JP7099849B2 - Ophthalmic laser system - Google Patents

Description

The present invention relates to an ophthalmic laser system that irradiates an affected area with laser light to perform retinal photocoagulation.

Laser treatment devices as ophthalmic laser systems are used in the treatment of various eye diseases. For example, in the treatment of certain types of glaucoma, there is a treatment method in which the angle (the site between the cornea and the iris, including the trabecular meshwork) is irradiated with a laser to form an outflow path of aqueous humor. In addition, retinal photocoagulation is used in retinal diseases such as diabetic retinopathy.

Further, in the laser treatment device, after aiming at the treatment site using the aiming light of a predetermined pattern (arrangement of a plurality of spots), the treatment site is configured to irradiate a predetermined pattern of laser light having a predetermined spot size. What was done is known.

In such laser treatment, the treatment site is observed and laser irradiation is performed through a contact lens for laser treatment that is in contact with the patient's eye. With this contact lens, the fundus of the patient's eye can be irradiated with laser light.

FIG. 6 is a schematic diagram showing a laser beam transmitted through a contact lens worn on the patient's eye, and FIG. 7 shows the relationship between the spot magnification of the contact lens when the contact lens is used and the spot diameter, spot area, and energy density on the fundus. It is a table.

Here, the laser spot size set by the laser treatment device is specified by the size at the condensing position in the air. As shown in FIG. 6, the laser beam L passing through the contact lens CL passes through the patient's eye E and irradiates the fundus EF with the laser spot LS. Here, the contact lens CL has a predetermined spot magnification (1x, 1.44x, 2x, etc.) depending on the purpose of use.

Therefore, even if the size (diameter d) of the laser spot is specified by the laser treatment device, this size (diameter d) is the size of the laser spot irradiated to the target tissue of the patient's eye via the contact lens CL. It is different from (diameter D). FIG. 7 shows the relationship between the spot magnification of the contact lens and the spot diameter, spot area, and energy density of the eye steady state. This table shows the values when the laser beam is irradiated for 20 ms with the power of the light source set to 300 mW and the spot diameter set to 200 μm. The spot magnification of the contact lens CL is 1 to 1.44 times, 2 When doubled, the spot diameter at the fundus EF becomes 1x, 1.44x, 2x, the spot area becomes 1x, 2x, 4x, and the energy density becomes 1, 1/2, 1 It turns out that it becomes / 4.

The practitioner needs to know the spot diameter and energy density that are actually applied to the target tissue and irradiate the laser beam. Therefore, various techniques have been proposed for the convenience of the practitioner.

On the other hand, in a conventional laser treatment device, a central surgical area configured to display a focal area is included, and a surgical process, surgical components, and other parts of a liquid crystal panel are surrounded by a central surgical display area. A wearable interface that includes a peripheral data display area or display frame that shows information about the surgery, is displayed on the wearable user face, and allows the eyepiece of the microscope to be seen through the interface. Is known (see Patent Document 1, paragraphs 0027 to 0029, FIG. 3, etc.).

Further, in the optical interference tomography device that scans the fundus retina of the eye to be inspected, which is a laser treatment device, it is driven by the voice of the subject and recognizes the human voice as shown in FIG. It is known to have a user interface module configured to communicate with the user, instruct the user, and interact with the user through a voice recognition interface or the like (Patent Document 2, claim 8, paragraph number, See 0067, FIG. 8 etc.).

Japanese Patent No. 6034509, Japanese Unexamined Patent Publication No. 2014-94313

However, whether the subject observes the fundus alone or the subject conducts an eye examination at a remote location while interacting with the user, the subject's eye is actually observed and the subject is accurately adjusted according to the subject. It is necessary to carry out examination and treatment. On the other hand, since the operator performs operations such as eye treatment and surgery on the subject, he / she quickly and accurately controls data such as the diameter, energy density, and power of the irradiated laser spot on the operation panel. It's not easy.

The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide an ophthalmic laser system capable of performing various controls quickly and accurately without touching an operation panel.

The invention according to claim 1 is an ophthalmic laser system that irradiates a target tissue of a patient's eye with a laser spot having a predetermined energy density and a predetermined spot diameter, and emits laser light with a variable output power. Contact lens information input for inputting information on a light source to be emitted, a laser beam diameter setting means for receiving the laser beam from the light source and outputting a laser beam having a predetermined beam diameter, and a contact lens to be worn on the patient's eye. Means, irradiation beam value input means for inputting the spot diameter of the laser spot to be irradiated to the target tissue, output power of the light source, and irradiation time, contact lens information input means, and irradiation beam value input means. A calculation means that calculates the energy density of the laser spot based on the information from, a voice detection means that detects the voice of the operator, and a voice that analyzes the voice detected by the voice detection means and outputs an operation instruction. Based on the analysis means , the learning means that learns the input voice data about the accumulated past voice analysis and the output operation as teaching materials, and optimizes the voice recognition setting of the voice analysis means, and the operation instruction. The ophthalmic laser system is characterized by comprising a drive control unit for controlling the drive of the light source and the laser beam diameter setting means.

Similarly, the invention according to claim 2 is provided with data on appropriate examination and treatment corresponding to each patient's eye by accumulating information on the target tissue of the patient's eye, and the operation is appropriate for the patient's eye. The ophthalmic laser system according to claim 1, further comprising a determination unit for determining whether or not the setting is correct and outputting the determination unit.

In the invention according to claim 3, the calculation means outputs the output power of the light source based on the information from the contact lens information input means and the irradiation beam value input means, and the drive control unit uses the light source. The ophthalmic laser system according to claim 1, wherein the system is controlled.

In the invention according to claim 4, the calculation means performs a calculation based on information from the contact lens information input means and the irradiation beam value input means, and the beam diameter of the laser beam output by the laser beam diameter setting means. The ophthalmic laser system according to any one of claims 1 to 3, wherein the drive control unit controls the laser beam diameter setting means.

The invention according to claim 5, wherein the laser spot magnification of the contact lens to be worn on the patient's eye is input to the contact lens information input means, claim 1, claim 3 or claim 4. The ophthalmic laser system according to any one of the above.

The invention according to claim 6 comprises a contact lens data storage means for storing the name of the contact lens to be worn on the patient's eye and the laser spot magnification of the contact lens in association with each other, and the contact lens information input means includes the contact lens information input means. One of claims 1 or 3, wherein the name of the contact lens is input, and the calculation means acquires the laser spot magnification of the contact lens from the contact lens data storage means and performs the calculation. The ophthalmic laser system according to paragraph 1.

The invention according to claim 7 is the ophthalmic laser system according to any one of claims 1 to 6, further comprising a display means for displaying the energy density and the spot diameter.

According to the ophthalmic laser system according to the present invention, various controls can be performed quickly and accurately without touching the operation panel.

That is, according to the ophthalmic laser system according to claim 1, when the spot diameter of the laser spot to be irradiated on the target tissue, the output power of the light source, and the irradiation time are input to the irradiation beam value input means, the contact is made. The energy density of the laser spot is calculated based on the information from the lens information input means and the irradiation beam value input means.

Further, the voice detecting means acquires the voice of the operator, the voice analysis means analyzes the voice detected by the voice detecting means and instructs the operation by the operation panel, and the drive control unit operates the operation panel. Based on this, the drive of the light source and the laser beam diameter setting means is controlled. Therefore, the operator can instruct the operation of the operation panel by voice, and the ophthalmic laser system can be set easily and surely.

Further, according to the ophthalmic laser system according to claim 1, the learning means learns the input voice data and the output operation of the accumulated past voice analysis as teaching materials, and sets the voice recognition of the voice analysis means. Optimize. Therefore, the voice recognition unit can perform accurate voice recognition, and can operate the ophthalmologic laser system according to the intention of the operator.

Further, according to the ophthalmic laser system according to claim 2, the judgment unit accumulates information on the target tissue of the patient's eye and has data on appropriate examination and treatment corresponding to each patient's eye, and operates the system. It is determined whether the panel operation is an appropriate setting for the patient's eye and output. Therefore, it is possible to accurately control the ophthalmic laser system and perform corrective measures.

Further, according to the ophthalmic laser system according to claim 3, the calculation means performs a calculation based on the information from the contact lens information input means and the irradiation beam value input means, and the laser beam diameter setting means outputs the laser beam. Since the beam diameter is output and the drive control unit controls the laser beam diameter setting means, the diameter and energy density of the laser spot irradiated from the ophthalmic laser system to the target tissue can be easily set.

Further, according to the ophthalmic laser system according to claim 4, the calculation means performs a calculation based on the information from the contact lens information input means and the irradiation beam value input means, and the laser beam is output by the laser beam diameter setting means. Since the beam diameter is output and the drive control unit controls the laser beam diameter setting means, the diameter and energy density of the laser spot irradiated to the target tissue from the ophthalmic laser system can be easily set.

Further, according to the ophthalmic laser system according to claim 5, when the laser spot magnification of the contact lens to be attached to the patient's eye is input to the contact lens information input means, the calculation means simply serves as the laser beam diameter setting means. Can be easily set.

Further, according to the ophthalmic laser system according to claim 6, when the name of the contact lens is input to the contact lens information input means, the calculation means acquires the laser spot magnification of the contact lens from the contact lens data storage means and performs the calculation. Therefore, the ophthalmic laser system can be easily set by simply inputting the name of the contact lens.

Further, according to the ophthalmic laser system according to claim 7, since the display means for displaying the energy density and the spot diameter is provided, the practitioner confirms the diameter and energy density of the laser spot actually irradiated to the target tissue. can do.

The configuration of the ophthalmic laser system according to the embodiment of the present invention is shown, (a) is a block diagram showing an overall structure, and (b) is a block diagram showing a functional configuration of a control system. It is a schematic diagram which shows the structure of the laser beam diameter setting means of the same ophthalmology laser system. It is a schematic diagram which shows the display of the touch panel of the same ophthalmology laser system. It is a flowchart which shows the processing of the same ophthalmology laser system. It is a flowchart which shows the processing of the same ophthalmology laser system. It is a schematic diagram which shows the laser beam which passes through the contact lens attached to the patient's eye. It is a table which shows the relationship between the spot magnification of a contact lens when using a contact lens, the spot diameter on the fundus, the spot area, and the energy density.

An ophthalmic laser system according to an embodiment for carrying out the present invention will be described. Hereinafter, a scanning laser treatment device will be described as an ophthalmic laser system. 1A and 1B show a configuration of an ophthalmic laser system according to an embodiment of the present invention, FIG. 1A is a block diagram showing an overall structure, FIG. 1B is a block diagram showing a functional configuration of a control system, and FIG. 2 is the same. It is a schematic diagram which shows the structure of the laser beam diameter setting means of an ophthalmic laser system.

The ophthalmologic laser system 1 creates and irradiates a pattern of laser spots on the patient's fundus EF. The ophthalmic laser system 1 includes a light source assembly 2 and a slit lamp assembly 3. Further, the ophthalmic laser system 1 according to the present embodiment includes a control unit 300, a voice detection device 350 which is a voice detection means, and a foot switch 360. The foot switch 360 includes a first foot switch 361 and a second foot switch 362.

The light source assembly 2 includes a therapeutic light source 12 which is a light source having a variable output power to generate a treatment beam 14 which is a laser beam for performing treatment, and an aiming light source 16 which generates an aiming beam 18 for aiming. The treatment beam 14 from the treatment light source 12 is initially adjusted by the lens 20. The lens 20 adjusts the treatment beam 14 so that the emitted light is used in combination with the curved mirror 22 to enter the optical fiber bundle 24. After incident on the lens 20, the treatment beam 14 is sampled by the partial reflector 26.

The light reflected by the partial reflector 26 is used as an input to the photodiode 28 that monitors the output power of the treatment beam 14 to ensure that the treatment light source 12 is operating at the desired output. The mirror 30 is used to direct the treatment beam 14 toward the curved mirror 22, and the curved mirror 22 directs the treatment beam 14 toward the movable mirror 32. The aiming beam 18 from the aiming light source 16 is directed at the movable mirror 32 via the mirrors 34 and 36.

The movable mirror 32 is preferably mounted on a galvano scanner, and the treatment beam 14 and the aiming beam 18 are attached to the fiber ports 25a, 25b of the optical fibers 24a, 24b, 24c, 24d of the optical fiber bundle 24 at an arbitrary given time. , 25c, 25d are driven to selectively point to one of, 25c, 25d. It should be noted that the galvano scanner can be driven by a piezo actuator or other well-known optical moving device instead of the galvano scanner. The movable mirror 32 and the respective optical fibers 24a, 24b, 24c, and 24d function as a laser beam diameter setting means 280 that outputs a laser beam having a different size (laser spot diameter).

FIG. 2 is a schematic diagram showing the configuration of a laser beam diameter setting means in an ophthalmic laser system. The light from the movable mirror 32 is incident on any of the fiber ports 25a, 25b, 25c, and 25d of the optical fibers 24a to 24d. In this example, the fiber port 25a is used to output a laser beam having a spot size of 400 μm, the fiber port 25b is 100 μm, the fiber port 25c is 50 μm, and the 25d is 200 μm.

At that time, the lenses 42 and 44 focus the treatment beam 14 and the aiming beam 18 into the selected optical fiber. The movable mirror 32 is preferably separated from the lens 20 by one focal length to provide telecentric scanning conditions. It should be noted that the treatment beam 14 can be injected into all the optical fibers 24a-24d in a parallel path, which maintains the launch numerical aperture over the optical fiber bundle. Beam dumps 38, 40 are arranged adjacent to the optical fibers 24a to 24d, and the beam dumps 38, 40 contribute to holding the treatment beam 14 in the standby position.

The optical fibers 24a to 24d transmit the treatment and treatment beam 14 from the light source assembly 2 and the aiming beam 18 to the slit lamp assembly 3. The additional optical fiber 46 can be used to direct the treatment and / or treatment beam 14, aiming beam 18 to the patient via other means such as an end probe or laser indirect ophthalmoscope (not shown). ..

The slit lamp assembly 3 includes an optical fiber input unit 50 that receives optical fibers 24a to 24d, a scanner assembly 52 that is a scanner unit, a transmission assembly 54, and a binocular assembly 56. The optical fiber input unit 50 includes an optical adjustment system specific to each of the optical fibers 24a to 24d, so that each optical fiber creates the spot size described above in the image plane IP of the slit lamp assembly 3.

For example, the light from the optical fiber 24a first encounters a lens 58a that collimates the light, and then an aperture 60 that reduces the numerical aperture by covering all but the central portion of the light beam. The light from the optical fibers 24b to 24d first encounters the lenses 58b to 58d, respectively. The lenses 58b to 58d irradiate a laser spot LS having a predetermined diameter in the image plane IP, subsequently through the contact lens CL, and in the target tissue (fundus EF).

In the illustrated ophthalmic laser system 1, the optical fibers 24a and 24b have the same core diameter but use different lenses 58a and 58b to form different spot sizes. The optical fibers 24c and 24d have different core diameters. It is preferable that all optical fibers transmit light with the same numerical aperture. This configuration is not essential. Therefore, in order to keep the numerical apertures equal for these different channels, the aperture 60 can be used to counteract changes in the optical output of the lens 58a with respect to the lenses 58b, 58c, 58d.

The optical output of each optical fiber 24a-24d is adjusted by an accompanying optical system (eg, lenses 58a-58d, aperture 60, etc.) and then two galvano scanners 66, 68 (such as piezo actuators) of any well-known optics. It is directed to a scanner assembly 52 with two movable mirrors 62, 64 attached to (where mobile devices can be used). The movable mirrors 62 and 64 rotate within the two orthogonal axes to scan (ie, move) the incident light to form the laser spot LS with any desired light pattern P.

The movable mirror 62 can rotate to direct light from any given one of the optical fibers 24a to 24d toward the rest of the slit lamp assembly 3, and thus the output from the optical fiber. At the same time, it acts to prevent any light from other optics from continuing throughout the slit lamp assembly 3. Since the output ends of the optical fibers 24a to 24d do not match, the movable mirror 62 needs to be rotated to block the light from the desired optical fiber and send the light to the movable mirror 64, and the movable mirror 64 has an orthogonal axis. The light can be further moved within.

This configuration has the additional advantage of preventing any stray light emitted by unselected optics from leaving the system. In FIG. 1, the optical fiber 24b is depicted as the selected fiber, where the output of this fiber is scanned by the movable mirrors 62, 64 to form a scanning pattern of light traveling over the rest of the system.

The light pattern P formed by scanning the therapeutic light source 12 and the aiming light source 16 leaving the scanner assembly 52 passes through the transmission assembly 54, which is a lens 70 (image plane IP) which is a condensing means. (Generates an intermediate scanning pattern), lens 72 (adjusts the light pattern to focus on the eyeball), mirror 74 (points the light pattern toward the target eyeball tissue), lens 76 (infinity correction microscope objective lens) It is preferable that the lens 78 (preferably a contact lens that finally concentrates the light pattern P on the target eyeball tissue such as the fundus EF). The illumination light source 80 (for example, a halogen bulb) is used to illuminate the fundus EF, which is the target eye tissue, so that the doctor who is the practitioner can see the target eye tissue.

The physician can see the fundus EF directly through the binocular assembly 56. The binocular assembly 56 includes a magnifying optic (eg, one or more lenses used to magnify an image of the target eye tissue in an adjustable manner), an eye safety filter 84 (potentially harmful). It is provided with an optical element 86, and an eyepiece 88, which can be a color-balanced type that prevents high levels of light from reaching the user's eyes and provides a brightly neutral transmittance).

The light pattern P is finally generated on the fundus EF of the patient by using the treatment light source 12, the treatment beam 14 from the aiming light source 16, and the aiming beam 18 under the control of the control unit 300. The light pattern P draws a spot pattern on the fundus EF. The control unit 300 is connected to each unit of the system by the input / output interface 90, and drives and controls each of these units.

For example, the control unit 300 monitors the photodiode 28 to ensure that the treatment beam 14 is produced at the desired output level. Further, the control unit 300 performs operations such as turning on / off the switch of the treatment light source 12 and the aiming light source 16, setting the output level, treating the movable mirror 32 and / or optics for the treatment beam 14 and the aiming beam 18. Operate to choose whether to use fiber. Then, the directions of the galvano scanners 66 and 68 are controlled to generate a desired light pattern P on the target eye tissue.

A liquid crystal display device (LCD) 301, which is a display means, and a touch panel 304 are connected to the control unit 300. The liquid crystal display device 301 and the touch panel 304 function as contact lens information input means and irradiation beam value input means. The touch panel 304 is arranged on the surface of the liquid crystal display device 301. Further, a keyboard 302, a pointing device 303 such as a mouse or a joystick, a voice detection device 350, and a foot switch 360 are connected to the control unit 300 as instruction input units.

Here, the voice detection device 350 is configured to include a microphone. The voice analysis unit 340 identifies the utterance of the operator from the voice detected by the voice detection device 350, recognizes the meaning of this utterance, that is, the instruction content, and outputs the voice. Recognition is by a known method for language analysis. The voice detection device 350 can be arranged on the cloud via the net, not in the ophthalmic laser system 1.

A learning unit 370 is connected to the voice analysis unit 340 as a learning means. The learning unit 370 learns the input voice data and the output operation of the accumulated past voice analysis as teaching materials, and optimizes the voice recognition setting of the voice analysis means. Methods using big data, methods using deep learning, and methods such as indoctrination learning are effective.

The foot switch 360 includes a first foot switch 361 and a second foot switch 362. The first foot switch 361 is operated when the setting by the voice detection device 350 is correct, and acts as a definite means for issuing a setting confirmation signal. The second foot switch 362 finally instructs to irradiate the laser beam.

The control unit 300 includes a CPU (Central Processing Unit), a ROM (Read Only Memory) as a main storage device, a RAM (Random Access Memory), and an HDD (Hard Disc Drive) as an auxiliary storage device, and executes a program by the CPU. Realize various functions. That is, as shown in FIG. 1 (b), the control unit 300 performs a calculation based on the information from the contact lens information input means and the irradiation beam value input means, and performs the calculation, and the output power of the treatment light source 12 and the laser beam diameter. A drive that controls the output of the treatment light source 12 and the drive of the laser beam diameter setting means 280 based on the output of the calculation unit 310, which is a calculation means that outputs the beam diameter of the laser beam output by the setting means 280, and the calculation unit 310. It has the function of the control unit 320. Further, the control unit 300 includes a contact lens data storage unit 330, which will be described later.

Further, the control unit 300 includes a voice analysis unit 340 which is a voice analysis means. The voice analysis unit 340 analyzes the voice detected by the voice detection device 350 described above, and outputs the type and content of the operation as an operation instruction to the drive control unit 320 for the operation of the display input screen 100 instructed by the voice.

In the present embodiment, the control unit 300 includes a determination unit 380. Judgment unit 380 accumulates information on the target tissue of the patient's eye, has data on appropriate tests and treatments corresponding to each patient's eye, and determines whether the operation is an appropriate setting for the patient's eye. And output. The control unit 300 determines whether or not the setting of the ophthalmic laser system 1 selected by the operator is appropriate for the treatment of the patient's eye based on the determination result of the determination unit 380. If the setting is correct, continue the treatment, and if it is not appropriate, prompt the reset. The judgment unit 380 is constructed by a method using big data, a method by deep learning, a method such as indoctrination learning, and the like. It is effective. Further, the determination unit 380 can be arranged on the cloud via the net, not in the ophthalmic laser system 1.

The touch panel 304 has functions as a contact lens information input means and an irradiation beam value input means. When commands related to, for example, spot size and pattern, pulse time width, and light output from the treatment light source 12 and the aiming light source 16 are issued from the touch panel 304, the physical adjustment of the slit lamp assembly 3 by the user for rough adjustment is performed. In addition to the smooth movement, the final fine-tuning of the light pattern P on the target tissue is to change the rotation angle as the movable mirrors 62, 64 scan the light beam to move the entire pattern onto the target tissue. Further control can be performed by using the pointing device 94 or the touch panel 304. This method provides very fine control of the placement of the scanning beam.

An additional input device can be added as a pointing device 303. The additional input device may include a therapeutic light source 12, a knob for adjusting the output of the aiming light source 16, a foot switch for activating the irradiation of the aiming pattern and / or the treatment pattern, or other activation device. The final arrangement of the light outputs of the therapeutic light source 12 and the aiming light source 16 is to generate a light pattern P in a shape surrounding the retinal column hole generated in the fundus EF of the patient.

Next, the touch panel 304 will be described. FIG. 3 is a schematic view showing the display of the touch panel of the same ophthalmology laser system. The touch panel 304 transmits the image of the liquid crystal display device 301. The display input screen 100 shown in FIG. 3 is displayed as an operation panel displayed by the touch panel 304, and the following display and input items are displayed on the display input screen 100.

The display input screen 100 includes an operation standby display unit 110, an energy density display unit 120 for a laser spot irradiated to the fundus EF, an irradiation frequency display unit 130, a time display unit 140, and an output power setting display unit 150 for the treatment light source 12. Irradiation time setting display unit 160, pattern selection unit 170, laser spot diameter setting display unit 210, spacing setting display unit 220, contact lens name selection unit 230, practitioner name specification unit 240, default value setting unit 250, and end treatment. The setting unit 260 is displayed. The operation of each part can be specified by voice as well as by touch. When the operation is selected by voice, confirmation by the first foot switch 361 or confirmation by voice is performed.

The operation standby display unit 110 displays the operating state of the ophthalmic laser system 1, that is, whether the ophthalmic laser system 1 is operating or on standby. The energy density display unit 120 displays the energy density of the laser spot irradiated to the fundus EF. The number of irradiations of the laser spot is displayed on the irradiation number display unit 130. The time display unit 140 displays the current time. The output power of the treatment light source 12 is displayed on the output power setting display unit 150. Further, the output power of the treatment light source 12 is set from the output power setting display unit 150. This setting is made by touching the up / down triangular arrow at the right end of the output power setting display unit 150 or by specifying by voice.

The irradiation time of the laser spot is displayed on the irradiation time setting display unit 160. Further, the irradiation time of the laser spot can be set from the irradiation time setting display unit 160. This setting is made by touching the up / down triangular arrow at the right end of the irradiation time setting display unit 160 or by specifying by voice.

The pattern selection unit 170 displays three types of preset selection units, and the pattern can be selected in each selection unit. In this example, one is a first display selection unit 180 that displays six irradiation patterns with an irradiation time of 20 ms in a selectable manner, and a second display selection unit 190 that displays two irradiation patterns with an irradiation time of 10 ms in a selectable manner. A third display selection unit 200 on which a spot can be selected is displayed. The spot diameter of the laser spot irradiated from the ophthalmic laser system 1 is displayed on the laser spot diameter setting display unit 210. Further, the spot diameter of the laser spot can be set from the laser spot diameter setting display unit 210. This setting is made by touching the up / down triangular arrow at the right end of the laser spot diameter setting display unit 210 or by specifying by voice. By setting the laser spot diameter setting display unit 210, the movable mirror 32 is driven and the light from the treatment light source 12 is incident on any of the fiber ports 25a to 25d of the optical fibers 24a to 24d and emitted from the ophthalmic laser system 1. The diameter of the laser beam to be formed is set.

When the pattern is irradiated, the spacing setting display unit 220 displays the gap size between the laser spots. For example, 0.50φ means that there is a gap of 50% (= 100 μm) with respect to the spot diameter of 200 μm. Further, the gap interval between the laser spots can be set from the spacing setting display unit 220. This setting is made by touching the up / down triangular arrow at the right end of the spacing setting display unit 220 or by specifying by voice.

The name of the contact lens registered in advance can be selected from the contact lens name selection unit 230. This selection is made by pulling down from the name of the contact lens registered in advance by specifying by touch or voice. The control unit 300 is provided with a contact lens data storage means for storing the name of the contact lens worn on the patient's eye and the laser spot magnification of the contact lens in association with each other. The control unit 300 acquires the laser spot magnification from the input contact lens name and performs an operation.

The practitioner name designation unit 240 sets the name of the doctor or the like performing the treatment. It can be selected by pulling down from the practitioner name registered in advance. From the default value setting unit 250, the output power value of the light source, the irradiation time, the laser spot diameter, the spacing, and the like are set in advance as default values. That is, it is possible to give a name to these and store a plurality of default values.

The end treatment setting unit 260 is operated when the ophthalmic laser system 1 is returned to the initial screen after the treatment is completed.

Then, in the ophthalmic laser system 1, the operator makes a voice designation by the voice detection device 350 and the voice analysis unit 340. The designation is made by specifying the item and the operation.

If the diameter, energy density, power, etc. of the laser spot are changed by voice designation, and if it is determined that this setting is correct, the first foot switch 361 that emits a consent signal is operated or voice consent is given. Then, when irradiating the laser beam, the second foot switch 362 is operated to start the irradiation of the laser beam.

Next, the operation of the ophthalmic laser system 1 according to the present embodiment will be described. The ophthalmic laser system 1 is used in the following embodiments.

For example, in the treatment of the posterior pole of the fundus EF, the treatment is performed by irradiating the laser spot with a preset laser spot diameter and energy density. These values differ depending on the content of treatment and the individual of the patient's eye E.

In this case, it is assumed that the laser spot is irradiated with the following settings.
-Light source output: 1st set value (A1)
-Spot diameter: 1st set value (B1)
-Irradiation time: First set value (C1)
・ Contact lens: 1st magnification (N1)
As a result, the energy density becomes the first setting (D1).

Subsequently, the contact lens is replaced with a second contact lens in order to treat the periphery of the posterior pole. At this time, the magnification of the contact lens is changed. The ophthalmic laser system 1 according to the present embodiment adjusts the laser spot diameter of the laser spot irradiating the fundus EF and the output of the light source so that the energy density is not changed.
-Light source output: 2nd set value (A2)
-Laser spot diameter: 1st set value (B1)
-Irradiation time: First set value (C1)
・ Second contact lens: 2nd magnification (N2)
-Energy density: 1st set value (D1)

Further, the spot diameter may be changed (B2) by using a second contact lens, and in this case as well, the output of the light source is adjusted so that the energy density is not changed.
-Light source output: 1st set value (A1)
-Laser spot diameter: 2nd set value (B2)
-Irradiation time: First set value (C1)
2nd contact lens: 2nd magnification (n2)
-Energy density: 1st set value (D1)

Further, both the output of the light source and the spot diameter may be adjusted, and in this case as well, the ophthalmic laser system 1 according to the embodiment does not change the energy density of the laser spot.
-Light source output: 3rd set value (A3)
-Laser spot diameter: 3rd set value (B3)
-Irradiation time: First set value (C1)
2nd contact lens: 2nd magnification (n2)
-Energy density: 1st set value (D1)

As described above, when the laser spot is irradiated by changing from the first contact lens to the second contact lens, the ophthalmic laser system 1 is a light source so that the energy density of the laser spot irradiated to the fundus EF is the same. Switch output and / or spot diameter.

Here, the energy density is expressed by the following equation.
Energy density =
Light source output x irradiation time / {1/4 x π x (spot diameter x contact lens magnification) 2}
This represents the energy per unit area at the laser spot. The same energy density means that the energy per unit area applied to the target tissue is the same, and the degree of scarring in the target tissue is the same.

In the ophthalmic laser system 1 according to the present embodiment, the contact lens name to be used is input from the display input screen 100 to acquire the magnification, and the above-mentioned light source output and laser spot diameter values are automatically changed to always be the same. It irradiates the fundus EF with a laser spot of energy density.

Hereinafter, specific examples will be described. First, a process when the operator operates the display input screen 100 by voice will be described. FIG. 4 is a flowchart showing the processing of the same ophthalmic laser system.

In the ophthalmic laser system 1 according to the present embodiment, when the operator specifies a predetermined position and operation of the display input screen 100 by voice, the voice detection device 350 recognizes this voice (step SA1). The designations include, for example, "set the spot diameter to 200 micrometers", "power to 300 milliwatts", "rise", "fall", "expansion", "acceptance", "confirmation" and the like.

Then, the voice analysis unit 340 analyzes the voice instruction, and the drive control unit 320 specifies the state of the light source assembly 2 (step SA2). These phrases and words are learned by the learning unit 370, and the accuracy can be improved. The content and status of the voice setting are displayed in numerical values or characters at a predetermined position on the display input screen 100 (step SA3). The operator confirms this, and if the setting is correct, operates the first foot switch 361 (Yes in step SA) to confirm the setting (step SA6). This confirmation can also be done by voice.

When the setting is inappropriate, the first foot switch 361 is not operated or is not confirmed by voice (No in step SA6), the process returns to step SA1, and the setting is reset by voice.

When this setting is made for each item and the necessary setting is completed (Yes in step S7), the operator operates the second foot switch 362 to irradiate the laser beam.

Next, a specific example of laser treatment by the ophthalmic laser system 1 will be described. FIG. 5 is a flowchart showing the processing of the same ophthalmic laser system. Here, a case where the contact lens having a magnification of 2 times is first selected and used is changed to a contact lens having a magnification of 1 time to maintain the laser spot diameter, and a case where the change is made will be described. In the following processing, selection and designation on the display input screen 100 can be performed from the touch panel 304, or can be performed by instructing by voice and confirming with the first foot switch 361.

In the case of selecting by voice, when the operator emits a voice, this voice is detected by the voice detection device 350 and analyzed by the voice analysis unit 340 to specify the operation of the display input screen 100.

First, a contact lens having a laser spot magnification of 1 is selected (step SB1) and attached to the patient's eye E. In this state, the name of the contact lens used in the contact lens name selection unit 230 of the display input screen 100 is selected and specified. The control unit 300 acquires from the contact lens data storage means that the spot magnification of this contact lens is 1.

Next, the spot diameter is selected (step SB2). For example, a laser spot diameter of 200 μm is selected. This setting is performed from the laser spot diameter setting display unit 210 of the display input screen 100. This laser spot diameter can be selected as needed.

Further, the output power of the treatment light source 12 and the irradiation time are selected (step SB3). This selection is made from the output power setting display unit 150 and the irradiation time setting display unit 160 of the display input screen 100. Here, the irradiation time is 20 ms with an output power of 300 mW. The output power and irradiation time can be selected as needed.

As a result, the calculation unit of the control unit 300 calculates the energy density of the laser spot and displays it on the energy density display unit 120, and the practitioner confirms this value (step SB4). Then, the operator operates the second foot switch 362 to oscillate the treatment light source 12 of the ophthalmic laser system 1 to irradiate the patient's eye E with the laser spot (step SB5).

From this state, a case where the contact lens is changed and a laser spot magnification of 1 is used will be described. At this time, the contact lens name selection unit 230 is operated to specify a new contact lens.

Hereinafter, the case where the laser spot diameter is maintained (No in step SB7) and the case where the laser spot diameter is changed and a new laser spot diameter is selected (Yes in step SB7) will be described separately. In either case, the energy density of the laser spot irradiated from the ophthalmic laser system 1 to the fundus EF is about the same as the previous irradiation.

When the laser spot diameter is not changed (No in step SB7), the calculation unit 310 of the control unit 300 obtains the power (new output) output by the aiming light source 16 by the following calculation.

New output = front output x (new laser spot magnification / front laser spot magnification) 2
Here, since the front output is 300 mW, the new laser spot magnification is 1, and the front laser spot magnification is 2, the new output = 300 mW × (1/2) 2 = 300 × (1/4) ≈80 m. As a result, the control unit 300 sets the output of the treatment light source 12 to 80 mW by the drive control unit 320.

Next, the control unit 300 calculates the energy density of the laser spot LS at the fundus EF by the calculation unit 310. 4.8 J / cm2 is acquired as the energy density and displayed on the energy density display unit 120 of the display input screen 100, and the practitioner confirms this value (step SB10).

The practitioner confirms that this energy density is the same as or equivalent to the previous time (Yes in step SB11). Then, the judgment unit 380 makes a judgment about this setting and presents the judgment result (SB20). This presentation is displayed on the display input screen 100 or by voice.

If it is determined to be appropriate (Yes in step SB21), the practitioner operates the second foot switch 362 to oscillate the treatment light source 12, and the ophthalmologic laser system 1 passes through the contact lens CL to the fundus EF. Is irradiated with a laser spot (step SB22). If the energy density is the same as or not equivalent to the previous time (No in step SB11), the output of the treatment light source 12 and the irradiation time are selected again (step SB13), and the same judgment is made.

On the other hand, when the laser spot diameter is selected (Yes in step SB7), the calculation unit 310 of the control unit 300 obtains a new laser spot diameter by the following calculation (step SB14).

New spot diameter = front spot diameter x front laser spot magnification / new laser spot magnification Here, since the front spot diameter is 200 μm, the new laser spot magnification is 1, and the front laser spot magnification is 2, the new spot diameter = 200 μm × ( 1/2) = 400 μm.

As a result, the control unit 300 controls the laser beam diameter setting means 280 by the drive control unit 320 to irradiate the fiber port 25a (400 μm) with the reflected light from the movable mirror 32 (step SB15).

Next, the control unit 300 calculates the energy density of the laser spot in the fundus EF by the calculation unit 310, acquires 4.8 J / cm2, displays it on the energy density display unit 120 of the display input screen 100, and the practitioner. Confirms this value (step SB16).

After confirming that this energy density is the same as or equivalent to the previous time (Yes in step SB17), the practitioner oscillates the therapeutic light source 12 and causes a laser spot from the ophthalmic laser system 1 to the fundus EF via the contact lens CL. Irradiate. If the energy density is the same as or not equivalent to the previous time (No in step SB17), the output of the treatment light source 12 and the irradiation time are selected again (step SB18), and the same judgment is made.

As described above, according to the ophthalmic laser system 1 according to the present embodiment, the size and angle of the spot pattern can be set reliably and easily by voice designation without the operator manually operating the display input screen. be able to. Further, since it is determined from the past treatment examples whether this setting is appropriate, the laser irradiation can be performed with the setting suitable for the symptom of the patient's eye.

1: Ophthalmology laser system 2: Light source assembly 3: Assembly 12: Treatment light source 14: Treatment beam 16: Aiming light source 18: Aiming beam 20: Lens 22: Curved mirror 24: Optical fiber bundle 24a: Optical fiber 24b: Optical fiber 24c: Optical fiber 24d: Optical fiber 25a: Fiber port 25b: Fiber port 25c: Fiber port 25d: Fiber port 26: Partial reflector 28: Photo diode 30: Mirror 32: Movable mirror 34: Mirror 38: Dump 40: Dump 42: Lens 44: Lens 46: Optical fiber 50: Optical fiber input unit 52: Assembly 54: Sending assembly 56: Binocular assembly 58a: Lens 58b: Lens 58c: Lens 58d: Lens 60: Aperture 62: Movable mirror 64: Movable mirror 66: Galvano Scanner 68: Galvano Scanner 70: Lens 72: Lens 74: Mirror 76: Lens 78: Lens 80: Illumination light source 84: Eye safety filter 86: Optical element 88: Eyepiece lens 90: Input / output interface 94: Pointing device 100: Display Input screen 110: Operation standby display unit 120: Energy density display unit 130: Irradiation count display unit 140: Time display unit 150: Output power setting display unit 160: Irradiation time setting display unit 170: Pattern selection unit 180: First display selection Unit 190: Second display selection unit 200: Third display selection unit 210: Laser spot diameter setting display unit 220: Spacing setting display unit 230: Contact lens name selection unit 240: Practitioner name designation unit 250: Default value setting unit 260: End treatment setting unit 280: Laser beam diameter setting means 300: Control unit 300 mW: Output power 301: Liquid crystal display device 302: Keyboard 303: Pointing device 304: Touch panel 310: Calculation unit 320: Drive control unit 330: Contact lens data Storage unit 340: Voice analysis unit 350: Voice detection device 360: Foot switch 361: First foot switch 362: Second foot switch 370: Learning unit 380: Judgment unit

Claims (7)

An ophthalmic laser system that irradiates a target tissue of a patient's eye with a laser spot having a predetermined energy density and a predetermined spot diameter.
A light source that emits laser light with variable output power,
A laser beam diameter setting means that receives the laser beam from the light source and outputs a laser beam having a predetermined beam diameter.
A contact lens information input means for inputting information on a contact lens to be worn on the patient's eye,
An irradiation beam value input means for inputting the spot diameter of the laser spot to be irradiated on the target tissue, the output power of the light source, and the irradiation time.
A calculation means for calculating the energy density of the laser spot based on the information from the contact lens information input means and the irradiation beam value input means , and
A voice detection means that detects the operator's voice,
A voice analysis means that analyzes the voice detected by the voice detection means and outputs an operation instruction,
A learning means that optimizes the voice recognition setting of the voice analysis means by learning the input voice data about the accumulated past voice analysis and the output operation as teaching materials.
A drive control unit that controls the drive of the light source and the laser beam diameter setting means based on the operation instruction.
An ophthalmic laser system characterized by being equipped with. It accumulates information about the target tissue of the patient's eye, has data on appropriate examinations and treatments corresponding to each patient's eye, determines whether the operation is an appropriate setting for the patient's eye, and outputs it. The ophthalmic laser system according to claim 1, further comprising a determination unit. The calculation means outputs the output power of the light source based on the information from the contact lens information input means and the irradiation beam value input means.
The ophthalmic laser system according to claim 1, wherein the drive control unit controls the light source. The calculation means performs a calculation based on the information from the contact lens information input means and the irradiation beam value input means, and outputs the beam diameter of the laser beam output by the laser beam diameter setting means.
The ophthalmic laser system according to any one of claims 1 to 3, wherein the drive control unit controls the laser beam diameter setting means. The ophthalmology according to any one of claims 1, 3, or 4, wherein the contact lens information input means inputs the laser spot magnification of the contact lens to be worn on the patient's eye. Laser system. A contact lens data storage means for storing the name of the contact lens to be worn on the patient's eye and the laser spot magnification of the contact lens in association with each other is provided.
A claim characterized in that a name of the contact lens is input to the contact lens information input means, and the calculation means acquires a laser spot magnification of the contact lens from the contact lens data storage means and performs a calculation. The ophthalmic laser system according to any one of claim 1 and claim 3. The ophthalmic laser system according to any one of claims 1 to 6, further comprising a display means for displaying the energy density and the spot diameter.

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