JPS62503151A - Laser surgery device for corneal incision (2) - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] name of invention Laser surgical device for corneal incision (I [) Technical field The present invention relates to a device related to laser surgery, and the preamble of claim 1 As mentioned above, especially lasers, especially lasers for corneal incisions using ultraviolet laser light. It is a surgical surgical device.

existing technology In particular, argon/fluorine excitation lasers with a wavelength of 193 nm may be used in corneal surgery. But, for example, 5tephen L.

Research report of Troke l “Surgery using excitation laser” (Amer-ica n Journal of 0phtha! mology, vol, 96. pp. 710-715° 1983). This kind of surgery For example, a special incision pattern may be used to remove an abnormal corneal curvature. I'll send it out.

Reports on lasers with other wavelengths, such as r, f, and lasers, have also been published. These are also common to keratotomy.

For example, the known corneal incision device described in the above-mentioned research report, and also as claimed in claim 1. The device described above has the necessary “incision pattern” in the UV transmittable region. It has a mask. This mask is placed directly in front of the eye to be operated on and laser light is irradiated onto it.

The existing device shown in the preamble of claim 1 has many drawbacks due to its construction. Ru.

Because the diaphragm is placed directly on the tissue being operated on, the results can be visualized during surgery. It cannot be confirmed visually. Incision related to this! Some laser beams are used when applying pressure. It must be kept in mind that Luz is usually required. For this reason Consideration should be given to integrating known technologies such as slit lamp mechanisms, etc. I couldn't do it.

Solving the problem of placing the diaphragm just above the tissue to be operated on, as well as optical imaging Solving the problem of imagining has not been considered in the past. The reason is the table of eyes that connect the image. The surface is not flat, but highly curved, typically with a 45 degree slope. It is. This means that with known optical imagers it is difficult to maintain reception of the diaphragm image. means not possible.

Disclosure of the invention The problem of the invention is a further development of the device according to the preamble of claim 1, in which the diaphragm The optical image of the eye is placed at a distance in front of the eye to be operated on, deep in the visual field, and the cornea of the eye is The diaphragm image can be highly accepted even on extremely curved tissue surfaces such as the It is to be.

This problem can be solved by the characteristic elements of claim 1 of the invention.

According to the invention, the device has two focusing mechanisms, which is a remote focusing device, i.e. In other words, it is a device in which two optical mechanisms are arranged at an interval equal to the sum of their focal lengths.

For example, laser light such as ultraviolet laser light first passes through the first condensing mechanism as a parallel beam of light. This is immediately focused, and is then sent back to the second condensing mechanism as a beam of light. leave. The combination of this arrangement and coherence, which is an important property of lasers, allows Created with laser light for illumination array according to the invention with non-coherent light A high degree of depth can be created in the diaphragm image.

The depth of field of the diaphragm image is several millimeters, and even if it is placed on the cornea of the human eye, it will not be visible. It will leave a clear image of Iapuram.

As a result, the device according to the present invention can be easily integrated into an optometry device. It can be integrated with ophthalmic spectroscopes, slit lamps, etc.

As a result, the device related to the present invention can be used as a telephoto bracket for laser slit lamps. Can be incorporated. For such laser slit lamps, the laser The light is first introduced into the slit lamp and the normal rotating axis of the microscope, and then From there, it is refracted 90 degrees and introduced into the vertical part of the telephoto bracket, and then projected into the human eye. shot.

However, the slit is capable of transmitting laser light such as the excitation laser according to claim 2. Coaxial to the optical path of a slit lamp with flam, stop or aperture If it can be introduced into the system, the structure can be particularly simple. This results in , slit length 2 width.

Regarding axis adjustment, the slit adjustment mechanism of the slit lamp can be used for visible light and ultraviolet light at the same time. In addition to this, the visible slit image can be becomes image-forming light in invisible ultraviolet rays, making it easy to confirm the direction of invisible ultraviolet rays. can be done. However, if incoherent visible light is used, visible light becomes It must be noted that demand for highly coherent light cannot be expected. . Using an achromatic ultraviolet optical system in the optical path of the slit lamp according to claim 3. When using an ultraviolet laser in A complete agreement is obtained.

For example, to synchronize the diaphragm image on the tissue being operated on, such as in corneal curved incisions. Mechanical rotation of the slit or diaphragm of the slit lamp is usually possible.

However, the slit is used for flat plate irradiation, and the slit or diaphragm is directed toward the tissue to be operated on. Because only a portion of the ultraviolet light transmitted passes through, the surgical time is significantly increased. Ras.

Claim 4 describes a solution to this problem.

Adjust only the length and width without changing the axial alignment or direction of the slit or diaphragm. do. Rotating optics to direct the diaphragm or slit image onto the tissue being operated on is placed between the diaphragm and the optical axis to deflect the optical axis. Adjusting the slit for axis alignment Since there is no more irradiation, the slit is sufficiently irradiated. excitation laser light pro The fill is extended without a light cross section modification mechanism and helps extend in one direction, so it is non-trivial. It will always be convenient.

Claim 5 relates to the optimal arrangement of the rotation mechanism that can shorten the structural length of the completed device. It is written as follows.

Claim 6 provides a rotation mechanism which is particularly advantageous compared to known rotation mechanisms, and which is applicable to all entrances and exits. The rotating mechanism is characterized by the fact that the light passes vertically and does not interfere with the separation line on the reflective surface. This is what I described.

Brief description of the drawing The invention will now be explained in an exemplary form with reference to the drawings.

Figure 1 is a vertical sectional view of the device according to the present invention, and Figure 2 is an optimal example of the rotary optical front groove. It is.

How to practice the invention A vertical cross-sectional view of the device according to the invention, ie the essential slit lamp, is shown in FIG.

In a method known per se6, a slit lamp is used together with an optical system such as a condenser. have a pump. These elements are indicated as 1 and are not described in detail below. . Although not shown in Figure 1, the ultraviolet laser beam is slitted by beam splitter 2. is introduced into the optical path of the amplifier. Visible light is transmitted and ultraviolet light is reflected. Light gathering structure 3,5 is essentially a slit lamp slit made in a known manner in the direction of the light path. The structure is such that the cut 4 can be moved up and down. The light collecting mechanism 3゜5 constitutes a remote light collecting mechanism. , that is, placed at a distance equal to the sum of their focal lengths. The condensing mechanism 3 is a slit Placed outside (position 3) or within the optical path (position 3') of the playing card "through" the playing card. be placed. In essentially a known manner, there is a speculum 6 and the tissue to be operated on 7, e.g. For example, deflecting the optical path of the slit onto the human cornea.

In addition, an optical rotation front groove 8 is arranged behind the slit 4 in the optical path of the slit lamp. It is best to place this in front of the condensing R structure 5 because it can shorten the length of the metal body. stomach.

A specific example of the optical rotation machine @8 in a particularly optimal form is shown in FIG. As shown in Figure 2, the light transmitting surface D1 ．． Similar to D2 and light guide, the slopes of each reflective surface R1, R2, and R3 are shown, but the detailed light An explanation of the rotating wave groove is unnecessary. The light condensing mechanism according to FIG. Transparent surface D1. D2 allows the light to cross at the correct angle and the reflective surface interferes with the slit image. However, it has the advantage that there is no separated light in the prism part. Make a total of 3 reflections Two prisms ff1D1. for unilateral image inversion. D2 also has a wall of nitrogen between them. is optically sealed but not cemented. Figure 12 The book shown in Figure 2 The device according to the invention has a number of advantages. The tissue to be operated on, such as the cornea, The field of view of the lit image is very deep, with a focal depth of about 2002mm and a focusing mechanism of about 200mm. 50 to 1005, and the optimum depth of field is 60"J for the focusing device 5. As a result, the ultraviolet diaphragm image on the cornea has sufficient receptivity. show. Visible diaphragm images created with introduced non-coherent light show sufficient receptivity. However, if the normal optical path of visible light and ultraviolet light is This is the image form of the ultraviolet diaphragm image if it is formed with an achromatic ultraviolet optical system. It is particularly useful as a beam. The diaphragm image can be easily rotated optically. Therefore, the length and width of the slit can be adjusted using normal mechanisms. In addition to being able to create variable incision patterns, ultraviolet excitation lasers can also be used in surgery. - can utilize all light intensities.

The present invention has been specifically illustrated above. Remote collection for obtaining images with a deep depth of focus Many modifications are possible within the scope of the inventive principles using optical mechanisms.

There is no need to integrate the remote focusing mechanism of the present invention into a slit lamp. For UV images It is clear that additional slits or adjustable diaphragms can be used.

There is also no need for the diaphragm to be adjustable, but instead several lines Using a removable diaphragm such as a complete incision pattern consisting of be able to.

The introduction of ultraviolet laser light above the slit lamp is carried out in a known manner. purple The external laser beam is guided to the rotation axis of the slit lamp, and then reflected at a 90 degree angle. The light is then reflected back into the slit lamp. Also, the slit lamp is straight the jaw support is adjustable; It may also be used in new configurations of devices disclosed in other co-pending patents. Ru.

If the mirror mechanism for ultraviolet laser light is made of a coated prism, the coating is easy. Coated prisms are particularly advantageous because they have a higher degree of reflection than simple reflective coating methods. Ru. Of course, the remote focusing mechanism described here can also be applied to lasers of other wavelengths. Those who have a deep perspective have similar advantages.

international search report 1mmmw1Aps&J1m”’ PCT/DE 8610026

Claims (6)

[Claims] 1. A laser surgical device, especially one related to corneal incision, that has a laser and In particular, it has an ultraviolet laser, and the laser light forms an image on the tissue to be operated (7). The optical path (S) is arranged in a diaphragm (4), which illuminates the tissue. In the area-limiting device, two light-collecting mechanisms (3, 5) forming a remote light-collecting mechanism A laser surgical device characterized in that the diaphragm (4) is arranged between . 2. Laser light is coaxially introduced into the optical path (S, S') of the slit lamp, and the slit lamp Claim 1 characterized in that the slit (4) can be used as a diaphragm. The laser surgical device described in . 3. When using ultraviolet laser light, a remote focusing mechanism is placed in the optical path of the observation device. The optical system (5), for example, the slit lamp is an ultraviolet achromatic optical system. A laser surgical device according to claim 2. 4. Rotate the diaphragm image between the tissue to be operated on (7) and the diaphragm (4) Therefore, the optical rotation system that guides the light beam to the optical axis (S') Any one of claims 1 to 3 characterized by having between the iaphragms (4) The laser surgical device described in . 5. A rotation mechanism (8) is arranged between the diaphragm (4) and the second optical system (5). 5. The laser surgical device according to claim 4, characterized in that: 6. The rotation mechanism (8) is a prism with two parts, its entrance surface (E) and exit surface. (A) has a clockwise rotation angle with respect to the optical axis, and it also has three surfaces that reflect all light. , and between the two parts there are two transparent surfaces (D 1, D2), and the normals of these surfaces are 67.5 degrees, 90 degrees, and 112 degrees with respect to the optical axis. The lens according to claim 4 or 5, characterized in that it is made to have an angle of 5 degrees. laser surgical device.