JP5627898B2 - Ophthalmic laser treatment device - Google Patents

Description

  The present invention relates to an ophthalmic laser treatment apparatus that performs treatment by irradiating a patient's eye with laser light.

  A photocoagulation device is known as one of ophthalmic laser treatment devices. In photocoagulation treatment (for example, panretinal photocoagulation treatment), treatment laser light is irradiated to the fundus tissue of a patient's eye one by one to heat the tissue. When the treatment laser light is irradiated, visible aiming light (aiming light) for aiming the treatment laser light is emitted. In this photocoagulation treatment, each time a trigger signal is input by pressing the foot switch, a single mode that irradiates the treatment laser beam for the set irradiation time, and a preset irradiation time while the foot switch is pressed. And a repeat mode in which laser beam irradiation is repeated during the downtime (see, for example, Patent Document 1).

  In recent years, an apparatus has been proposed in which a scanning unit equipped with a galvanometer mirror or the like is incorporated in a laser light delivery unit, and a treatment laser light spot is scanned on the fundus tissue based on a scanning pattern of a plurality of preset spot positions. (For example, refer to Patent Documents 2 and 3). In this apparatus, the treatment laser light according to the scanning pattern is set by setting the irradiation time of the treatment laser light at one spot shorter and setting the energy higher than when irradiating the treatment laser light one spot at a time. Light irradiation is completed in a short time (for example, within 1 second).

JP 2002-224154 A JP 2006-524515 A Special table 2009-514564 gazette

  In the devices of Patent Documents 2 and 3, the aiming light is emitted only at the time of aiming before the irradiation of the therapeutic laser beam, and after the irradiation of the therapeutic laser beam is started, the therapeutic laser beam based on the scanning pattern Aimin light is not irradiated until irradiation to a plurality of spot positions is completed. When the number of spot positions in the scanning pattern is small, or when the irradiation time of the treatment laser beam at one spot is short and the irradiation interval to the next spot position is set to be short, all the spots in the scanning pattern Since the time until the irradiation of the position is completed is short, the operator can recognize each spot position by the afterimage of the aiming light before the irradiation of the treatment laser light. However, in order for the surgeon to perform treatment based on the conventional experience, the same irradiation time and energy as in the case of irradiating the treatment laser beam for each spot are set, and the rest time is set as in the repeat mode. If it is set long (for example, 500 milliseconds or longer), the afterimage of the first aiming light disappears and the operator can no longer recognize the spot position of the scanning pattern. In this case, even if the patient's eyes are moving with respect to the initial aim, the surgeon is not aware of this, and the treatment laser light is irradiated to the wrong position.

  The present invention provides an ophthalmic laser treatment apparatus in which an operator can confirm an irradiation position where a treatment laser beam is scanned even after treatment laser beam irradiation is started in view of the above-described problems of the prior art. Let it be a technical issue.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) A treatment laser light source that emits treatment laser light, an aiming light source that emits aiming light, and an irradiation optical system that irradiates the patient's eye with the treatment laser light and aiming light, the spot of the treatment laser light and aiming light And an irradiation optical system including a scanning optical system for two-dimensionally scanning the tissue of the patient's eye, and sequentially scanning the spot of the treatment laser light to a plurality of spot positions based on a predetermined scanning pattern In an ophthalmic laser treatment apparatus that irradiates a patient's eye with a treatment laser beam for a set irradiation time at each spot position,
This is the time from the end of irradiation of the treatment laser beam to the first spot position in the scanning pattern until the start of irradiation of the treatment laser beam to the second spot position during the series of irradiation of the treatment laser beam. Control means for controlling the driving of the scanning optical system based on the scanning pattern so that a spot position corresponding to the scanning pattern is recognized by an operator by the spot of aiming light during the pause time. And
(2) In the ophthalmic laser treatment apparatus according to (1), the control unit automatically sets the pause time based on the number of spots of the scanning pattern so that an operator can confirm each spot position by irradiation of aiming light. It is characterized by setting to.
(3) In the ophthalmic laser treatment apparatus according to (1) or (2), when the control means scans the aiming light during the pause time during irradiation of a series of treatment laser lights, The driving of the scanning optical system is controlled so that the spot of the aiming light is scanned at a spot position not irradiated with the treatment laser light within each spot position.

  According to the present invention, when laser irradiation is performed on a plurality of spot positions according to a scanning pattern, the operator can confirm the irradiation position where the treatment laser light is scanned even after the irradiation of the treatment laser light is started.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic configuration diagram showing an optical system and a control system of an ophthalmic laser treatment apparatus that performs photocoagulation treatment of the fundus.

  The ophthalmic laser treatment apparatus 100 roughly includes a laser light source unit 10, a laser irradiation optical system 40, an observation optical system 30, an illumination optical system 60, a control unit 70, and an operation unit 80. The laser light source unit 10 includes a treatment laser light source 11 that emits treatment laser light, an aiming light source 12 that emits visible aiming laser light (aiming light), and a beam splitter (combiner) that combines the treatment laser light and the aiming light. 13 and a condenser lens 14 are provided. The beam splitter 13 reflects most of the treatment laser light and transmits part of the aiming light. The combined laser light is collected by the condenser lens 14 and is incident on the incident end face of the optical fiber 20 that is guided to the laser irradiation optical system 40. In addition, a shutter 15 for blocking the treatment laser light is provided between the treatment laser light source 11 and the beam splitter 13. A second shutter 16 is provided in the optical path through which the aiming light and the treatment laser light are guided from the aiming light source 12. The shutter 16 is a safety shutter that is closed in the event of an abnormality, but may be used to irradiate and block the aiming light when the aiming light is scanned. The shutter 15 may also be used to irradiate and block treatment laser light. Each shutter may be replaced with a galvanometer mirror having a function of switching the optical path.

  In this embodiment, the laser irradiation optical system 40 is a delivery attached to a slit lamp. Laser light (treatment laser light and aiming light) emitted from the optical fiber 20 passes through a relay lens 41, a zoom lens 42 that can move in the optical axis direction to change the spot size of the laser light, a mirror 43, and a collimator lens 44. Then, the fundus of the patient's eye E is irradiated through the scanning unit 50, the objective lens 45, and the reflection mirror 49. The scanning unit 50 is configured by a scanning optical system having a scanner mirror that two-dimensionally moves the irradiation direction (irradiation position) of laser light. The scanning unit 50 includes a first galvanometer mirror (galvano scanner) 51 and a second galvanometer mirror 55. The galvanometer mirror 51 includes a first mirror 52 that reflects laser light and an actuator 52 that is a drive unit that drives (rotates) the mirror 52. Similarly, the galvanometer mirror 55 includes a second mirror 56 and an actuator 57. The laser light that has passed through each optical element of the laser irradiation optical system 40 is reflected by the reflection mirror 49 and irradiated to the fundus that is the target surface of the patient's eye E (on the tissue of the patient's eye) via the contact lens CL. . The zoom lens 42 is held by a lens cam (not shown), and each zoom lens 42 is moved in the optical axis direction by rotating the lens cam. The position of the zoom lens 42 is detected by an encoder 42a attached to the lens cam. The control unit 70 receives position information (detection signal) of each lens from the encoder 42a, and obtains the spot size of the laser light. Although details will be described later, the scanning unit 50 is controlled based on a command signal from the control unit 70 so that the laser beam (spot) is formed as a two-dimensional pattern on the target surface. Although not shown, the reflection mirror 49 includes a mechanism for two-dimensionally tilting the optical axis of the laser light by an operator's operation.

  The configuration of the scanning unit 50 will be described. FIG. 2 is a perspective view of the scanning unit 50. The mirror 52 is attached to the actuator 53 so that the reflecting surface can be swung in the x direction. On the other hand, the mirror 56 is attached to the actuator 57 so that the reflecting surface can be swung in the y direction. In this embodiment, the rotation axis of the mirror 52 coincides with the y axis, and the rotation axis of the mirror 56 coincides with the z axis. The actuators 53 and 57 are connected to the control unit 70 and driven individually. The actuators 53 and 57 include a motor and a potentiometer (both not shown), and the mirrors 52 and 56 are independently rotated (oscillated) based on a command signal from the control unit 70. At this time, the position information of how much the mirrors 52 and 56 have been rotated is sent to the control unit 70 by the potentiometers of the actuators 53 and 57, and the control unit 70 can grasp the rotation positions of the mirrors 52 and 56 with respect to the command signal. .

  The observation optical system 30 for observing a patient's eye includes an objective lens, a variable power optical system, a protective filter, an erecting prism group, a field stop, an eyepiece, and the like. The illumination optical system 60 that can illuminate the patient's eye with slit light includes an illumination light source, a condenser lens, a slit, a projection lens, and the like.

  A memory 71, light sources 11 and 12, an encoder 42 a, actuators 53 and 57, and an operation unit 80 are connected to the control unit 70 of the ophthalmic laser treatment apparatus 100. The operation unit 80 includes a foot switch 81 that is a trigger input unit that irradiates laser light, and a touch panel monitor 82 that is a setting unit that also serves as a display unit. Various types of panel switches are provided on the monitor 82, and parameters of irradiation conditions for laser light irradiation can be set. Items of irradiation conditions include a treatment laser light output setting unit 83, an irradiation time (pulse width) setting unit 84, a pause time (treatment laser light irradiation time interval) setting unit 85, and a scanning pattern (target surface) of the treatment laser light. A pattern of a two-dimensional array of spot positions of the treatment laser beam to be formed in the following (hereinafter referred to as a pattern) setting unit 86, a mode setting unit (mode selection means) 87 for setting the aiming mode, and other setting units are called. Menu buttons are provided for this purpose. The mode setting unit 87 can switch and set the first aiming mode and the second aiming mode. Further, a mode in which the treatment laser beam is irradiated for each spot by a signal from the foot switch 81 and a mode in which the spot of the treatment laser beam is scanned according to the set scanning pattern can be selected.

  A numerical value can be set by touching each item on the monitor 82. For example, a candidate that can be set in a pull-down menu is displayed when the surgeon touches an item, and the setting value in the item is determined by the operator selecting a numerical value from the candidate. The various parameters that have been set are stored in the memory 71. A plurality of patterns are prepared in advance, and the operator selects on the monitor 82. Examples of the pattern include a pattern in which spot positions of the treatment laser light are arranged in a square matrix such as 2 × 2, 3 × 3, 4 × 4, a pattern in which spots are arranged in correspondence with a figure such as an arc or a triangle. Can be mentioned. The monitor 82 displays various set parameters. In addition, the spot size set by the laser irradiation optical system 40 obtained by the control unit 70 based on the detection signal of the encoder 42 a is displayed on the monitor 82.

  When the foot switch 81 is stepped on by the operator, the control unit 70 irradiates the laser beam so as to form a pattern of the treatment laser beam on the target surface based on various parameter settings. The control unit 70 controls the light source 11 and controls the scanning unit 50 based on the set pattern to form a treatment laser light pattern on the target surface (fundus). Although details will be described later, when the first aiming mode is set by the mode setting unit 87, the control unit 70 receives the irradiation signal of the treatment laser light from the foot switch 81, and starts the irradiation of the treatment laser light from the scanning unit. The spot of the aiming light is formed corresponding to the pattern in order to make each spot position visible during the set pause time until the spot scanning by 50 is completed. The scanning unit 50 is controlled. On the other hand, when the second aiming mode is set, the control unit 70 stops the irradiation of the aiming light from the start of irradiation of the treatment laser light until the scanning of the spot by the scanning unit 50 ends.

  FIG. 3 is a diagram illustrating an example of a spot position pattern. As shown, the spots S are arranged in a 3 × 3 square matrix to form a pattern. Here, the spot S indicates both aiming light and treatment laser light. Based on such a pattern, the treatment laser beam and the aiming beam are scanned by the scanning unit 50, and a pattern is formed on the target surface. Irradiation of the spot S is started from the start position SP, and the spot S is scanned two-dimensionally toward the end position GP. In the present embodiment, as indicated by the arrows in the figure, the spots S are scanned in order to the adjacent spots S so as to move between the spots S as efficiently as possible. The interval between the spots S is preferably about 0.5 to 2 times the spot diameter in consideration of the influence of the heat of the tissue irradiated with the treatment laser beam. It is supposed to be one time. In other words, the space between the spots S is one spot in the vertical and horizontal directions. Note that a configuration for setting the spot interval may be added to the monitor 82.

  In the apparatus having the above-described configuration, the operation when the mode in which the spot of the treatment laser beam is scanned by the scanning unit 50 is set will be described. Prior to the description of the first aiming mode, first, the second aiming mode (a mode in which the irradiation of the aiming light is stopped from the start of irradiation of the treatment laser light until the scanning of the spot by the scanning unit 50 is completed) is set. The case where it is done will be described. In this second aiming mode, the treatment laser beam energy in one spot is increased and the irradiation time is shortened, thereby shortening the time of one pattern scan (one scan) (for example, within one second) Applied during treatment). For example, assume that the output of the treatment laser beam is set to 500 mW, the pulse width Td that is the irradiation time of one spot is set to 20 ms, and the pause time Ti that corresponds to the moving time of the spot is 5 ms. In this case, in the nine-spot pattern shown in FIG. 3, one scan is completed in 220 ms.

  The surgeon observes the fundus illuminated by the illumination light from the illumination optical system 60 with the observation optical system 30, observes the spot position where the aiming light is irradiated, and focuses on the treatment site. In the aiming stage before laser irradiation, the driving of the aiming light source 12 and the scanning unit 50 is controlled based on the pattern so that the pattern of the nine spot positions is observed as an afterimage of the aiming light. Specifically, the control unit 70 controls the aiming light source 12, emits aiming light with a pulse width Tad (for example, 20 ms) for a predetermined time at each spot position, and pause time Tai during movement of the spot (for example, 5 ms), the emission of aiming light is stopped. Further, the scanning unit 50 rotates the mirrors 52 and 56 so as to guide the aiming light to a position corresponding to the pattern in synchronization with the emission of the aiming light, and stops the rotation of the mirrors 52 and 56 during the pulse width Tad. Let In addition, the control unit 70 controls the scanning unit 50 during the pause time Tai to rotate the mirrors 52 and 56 so that the next position of the pattern can be irradiated with the aiming light. When the direction (position) of the mirrors 52 and 56 is the direction corresponding to the next irradiation position of the aiming light, the rotation of the mirrors 52 and 56 is stopped until the aiming light is emitted from the aiming light source 12. By performing one scan repeatedly within a short time of 0.5 seconds or less, the operator can observe the afterimage of the aiming light irradiated to each spot position and confirm each spot position of the pattern. In addition, in order to control the irradiation and stop of the aiming light, the configuration in which the aiming light source 12 is turned on and the shutter disposed in the optical path between the aiming light source 12 and the laser irradiation optical system 40 is driven. Is also included.

  When the surgeon steps on the foot switch 81, irradiation of the treatment laser beam is started. Based on the trigger signal from the foot switch 81, the control unit 70 stops emitting the aiming light from the aiming light source 12, emits the treatment laser light from the treatment laser light source 11, and controls the scanning unit 50 to control each spot. The treatment laser beam is sequentially irradiated to the position. Each spot position is irradiated with the treatment laser beam based on the set time of the pulse width Td, and the spot is moved during the pause time Ti. Here, in the second aiming mode, the aiming light is also stopped during the pause time Ti, but if the total time of the pulse width Td of the treatment laser beam and the pause time Ti is relatively short, aiming at the aiming stage is performed. Irradiation of the treatment laser light is completed while the light pattern is recognized by the operator as an afterimage. However, in order for the surgeon to make use of the conventional experience, when the irradiation time (pulse width Td) of the treatment laser beam is set to be long, or the pulse width Td of the treatment laser beam is a value similar to the repeat mode described above. When the pause time Ti is set, the total time for one scan becomes longer. In this case, it is difficult to confirm the afterimage of the aiming light, and the patient's eye may move relative to the initial aim. As this correspondence, the first aiming mode described below is used.

  The operation in the first aiming mode will be described. FIG. 4 shows a timing chart of irradiation of the input signal of the foot switch 81, the treatment laser light, and the aiming light in the first aiming mode. Here, the output of the treatment laser beam is set to 200 mW by the output setting unit 83, the pulse width Td as the irradiation time is set to 200 ms by the irradiation time setting unit 83, and the pause time Ti is set by the pause time setting unit 85. Is set to 500 ms. These parameters are similar to the repeat mode setting in conventional photocoagulation therapy.

  Since the operation at the aiming stage before the ON signal Fi from the foot switch 81 is input is the same as described above, the description thereof is omitted. When the surgeon steps on the foot switch 81, irradiation of the treatment laser beam is started. When the ON signal Fi from the foot switch 81 is input, the control unit 70 emits the treatment laser light from the treatment laser light source 11 and controls the scanning unit 50, and the pattern set as shown in FIG. Based on the above, the spot of the treatment laser beam is moved. The controller 70 stops the movement of the spot at each spot position, and irradiates the treatment laser beam with the pulse width Td. Further, when the time of the pulse width Td at one spot position has elapsed, the control unit 70 stops driving the treatment laser light source 11 so as to cut off the treatment laser light at the pause time Ti (the light guide optical path of the laser light). The scanning unit 50 is controlled so as to move the spot to the next spot position. In addition, when the treatment laser beam is irradiated at each spot position, the aiming beam may be irradiated at the same time. However, in order to make it easy to confirm the coagulation spots formed by the treatment laser beam, preferably the aiming beam is used. Is cut off.

  In order to allow the surgeon to recognize the spot of the aiming light at each spot position during the pause time Ti when the treatment laser light is interrupted, the controller 70 determines that the spot of the aiming light is at least based on the scanning pattern. Based on the number of spots in the scanning pattern and the pause time Ti so that one scan is performed, the irradiation time of one spot and the stop time at each spot position are obtained, and the aiming light source 12 and the scanning unit 50 are controlled. For example, when the pause time Ti is set to 500 ms, the spot positions are set to nine patterns as shown in FIG. 3, and the moving time to the next spot position requires about 5 ms, the control unit 70 The driving of the aiming light source 11 is controlled so that the pulse width (irradiation time) Tad of the aiming light at each spot position is about 50 ms and the pause time Tai of the aiming light is 5 ms (in the light guide optical path of the aiming light). This includes the case where the blocking of the aiming light is controlled by the arranged shutter). As another example, when the pulse width (irradiation time) Tad of aiming light is set in advance as 20 ms and the spot positions are set to nine patterns, about 2 scans are performed at a rest time Ti of 500 ms. As performed, the driving of the aiming light source 12 and the driving of the scanning unit 50 are controlled. Thereby, even during the rest time Ti of the treatment laser beam, the operator can check each spot position with the aiming beam. If it takes a long time for one scan of the treatment laser light, the patient's eye may move carelessly, and the spot position may be deviated from the aiming time. In this case, even if the surgeon stops the input of the on signal Fi by the foot switch 81 (turns off the on signal Fi), even before the scanning of the treatment laser beam to each spot position is completed. The driving of the treatment laser light source 11 is stopped or the shutter 15 is closed, and the irradiation of the treatment laser light is cut off. Thereby, irradiation of the treatment laser beam to an inappropriate position can be avoided.

  The aiming light scanning during the pause time Ti may be performed at all spot positions of the scanning pattern as described above, but preferably, only the non-irradiated positions of the treatment laser light within the scanning pattern spot positions. A spot of aiming light is scanned.

  FIG. 5 is a diagram for explaining a case where the spot of the aiming light is scanned only at the position where the treatment laser light is not irradiated. In FIG. 5, four spot positions SP1 to SP4 that are shaded are spot positions that have been irradiated with the treatment laser light, and five spot positions SP5 to SP9 that are not shaded are treatment laser light. It is an unirradiated spot position. During the rest time Ti after the irradiation of the treatment laser beam to the spot position SP4 is completed, only the remaining spot positions SP5 to SP9 are scanned with the spots of the aiming light and the scanning unit 50 and the aiming light source. Drive is controlled. By scanning with such aiming light, the surgeon can clearly confirm the unirradiated position of the treatment laser light. As a result, even when the patient's eyes move unexpectedly, the spot position where the treatment laser light is next irradiated can be easily grasped, and the operator can easily take an appropriate response.

  When irradiation of the treatment laser light to each spot position of the scanning pattern is completed, the aiming stage is again performed, and the driving of the scanning unit 50 is controlled so that the aiming light is repeatedly scanned to each spot position of the scanning pattern.

  Note that when the aiming light is moved to the next spot position during the rest time Ti of the treatment laser light, the aiming light does not necessarily have to be blocked at the rest time Tai as described above. Even when the aiming light is continuously irradiated, if the irradiation time (pulse width) Tad of the aiming light at each spot position is set longer than the movement time of the spot corresponding to the rest time Tai, the operation is performed. Since the spot of the aiming light at each spot position is observed brightly by the person, each spot position can be recognized.

  In the above embodiment, the rest time Ti of the treatment laser beam when the aiming beam scan is performed is set by the operator, but this is automatically performed by the control unit 70 based on the number of spots in the scan pattern. This configuration can also be set as follows. Hereinafter, this embodiment will be described.

  For example, it is assumed that the scanning pattern is set by the pattern setting unit 86 to a pattern in which one spot is arranged in a 5 × 5 square matrix. Further, the pulse width T, which is the irradiation time of the treatment laser beam, is set to 200 ms as in the case where the surgeon irradiates the treatment laser beam for each spot in order to form a coagulation spot based on the conventional experience. Suppose. In this case, the time required for one scan of 5 × 5 (25) spots is 5 seconds or more, and the afterimage of the aiming light disappears at the aiming stage by the end of one scan of the treatment laser light, and the operator Cannot recognize the spot position of the scanning pattern. Therefore, the control unit 70 obtains the time required for the scanning of the aiming light that allows the operator to confirm each spot position based on the number of spots of the scanning pattern, and the rest time Ti of the treatment laser light for scanning the aiming light. To decide. Assuming that the irradiation time of the aiming light at each spot position is Tad, the number of spots is N, and the time (pause time) for moving the spot of the aiming light to the next spot position is Tai, one scan of all spot positions of the aiming light The necessary treatment laser light pause time Ti is calculated by the following equation.

Ti = Tad × N + Tai × (N−1) (Formula 1)
For example, in order to make it easy for the surgeon to visually recognize the aiming light, if the irradiation time Tad of the aiming light is 10 ms and the moving time (pause time) Tai of the aiming light is 5 ms, the number of spots N is 25 × 5 × 5. In this case, the pause time Ti is 370 ms.

  When the ON signal Fi from the foot switch 81 is input, the control unit 70 emits the treatment laser light from the treatment laser light source 11 and controls the scanning unit 50, and based on the set pattern (5 × 5). The spot of the treatment laser light is moved. When moving the spot of the treatment laser beam to the next spot position, the control unit 70 pauses the irradiation of the treatment laser beam for the pause time Ti set as described above, and during this time the aiming light is based on the scanning pattern. The driving of the scanning unit 50 is controlled so as to scan, and the aiming light source is driven based on the irradiation time Tad of the aiming light and the pause time Tai of the aiming light. As a result, even if it takes a long time to complete one scan of the treatment laser beam, the surgeon can confirm each spot position by the irradiation of the aiming beam during the period. For this reason, even if the patient's eyes move unexpectedly, the surgeon can grasp the irradiation position of the treatment laser light by observing the aiming light, and can easily take appropriate measures such as blocking the irradiation of the treatment laser light. Become.

  The scanning of the aiming light during the pause time Ti does not have to be performed every time the spot of the treatment laser light is moved to the next position, and the operation is not performed until one scan of the treatment laser light is completed. It is only necessary to prevent the afterimage of the aiming light visually recognized by the person from disappearing. For example, if the irradiation time Td of the treatment laser light is set to 200 ms and the aiming light is recognized as an afterimage by the operator within the time of 500 ms, the aiming light is emitted every time two treatment laser light spots are moved. May be scanned. The pause time of the treatment laser beam while the aiming beam is not scanned is set only for the time required for the movement of the spot (for example, 5 ms). In this case, the treatment time until the end of one scan can be shortened as compared with the case where the aiming light is scanned every time the treatment laser light moves.

  Further, as in the case of the previous embodiment, the aiming light may be scanned only at the position where the treatment laser light is not irradiated. That is, when the total number of spots is 25 of 5 × 5, after the irradiation of the treatment laser beam to the 10 spot positions is finished, the treatment is performed so that the aiming light is scanned at the remaining 15 spot positions. The laser beam pause time Ti is set. In the case of 15 remaining spot positions, if the irradiation time Tad and the pause time Tai of the aiming light are set to the same conditions as described above, the pause time Ti of the treatment laser light necessary for scanning the aiming light is 220 ms. .

  Thus, in the configuration in which the necessary rest time Ti is set according to the number of spots in the scanning pattern or the number of remaining spots, one scan of the treatment laser beam is performed when the operator sets the rest time Ti. The time until completion can be further shortened.

  In the apparatus that scans the treatment laser light according to the scanning pattern, it is preferable to provide an eyeball tracking mechanism that automatically tracks the irradiation position of the treatment laser light in accordance with the movement of the patient's eye when the treatment time of one scan is prolonged. . As the eye tracking mechanism, an imaging unit for imaging a feature part such as a fundus of a patient's eye is provided in the observation optical system 30, a captured part is processed to detect the feature part, and treatment laser light irradiation starts or The configuration may be such that eye movement information with respect to the aiming time is detected and the driving of the scanning unit 50 is controlled based on the eye movement information. However, even in the configuration provided with the eye tracking mechanism, when the patient's eye moves beyond the range that can be tracked, when an eye movement information detection error occurs, or when an abnormality occurs in the eye tracking mechanism itself Etc. As a countermeasure for this, even in the configuration provided with the eyeball tracking mechanism, a configuration is provided in which the aiming light scan is performed in the middle of the irradiation of the one treatment laser beam as described above. It is preferable.

  The embodiment described above can be variously modified. For example, in the configuration of the scanning unit 50, a member configured to incline one mirror in the xy direction may be used. Alternatively, an element that forms a two-dimensional pattern such as a liquid crystal spatial phase modulator or a deformable mirror may be used. In this specification, even when such an element is used, the spot is scanned two-dimensionally on the target surface. Further, the scanning with a laser beam or the like may be realized by tilting the lens. Moreover, it is good also as an irradiation optical system which guides aiming light and treatment laser light separately to a patient's eye. If the aiming light is invisible, such as infrared light, a camera with sensitivity to infrared light is attached to the observation optical system, and the photographed image taken by the camera is displayed on the monitor, etc. It is good also as a structure which makes aiming light visible. Alternatively, the first aiming mode and the second aiming mode may be automatically selected based on the setting values of the treatment laser light irradiation time and the rest time. Further, the second aiming mode is not necessarily provided, and only the first aiming mode may be provided. Further, the setting of the treatment laser light irradiation time and the resting time may be selected from preset conditions.

It is a schematic block diagram of the optical system and control system of an ophthalmic laser treatment apparatus. It is a perspective view of a scanning part. It is a figure which shows an example of a pattern. It is a timing chart. It is a figure explaining the case where the spot of aiming light is scanned only to the unirradiated position of treatment laser light.

DESCRIPTION OF SYMBOLS 11 Treatment laser light source 12 Aiming light source 30 Observation optical system 40 Laser irradiation optical system 50 Scan part 60 Illumination optical system 70 Control part 80 Operation unit 81 Foot switch 82 Monitor

Claims (3)

A treatment laser light source that emits treatment laser light, an aiming light source that emits aiming light, and an irradiation optical system that irradiates the patient's eye with treatment laser light and aiming light. And an irradiation optical system including a scanning optical system that scans two-dimensionally on the tissue, and sequentially scans the spot of the treatment laser light at a plurality of spot positions based on a predetermined scanning pattern, and each spot In an ophthalmic laser treatment apparatus that irradiates a patient's eye with a treatment laser beam for a set irradiation time at a position,
This is the time from the end of irradiation of the treatment laser beam to the first spot position in the scanning pattern until the start of irradiation of the treatment laser beam to the second spot position during the series of irradiation of the treatment laser beam. Control means for controlling the driving of the scanning optical system based on the scanning pattern so that a spot position corresponding to the scanning pattern is recognized by an operator by the spot of aiming light during the pause time. Ophthalmic laser treatment device. 2. The ophthalmic laser treatment apparatus according to claim 1, wherein the control unit automatically sets the pause time based on the number of spots of the scanning pattern so that an operator can confirm each spot position by irradiation of aiming light. An ophthalmic laser treatment apparatus characterized by the above. 3. The ophthalmic laser treatment apparatus according to claim 1, wherein when the control unit scans the aiming light during the pause time during irradiation of a series of treatment laser lights, The ophthalmic laser treatment apparatus controls the drive of the scanning optical system so that the spot of the aiming light is scanned at the spot position not irradiated with the treatment laser light.

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