JP6813053B2 - Laser treatment device - Google Patents

Description

The present disclosure relates to a laser treatment apparatus that irradiates an affected portion of a patient's eye with a treatment laser beam.

There is known a laser treatment device that allows an operator to observe the patient's eye and irradiates the affected part of the patient's eye with a treatment laser beam. For example, in the laser treatment apparatus disclosed in Patent Document 1, the color information range related to the selected laser wavelength is displayed in the observation field of view of the eyepiece for observing the observation image.

Japanese Unexamined Patent Publication No. 11-276500

When the observation image of the patient's eye and the display (color information in Patent Document 1) different from the observation image are presented in the field of view of the operator, the presentation information may make it difficult to see the observation image. In addition, the observation image may make it difficult to see the presented information.

It is a technical subject of the present disclosure to provide a laser treatment apparatus that allows an operator to preferably visually recognize both an observation image of a patient's eye and a display relating to irradiation conditions.

In order to solve the above problems, the present invention is characterized by having the following configurations.
A laser treatment device that irradiates an affected portion of a patient's eye with a therapeutic laser beam, that is, an illumination means for projecting slit light at an observation site of the patient's eye, a presentation means for presenting an observation image of the observation site, and the observation. The display means for displaying the display in a mode different from the image on the observation image presented by the presentation means, and the display position of the display in a mode different from the observation image displayed on the observation image are described. It is characterized by comprising a display position determining means for arranging the outside of the slit illumination area by the slit light .

According to the present disclosure, it is possible to provide a laser treatment apparatus that allows an operator to preferably visually recognize an observation image of a patient's eye and a display relating to irradiation conditions.

It is a schematic block diagram of the control system and the optical system of the laser treatment apparatus of this embodiment. It is a figure explaining the deformation of the opening of the Teruno diaphragm. It is a figure explaining the deformation of the opening of the Teruno diaphragm. It is a figure explaining the deformation of the opening of the Teruno diaphragm. Observation images and parameters to be presented to the operator. It is explanatory drawing about the display position of a parameter. It is explanatory drawing about the display position of a parameter. It is a figure explaining the transformation example of the display position of a parameter. It is a figure for comparison.

Hereinafter, typical embodiments in the present disclosure will be described with reference to the drawings. As an example of an ophthalmic device that observes a patient's eye for surgery, examination, or diagnosis, in this embodiment, late cataract, iris incision, laser vitreous resection, late cataract, selective laser trabecular meshwork ( A laser treatment apparatus for performing surgery such as Selective Laser Trabeculoplasmy (SLT) using a giant pulse will be described.

FIG. 1 is a schematic configuration diagram of a control system and an optical system of the laser treatment apparatus 1 of the present embodiment. As an example, the laser treatment apparatus 1 of the present embodiment includes a laser irradiation optical system 10, an aiming optical system 20, an illumination optical system 30, an observation optical system 40, a display optical system 50, and a control unit 60.

<Laser irradiation optical system>
The laser irradiation optical system 10 of the present embodiment is an irradiation means for irradiating the therapeutic laser light, and is used for irradiating the site to be treated with the therapeutic laser light. The laser irradiation optical system 10 of the present embodiment includes a laser light source 11, an energy adjusting unit 13, a shift adjusting unit 15, a dichroic mirror 22, an expander lens group 23, a dichroic mirror 24, and an objective lens 25. Further, the laser irradiation optical system 10 has an optical axis L1. The laser light source 11 emits a therapeutic laser beam for treating the tissue of the patient's eye Ep. In this embodiment, a neodymium-doped YAG (yttrium aluminum garnet) crystal (Nd: YAG) is used as the laser rod of the laser light source 11. A wavelength conversion element (not shown) can convert infrared laser light (wavelength: 1064 nm) emitted from the laser light source 11 into visible laser light (wavelength: 532 nm). As the therapeutic laser beam, another type of solid-state laser, gas laser, semiconductor laser, or the like may be used.

The energy adjusting unit 13 of the present embodiment is an energy adjusting means for adjusting the emission energy of the therapeutic laser light, and is used for adjusting the energy of the therapeutic laser light emitted from the laser treatment device 1. The energy adjusting unit 13 of the present embodiment attenuates the therapeutic laser light emitted from the laser light source 11. The energy adjusting unit 13 of the present embodiment includes a 1/2 wave plate and a polarizing plate. The 1/2 wavelength plate and the polarizing plate are arranged on the optical axis L1, and the motor 14 is connected to the 1/2 wavelength plate. The control unit 60 can rotate the 1/2 wavelength plate to adjust the energy of the therapeutic laser beam. The shift adjusting unit 15 can shift the focusing position of the treatment laser light to a distant position or a near position with respect to the focusing position of the aiming light (hereinafter, referred to as a focus shift). A motor 16 is connected to the shift adjusting unit 15, and the control unit 60 can adjust the focus shift position. The focusing position of the aiming light and the focusing position of the treatment laser light may be the same position.

<Aiming optics>
The aiming optical system 20 of the present embodiment is an aiming means for irradiating a site to be treated with aiming light, and is used to aim at the site to be treated. The aiming optical system 20 of the present embodiment has an optical axis L2. The aiming optical system 20 of the present embodiment shares the optical path from the dichroic mirror 22 to the objective lens 25 with the laser irradiation optical system 10. An aiming light source 12, a collimator lens 21, and an aperture 27 are arranged in the optical path of the laser irradiation optical system 10 branched from the dichroic mirror 22. The aiming light emitted from the aiming light source 12 is separated into two light fluxes by the aperture 27 and then focused by the tip of the objective lens 25.

<Illumination optics>
The illumination optical system 30 of the present embodiment is an illumination means for projecting illumination light onto an observation site, and is used to illuminate an observation site including a tissue to be treated. The illumination optical system 30 of the present embodiment includes a lamp 31, a condenser lens 32, a Teruno diaphragm 33, a projection lens 34, and a prism 35. The illumination optical system 30 has an optical axis L3. For example, a white light emitting element or the like may be used for the lamp 31. The optical axis L3 penetrates through the opening region of the Teruno diaphragm 33. The Teruno diaphragm 33 is provided at a position where it is optically conjugated with the observation portion via the projection lens 34. That is, in the present embodiment, the illumination range of the illumination light at the observation site can be suppressed by the Teruno diaphragm 33. In other words, the illumination optical system 30 of the present embodiment forms an image of the opening of the Teruno diaphragm 33 and an image of the light-shielding portion at the observation portion. The control unit 60 has a function as a dimming means of the illumination light projected onto the observation portion, and in the present embodiment, the amount of emitted light of the lamp 31 can be adjusted.

The illumination optical system 30 of the present embodiment includes an adjustment means for adjusting the illumination region of the illumination light projected on the observation site. In the present embodiment, the opening shape of the Teruno diaphragm 33 is deformed as an adjusting means. In the present embodiment, the drive means 36 is connected to the Teruno diaphragm 33, and the control unit 60 can deform the opening shape of the Teruno diaphragm 33. In the present embodiment, the three deformation mechanisms are combined as the adjusting means. 2 (a) to 2 (c) show how the opening diameter of the Teruno diaphragm 33 is deformed by the first deformation mechanism. 3 (a) to 3 (c) show a state in which the shape of the opening of the Teruno diaphragm 33 is deformed from a circular shape to a slit shape by the second deformation mechanism. FIGS. 4 (a) to 4 (c) show how the slit angle (direction in which the long axis of the slit shape faces) is changed by the third deformation mechanism. The laser treatment device 1 of the present embodiment can deform the opening shape of the Teruno diaphragm 33 by combining the three deformation mechanisms described above. Thereby, for example, when projecting slit-shaped light (hereinafter referred to as slit light), the slit width, slit length, and slit angle can be deformed. Each of the first deformation mechanism to the third deformation mechanism can deform the opening shape of the Teruno diaphragm 33 in multiple stages. For the mechanism of the Teruno diaphragm 33, refer to, for example, Japanese Patent Application Laid-Open No. 6-142047. The method of deforming the opening shape of the Teruno diaphragm 33 is not limited to the method in which the control unit 60 controls the drive means 36. For example, the opening shape of the Teruno diaphragm 33 may be changed by the operator manually operating a knob, a dial, or the like connected to the Teruno diaphragm 33. In this case, the control unit 60 may input the output signal of the detector provided in the Teruno diaphragm 33 to detect the aperture shape of the Teruno diaphragm 33.

The shape of the Teruno diaphragm 33 of the present embodiment is symmetrical with respect to the optical axis L3, but may be asymmetrical. Further, the opening of the Teruno diaphragm 33 does not have to be located on the optical axis L3. The method of deforming the opening shape of the Teruno diaphragm 33 is not limited to this. For example, the illumination optical system 30 may change only the slit angle. Further, as the illumination light, light that is separated at the observation site may be projected.

By the adjustment means described above, the illumination optical system 30 of the present embodiment can change the shape of the illumination light projected on the observation site into a circular shape, a substantially square shape, and a substantially rectangular shape (slit light). Thereby, the observation site can be suitably observed. For example, by projecting slit light onto the observation site, unnecessary reflections (flares, ghosts) generated in the cornea of the patient's eye Ep can be suppressed, and the observation site (for example, the crystalline lens) can be suitably observed. The control unit 60 of the present embodiment can detect the aperture shape (in other words, the illumination shape) of the Teruno diaphragm 33 by using the control signal to the drive means 36. The aperture shape of the Teruno diaphragm 33 may be deformed by a manual operation by the user. The Teruno diaphragm 33 may include a detector and output a signal regarding the aperture shape of the Teruno diaphragm 33 to the control unit 60.

<Observation optical system>
The observation optical system 40 of the present embodiment is an observation means for observing the observation site, and is used by the operator to observe the observation site of the patient's eye E. The observation optical system 40 of this embodiment is incorporated in the microscope 41. The observation optical system 40 of the present embodiment includes a variable magnification optical system 42, a beam splitter 51, an imaging lens 44, an erect prism group 45, a field diaphragm 46, and an eyepiece lens 47. Further, the observation optical system 40 has an optical axis L4. The dichroic mirror 24 and the objective lens 25 are shared by the laser irradiation optical system 10 and the observation optical system 40. The variable magnification optical system 42 is used to change the observation magnification. For example, as the variable magnification optical system 42, a rotating drum or the like in which a plurality of lenses having different refractive powers are combined may be used. The observation optical system 40 does not have to include the variable magnification optical system 42.

The beam splitter 51 is installed on the optical axis L4. The beam splitter 51 of the present embodiment is an optical path synthesizing means, and synthesizes the optical path of the display optical system 50 and the optical path of the observation optical system 40. Details of the display optical system 50 will be described later. The field diaphragm 46 is provided at a position conjugate with the observation site via the lens of the observation optical system 40. The field diaphragm 46 masks an unnecessary region of the observation image. The field diaphragm 46 of the present embodiment masks the peripheral portion of the observation image. The eyepiece 47 of the present embodiment is a presentation means for presenting an observation image of an observation site to the operator, and is used by the operator to look through the operator's eye Eo. The observation optical system 40 of the present embodiment has diopter adjusting means. The diopter adjusting means moves the eyepiece 47 along the optical axis L4. By the diopter adjusting means, the visual field diaphragm 46 and the fundus of the operator's eye Eo can be in an optically conjugate positional relationship.

<Display optical system>
The display optical system 50 of the present embodiment is used to display the irradiation conditions (information) of the treatment laser light to the operator as a display means for displaying information regarding the operation of the laser treatment device 1. The display optical system 50 of the present embodiment shares the members from the beam splitter 51 to the eyepiece 47 with the observation optical system 40. The optical path of the display optical system 50 branched from the observation optical system 40 includes a display unit 53 and a collimator lens 52. The display optical system 50 has an optical axis L5. The beam splitter 51 merges the display optical system 50 with the observation optical system 40. The beam splitter 51 makes the optical axis L5 and the optical axis L4 coaxial. The display unit 53 has a display surface 53a. The display surface 53a is arranged at a position conjugate with the field diaphragm 46 via a lens (collimator lens 52, imaging lens 44).

The control unit 60 of the present embodiment displays the parameters related to the irradiation conditions of the therapeutic laser beam on the display surface 53a. Specifically, the display regarding the type of laser light irradiating the patient eye Ep is set as the parameter Sa, the display regarding the energy of the laser light irradiating the patient eye Ep is set as the parameter Sb, the display regarding the number of bursts is set as the parameter Sc, and the focus shift. The display related to the position is displayed on the display surface 53a as the parameter Sd (see FIG. 7). The information displayed on the display surface 53a is presented in the field of view of the operator's eye Eo looking through the eyepiece 47 (see FIG. 5). The display contents of each parameter are sequentially updated when the operator makes changes on the operation panel or the like. Further, the parameter S is displayed in a predetermined direction on the display surface 53a so that the parameter S'can be visually recognized as an upright image when the operator looks into the eyepiece lens 47.

Details of each parameter displayed on the display surface 53a will be described. The laser treatment device 1 of the present embodiment can irradiate the patient's eye Ep with the treatment laser light of 1064 nm and the treatment laser light of 532 nm. At the location of the parameter Sa, a display corresponding to the wavelength of the therapeutic laser beam irradiating the patient's eye Ep is displayed. As an example, when irradiating a therapeutic laser beam having a wavelength of 1064 nm, “YAG” is displayed at the position of parameter Sa (see FIG. 7). When irradiating the therapeutic laser light having a wavelength of 532 nm, "SLT" is displayed in the place of the parameter Sa.

The energy adjusting unit 13 of the present embodiment can adjust the energy of the therapeutic laser beam in the range of 0.3 mJ to 10.0 mJ. At the parameter Sa, a display corresponding to the energy value of the treatment laser light emitted by the laser treatment device 1 is displayed. As an example, when irradiating the treatment laser light of 2.0 mJ, the character "E: 2.0" is displayed at the position of the parameter Sb (see FIG. 7).

The laser treatment device 1 of the present embodiment can intermittently irradiate the treatment laser light when the trigger switch 67 is pressed (referred to as burst). In this embodiment, the number of bursts can be adjusted between 1 and 3. In the place of the parameter Sc, the display corresponding to the number of bursts is displayed. As an example, when the number of bursts is 3, the character "B: 3" is displayed in the place of the parameter Sc (see FIG. 7).

The shift adjusting unit 15 of the present embodiment can adjust the focus shift position in the range of −500 μm to +500 μm. At the location of the parameter Sd, a display corresponding to the focus shift position is displayed. As an example, when the focus shift position is +125 μm, the character “P125” is displayed at the parameter Sd (see FIG. 7).

The display mode of the parameter is not limited to characters. For example, parameters may be represented by icons and indicators. Further, the types of parameters displayed on the display surface 53a are not limited to the parameters Sa to Sd. For example, the cumulative number of irradiations of the treatment laser light after the power of the laser treatment device 1 is turned on may be displayed. Further, the type of the parameter to be displayed on the display surface 53a may be selectable according to the operator's preference. For example, only the parameter Sa may be displayed on the display surface 53a. Further, the display position of the parameter may be selectable according to the operator's preference. It is preferable to store the settings selected by these operators in the non-volatile memory 65. Here, it is more preferable to memorize the settings for each operator.

In this embodiment, an LCD (liquid crystal display) is used for the display unit 53. An organic EL display, a dot matrix LED, or the like may be used as the display unit 53. Further, the display unit 53 may be formed by combining the opening formed in the shape of an icon or the shape of an indicator with one or a plurality of light sources. Further, the liquid crystal panel may be arranged at the position of the field diaphragm 46. In the present embodiment, the control unit 60 displays the parameter S in red.

<Interrelationship of each optical system>
The interrelationship of each optical system of the laser treatment apparatus 1 of the present embodiment will be described. In the present embodiment, the optical axis L3 and the optical axis L4 intersect at the observation site. Further, in the present embodiment, the Teruno diaphragm 33, the observation site, the visual field diaphragm 46, the display surface 53a, and the fundus of the operator's eye Eo are optically conjugated (for reference, each optical axis in FIG. 1). The conjugate position is marked with an X mark). As a result, when observing the observation site, the operator displays the observation image of the observation site, the illumination area of the illumination optical system 30 (in other words, the projection image of the light-shielding portion of the visual field diaphragm 46), and the display unit 53. You can see the information to be displayed. The observation optical system 40 does not have to include the field diaphragm 46.
<Control unit>
The control unit 60 is an example of a control means for controlling the operation of the laser treatment device 1. The control unit 60 of this embodiment includes a CPU 61 (processor), a ROM 62, a RAM 63, a non-volatile memory 65, and the like. The CPU 61 controls each part of the laser treatment device 1. Various programs, initial values, and the like are stored in the ROM 62. The RAM 63 temporarily stores various types of information. The non-volatile memory 65 is a non-transient storage medium capable of retaining the storage contents even when the power supply is cut off. For example, a USB memory detachably attached to the control unit 60, a flash ROM built in the control unit 60, and the like can be used as the non-volatile memory 65. The non-volatile memory 65 may be used as a storage means for storing parameters related to irradiation of the therapeutic laser beam. As the storage means, a RAM 63, a ROM 62, or another state holding medium (for example, DIP SW or the like) may be used.

A laser light source 11, a motor 14, a motor 16, an aiming light source 12, a display unit 53, a display unit 66, a trigger switch 67, a buzzer 68, and the like are connected to the control unit 60 of the present embodiment. The control unit 60 of the present embodiment is a display control means of the display unit 53. The display unit 66 displays the operating conditions and the like of the laser treatment device 1. The parameter S, which will be described later, is also displayed on the display unit 66. The control unit 60 of the present embodiment has a function as a display control means for controlling the display of the display unit 66. The display unit 66 has a touch panel function and may serve as both a display means and an input means. The trigger switch 67 is operated by the operator to input an irradiation execution instruction of the therapeutic laser beam.

<Display of the observation image in the area>
The display of parameters related to the irradiation conditions of the therapeutic laser beam will be described. FIG. 9 is illustrated for comparison with the display of this embodiment. An observation image IMG and parameters S'(Sa' to Sd') are presented in the field of view of the operator looking through the eyepiece 47. The observation image IMG corresponds to the observation site. The observation image IMG includes an illumination region U corresponding to the opening of the Teruno diaphragm 33 and a light-shielding region N corresponding to the projected image of the light-shielding portion of the Teruno diaphragm 33. The parameter S'is a display relating to the irradiation condition (information) of the therapeutic laser beam. The parameter S'indicates that it is a projection image of the parameter S displayed on the display surface 53a of the display unit 53.

In FIG. 9, the parameter Sb'and the parameter Sc'overlap with the illumination region U. As a result, the information on the observation site in the illumination area U is missing. Further, the information of the observation portion in the illumination region U is difficult to see due to the parameter S'. As a result, for example, the operator takes time to take his eyes off the eyepiece 47 and check the display on the display unit 66. Further, since the illumination region U is bright, the brightness in the illumination region U and the brightness of the parameter S'(parameter Sb', parameter Sc') come close to each other, and it tends to be difficult to visually recognize the parameter S'. As a result, for example, the operator has to operate the operating member or the like to temporarily reduce the amount of illumination light. If the display of the parameter S'is too bright, only the parameter S'is conspicuous, and the observation image IMG may be difficult to visually recognize.

FIG. 5 is a diagram of an observation image presented by the laser treatment device 1 of the present embodiment. In FIG. 9 illustrated for comparison, the parameter S'was displayed in the illumination area U, but in the present embodiment, the parameter S'is displayed outside the illumination area U as shown in FIG. The control unit 60 of the present embodiment determines the display position of the parameter S'in the observation image IMG in consideration of the illumination region U for the observation portion (the method of determining the display position will be described later). Specifically, the control unit 60 displays the parameter at a position in the area of the observation image IMG where the image of the light-shielding portion of the Teruno diaphragm 33 is formed. As a result, the operator can preferably visually recognize both the observation image IMG and the parameter S'. Further, the control unit 60 of the present embodiment determines the brightness of the parameter S'in consideration of the amount of illumination light. Thereby, for example, the operator can suitably observe the observation image IMG even when the parameter S'is displayed.

<Determination of parameter display position>
The display position of the parameter S'determined by the control unit 60 will be described with reference to FIGS. 5 to 8. The control unit 60 of the present embodiment acquires information regarding the aperture shape of the Teruno diaphragm 33 from the non-volatile memory 65. Specifically, the non-volatile memory 65 is associated with the parameters used for controlling the drive means 36 and the parameters related to the aperture shape of the Teruno diaphragm 33, and is stored in advance as table data. The control unit 60 calls from the non-volatile memory 65 data regarding the aperture shape of the Teruno diaphragm 33 corresponding to the control data used for controlling the drive means 36. Then, the control unit 60 determines the display position of the parameter S by using the data regarding the aperture shape of the called Teruno diaphragm 33. Here, the control unit 60 determines the display position of the parameter S in consideration of the illumination area U. That is, in the present embodiment, the adjustment means of the illumination optical system 30, the non-volatile memory 65, and the control unit 60 constitute an area detection unit that detects the illumination area U adjusted by the adjustment means. Then, the control unit 60 determines the display position of the parameter based on the illumination area U detected by the area detection unit.

FIG. 6 is a diagram illustrating an area of the display surface 53a. In FIG. 6, when the display surface 53a is projected onto the position of the field diaphragm 46, the area overlapping the illumination area U is indicated by the symbol (U), the area overlapping the field diaphragm 46 (light-shielded) is indicated by the light-shielding area P, and the control unit 60 is used. The area where it is determined that the parameter S can be displayed is shown as the displayable area M. The control unit 60 of the present embodiment determines that the area that does not overlap with the illumination area (U) and does not overlap with the light-shielding area P is the displayable area M capable of displaying the parameters. When the control unit 60 reads data regarding the aperture shape of the Teruno diaphragm 33 from the non-volatile memory 65, the control unit 60 determines the distribution of the illumination region (U) on the display surface 53a using the data. At this time, the control unit 60 considers the magnification of the observation optical system 40 when distributing the illumination region (U). Specifically, the magnification of the observation optical system 40 is considered by using the signal of the detector provided in the variable magnification optical system 42. The control unit 60 calls the shape data of the field diaphragm 46 stored in advance in the non-volatile memory 65 to determine the distribution of the light-shielding region P on the display surface 53a. Then, the control unit 60 determines a region of the display surface 53a that does not overlap the illumination region (U) and the light-shielding region P as the displayable region M.

FIG. 7 shows how the control unit 60 displays the parameters S (Sa to Sd) in the displayable area M described above. The control unit 60 of the present embodiment determines the display positions of a plurality of types of parameters in consideration of the distribution of the displayable area M. Specifically, the control unit 60 may display a part of the plurality of parameters at a position separated from the position where the other parameters are displayed in consideration of the shape of the illumination area U. More specifically, the control unit 60 may lay out the four types of parameters by dividing them into two groups. The control unit 60 arranges the parameter Sa and the parameter Sb in the displayable area M above the paper surface of FIG. 6, and arranges the parameter Sa and the parameter Sb in the displayable area M below the paper surface of FIG. There is. As a result, the parameter S is presented in the vicinity of the illumination region U, so that the movement of the operator's line of sight can be suppressed. The control unit 60 of the present embodiment determines the brightness of the parameter S to be displayed on the display surface 53a in consideration of the amount of lighting light of the lamp 31. For example, the control unit 60 increases the display light amount of the parameter S as the illumination light amount increases. As a result, the operator can preferably visually recognize the parameter S'regardless of the amount of illumination light.

As described above, the control unit 60 determines the display position of the parameter S in consideration of the illumination area U, and displays the parameter S on the display surface 53a. When the operator looks through the eyepiece 47, the observation image IMG and the parameter S'are displayed in the field of view of the operator's eye Eo in the manner shown in FIG. Needless to say, if the observation optical system 40 does not include the field diaphragm 46, the parameter S'can be displayed in the region shown by the light-shielding region P in FIG.

<Example of transformation of display position>
FIG. 8 is a diagram showing an example of transformation of the display position of the parameter S'. In FIG. 8A, the control unit 60 displays the parameter S'outside the illumination area U in consideration of the slit-shaped illumination area U extending in the vertical direction of the paper surface. Unlike FIG. 5, the control unit 60 has a layout in which four types of parameters S (Sa to Sb) are arranged vertically on the paper surface without being separated from each other. That is, the control unit 60 determines the display position of the parameter S'in consideration of the distribution of the illumination region U in the region of the observation image IMG. In FIG. 8B, the control unit 60 displays the parameter S'outside the illumination area U in consideration of the slit-shaped illumination area U extending from the upper right direction to the lower left direction of the paper surface. Similar to FIG. 5, the control unit 60 lays out four types of parameters S (Sa to Sb) by dividing them into two groups. Both FIGS. 5 and 8 are laid out in the order of parameter Sa', parameter Sb', parameter Sb', and parameter Sc'from the upper side of the paper surface to the lower side of the paper surface. As a result, even if the control unit 60 changes the display position of the parameter S'in consideration of the distribution of the illumination area U, the operator can easily find the parameter S'that he / she wants to confirm.

The display position of the parameter S'shown in FIGS. 5 and 8 is merely an example. The control unit 60 may determine the display position of the parameter S'according to the distribution (shape, area, position) of the illumination region U in the region of the observation image IMG. For example, the display position of the parameter S'may be determined according to the slit length, the slit width, and the slit angle of the slit light. Further, even when the illumination area is divided into a plurality of areas, the parameter S'may be displayed at a position that does not overlap with each illumination area. It should be noted that the parameter S'does not have to strictly avoid the illumination region U. That is, the parameter S'may overlap a part of the illumination region U. By determining the display position of the parameter S'in consideration of the illumination area U, the control unit 60 may reduce the overlap between the parameter S'and the illumination area U. Further, the display mode of each parameter S'may be changed according to the distribution of the illumination region U. For example, when the distribution of the illumination region U is large in the region of the observation image IMG, the control unit 60 may reduce the display area of each parameter S'. Further, the number of characters of each parameter S'may be reduced. For example, in FIG. 5, the parameter Sb'is displayed as "E: 2.0", but this display may be omitted as "2.0". Further, the control unit 60 may increase or decrease the type of the parameter S'to be displayed according to the change in the ratio in which the illumination region U is distributed.

<How to use>
An example of the operation of the laser treatment device 1 will be described. When the operator turns on the power of the laser treatment device 1, test irradiation is performed several seconds later. The test irradiation is performed with the safety shutter inserted on the optical axis L1 of the laser irradiation optical system 10, and the therapeutic laser light emitted from the laser light source 11 is a beam splitter installed on the optical axis L1. It is reflected and incident on the optical detector. The control unit 60 calculates the energy of the treatment laser light from the amount of received light detected by the photodetector, and displays the energy on the parameter Sa on the display surface 53a. The test irradiation is performed every time the energy is set in the operation unit, and the display of the parameter Sa is updated each time. Also, when the irradiation mode of the therapeutic laser beam is changed, the test irradiation and the display of the parameter Sa are updated.

After that, the operator operates an input switch or the like on the control panel to set irradiation conditions such as an irradiation mode, a laser output amount, and the number of irradiation pulses according to the treatment purpose of the patient's eye Ep. After the setting is completed, the operator places the patient's eye Ep in place. The surgeon looks into the eyepiece 47 after sitting the patient in place and immobilizing it. In the field of view of the operator, the observation image IMG and each parameter S'of the aspect shown in FIG. 5 are displayed. While looking through the eyepiece, the surgeon operates the joystick or the like so that the slit light projected by the illumination optical system 30 is on the patient's eye Ep to move the slit delivery of the laser treatment device 1.

After adjusting the amount and focus of the slit light, the surgeon sets the contact lens 26 on the patient's eye Ep and observes the observation site of the patient's eye Ep while looking into the eyepiece 47 again. Further, when irradiating the laser, the switch provided on the joystick is operated to set the laser output amount. When the laser output amount is set, the control unit 60 controls the energy adjusting unit 13, the display unit 53, the display unit 66, and the like based on the set conditions. The display of the parameter Sb'is updated (changed) as the laser output amount is changed. The display of other parameters (Sa', Sc', Sd') is updated (changed) every time the corresponding setting is changed.

The aiming light emitted from the aiming light source 12 is divided into two and then incident on the patient's eye Ep. Since the focal position of the therapeutic laser beam is shifted in the optical axis direction by the distance displayed as the parameter Sd'from the intersection of the two aiming lights, the operator refers to this intersection to set the laser focal position to the affected area. Align by operating the joystick etc. so that they match.

When the alignment by the aiming light is completed, the operator presses the trigger switch 67 to transmit the trigger signal. When the control unit 60 receives the trigger signal, the control unit 60 drives and controls the actuator to retract the safety shutter of the laser irradiation optical system 10 from the laser optical axis (optical axis L1) and emits the therapeutic laser light.

After emitting the laser light source 11, the therapeutic laser beam is irradiated to the patient's eye Ep through the dichroic mirror 24 to cause tissue destruction due to plasma generation in the affected part of the patient's eye Ep. The control unit 60 emits the therapeutic laser light for the number of irradiations based on the number of irradiations displayed in the parameter Sc'.

<Others>
In the present embodiment, the eyepiece lens 47 is used as the presentation means for presenting the observation image of the observation portion where the illumination light is projected, but the presentation means is not limited to this. It suffices if the observation image can be presented to the surgeon. For example, a monitor connected to the laser treatment device 1 may be used as a presentation means. In this case, for example, an image sensor is arranged in an optical path separated from the observation optical system 40 to photograph an observation site, and an observation image IMG is displayed on a monitor connected to the laser treatment device 1 using the output signal of the image sensor. do it. In the observation image IMG displayed on the monitor, the parameter S relating to the irradiation condition of the therapeutic laser light may be displayed in the region of the observation image IMG in the same manner as in the present embodiment. Here, instead of the eyepiece lens 47 and the display optical system 50, the laser treatment device 1 may be provided with an EVF (electronic viewfinder).

Further, the observation optical system 40 may take an observation image IMG, and the control unit 60 may detect the illumination region U by using image processing. The control unit 60 performs image processing and detects the illumination region U from the observed image. Then, the display position of the parameter is determined in consideration of the detected illumination area U. For example, the illumination region U may be detected by performing image processing using the brightness information of the observed image. In the same manner as in the above-described embodiment, a composite image obtained by synthesizing the parameter S relating to the irradiation condition of the therapeutic laser light may be generated on the observation image IMG and outside the detected illumination region U. By detecting the illumination area by image processing, it is considered that the illumination area U can be detected accurately even with a simple configuration. The amount of illumination light may be detected by using image processing.

Further, the change (change) in the display mode of the parameter S'changed by the display means is not limited to the brightness. For example, the display color of the parameter S'may be changed in conjunction with the change of the operating conditions of the laser treatment device 1. For example, when the color filter is inserted on the optical axis L3 of the illumination optical system 30, the hue of the observation image IMG and the hue of the parameter S'may come close to each other, making it difficult to see the parameter S'. In such a case, the control unit 60 may determine the display color of the parameter S'in consideration of the hue of the entire observation image IMG or the region of interest. As an example, the control unit 60 may display the parameters in green in the color observation mode (illuminated in white) and the parameters in red in the red-free observation mode (illuminated in green).

Although the description has been made using the laser treatment device 1 in the present embodiment, the scope of application of the present technology is not limited to the laser treatment device 1. For example, it may be applied to a slit lamp microscope (slit lamp). It may also be applied to a mydriatic fundus camera that tends to require delicate observation. Further, it may be applied to other devices for observing the anterior segment of the eye, devices for observing the fundus, and the like. In such an apparatus, the technique relating to the display of the parameter S'disclosed in the present embodiment can be applied when displaying the parameters relating to the operating conditions of the apparatus. In addition, since the amount of information is large when observing in chromatic colors, the appearance of the observed image is often important. The application of this technique is considered to be particularly suitable when observing the observation site in chromatic colors.

<Action and effect>
The laser treatment device 1 of the present embodiment irradiates the affected portion of the patient's eye with the treatment laser light. The laser treatment device 1 includes a lighting means for projecting illumination light on the observation site of the patient's eye Ep, a presentation means for presenting an observation image IMG of the observation site on which the illumination light is projected, and a region of the observation image IMG. , A display means for displaying the parameter S'related to the irradiation condition of the therapeutic laser light, and the display means displays the display position of the parameter S'in the observation image IMG in consideration of the illumination area U of the illumination means. decide. As a result, the operator (operator) can suitably visually recognize the observation image IMG of the patient's eye Ep and the display (parameter S') regarding the irradiation conditions. For example, it is possible to suppress the inconvenience that the parameter S'overlaps the illumination region U and the information of the observation site is lost, making observation difficult. Further, the parameter S'overlaps the illumination area U, and the brightness of the illumination area U can suppress the inconvenience that the operator cannot easily see the parameter S'. Therefore, the surgeon can easily treat the affected area promptly.

Further, the illumination means of the laser treatment apparatus 1 of the present embodiment includes a Teruno diaphragm 33 having an opening and a light-shielding portion at a position conjugate with the observation portion, and an image of the opening (illumination region U) and an image of the opening in the observation portion. An image of the light-shielding portion (light-shielding region N) is formed. The display means displays the parameter S'at a position in the area of the observation image IMG where the image of the light-shielding portion is formed. As a result, for example, the contrast between the parameter S'and the background of the parameter S'can be easily obtained, and the operator can easily visually recognize the display content of the parameter'. Further, the control unit 60 can easily detect (detect) the illumination area and can display the parameter S'with a simple configuration.

Further, the parameter S'of the laser treatment apparatus 1 of the present embodiment includes a plurality of parameters (Sa'to Sb') of different types, and the display means has a plurality of parameters in consideration of the shape of the illumination region U. Some of the parameters may be displayed at a position away from the position where other parameters are displayed. Thereby, for example, a plurality of parameters can be displayed while maintaining the number of characters of the parameter S'or the size of the characters. Therefore, the parameter S'can be displayed to the operator without damaging the presentation information. Further, it is easy to display the parameter S'in the vicinity of the illumination area U, which can be said to be the area of interest of the operator. As a result, the observation site is brightly presented, and the movement of the line of sight from the illumination area U (area of interest) to be watched by the operator can be reduced. Therefore, the surgeon can easily treat the affected area promptly.

Further, the laser treatment device 1 of the present embodiment includes an adjustment means for adjusting the illumination area U by the illumination means and an area detection unit for detecting the illumination area U adjusted by the adjustment means, and the display means. Determines the display position of the parameter S'based on the illumination area U detected by the area detection unit. As a result, even if the illumination region U changes, the parameter S'can be displayed at a suitable position on the observation image IMG. Therefore, the operator can easily visually recognize the parameter S'while observing the observation site with various shapes of the illumination region U.

Further, the presentation means of the laser treatment apparatus 1 of the present embodiment includes a scaling means for scaling the observation site to form an observation image IMG. The display means may detect the scaling amount of the scaling means and determine the display position of the parameter S'based on the scaling amount. Thereby, for example, the display position of the parameter S'can be determined more accurately.

Further, as a transformation example of the laser treatment apparatus 1 of the present embodiment, the display means may detect the illumination area U from the observation image IMG and determine the display position of the parameter S'in consideration of the illumination area U. .. As a result, for example, even if the contact lens 26 causes unintended refraction of the illumination light, the illumination region U is detected from the observation image IMG by image processing, so that the detection error of the distribution of the illumination region U on the observation image IMG Is unlikely to occur. Therefore, it is easy to display the parameter S'at a suitable position.

Further, the display means of the laser treatment apparatus 1 of the present embodiment displays the parameter S'on the observation image IMG and outside the detected illumination region U. As a result, the operator can visually recognize the parameter S'without impairing the visibility of the observation image IMG. In addition, the parameter S'can be arranged with high accuracy.

Further, the illumination means of the laser treatment apparatus 1 of the present embodiment includes a light amount adjusting means for adjusting the projected light amount (illuminated light amount) of the illumination light, and the display means is an observation image IMG according to the projected light amount. The brightness of the display of the parameter to be displayed in is determined. As a result, the operator can easily visually recognize the parameter S'regardless of the amount of projected illumination light. For example, an event in which the parameter S'is too bright for the observation image IMG and is difficult to observe is suppressed. Further, the phenomenon that the observation image IMG is too bright with respect to the parameter S'and the parameter S'is difficult to see is suppressed.

Further, the laser treatment apparatus 1 of the present embodiment includes an eyepiece (eyepiece 47) and an observation optical system 40 for observing the observation site, and the presentation means is within the observation field of view by the eyepiece. The observation image IMG is presented. Thereby, for example, even when the operator looks into the eyepiece and makes a precise (or delicate) observation, the observation image IMG and the parameter S'can be preferably visually recognized. Therefore, the operability of the laser treatment device 1 is improved. In addition, observation errors are unlikely to occur.

The embodiments disclosed this time should be considered as exemplary in all respects and not restrictive. The scope of the present invention is shown by the scope of claims, not the above description, and is intended to include all modifications within the meaning and scope of the claims and their equivalents.

1: Laser treatment device 30: Illumination optical system 40: Observation optical system 47: Eyepiece 50: Display optical system 53: Display unit 60: Control unit

Claims (3)

A laser treatment device that irradiates the affected area of the patient's eye with a treatment laser beam.
An illumination means that projects slit light onto the observation site of the patient's eye,
A presentation means for presenting an observation image of the observation site and
A display means for displaying a display in a mode different from the observation image on the observation image presented by the presentation means, and
A display position determining means for arranging a display position of a display having a mode different from that of the observation image to be displayed on the observation image outside the slit illumination region by the slit light.
A laser treatment apparatus comprising. The laser treatment apparatus according to claim 1.
The display position determining means can arrange displays in a mode different from the observation image on both sides of the slit illumination region.
A laser treatment device characterized in that. The laser treatment apparatus according to claim 1 or 2.
An adjustment means for adjusting the illumination area by the illumination means, and
A region detection unit that detects the illumination region adjusted by the adjustment means is provided.
The display position determining means determines a display position of a display different from the observation image displayed on the observation image based on the illumination area detected by the area detection unit.
A laser treatment device characterized in that.

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