein the control means changes the moving speed of the barrel by controlling the moving mechanism,
The microscope for ophthalmic surgery according to claim 2 or claim 3, wherein The moving speed in the toric IOL transplant mode is in a range of 1.5 to 3.0 mm per second.
The microscope for ophthalmologic surgery according to any one of claims 2 to 5, wherein The moving speed in the normal observation mode is in a range of 4.0 to 6.0 mm per second.
The ophthalmic surgical microscope according to claim 6.

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