JP6756220B2 - Laser treatment device for ophthalmology - Google Patents

Description

The present disclosure relates to an ophthalmic laser treatment apparatus that irradiates a patient's eye with a laser beam for treatment.

A laser treatment device that irradiates a patient's eye with a laser beam for treatment is known. For example, the laser treatment apparatus of Patent Document 1 includes an observation optical system for observing an observation site of a patient's eye by an operator, and an irradiation optical system for emitting a laser beam for treating a tissue of the patient's eye. Further, the laser treatment apparatus of Patent Document 1 can convert an infrared laser beam (wavelength: 1064 nm) emitted by a laser light source into a visible laser beam (wavelength: 532 nm) by using a wavelength conversion element.

Japanese Unexamined Patent Publication No. 2014-233469

By the way, when irradiating a patient's eye with a plurality of types of laser light having different optical characteristics, a method of branching or distributing the laser light emitted by a laser light source into a plurality of optical paths to generate a plurality of types of laser light having different optical characteristics. Can be considered. However, when the laser beam is deflected by the insertion / removal of the mirror, there is a possibility that the optical axis shift is likely to occur due to the insertion / removal of the mirror. Further, when a light distribution member such as a half mirror is arranged on the optical path to distribute the laser light, the energy efficiency of the laser light emitted toward the patient's eye is not good.

A technical subject of the present disclosure is to provide an ophthalmic laser treatment apparatus capable of irradiating a patient's eye with a plurality of types of laser beams having different optical characteristics while having a simple structure.

In order to solve the above problems, the present invention is characterized by having the following configurations.
(1) An ophthalmic laser treatment apparatus for irradiating a patient's eye with a laser beam emits a laser beam emitted from a laser beam emitting means having a laser light source at at least one of a first irradiation optical system and a second irradiation optical system. An optical path branching member for guiding to an optical path, which is provided with an optical path branching member in which a reflection region and a transmission region are distinguished as an optical path branch, and a laser beam reflected from the reflection region is used as a first therapeutic laser beam. It is characterized in that the laser light transmitted through the transmission region is used as the laser light for the second treatment.

According to the present disclosure, it is possible to provide an ophthalmic laser treatment apparatus capable of irradiating a patient's eye with a plurality of types of laser beams having different optical characteristics despite a simple configuration.

It is external perspective view of the laser treatment apparatus for ophthalmology of this disclosure. It is the schematic of the optical system of 1st Embodiment. It is a schematic diagram of a control system. It is explanatory drawing of the 1st laser irradiation condition. It is explanatory drawing of the 2nd laser irradiation condition. It is the schematic of the optical system of 2nd Embodiment. It is an external perspective view of an optical path branch member. It is explanatory drawing of the laser beam which is reflected by an optical path branch member. It is explanatory drawing of the laser beam which passes through an optical path branch member. It is a figure which shows the shape of the laser beam when leaving the spiral phase plate. It is a figure which shows the shape of the laser beam when the spiral phase plate is inserted.

Hereinafter, typical embodiments in the present disclosure will be described with reference to the drawings.

<First Embodiment>
FIG. 1 is an external perspective view of the ophthalmic laser treatment device 1 of the first embodiment as viewed from the user side. FIG. 2 is a schematic configuration diagram of an optical system included in the ophthalmic laser treatment apparatus 1 of FIG. FIG. 3 is a schematic configuration diagram of a control system included in the ophthalmic laser treatment device 1 of FIG.

The ophthalmic laser treatment device 1 of the present embodiment includes a laser treatment device 2 and a table unit 3. The laser treatment device 2 of the present embodiment can irradiate the patient's eye Ep with a laser beam for treatment. The laser treatment device 2 is placed on the table portion 3 of the present embodiment. The laser treatment device 2 of the present embodiment includes a main body unit 4, an illumination unit 5, an eyepiece unit 6, a displacement means 7, an operation panel unit 8, a joystick unit 9, and a headrest unit 10. In the present embodiment, the first irradiation optical system 30, the control unit 80, and the like are housed in the housing of the main body 4.

The illumination unit 5 of the present embodiment is used to illuminate the observation site of the patient's eye Ep. The operator can observe the observation site by looking through the eyepiece 6. The displacement means 7 of the present embodiment has an optical system (for example, the first irradiation optical system 30) included in the laser treatment apparatus 1 for ophthalmology in the vertical direction (Y-axis direction in FIG. 1) and the horizontal direction (X-axis direction in FIG. 1). ), Or can be displaced (moved) in the front-back direction (Z-axis direction in FIG. 1). The displacement means 7 of the present embodiment has a rotation axis extending in the vertical direction, and the above-mentioned optical system can be rotated in the left-right direction with respect to the patient's eye Ep.

The operation panel unit 8 of the present embodiment is used by the operator to set various operating conditions of the ophthalmic laser treatment device 1. In the present embodiment, the operation panel unit 8 can be operated to select the laser irradiation conditions (for example, the first laser irradiation condition or the second laser irradiation condition). The joystick unit 9 is used by the operator to align various optical systems with respect to the patient's eye Ep. A trigger switch for starting irradiation of the laser beam is provided at the tip of the joystick portion 9 of the present embodiment. The headrest portion 10 of the present embodiment is used to fix the patient's face. The illumination unit 5 of the present embodiment contains an optical member for illuminating the treatment site of the patient's eye Ep.

<Optical system>
The optical system included in the ophthalmic laser treatment apparatus 1 of the present embodiment will be described. The ophthalmic laser treatment apparatus 1 of the present embodiment includes a first irradiation optical system 30 (laser light emitting means) for irradiating a patient's eye Ep with a laser beam having a first wavelength (wavelength: 532 nm), and a laser having a first wavelength. The first guide optical system 50 for guiding the light irradiation position, the second irradiation optical system 20 (laser light emitting means) for irradiating the patient's eye Ep with the laser light of the second wavelength (wavelength: 1064 nm), the first A second guide optical system 40 for guiding the irradiation position of the laser beam of two wavelengths and an observation optical system 60 for observing the patient's eye Ep are provided (see FIG. 2).

In the following description, the condition for irradiating the patient's eye Ep with the laser beam of the first wavelength is referred to as the first irradiation condition, and the condition for irradiating the patient's eye Ep with the laser beam of the second wavelength is the second irradiation condition. It may be called. As an example, the first irradiation condition is used in the treatment of Selective Laser Trabeculoplasty (SLT), and the second irradiation condition is used in the treatment of late cataract. The second irradiation optical system 20 of the present embodiment can generate plasma outside the ophthalmic laser treatment apparatus 1 by increasing the energy density of the laser beam at the condensing position of the objective lens 28. By generating plasma in the patient's eye Ep, for example, the cloudy posterior capsule can be optically destroyed.

<1st irradiation optical system>
The first irradiation optical system 30 of this embodiment will be described. The first irradiation optical system 30 of the present embodiment includes a laser light source 21, a light distribution member 22, a beam expander 31, a wavelength conversion element 32, a dichroic mirror 33, a switching member 34, a shutter 29, a beam expander unit 26, and a dichroic mirror 27. And an objective lens 28. The first irradiation optical system 30 of the present embodiment has an optical member that forms one of the laser beams distributed by the light distribution member 22 so as to meet the first laser irradiation conditions.

In the laser light source 21 of the present embodiment, a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd: YAG) is used as the laser rod. The laser light source 21 can emit a laser beam having a wavelength of 1064 nm. The laser light source 21 includes a Q switch and can emit a short pulse laser beam (giant pulse). The laser light source 21 of the present embodiment includes means for adjusting the emitted energy.

The light distribution member 22 of the present embodiment is a light reflection member, and can transmit and reflect the laser light emitted from the laser light source 21 at an desired ratio. In this embodiment, a half mirror is used as the light distribution member 22. The light distribution member 22 is fixed on the optical path of the first irradiation optical system 30. The beam expander 31 can reduce the luminous flux diameter of the laser beam. In the present embodiment, the laser beam having a wavelength of 1064 nm (the laser beam having the first wavelength) incident on the wavelength conversion element 32 is converted into the laser beam having a wavelength of 532 nm (the laser beam having the second wavelength) and emitted. In this embodiment, a KTP crystal is used as the wavelength conversion element 32.

The dichroic mirror 33 has a property of transmitting laser light and reflecting the first guide light. The switching member 34 can switch the optical path of the laser beam emitted toward the patient's eye Ep to either the optical path of the first irradiation optical system 30 or the optical path of the second irradiation optical system 20. The switching member 34 of the present embodiment is a light reflecting member having a mirror surface. In this embodiment, a flat mirror is used as the switching member 34. The switching member 34 of the present embodiment has a mirror surface formed on one side of the flat glass. In addition, mirror surfaces may be formed on both sides of the flat glass. A drive unit 16 is connected to the switching member 34.

In the present embodiment, the switching member 34 (light reflecting member) can be inserted and removed at a position where the optical path of the first irradiation optical system 30 and the optical path of the second irradiation optical system 20 are common optical paths. In the present embodiment, the switching member 34 can be moved in the direction orthogonal to the optical path (the front-back direction of the paper surface in FIG. 2). When irradiating the patient's eye Ep with the laser beam of the first wavelength, the switching member 34 is retracted from the optical path of the second irradiation optical system 20. On the other hand, when irradiating the patient eye Ep with the laser beam of the second wavelength, the switching member 34 is arranged on the optical path of the second irradiation optical system 20.

The switching member 34 of the present embodiment reflects the laser beam passing through the optical path of the first irradiation optical system 30 by using the mirror surface of the switching member 34, and reflects the laser light through the common optical path (in FIG. 2, from the switching member 34 to the patient's eye Ep). You can lead to the section). When the switching member 34 is retracted from the optical path of the second irradiation optical system 20, the laser beam that has passed through the dichroic mirror 33 is incident on the detection means 15. The detection means 15 of the present embodiment includes a light receiving element. The shutter 29 has an opening / closing mechanism. The beam expander unit 26 can expand the luminous flux diameter of the laser beam. The dichroic mirror 27 has a property of reflecting the laser light irradiating the patient's eye Ep, partially reflecting the guide light, partially transmitting the guide light, and further transmitting the observation light.

The flow of the laser beam emitted from the laser light source 21 will be described with reference to FIG. The laser light emitted from the laser light source 21 is distributed in two directions by the light distribution member 22. The laser beam reflected by the light distribution member 22 is wavelength-converted by the wavelength conversion element 32 after the luminous flux diameter is reduced by the beam expander 31. The laser beam (laser beam for the first treatment) whose wavelength is converted by the wavelength conversion element 32 is reflected on the mirror surface (surface) of the switching member 34 after passing through the dichroic mirror 33. The therapeutic laser beam reflected by the switching member 34 travels through the opening of the shutter 29, the beam expander portion 26, the dichroic mirror 27, the objective lens 28, and the contact lens 12 held by the operator in this order, and travels through the patient's eye Ep. It is focused farther than the treatment site of (see path U1 in FIG. 4). On the other hand, the laser light transmitted through the light distribution member 22 travels through the second irradiation optical system 20 and is reflected by the mirror surface (back surface) of the switching member 34. The laser beam reflected by the switching member 34 is received by the detecting means 15 (see path U2 in FIG. 4).

<1st guide optical system>
The first guide optical system 50 of the present embodiment includes a first guide light source 51, a dichroic mirror 33, a switching member 34, a beam expander unit 26, a dichroic mirror 27, and an objective lens 28. The first guide optical system 50 shares the optical member from the dichroic mirror 33 to the objective lens 28 with the first irradiation optical system 30. The first guide light source 51 emits a laser beam (for example, a wavelength of 635 nm). The first guide light emitted from the first guide light source 51 passes through the dichroic mirror 33, the switching member 34, the opening of the shutter 29, the beam expander portion 26, the dichroic mirror 27, the objective lens 28, and the contact lens 13 in this order. Willingly focused on the treatment area. The second guide light is focused on the focal position of the observation optical system 60.

<Second irradiation optical system>
The second irradiation optical system 20 of this embodiment will be described. The second irradiation optical system 20 includes a laser light source 21, a light distribution member 22, a mirror 23, a focus shift unit 24, a dichroic mirror 25, a shutter 29, a beam expander unit 26, a dichroic mirror 27, and an objective lens 28. The second irradiation optical system 20 shares the laser light source 21, the light distribution member 22, and the optical member from the beam expander unit 26 to the objective lens 28 with the first irradiation optical system 30. The second irradiation optical system 20 of the present embodiment is an optical for molding the other laser beam distributed by the light distribution member 22 so as to meet a second laser irradiation condition different from the first laser irradiation condition. It has a member.

The focus shift unit 24 can shift (displace) the focused position of the laser beam to a distance or a near position with respect to the observation position of the observation optical system 60. That is, the ophthalmic laser treatment device 1 of the present embodiment includes the focus shift means. The focus shift means can adjust the generation position of the plasma generated by using the laser beam to be far or near from the observation position. A drive unit 17 is connected to the focus shift unit 24. The focus shift unit 24 of the present embodiment can increase the luminous flux diameter of the laser beam. That is, in the second irradiation optical system 20 of the present embodiment, the luminous flux diameter of the laser beam can be expanded by each of the beam expander unit 26 and the focus shift unit 24. The dichroic mirror 25 has a property of reflecting the laser beam and transmitting the second guide light.

The flow of the laser beam emitted from the laser light source 21 will be described with reference to FIG. The laser light emitted from the laser light source 21 is distributed in two directions by the light distribution member 22. The laser light (laser light for the second treatment) transmitted through the light distribution member 22 is reflected by the mirror 23, and then the focus shift portion 24, the dichroic mirror 25, the opening of the shutter 29, the beam expander portion 26, and the dichroic mirror 27. It advances through the objective lens 28 in the order of. The laser beam transmitted through the objective lens 28 is focused on the treatment site of the patient's eye Ep via the contact lens 11 held by the operator (see path U3 in FIG. 5). On the other hand, the laser beam reflected by the light distribution member 22 travels through the first irradiation optical system 30, but since the switching member 34 is retracted, it travels straight and is received by the detection means 15 (FIG. 5). See Route U4).

The light beam diameter of the laser beam (second therapeutic laser beam) transmitted through the objective lens 28 via the second irradiation optical system 20 sharply decreases as it approaches the condensing position (treatment site) of the laser beam. As a result, the energy density of the laser beam increases as it approaches the focusing position, and plasma is generated at the focusing position. In the present embodiment, the cone angle (position of the treatment site) of the second irradiation optical system 20 is larger (5 times or more) than the cone angle of the first irradiation optical system 30.

<2nd guide optical system>
The second guide optical system 40 of the present embodiment includes a second guide light source 41, a dichroic mirror 25, a shutter 29, a beam expander unit 26, a dichroic mirror 27, and an objective lens 28. The second guide optical system 40 shares the optical member from the dichroic mirror 25 to the objective lens 28 with the second irradiation optical system 20. The second guide light source 41 emits a laser beam (for example, a wavelength of 635 nm). The second guide light emitted from the second guide light source 41 proceeds through the dichroic mirror 25, the opening of the shutter 29, the beam expander unit 26, the dichroic mirror 27, the objective lens 28, and the contact lens 11 in this order, and proceeds to the treatment site. Is focused on. The second guide light is focused on the focal position of the observation optical system 60.

<Observation optical system>
The observation optical system 60 of the present embodiment includes an objective lens 28, a dichroic mirror 27, a lens group 61, and an eyepiece lens 62. The observation optical system 60 shares the objective lens 28 and the dichroic mirror 27 with the first irradiation optical system 30 and the like. The light emitted from the observation site (for example, the reflected light of the illumination light emitted by the illumination unit 5) proceeds through the contact lens 12, the objective lens 28, the dichroic mirror 27, the lens group 61, and the eyepiece lens 62 in this order. Condenses (imaging) on the fundus of the eye Eo. The observation optical system 60 may include a protective filter for protecting the operator's eye Eo.

<Control unit>
The control unit 80 of this embodiment includes a CPU 81, a ROM 82, a RAM 83, a non-volatile memory 84, and the like. The CPU 81 controls each part of the ophthalmic laser treatment device 1. Various programs, initial values, and the like are stored in the ROM 82. The RAM 83 temporarily stores various types of information. The non-volatile memory 84 is a non-transient storage medium capable of retaining the storage contents even when the power supply is cut off. The control unit 80 of the present embodiment includes a laser light source 21, a first guide light source 51, a drive unit 16, a drive unit 17, a shutter 29, a second guide light source 41, an operation panel unit 8, a joystick unit 9, a detection means 15, and the like. Is connected.

<Laser irradiation conditions>
The ophthalmic laser treatment apparatus 1 of the first embodiment includes a first laser irradiation condition and a second laser irradiation condition as irradiation conditions of the laser beam (for treatment) on the patient's eye Ep. First, the irradiation of the laser beam under the first laser irradiation condition will be described with reference to FIG. Under the first laser irradiation condition, the switching member 34 is inserted into the common optical path of the first irradiation optical system 30 and the second irradiation optical system 20. The first irradiation optical system 30 forms one of the laser beams distributed by the light distribution member 22 so as to meet the first laser irradiation conditions. The detection means 15 sets the optical path of the laser beam emitted toward the patient's eye Ep as the optical path of the first irradiation optical system 30 by the switching member 34 (inserted into the common optical path), and the second irradiation optical system 20 The output of the laser beam passing through the optical path of is detected.

The switching member 34 of the present embodiment reflects the laser light passing through the optical path of the first irradiation optical system 30 by using the mirror surface of the light reflecting member to guide the laser light to the common optical path, and the laser passing through the optical path of the second irradiation optical system 20. The light is reflected toward the detection means 15 by using the mirror surface of the switching member 34. The switching member 34 of the first embodiment is a plane mirror, and the mirror surface of the plane mirror reflects the laser light passing through the optical path of the first irradiation optical system 30 and the laser light passing through the optical path of the second irradiation optical system 20, respectively. it can. As described above, under the first laser irradiation condition, the irradiation of the laser beam to the patient's eye Ep using the first irradiation optical system 30 (see the path U1 in FIG. 4) and the laser beam using the detection means 15 Energy detection (see path U2 in FIG. 4) is possible at the same time.

For example, correction data indicating the relationship between the energy of the laser beam at the position of the patient's eye Ep and the energy of the laser beam received by the detection means 15 is stored in advance in the storage means (for example, ROM 82). The control unit 80 may correct the energy of the laser beam emitted by the laser light source 21 under the first laser irradiation condition by using the correction data stored in the storage means and the detection result of the detection means 15. .. For example, the above-mentioned correction may be performed when the irradiation of the laser beam under the first laser irradiation condition is repeated. As a result, fluctuations in the output of the laser beam can be suitably suppressed.

Next, the irradiation of the laser beam under the second laser irradiation condition will be described with reference to FIG. Under the second laser irradiation condition, the switching member 34 is separated from the common optical path of the first irradiation optical system 30 and the second irradiation optical system 20. The second irradiation optical system 20 forms the other laser beam distributed by the light distribution member 22 so as to meet a second laser irradiation condition different from the first laser irradiation condition. The detection means 15 sets the optical path of the laser beam emitted toward the patient's eye Ep as the optical path of the second irradiation optical system 20 by the switching member 34 (escape from the common optical path), and the first irradiation optical system 30 The output of the laser beam passing through the optical path of is detected.

The switching member 34 of the present embodiment allows the laser beam passing through the optical path of the second irradiation optical system 20 to pass straight through to the common optical path, and also allows the laser beam passing through the optical path of the second irradiation optical system 20 to pass straight through. Aim at the detection means 15. That is, under the second laser irradiation condition, the laser beam passing through the optical path of the first irradiation optical system 30 and the laser beam passing through the optical path of the second irradiation optical system 20 are passed straight through. In the second laser irradiation condition, the irradiation of the laser beam to the patient's eye Ep using the second irradiation optical system 20 (see the path U3 in FIG. 5) and the detection of the energy of the laser beam using the detection means 15 (see the path U3 in FIG. 5). (See path U4 in FIG. 5) at the same time. Similar to the first laser irradiation condition described above, the laser light emitted by the laser light source 21 under the second laser irradiation condition is generated by using the correction data stored in the storage means and the detection result of the detection means 15. The energy may be corrected.

When the removable mirror is arranged at the position of the light distribution member 22, the optical axis may be displaced due to the insertion / removal of the mirror. However, in the present embodiment, since the light distribution member 22 is fixed, the optical axis is unlikely to shift. Further, in the present embodiment, the energy of the laser beam can be detected without adding a light distribution member (for example, a half mirror) dedicated to energy detection on the passing optical path of the laser beam. Therefore, there is no possibility that the laser beam is attenuated by the light distribution member dedicated to energy detection. That is, in the present embodiment, the optical axis shift is suppressed by the light distribution member 22, and the loss of the amount of laser light is small. Further, in the present embodiment, since the detection means 15 is shared by the first laser irradiation condition (see FIG. 4) and the second laser irradiation condition (see FIG. 5), the configuration of the ophthalmic laser treatment device 1 is simplified. easy.

<Summary of the first embodiment>
As described above, the ophthalmic laser treatment device 1 of the first embodiment can irradiate the patient's eye Ep with the laser beam. The ophthalmic laser treatment apparatus 1 of the first embodiment is distributed by a light distribution member 22 that transmits and reflects laser light emitted from a laser light emitting means having a laser light source 21 at an desired ratio, and a light distribution member 22. The first laser irradiation is performed on the first irradiation optical system 30 having an optical member for shaping one of the laser beams to meet the first laser irradiation conditions, and the other laser beam distributed by the light distribution member 22. The second irradiation optical system 20 is provided with an optical member for shaping so as to meet the second laser irradiation conditions different from the conditions. Further, the ophthalmic laser treatment apparatus 1 of the first embodiment further sets the optical path of the laser beam emitted toward the patient's eye Ep to either the optical path of the first irradiation optical system 30 or the optical path of the second irradiation optical system 20. The optical path of the second irradiation optical system 20 in a state where the switching member 34 for switching between the two and the optical path of the laser light emitted toward the patient's eye Ep are set as the optical path of the first irradiation optical system 30 by the switching member 34. The detection means 15 for detecting the output of the laser beam passing through the above is provided. Thereby, for example, it is possible to detect while suppressing the optical axis deviation generated by the light distribution member 22 and suppressing the energy attenuation of the laser beam.

Further, the switching member 34 of the first embodiment can be inserted and removed at a position where the optical path of the first irradiation optical system 30 and the optical path of the second irradiation optical system 20 are a common optical path, and the switching member 34 is , The laser light passing through the optical path of the first irradiation optical system 30 is reflected by the mirror surface of the switching member 34 to guide it to the common optical path, and the laser light passing through the optical path of the second irradiation optical system 20 is reflected on the mirror surface of the switching member 34. Can be used to reflect towards the detection means 15. Thereby, for example, switching of laser light and detection of irradiation energy can be performed with a simple configuration. Further, the switching member 34 of the first embodiment is a plane mirror, and the laser light passing through the optical path of the first irradiation optical system 30 and the laser light passing through the optical path of the second irradiation optical system 20 on the mirror surface of the plane mirror, respectively. Reflect. Thereby, for example, the switching member 34 can have a simpler configuration. Further, the laser beam emitting means of the first embodiment has a high energy density and can emit a laser beam having a short pulse of 1064 nm, which is the first wavelength. Further, the first irradiation optical system 30 of the first embodiment has a wavelength conversion element 32 for converting the laser light of the first wavelength into the laser light of 532 nm, which is the second wavelength. Thereby, for example, treatment of late cataract and treatment by selective laser trabecular meshwork can be performed with one device.

In the first embodiment, the detection means 15 is shared by the first laser irradiation condition and the second laser irradiation condition. However, the ophthalmic laser treatment apparatus 1 may include a plurality of detection means, and may be able to detect the energy of the laser beam by using different detection means under the first laser irradiation condition and the second laser irradiation condition. Further, in the first embodiment, the wavelength of the laser beam irradiated to the patient's eye Ep is different between the first irradiation optical system 30 and the second irradiation optical system 20. However, the aspect of the first embodiment is only an example, and the optical characteristics of the laser beam irradiating the patient's eye Ep may be different between the first irradiation optical system 30 and the second irradiation optical system 20.

<Second Embodiment>
Next, the ophthalmic laser treatment apparatus 1 of the second embodiment will be described with reference to FIGS. 6 to 9. A part of the optical system accommodated in the main body 4 is different between the first embodiment and the second embodiment. Hereinafter, the description of the parts having the same reference numerals in the first embodiment and the second embodiment will be omitted, and the parts different between the first embodiment and the second embodiment will be described. The ophthalmic laser treatment apparatus 1 of the second embodiment also irradiates the patient's eye Ep with the first therapeutic laser beam (wavelength 532 nm) in the same manner as the ophthalmic laser treatment apparatus 1 of the first embodiment described above. It has 1 laser irradiation condition and a 2nd laser irradiation condition for irradiating the patient's eye Ep with a second therapeutic laser beam (wavelength 1064 nm).

<1st irradiation optical system>
The first irradiation optical system 30 of the second embodiment includes a laser light source 21, a light beam diameter changing means 72, an optical path branching member 71, an optical distribution member 75, a wavelength conversion element 32, a dichroic mirror 33, a combiner member 73, and a shutter 29. It includes a beam expander unit 26, a dichroic mirror 27, an objective lens 28, and a detection means 76. The luminous flux diameter changing means 72 can change the luminous flux diameter of the laser beam emitted from the laser light source 21. The luminous flux diameter changing means 72 is connected to the control unit 80.

The optical path branching member 71 can branch the laser beam incident on the optical path branching member 71 into two optical paths. In this embodiment, a partial reflection mirror is used as the optical path branching member 71. FIG. 7 is a view of the optical path branching member 71 as viewed from the light flux diameter changing means 72 side. The optical path branching member 71 has a transmission region T through which the laser beam is transmitted and a reflection region R through which the laser beam is reflected. In the present embodiment, a part of the surface of the transparent flat glass is coated to form a reflection region R. The reflection region R of the present embodiment is arranged on the optical axis L1, and the transmission region T is arranged around the reflection region R. That is, in the optical path branching member 71 (partial reflection mirror) of the present embodiment, the central region is the reflection region R, and the peripheral region surrounding the central region is the transmission region T. In the present embodiment, the area of the transmission region T is more than twice the area of the reflection region R. As a result, plasma is more likely to be generated under the second irradiation condition. The optical path branching member 71 is obliquely provided on the optical axis L1.

The light distribution member 75 is obliquely provided on the optical axis of the first irradiation optical system 30. The light distribution member 75 can transmit and reflect the laser light incident on the light distribution member 75 at a desired ratio. The laser light transmitted through the light distribution member 75 advances to the wavelength conversion element 32, and the laser light reflected by the light distribution member 75 advances to the detection means 76. The light distribution member 75 of the present embodiment has a property of transmitting 95% of the laser light incident on the light distribution member 75 and reflecting it by 5%. The detection means 76 of the present embodiment uses the same member (light receiving element or the like) as the detection means 15 of the first embodiment.

The combiner member 73 of the present embodiment reflects the laser beam (first wavelength: 532 nm) that has traveled through the first irradiation optical system 30, and the laser beam (second) that has traveled through the second irradiation optical system 20. Wavelength: 1064 nm) has the property of transmitting. The location of the combiner member 73 may be the same as that of the switching member 34 of the first embodiment (insertion / removal of the reflection member). The combiner member 73 has a characteristic of reflecting the first guide light emitted by the first guide light source 51 at the desired ratio and transmitting the second guide light emitted by the second guide light source 41 at the desired ratio. You may. The combiner member 73 is obliquely provided on the optical axis L1. In this embodiment, a dichroic mirror is used as the combiner member 73.

Under the first laser irradiation condition of the present embodiment, the laser beam emitted from the laser light source 21 is incident on the optical path branching member 71 while the luminous flux diameter is reduced by the luminous flux diameter changing means 72. The laser beam incident on the optical path branching member 71 hits the reflection region R (see FIG. 7) and is reflected. The relationship between the luminous flux diameter changing means 72 and the optical path branching member 71 will be described in detail later. The laser beam reflected by the optical path branching member 71 is incident on the wavelength conversion element 32. The laser beam (laser beam for the first treatment) whose wavelength has been converted by the wavelength conversion element 32 is reflected by the combiner member 73 after passing through the dichroic mirror 33. The laser beam reflected by the combiner member 73 is focused on the treatment site via the shutter 29, the beam expander unit 26, the dichroic mirror 27, the objective lens 28, and the contact lens 13 in this order.

<Second irradiation optical system>
The second irradiation optical system 20 of the second embodiment includes a mirror 23, an optical distribution member 77, a focus shift unit 24, a dichroic mirror 25, and a detection means 78, and includes a laser light source 21, a light flux diameter changing means 72, and a combined wave. The members from the member 73 to the objective lens 28 are shared with the first irradiation optical system 30. The light distribution member 77 is obliquely provided on the optical axis of the second irradiation optical system 20. The light distribution member 77 transmits and reflects the laser light incident on the light distribution member 77 at a desired ratio. The laser light transmitted through the light distribution member 77 advances to the focus shift unit 24, and the laser light reflected by the light distribution member 77 advances to the detection means 78. The light distribution member 77 of the present embodiment has a property of transmitting 95% of laser light and reflecting 5% of the laser light. The detection means 78 of this embodiment uses the same member (light receiving element or the like) as the detection means 76.

Under the second laser irradiation condition of the present embodiment, the laser beam emitted from the laser light source 21 is incident on the optical path branching member 71 while the luminous flux diameter is expanded by the luminous flux diameter changing means 72. The laser beam incident on the optical path branching member 71 passes through the transmission region T (see FIG. 7). A shutter (not shown) may be arranged between the optical path branching member 71 and the wave combining member 73 to attenuate the component of the laser light reflected by the reflection region R. The laser light (laser light for the second treatment) transmitted through the optical path branching member 71 includes a mirror 23, a light distribution member 77, a focus shift unit 24, a dichroic mirror 25, a wave combine member 73, a shutter 29, a beam expander unit 26, and a dichroic The light is focused on the treatment site through the mirror 27, the objective lens 28, and the contact lens 11 in this order. Plasma is generated near the treatment site.

<Relationship between luminous flux diameter changing means and optical path branching member>
The relationship between the luminous flux diameter changing means 72 and the optical path branching member 71 will be described with reference to FIGS. 8 and 9. 8 and 9 are views of the optical path branching member 71 as viewed from the light flux diameter changing means 72 side. The region BMa hatched in FIG. 8 indicates a region where the laser beam is reflected by the optical path branching member 71 under the first irradiation condition. The laser beam is reflected inside the reflection region R. The region BMb hatched in FIG. 9 indicates a region through which the laser beam passes through the optical path branching member 71 under the second irradiation condition.

The control unit 80 of the present embodiment controls the light beam diameter changing means 72 to irradiate the patient's eye Ep with the first therapeutic laser beam (wavelength 532 nm) under the first laser irradiation condition, and the second laser. The light beam diameter of the laser beam incident on the optical path branching member 71 is different from that when the second therapeutic laser beam (wavelength 1064 nm) is irradiated to the patient's eye Ep under the irradiation conditions. Specifically, the luminous flux diameter of the laser beam incident on the optical path branching member 71 is larger under the second laser irradiation condition than under the first laser irradiation condition. More specifically, the control unit 80 enlarges the luminous flux diameter of the laser beam incident on the optical path branching member 71 by 5 times when switching from the first laser irradiation condition to the second laser irradiation condition.

Under the first irradiation condition, the control unit 80 of the present embodiment makes the luminous flux diameter of the laser beam incident on the optical path branching member 71 smaller than that of the reflection region R. As a result, the laser beam emitted by the laser light source 21 can be efficiently guided to the treatment site via the first irradiation optical system 30. On the other hand, under the first irradiation condition, the luminous flux diameter of the laser beam incident on the optical path branching member 71 is set to be larger than the reflection region R. As a result, the laser beam emitted by the laser light source 21 is guided to the treatment site via the second irradiation optical system 20, and plasma is easily generated at the treatment site. In other words, in the present embodiment, when irradiating the patient's eye Ep with the first therapeutic laser beam, the luminous flux incident on the optical path branching member 71 is thinned to suppress the energy loss of the laser beam while suppressing the reflection region. Reflect with R. On the other hand, when irradiating the patient's eye Ep with the second therapeutic laser beam, the luminous flux incident on the optical path branching member 71 is thickened to reduce the ratio of the energy loss of the laser beam due to the reflection region R.

In the second embodiment, the beam expander 31 possessed by the first embodiment can be eliminated. In addition, the beam expander unit 26 of the first embodiment is unnecessary, or the enlargement ratio of the beam expander unit 26 can be reduced. That is, it is easy to eliminate the need to change the luminous flux diameter in the optical system downstream of the optical path branching member 71. As described above, in the second embodiment, the configuration of the ophthalmic laser treatment device 1 can be easily simplified. The magnification of the luminous flux diameter changing means 72 may be fixed.

A spiral phase plate may be used as the luminous flux diameter changing means 72. The spiral phase plate may be inserted and removed from the optical path, or two spiral phase plates may be arranged in the optical path and rotated. 10 and 11 show the luminous flux shape of the laser beam incident on the optical path branching member 71. FIG. 10 shows a state in which the spiral phase plate is removed from the optical path, and FIG. 11 shows a state in which the spiral phase plate is inserted in the optical path.

By inserting and removing the spiral phase plate into the optical path, the shape of the laser beam can be changed to Gaussian light (see FIG. 10) and an annular light vortex beam (see FIG. 11). In the first irradiation condition, the spiral phase plate is removed from the optical path, and the laser beam is reflected in the reflection region R (FIG. 7). On the other hand, under the second irradiation condition, the spiral phase plate is inserted into the optical path to allow the laser beam to pass through the transmission region T (FIG. 7). That is, it passes around the reflection region R. In this way, the optical path of the laser beam can be switched while suppressing the energy loss of the laser beam. When two spiral phase plates are arranged in the optical path, one spiral phase plate may be fixed and the other spiral phase plate may be rotated about an axis perpendicular to the optical axis. By rotating the spiral phase plate, the shape of the laser beam can be changed to Gaussian light and an optical vortex beam. Further, the member forming the shape of the laser beam is not limited to the spiral phase plate, and a beam forming element capable of forming the shape of the laser beam into an annular shape can also be used.

<Summary of the second embodiment>
As described above, the ophthalmic laser treatment device 1 of the second embodiment can irradiate the patient's eye Ep with the laser beam. The ophthalmic laser treatment apparatus 1 of the second embodiment guides the laser light emitted from the laser light emitting means having the laser light source 21 to at least one optical path of the first irradiation optical system 30 and the second irradiation optical system 20. The optical path branching member 71 in which the reflection region R and the transmission region T are distinguished as the optical path branching is provided. The laser beam reflected from the reflection region R can be used as the first therapeutic laser beam, and the laser beam transmitted through the transmission region T can be used as the second therapeutic laser beam. This makes it easy to eliminate the need to switch the optical element at the branch point, for example. In addition, it is easy to suppress the energy loss of the laser beam at the branching point.

Further, the optical path branching member 71 of the second embodiment is a partial reflection mirror in which the central region is the reflection region R and the peripheral region surrounding the central region is the transmission region T. Thereby, for example, it is easy to simplify the optical system configuration downstream of the optical path branching member 71. Further, in the ophthalmic laser treatment apparatus 1 of the second embodiment, the luminous flux diameter changing means 72 for changing the luminous flux diameter of the laser beam emitted from the laser beam emitting means is placed between the laser light source 21 and the optical path branching member 71. It is arranged. Thereby, for example, the energy loss of the laser beam at the branching point can be suppressed. Further, for example, it is easier to simplify the optical system configuration downstream of the optical path branching member 71.

A variable expander lens or a spiral phase plate may be used as the luminous flux diameter changing means 72. As a result, for example, it is easier to suppress the energy loss of the laser beam at the branching point. Further, in the ophthalmic laser treatment apparatus 1 of the second embodiment, the area of the transmission region T through which the laser beam is transmitted is more than twice the area of the reflection region R. Thereby, for example, an apparatus capable of performing selective laser trabecular meshwork using the first treatment laser beam and treatment of late cataract using the second treatment laser beam can be provided with a simple configuration. The reflection region R formed on the optical path branching member 71 of the second embodiment is a solid circle, but of course, it may have another shape. If the switching member 34, the driving unit 16, and the detecting means 15 of the first embodiment are arranged instead of the wave combining member 73 in the second embodiment, the light distributing member 75, the detecting means 76, and the optical distribution are arranged. Needless to say, the member 77 and the detecting means 78 can be eliminated.

The embodiments disclosed this time should be considered as exemplary in all respects and not restrictive. The scope of the present invention is shown not by the above description but by the scope of claims, and it is intended that the scope of claims and all modifications within the meaning and scope equivalent thereto are included.

1: Ophthalmic laser treatment device 15: Detection means 20: Second irradiation optical system 21: Laser light source 22: Light distribution member 30: First irradiation optical system 34: Switching member Ep: Patient eye

Claims (6)

In an ophthalmic laser treatment device for irradiating a patient's eye with a laser beam,
An optical path branching member for guiding a laser beam emitted from a laser beam emitting means having a laser light source to at least one optical path of the first irradiation optical system and the second irradiation optical system, and is a reflection region and a transmission region as an optical path branch. The feature is that the laser light that reflects the reflection region is used as the first therapeutic laser light, and the laser light that has passed through the transmission region is used as the second therapeutic laser light. Laser treatment device for ophthalmology. The ophthalmic laser treatment apparatus according to claim 1, wherein the optical path branching member is a partial reflection mirror having a central region as the reflection region and a peripheral region surrounding the central region as the transmission region. Laser treatment equipment for. In the ophthalmic laser treatment apparatus according to claim 2, a light beam diameter changing means for changing the light beam diameter of the laser light emitted from the laser light emitting means is provided between the laser light emitting means and the optical path branching member. An ophthalmic laser treatment device characterized by being placed. The ophthalmic laser treatment apparatus according to claim 3, wherein the light flux diameter changing means is a variable expander lens or an annular beam forming element. The ophthalmic laser treatment apparatus according to claim 4, wherein the annular beam forming element is a spiral phase plate. The ophthalmic laser treatment apparatus according to any one of claims 1 to 5, wherein the area of the transmission region through which the laser beam is transmitted is twice or more the area of the reflection region. Treatment device.