CN101632610B - Intelligent Ophthalmic Phacoemulsification Apparatus - Google Patents

Abstract

The invention relates to an intelligent ophthalmic ultrasonic emulsification apparatus, comprising a host machine of a surgical apparatus, an ultrasonic emulsification handle, an image collection system and a foot brake, wherein the host machine of the surgical apparatus comprises a signal generator, a surgical process and affected-part state identification system, a negative-pressure flow control system, an energy control system and a touch/display device; the ultrasonic emulsification handle is provided with a power supply at the end, and the interior is connected with an amplitude transformer, the front end of the amplitude transformer is connected with an ultrasonic emulsification pinhead and is provided with a transducer inside and a silica gel sleeve outside, an injection and absorption pipe passes from the inside of the handle; the ultrasonic emulsification handle is provided with three keys including an optical identification key, a loading identification key and an energy control key; the image collection system includes an electron microscope for an eye surgery, an image collection card and a microcomputer special for the image treatment; the surgical process and affected-part state identification system includes a special handle with an identification key, a hardware software module for the collection, analysis and treatment of the handle ultrasonic signals; the ultrasonic emulsification pinhead is titanium alloy and is formed by different inclined planes and is detachable, the emulsificated crystal fragments are sucked out from a hollow pipe.

Description

Intelligent Ophthalmic Phacoemulsification Apparatus

technical field

The invention is an ultrasonic surgical instrument for ophthalmic cataract treatment, and relates to an intelligent ophthalmic phacoemulsification equipment.

Background technique

The number of cataract cases in our country is increasing year by year. The disease not only causes psychological pain to the patients, but also becomes a serious burden to the society. So far, phacoemulsification combined with intraocular lens implantation is the most effective treatment for cataract.

Cataract phacoemulsification is a surgical method that uses mechanical acceleration generated by ultrasonic vibration, acoustic microfluidics, and cavitation to break up cataract hard core tissue, emulsify it, and remove it through negative pressure. This technique is an advanced technique in intraocular lens implantation. It has the advantages of small surgical incision, short healing time, fast recovery of postoperative visual function and small corneal astigmatism, and significantly reduces the incidence of complications.

With the gradual promotion of cataract phacoemulsification and the extensive development of intraocular lens implantation, phacoemulsification equipment has been popularized in major hospitals. However, the existing phacoemulsification apparatus has the following disadvantages: First, during the operation, the doctor needs to judge and monitor the hardness of the inner core and its emulsification process and state through a microscope, which increases the work intensity of the doctor and affects the effect and quality of the operation ; secondly, when the inner core is sucked out, the high negative pressure inside the eyeball will cause the sphere to sag, which may cause medical accidents such as posterior capsule tearing; thirdly, the doctor must control the output of ultrasonic energy by changing the angle of the foot switch to operate inconvenient.

Contents of the invention

The purpose of the present invention is to solve the deficiencies in the existing phacoemulsification technology and provide an intelligent ophthalmic cataract phacoemulsification instrument. Specifically, the image acquisition and recognition system is used to assist the cataract surgery process to reduce the doctor's work intensity; the affected part state recognition system is used to determine the hardness and emulsification of the inner core hard core; the negative pressure flow control system is used to avoid anterior chamber surge; The control system automatically controls the output of ultrasonic energy.

The present invention is achieved through the following technical solutions. An intelligent ophthalmic phacoemulsification instrument includes: a surgical instrument host, a phacoemulsification handle, an image acquisition system, and a foot switch. The surgical instrument host consists of a signal generator, an operation process, and an affected area It is composed of a state recognition system, a negative pressure flow control system, an energy control system and a touch/display device. The end of the phacoemulsification handle is equipped with a power supply, which is internally connected to a horn, and the front end of the horn is connected to a phacoemulsification needle with a built-in transducer device, the injection and suction pipeline passes through the handle, and the outer silicone sleeve is installed; the phacoemulsification handle is provided with three buttons, which are optical identification buttons, load identification buttons and energy control buttons; the image acquisition includes ophthalmic surgery. An electron microscope, an image acquisition card and a special image processing microcomputer; the operating process and the affected part state recognition system include a special handle with identification keys, a hardware and software module for the handle ultrasonic signal acquisition and analysis; the phacoemulsification The needle is titanium alloy, composed of different slopes, detachable, and the emulsified crystal fragments are sucked out from the hollow tube. The intelligent ophthalmic phacoemulsification apparatus adopts a negative pressure flow control system, which includes a balance liquid for perfusion, a perfusion solenoid valve, a perfusion pipeline, a peristaltic pump for suction, a suction pipeline, a pressure relief valve for pressure relief control, and a negative pressure sensor . The intelligent ophthalmic phacoemulsification instrument adopts an energy control system, which includes an ultrasonic signal generator, an emulsified ultrasonic output mode, and a foot switch to control the ultrasonic output power.

Compared with ordinary phacoemulsification devices, the intelligent ophthalmic phacoemulsification device of the present invention has its outstanding features, that is, "two identifications and two controls", which will be briefly explained below:

(1) Using the image acquisition and recognition system, the optical image information collected during the operation is sent to the recognition system, compared with the preoperative image, monitoring the operation process, and assisting the doctor to perform the emulsification operation. Before the operation, an expert database of cataract images was established, and according to the hardness grading standard of the cataract nucleus, a hardness grade was determined for each lens nucleus of each cataract case in the expert database, and a pattern recognition algorithm was used to extract image features for cataract images of the same hardness level. The larger the case base of this expert database, the higher the accuracy of cataract hardness feature extraction through surgical images.

During the operation, the eyeball surgery images are collected in real time, and the current cataract image is processed according to the pattern matching algorithm to judge the hardness level of the cataract core during the operation. Considering that emulsification ultrasound is only effective for a small area near the emulsification needle, the image recognition system mainly distinguishes Emulsify the hardness of the cataract core at the contact part of the needle, and at the same time, the needle has obvious features in the image of the eyeball. The recognition system only performs pattern recognition on the image of a small area around the needle according to the position of the needle, which can greatly reduce the calculation amount of image processing of the recognition system and improve Identify the real-time nature of the system.

In addition, it can be considered to establish different types of expert databases based on factors such as patient age, etiology, gender, etc., to effectively improve the accuracy of cataract core hardness identification.

(2) Using the affected part state recognition system, using optical and ultrasonic signals, to judge the hardness and emulsification state of cataract hard nucleus tissue, and feed back the information to the computer, so as to control the emulsified ultrasonic energy applied in real time.

The main mechanism of the state recognition system of the affected part of the ultrasonic handle is that different tissues have obvious differences in impedance to ultrasonic signals, and the emulsification effect is obvious for normal cataract tissues, but for non-cataract tissues, the emulsification effect is weak, reflecting the selectivity of phacoemulsification; in addition, Under the same power of ultrasound, cataract tissue with different hardness has a large difference in impedance. According to the specific level of impedance value, the hardness level of the current cataract core tissue can be judged, and the appropriate ultrasound power can be used to achieve emulsification.

The two recognition systems are combined to determine the hardness level of the cataract core, and the result is more reliable.

(3) A negative pressure flow control system is adopted. When the fragments generated after the hard nucleus tissue of the cataract in the eyeball is emulsified during the operation block the suction pipeline, after the negative pressure rises and sucks the tissue fragments, the negative pressure control system passes through a pressure relief port. The negative pressure instantly returns to zero to prevent the collapse of the anterior chamber caused by suction due to extremely low flow and high negative pressure.

In cataract surgery, besides the effect of ultrasound, the two most important indicators are suction negative pressure and perfusion flow. Suction negative pressure is used to suck the emulsified cataract tissue fragments out of the pipeline, and perfusion flow is used to maintain intraocular pressure balance. During the operation, maintaining the balance of perfusion volume and suction volume is the core purpose of the negative pressure flow control system of the intelligent ophthalmic emulsifier.

(4) The energy control system is adopted to automatically adjust the output size and mode of the emulsified ultrasonic energy according to the level, position and state of the cataract hard nucleus determined by the optical recognition and the affected part state system, so as to effectively perform real-time surgery and protect other tissues in the eye from damaged.

Traditional cataract emulsification surgery uses continuous ultrasound to emulsify the cataract core. The operation time is long, and the accumulation of ultrasonic energy in the eye will cause certain burns to the surrounding tissues. Improvement is made by using pulsed ultrasound for emulsification, and the ultrasonic transducer is fully cooled during the intermittent period of the pulse, which improves the long-term working performance of the ultrasonic transducer, obtains high-quality power ultrasonic signals, and obtains better phacoemulsification effect. In the actual test, the signal quality of the emulsified ultrasonic output signal is maintained at a very high level during the pulse release period. At the same time, the intermittent release of pulsed ultrasonic signals helps to reduce the damage to normal tissues during intraocular surgery,

Combined with clinical use cases, according to the hardness level of the cataract core, the intelligent ophthalmic emulsification device adopts a relatively low power and ultrasonic energy for emulsification under normal circumstances, so as to minimize intraocular damage and ensure the surgical effect at the same time. If the power is insufficient and the emulsification cannot be completed, the doctor compensates the ultrasonic energy by controlling the depth of the foot switch to complete the emulsification operation, which greatly relieves the doctor's work intensity and ensures the safety and efficiency of the operation.

Description of drawings

Fig. 1 is the working principle schematic diagram of complete machine of the present invention

Fig. 2 is a structural schematic diagram of the negative pressure flow control system of the present invention

Fig. 3 is a schematic diagram of the structure of the phacoemulsification handle of the present invention

Figure 4 is a flow chart of continuous ultrasonic enhanced blasting mode

Detailed ways

The present invention will be described in detail below in conjunction with the examples shown in the accompanying drawings.

As shown in Figure 1, it is a schematic diagram of the working principle of the whole machine of the present invention. The system consists of a surgical host 1, a phacoemulsification handle 2, an image acquisition system 3, an optical recognition system 4 and a foot switch 5. The surgical host includes a signal generator 9 , a computer 1 , a negative pressure flow control system 7 , an affected part state identification system 8 and an energy control system 10 . During the operation, the light source shines on the eyeball tissue, the image information in the surgical field of view is collected by the image acquisition system 3, and sent to the optical recognition system 4, compared with the pre-operative image, the operation process is monitored and judged together with the ultrasonic signal The hardness and emulsification of cataract hard core tissue (affected part state recognition system 8), and the information is fed back to the computer 1, so as to control the signal generator 9 and the energy control system 10 to output the emulsified ultrasound with appropriate energy, and display it on the touch/display 11 The output data will be displayed above. If the output ultrasonic energy power is too low to emulsify the inner core of the current needle contact part, then change the angle compensation ultrasonic power of the foot switch 5 to realize complete emulsification.

As shown in FIG. 2 , it is a schematic structural diagram of the negative pressure flow control system of the present invention. In this scheme, the balanced brine device 12 is connected to the solenoid valve 13, and the solenoid valve 13 controls the flow of the balanced brine entering the eyeball 6, and at the same time, the eyeball 6 sends excess balanced brine to the waste liquid box through a pump system 14 for discharge. To maintain normal intraocular pressure during surgery.

During this process, the central processing system monitors the negative pressure flow system in real time. Under normal circumstances, the perfused balanced saline will be discharged through the pipeline, and the emulsified tissue fragments will also be discharged along with the brine. The entire pipeline system is unblocked, and the perfusion The flow is maintained at a stable level, and the negative pressure is maintained at a low level. During the operation, the perfusion volume and suction volume in the anterior chamber are balanced, and the anterior chamber is stable; A relatively large blockage is formed in the suction pipe system. If the debris volume is large, the pipe blockage will be very strong. The system will strengthen the suction and maintain a large negative pressure in the suction pipe to pump out the tissue fragments that block the pipe. , when the fragments are pulled out of the pipeline, the suction pipeline will be unobstructed, and the negative pressure in the pipeline will drop rapidly. At this time, the central processing system will open the pressure relief valve connected with the suction pipeline, and the suction pipeline will The atmosphere is connected, and the negative pressure of the suction pipe is instantly zeroed to prevent the eyeballs from being sucked dry. After the negative pressure returns to zero, the pressure relief valve will be closed immediately, and the system will resume normal operation, thereby ensuring the safety of the operation, especially for doctors who are not very skilled, this technology is of great significance.

As shown in FIG. 3 , it is a structural schematic diagram of the ultrasonic handle of the present invention. During the operation, after the power wire 20 is connected to the power supply, the power ultrasonic signal source in the ultrasonic handle 17 generates an ultrasonic signal to drive the transducer, and converts the electrical energy into high-speed mechanical energy with a small amplitude. After the rod is amplified and coupled, the ultrasonic energy is output through the treatment needle connected to the needle interface 16, so as to emulsify the hard nucleus tissue of the cataract in the eyeball. During the emulsification process, first inject the liquid into the eye through the infusion interface 18 to prevent eyeball deformation caused by changes in the pressure of the intraocular tissue during the suction process; secondly, suck out the broken and emulsified tissue through the suction interface 19 . During the operation, the optical recognition button 21 can be used to control the system to perform optical recognition on the cataract hard nucleus tissue, and the contact between the phacoemulsification needle and the hard nucleus tissue can be detected through the opening and closing of the load identification button 22. At the same time, the energy control button 23 can be used to Control the output size of ultrasonic energy.

As shown in Fig. 4, it is a flow chart of the continuous ultrasonic enhanced blasting mode of the present invention. Under the condition of continuous ultrasonic enhanced blasting mode, the hardness level data is received through the serial port interruption, the minimum output ultrasonic power (ie continuous ultrasonic power) is determined, and the negative pressure in the eyeball reaches the maximum value allowed by the system (can be set freely) ). If the negative pressure has reached the maximum negative pressure, it means that the hard core tissue has not been emulsified, and the system is in a blocked state. At this time, it will automatically enter the power blasting mode. If the blasting cannot be completed, the ultrasonic blasting power can be compensated by changing the angle of the foot brake to complete the blasting function, and then realize the complete emulsification of the core, especially the hard core.

In blasting mode phacoemulsification, it can emulsify 4-5 grades of hard core, and the blasting emulsification frequency is 1-50 times per second. The release time and parameters can be set according to the doctor's requirements, reducing damage to other tissues and postoperative healing time. short.

Claims (3)

1. intelligent ophthalmic ultrasonic emulsification apparatus, comprise: surgery apparatus main frame, ultrasonic emulsification handle, image capturing system and backpedalling brake, described surgery apparatus main frame is by signal generator, operation process and affected part state recognition system, vacuum flow amount control system, energy management system and touch/display device is formed, the charged source of described ultrasonic emulsification handle end, its inner horn that connects, the horn front end connects the ultrasonic emulsification syringe needle, internal placed transducer, annotate the suction pipe road and in handle, pass through, adorn the silica gel sleeve pipe outward; Described ultrasonic emulsification handle is provided with three buttons, is respectively optical identification button, load identification button and energy control button; Described image acquisition comprises ophthalmologic operation ultramicroscope, image pick-up card and special image processing microcomputer; Described operation process and affected part state recognition system comprise and have the dedicated handle of discerning button, is used for that the handle ultrasonic signal is gathered and the hardware-software module of analyzing and processing; Described ultrasonic emulsification syringe needle is a titanium alloy, is made up of different inclined-planes, and detachable, emulsive crystal fragment is sucked out from hollow pipeline.

2. intelligent ophthalmic ultrasonic emulsification apparatus as claimed in claim 1, it is characterized in that adopting the vacuum flow amount control system, this system comprise perfusion with balance liquid, solenoid prime valves, perfusion pipeline, suction with peristaltic pump, suction channel, be used for relief valve, B/P EGR Back Pressure Transducer EGR that pressure release is controlled.

3. intelligent ophthalmic ultrasonic emulsification apparatus as claimed in claim 1 is characterized in that adopting energy management system, and this system comprises the backpedalling brake of supersonic signal generator, the ultrasonic output mode of emulsifying, the ultrasonic output of control.

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