Ophthalmic surgery visualization system, operating procedures and computer program

Abstract

Ophthalmic Surgery Visualization System (10) with a device (16) for stereoscopic visualization of an object area with an operating site (12) on a patient eye (14), which includes an image acquisition device (33) for acquiring object area image data containing image data for at least one patient eye registration structure (76), with a computing unit (54), and with a biometric data interface (70) for providing patient eye biometric data, which defines a patient eye model (102) with a model registration structure (76') corresponding to the patient eye registration structure (76) and a model coordinate system (77'), characterized by the fact that The computer unit (54) contains a computer program with a program routine for registering the patient eye model (102) to the patient eye (14) using the patient eye registration structure (76) and the model registration structure (76'), in which the object area image data acquired by means of the image acquisition device (33) are linked with optical imaging parameters of the image acquisition device (33) in order to provide a patient eye coordinate system (77) fixed to the patient eye (14) in the form of data, which is referenced to the model coordinate system (77'), wherein a stereoscopic display device (48) is provided for displaying image information in a stereoscopic visual impression, wherein the computer program has a program routine for calculating stereoscopic display information in the patient eye coordinate system (77),wherein the program routine serves to provide display information data which can be displayed at the display device (48) as a spatially extended structure (122) superimposed on the visualized object area, wherein the device (16) for stereoscopic visualization of an object area includes an adjustable imaging optic with an autofocus system (130) for automatically focusing on a structure (76) of the patient's eye or for automatically focusing on a point (140') in the patient's eye (14) corresponding to a structure (76') of the patient's eye model (102) or to a point (140') in the patient's eye (14) corresponding to a point of interest (140) of the patient's eye model (102), which has a focusing state interface (138) for providing z-focusing and / or xy-scaling of the imaging optics as well as xy-positioning of the device (16) for acquiring stereoscopic image data in a plane perpendicular to an optical axis (21) of a main objective (20) of the imaging optics, wherein the computer program receives information from the group z-focusing, xy-scaling of the imaging optics, xy-positioning from the focusing state interface (138) and receives patient eye biometric data from the biometric data interface and takes this into account for calculating the display information data.

Description

[0001] The invention relates to an eye surgery visualization system with a device for the stereoscopic visualization of an object area with an operating site on a patient's eye, wherein the device for the stereoscopic visualization of an object area comprises an image acquisition device for acquiring object area image data containing image data for at least one patient eye registration structure, a computer unit, and a biometric data interface for providing patient eye biometric data defining a patient eye model with a model registration structure corresponding to the patient eye registration structure and a model coordinate system.

[0002] From DE 20 2014 011 050 U1, an ophthalmic surgery visualization system of the type mentioned above is known. This visualization system includes an OCT system for scanning an object area volume 90 and has a device for setting the position P of the object area volume scanned by the OCT scan beam. The position P of the object area volume scanned is displayed by means of a display unit for visualizing a model of the patient's eye.

[0003] German patent DE 10 2020 102 011 A1 describes an ophthalmic surgery operating system that includes an OCT device used to capture the position of a surgical instrument in a model of a patient's eye. This model can be displayed to a surgeon as a 3D reconstruction of a region of the patient's eye. The display unit enables the showing of both the actual and target positions of the surgical instrument.

[0004] From DE 10 2018 124 065 A1 it is known to display to a surgeon in an eye surgery operating system position information referenced to a patient's eye for a surgical incision or surgical incisions.

[0005] US Patent 10 842 573 B2 describes an ophthalmic surgical system that includes a computing unit for generating a computational model to assist ophthalmic surgeons in estimating the stress on the retina during membrane peeling.

[0006] US Regulation 2018 / 000339 A1 specifies that in an ophthalmic operation, the model of a patient's eye is to be determined based on intraoperatively recorded data in order to display information about the model to a surgeon during the ophthalmic operation.

[0007] The correct display of auxiliary information for a surgeon in superimposition on the observation image of an object area is difficult with ophthalmic surgery visualization systems because the coordinates of transparent areas of a patient's eye, e.g. areas of the cornea, cannot be easily determined in a coordinate system that is fixed to an ophthalmic surgery visualization system.

[0008] The object of the invention is to provide an eye surgery operating system and to specify a computer program and a method that increases the precision of surgical procedures on a patient's eye.

[0009] This problem is solved by an ophthalmic surgery visualization system for the three-dimensional visualization of a surgical site on a patient's eye, comprising the features of claim 1, a method comprising the features of claim 10, and a computer program comprising the features of claim 11. Advantageous embodiments and further developments of the invention are specified in the dependent claims.

[0010] The invention defines a model of the patient's eye as a construct that describes only the properties of a model, in particular a patient's eye, that are considered important, in order to arrive at an abstract representation of the model that is manageable, mathematically calculable, or suitable for experimental investigations through this simplification.

[0011] A model of the patient's eye can be, for example, a point cloud describing the patient's eye. The model can also describe the surface shape of the cornea. In particular, a model of the patient's eye can be a CAD model and / or a height profile of a section of the patient's eye and / or a distance profile of the patient's eye and / or a depth profile of the patient's eye and / or a three-dimensional surface representation of a section of the patient's eye and / or a two-dimensional surface representation of a section of the patient's eye.

[0012] The invention is based on the idea that, using three-dimensional biometric data of a patient's eye, which are registered to a preferably stereoscopic view of the patient's eye, display information with a spatially extended structure can be displayed in an ophthalmic surgery visualization device, which is superimposed on a displayed stereoscopic image of the patient's eye.

[0013] Ophthalmic surgery involves procedures on the anterior and posterior chambers of a patient's eye. In the anterior chamber, cataract surgery is by far the most common operation, with approximately 8 million procedures performed worldwide annually. The selection of the implanted intraocular lens (IOL) is based on biometric data obtained using systems such as the IOLMaster 700 from Carl Zeiss. Surgical microscopes are used intraoperatively to perform the procedure. Analog surgical microscopes have been increasingly replaced by hybrid systems in recent years.

[0014] To increase the precision of surgical procedures on a patient's eye, it is desirable to superimpose information in the form of biometric data, which can be obtained with systems such as the IOL Master 700 from Carl Zeiss, such as the size of the capsulorhexis or the axis position of a toric intraocular lens (IOL), in 3D onto a stereoscopic image of the surgical site on a patient's eye using simple, cost-effective technologies.

[0015] An ophthalmic surgery visualization system according to the invention comprises a device for the stereoscopic visualization of an object area with a surgical site on a patient's eye, wherein the device for the stereoscopic visualization of an object area includes an image acquisition device for acquiring object area image data, which contains image data for at least one patient eye registration structure. The ophthalmic surgery visualization system includes a computer unit comprising a computer program and a biometric data interface for providing patient eye biometric data, which defines a patient eye model with a model registration structure corresponding to the patient eye registration structure and a model coordinate system.The computer program has a program routine for registering the patient eye model to the patient eye using the patient eye registration structure and the model registration structure, in which object area image data captured by the image acquisition device are linked to an image of the patient eye with optical imaging parameters of the image acquisition device in order to provide a patient eye coordinate system fixed to the patient eye in the form of data that is referenced to the model coordinate system.

[0016] In this way, an ophthalmic surgery visualization system is created that can display information such as the size of the capsulorhexis or the axis position of a toric IOL in 3D to a surgeon in the correct location superimposed on an image of a patient's eye using image processing and, in particular, with the help of fundamentally simple, cost-effective technologies.

[0017] In this context, an operating site on a patient's eye is understood to be an operating site that is located in the patient's eye, in the vicinity of the patient's eye, or partially inside and outside the patient's eye.

[0018] Object-area image data, as defined in the invention, refers to data containing information about the position and color of pixels in an image of the object area, which is a representation of the object area. Object-area image data can also be data based on processed information about pixels in an image of the object area.

[0019] Image data relating to at least one patient eye registration structure, as defined in the invention, means image data about the patient eye registration structure, i.e., image data of an image that is a complete or partial representation of the patient eye registration structure.

[0020] Patient eye biometric data can include, for example, specific lengths of structures of the patient eye derived from OCT data, and may also include an eye position image during an OCT image acquisition.

[0021] The invention understands OCT data to mean data provided by an OCT system designed for detecting structures in body tissue using OCT scanning radiation, wherein the data contain information on the spatial location of scattering centers for OCT scanning light, e.g., in body tissue.

[0022] It is advantageous if the ophthalmic surgery visualization system includes a stereoscopic display device that serves to display image information in a stereoscopic visual impression, wherein the computer program has a program routine for calculating stereoscopic display information in the patient's eye coordinate system, which serves to spread display information data that can be displayed as a spatially extended structure superimposed on the visualized object area at the display device.

[0023] Stereoscopic display information is understood here to mean display information that conveys a spatial impression of depth, as it contains image information for the left and right eye of an observer that corresponds to a stereoscopic visual impression.

[0024] In this way, an ophthalmic surgery visualization system can display auxiliary information to the surgeon that corresponds to the natural visual impression, making it easier for him to precisely move or guide surgical instruments in space.

[0025] The spatially extended structure can be, for example, a structure from the group rhexis circle at the location of the capsular bag, IOL axis position, corneal incision.

[0026] One idea of ​​the invention is that the patient eye model describes at least one physiological dimension of the patient eye from the group consisting of corneal curvature, corneal thickness, anterior chamber depth, lens extent, sclera diameter, iris extent, pupil extent, lens thickness, posterior chamber depth, and retinal extent.

[0027] The patient eye registration structure can be, for example, at least one structure from the group consisting of the structure of the iris, the structure of the retina, the structure of at least one vessel of the sclera, and the geometry of the white-to-white of the patient eye.

[0028] The device for stereoscopic visualization of an object area with an operating site on a patient's eye preferably includes an adjustable imaging optic with an autofocus system for automatic focusing on a structure of the patient's eye, wherein the computer program has a program routine for a sharpness evaluation for images based on object area image data acquired by means of the device for acquiring object area image data, which is designed to provide control data for adjusting a z-focus of the imaging optic.

[0029] It is advantageous if the device for stereoscopic visualization of an object area with an operating site on a patient's eye includes an autofocus system for automatically focusing on a point in the patient's eye corresponding to a structure of the patient's eye model or to a point of interest in the patient's eye model, wherein the computer program has a program routine that sets a z-focus and / or an xy-scaling and / or an xy-positioning of the imaging optics for sharply imaging a point or area of ​​the patient's eye corresponding to a point of interest or a model area of ​​the patient's eye model, by linking setting data for the imaging optics from coordinates of the point of interest or the area in the model coordinate system with optical imaging parameters of the device for stereoscopic visualization of an object area.

[0030] The autofocus system can have a focus state interface for providing z-focusing and / or xy-scaling of the imaging optics and / or xy-positioning of the device for acquiring stereoscopic image data in a plane perpendicular to an optical axis of a main objective of the imaging optics.

[0031] It is advantageous if the computer program receives at least one piece of information from the group z-focusing, xy-scaling of the imaging optics, xy-positioning from the focus state interface and receives patient eye biometric data from the biometric data interface and takes this into account for calculating the display information.

[0032] The biometric data interface can be designed, for example, to provide intraoperatively acquired patient eye biometric data. This patient eye biometric data can include, for example, OCT data of the patient eye, as well as lengths derived from OCT data of the patient eye. In particular, the patient eye biometric data can include an underlying image of the eye position derived from the OCT data of the patient eye.

[0033] It is advantageous if the image acquisition system is designed for capturing stereoscopic image data and includes a first and a second image sensor for this purpose. The stereoscopic display device can be a 3D monitor or a head-mounted device (HMD). It can also be integrated into a binocular tube, featuring a display for projecting image data into a first and a second stereoscopic partial observation beam path.

[0034] In the method according to the invention, object-area image data are acquired by means of a device for acquiring object-area image data, which shows at least one registration structure of the patient's eye, and patient-eye biometric data are provided that define a patient-eye model with a model coordinate system. The patient-eye model is registered to the patient's eye by linking object-area image data acquired by the device to form an image of the patient's eye with optical imaging parameters of the device and with data of the patient-eye model, in order to provide a patient-eye coordinate system fixed to the patient's eye in the form of data that is referenced to the model coordinate system.

[0035] The provided patient eye biometric data may have been acquired preoperatively or intraoperatively. It should be noted that a point of interest within the biometric data, which defines a model of the patient eye, may be selected and / or determined by a person or using an artificial intelligence-based computer program. Specifically, it should be noted that the provided patient eye biometric data are intraoperatively acquired OCT data of the patient eye.

[0036] The patient-eye coordinate system can, for example, provide display information data for showing a spatially extended structure superimposed on the visualized surgical site. It is also possible to provide imaging optics settings data for sharply imaging a point or area of ​​interest within the patient-eye coordinate system.

[0037] The invention will now be explained in more detail with reference to exemplary embodiments shown schematically in the drawing.

[0038] They show: Fig. 1. An ophthalmic surgery visualization system for the three-dimensional visualization of an operating site on a patient's eye; Fig. 2 a system for capturing patient eye biometric data that defines a model of the patient eye, Fig. 3 a partial view of the patient's eye with areas where the system captures patient eye biometric data; Fig. 4 Patient eye biometric data that the system provides for capturing patient eye biometric data; Fig. 5 a model of the patient's eye that defines the captured patient eye biometric data; Fig. 6. An image of the patient's eye captured in the ophthalmic surgery visualization system; Fig. 7 a flowchart with program routines of a computer program for calculating stereoscopic display information for display in the ophthalmic surgery visualization system, which is loaded into a program memory of a computer unit in the ophthalmic surgery visualization system; Fig. 8 stereoscopic display information provided in the ophthalmic surgery visualization system; Fig. 9 a flowchart with a program routine for calculating stereoscopic display information in the ophthalmic surgery visualization system; and Fig. 10 a flowchart with program routines of a computer program for setting a z-focus, an xy-scaling and an xy-position of the imaging optics in the ophthalmic surgery visualization system to enable a sharp image of an area in the patient's eye.

[0039] The one in Fig. The ophthalmic surgery visualization system 10 shown is used for the three-dimensional visualization of an object area with a surgical site 12 on a patient's eye 14. For this purpose, the ophthalmic surgery visualization system 10 has a device 16 for the stereoscopic visualization of the object area. The device 16 for the stereoscopic visualization of the object area has an imaging optic with a main objective system 20, which has an optical axis 21 and is housed in a base body 22. The device 16 for the stereoscopic visualization of the object area includes a lighting device 24, which enables the illumination of the surgical site 12 with a light beam path that passes through the main objective system 20.

[0040] The imaging optics in the device 16 for stereoscopic visualization of the object area has an afocal magnification system 26 through which a first stereoscopic partial observation beam path 28 and a second stereoscopic partial observation beam path 30 are guided.

[0041] The main objective system 20 and the magnification system 26 are motor-adjustable and allow the setting of a focal plane 31 and a magnification. The main objective system 20 is intersected by the first stereoscopic partial observation beam path 28 and the second stereoscopic partial observation beam path 30.

[0042] In the device 16 for stereoscopic visualization of the object area, there is an image acquisition device 33. The image acquisition device 33 is designed for acquiring stereoscopic object area image data that includes image data for a patient eye registration structure. For this purpose, the image acquisition device 33 has a first image sensor 32 with an objective lens system 34, which serves to acquire data with image information from the first stereoscopic partial observation beam path 22, and a second image sensor 36 with an objective lens system 38 to acquire image information from the second stereoscopic partial observation beam path 30.

[0043] The device 16 for stereoscopic visualization of the object area has a device 40 for providing stereoscopic images of the surgical site 12. The device 40 includes a binocular tube 42 connected to an interface of the base body 22, with a first binocular view 44 and a second binocular view 46. The device 40 has a display device 48 for image data projected into the stereoscopic partial observation beam paths 28 and 30. For this purpose, the display device 48 includes a display 50 for projecting image data into the first stereoscopic partial observation beam path 28 and a display 52, which serves for projecting image data into the second stereoscopic partial observation beam path 30.

[0044] The ophthalmic surgery visualization system 10 has a computer unit 54, which is connected to the image acquisition device 33 for acquiring stereoscopic object area image data. The computer unit 54 contains a computer program with an image processing stage that converts data from the first image sensor 32 and the second image sensor 36 into spatial image data. The computer unit 54 in the ophthalmic surgery visualization system 10 is also responsible for controlling the display device 48 for image data projected into the stereoscopic partial observation beam paths 28, 30. The computer unit 54 has a program memory and is connected to a screen for displaying a user interface 56.

[0045] The ophthalmic surgery visualization system 10 includes a biometric data interface 70. The biometric data interface 70 is used to provide patient eye biometric data, which defines a patient eye model with a model registration structure corresponding to the patient eye registration structure and a model coordinate system.

[0046] The Fig. Figure 2 shows a system 57 for acquiring such patient eye biometric data. The system 57 has an OCT device 58 and a camera 59. The OCT device 58 is designed for scanning an object area volume with an A, B, and C scan of the patient eye 14. It should be noted that the OCT device can be configured as a so-called SS-OCT device, which enables scanning of the object area with quasi-short-coherent light. For scanning the object area volume, an OCT scan beam 60 with short-coherent light is generated by the OCT device 58 and can be moved over the object area volume. The OCT scan beam 60 serves to acquire OCT data with spatial image information in the form of image data for tomographic images of the object area volume, as is the case, for example, in A.Ehnes, “Development of a layer segmentation algorithm for the automatic analysis of individual retinal layers in optical coherence tomography - B scans”, dissertation University of Giessen (2013) in which chapter 3 is described on pages 45 to 82.

[0047] The OCT device 58 has adjustable scan mirrors 62, 64 for moving the OCT scanning beam 60. In the ophthalmic surgery visualization device 10, the OCT scanning beam 60 is guided into the object area volume at the patient's eye 14 via a beam splitter 66 and a main objective system 68. The light of the OCT scanning beam 60, scattered in the object area volume, returns at least partially to the OCT device 58 via the same light path. In the OCT device 58, the path of the scanning light is then compared with a reference path. This allows patient eye biometric data to be acquired in the form of a precise location of scattering centers in the object area volume, which, in particular, describes the position of optically effective surfaces with an accuracy corresponding to the coherence length Ic of the short-coherent light in the OCT scanning beam 60.

[0048] The camera 59 is designed to capture an image of the patient's eye, containing the pupil, the iris and at least part of the sclera with vessels formed therein, resolved by the camera, as patient eye biometric data.

[0049] System 57 includes a computer unit 54' which controls the OCT scan beam 60 provided by the OCT device 58. The computer unit 54' allows for the adjustment of the spatial position and orientation of the object area volume scanned by the OCT scan beam 60 in section 18 of the patient's eye 14. System 57 can transmit the acquired patient eye biometric data to the biometric data interface 70 in the ophthalmic surgery visualization device 10.

[0050] It should be noted that, as an alternative to the system described above, an ophthalmological examination system in the form of the IOL Master 700 from Carl Zeiss can also be used for acquiring patient eye biometric data that defines a patient eye model and for supplying the patient eye biometric data to the biometric data interface 70 in the ophthalmic surgery visualization device 10. This system provides, as patient eye biometric data, not only an image of a patient eye with the pupil, iris, and at least a portion of the sclera with its resolved vessels, but also the keratometrically determined curvature of the cornea and the location of scattering centers in six different OCT scan planes. These planes lie on a common optical axis that passes through the cornea and pupil of the patient eye and are azimuthally offset from each other with respect to this axis.Furthermore, it should be noted that the system 57 described above for capturing such patient eye biometric data can also be used in a system in the . Fig. 1. The eye surgery visualization system shown can be integrated with 10.

[0051] The Fig. Figure 3 shows a partial view of the patient eye 14 with a patient eye coordinate system 77 fixed to the patient eye 14 and with areas in which the system 57 records patient eye biometric data. The first patient eye biometric data acquired by the system 57 are image points in an image plane 72 with the sclera 74 and the vessels formed therein as a patient eye registration structure 76. The second patient eye biometric data acquired by the system 57 are scattering centers 78 for the OCT scan beam in the OCT scan planes 80, 82, 84 and 86, which are offset from each other by the azimuth angle φ = 45°. These scattering centers 78 indicate the position of the cornea 88, its thickness, the depth 90 of the anterior chamber 91, the position of the lens 92, its thickness 94, the position of the retina 96, and the depth 98 of the posterior chamber 100 in the patient eye 14.

[0052] The Fig. Figure 4 shows patient eye biometric data provided by System 57 for patient eye biometric data acquisition. This patient eye biometric data includes OCT scan data 99.1, 99.2, 99.3, and 99.4 in the form of the location of scattering centers for OCT scan light in OCT scan planes 80, 82, 84, and 86 of the Fig. 3 as well as an image 101 of the patient's eye captured by the camera 59, showing the iris 101.1 and the white-to-white 101.2 as a section of the sclera 74.

[0053] In the Fig. Figure 5 shows a patient eye model 102, which defines the patient eye biometric data acquired by the system 57: Parameters of this model, in addition to the position and structure of vessels in the plane of the sclera as a model registration structure 76', are the spatial position and extent of the cornea 86, the thickness dc of the cornea 86, the spatial position and extent of the anterior chamber 91, the spatial position and extent of the lens 92, and the lens thickness dL , the spatial position and extent of the iris 106, the structure of vessels 76 of the sclera 74 and the spatial position and extent of the retina 96. It should be noted that a parameter of the model 102 of the patient's eye 14 can also be the structure and position of the iris 104 of the patient's eye 14.

[0054] The patient eye model 102 defines at least one spatial extent of a section of the patient eye 14 as well as a model coordinate system 77'. For this purpose, the model 102 has the property that it models the course of an optical axis 106 for the lens 92 of the patient eye 14 and the position and extent of at least one structure of a patient eye registration structure 76 in the form of a vessel of the sclera 74 and / or at least one structure of the iris 104 with respect to the optical axis 106.Based on this definition, the patient eye model 102 can be uniquely referenced to the patient eye 14 by means of an image of the patient eye 14 captured in the above-described ophthalmic surgery visualization system 10 at known magnification and known position of the focal plane as optical imaging parameters, which contains the at least one vessel of the sclera 74 or the at least one structure of the iris 104, based on the position and spatial extent of the at least one vessel of the sclera 74 and / or the at least one structure of the iris 104.

[0055] The Fig. Figure 6 shows an image 108 of the patient's eye 14 captured on the first image sensor 32 in the ophthalmic surgery visualization system 10. The computer unit 54 in the ophthalmic surgery visualization system 10 contains a computer program with a program routine for registering the patient eye model 102 of the patient's eye 14, defined by the patient eye biometric data provided at the biometric data interface 70, with the patient's eye 14 in the ophthalmic surgery visualization system 10.

[0056] The computer program determines, by means of image evaluation, the center 110 of the pupil 112 of the patient's eye as well as the position and spatial extent of the at least one vessel 76 of the sclera 74 contained in the model 102 of the patient's eye and / or the at least one structure of the iris 104 contained in the model 102 of the patient's eye in the image 112.

[0057] The computer program uses blood vessels in the sclera as non-transparent structures of the patient's eye. It is also fundamentally possible to reference a three-dimensional model of the patient's eye based on the structures of the iris.

[0058] Using the optical imaging parameters underlying image 108 of patient eye 14, the computer program then registers the patient eye model 102 for patient eye 14 based on image 108 by aligning the patient eye registration structure 76 and the model registration structure 76'. For this purpose, a determined center 110 of the pupil 112 as well as a determined position and structure of the iris of patient eye 14 can also be taken into account.

[0059] The Fig. Figure 7 is a flowchart 114 of the program routine for registering the patient eye model 102 of the patient eye 14 defined by the patient eye biometric data provided at the biometric data interface 70 to the patient eye 14 in the ophthalmic surgery visualization system 10.

[0060] The program routine includes a routine 116 for extracting characteristic features of the image data of image 108 as a patient eye registration structure 76 in the form of the structure of a vessel of the sclera 74 and / or a structure of the iris 104 and a routine 118 for extracting at least one corresponding model registration structure 76' of the patient eye model 102.

[0061] The program routine has a correlation routine 120 that correlates corresponding characteristic features of the image data of image 108 with the characteristic features of the patient eye model 102, taking into account the optical imaging parameters underlying image 108 of patient eye 14. This correlates the object area image data acquired by the device 33 for capturing stereoscopic object area image data with data from the patient eye model 102 and with the optical imaging parameters. The program routine then provides a patient eye model 102' of patient eye 14, registered and adapted to patient eye 14 in the ophthalmic surgery visualization system 10, with the patient eye coordinate system 77 and the model coordinate system 77' being referenced to each other.

[0062] The computer program enables the calculation of stereoscopic display information from the model 102 of the patient's eye 14, registered to the patient's eye 14, for the display device 48 in the device 16 for the stereoscopic visualization of the object area of ​​the ophthalmic surgery visualization system 10. The computer program includes a program routine for calculating the stereoscopic display information.

[0063] The Fig. Figure 8 shows the calculated stereoscopic display information in the form of a spatially extended structure 122 superimposed on the stereoscopic image data of the iris 104 and the sclera 74. This structure is in the form of the rhexis circle at the location of the capsular bag and can be displayed by means of the display device 48 for providing stereoscopic images. It should be noted that, for example, an IOL axis position or a corneal incision can also be displayed as a spatially extended structure 120 superimposed on the stereoscopic image data.

[0064] The Fig. Figure 9 is a flowchart 124 of the program routine for calculating stereoscopic display information in the ophthalmic surgery visualization system.

[0065] From the patient eye model 102' registered to the patient eye 14, the routine calculates in a step 126 in the patient eye coordinate system 77 referenced to the model coordinate system 77' a three-dimensional structure, e.g. in the form of the rhexis circle, which is an aid for an operator who performs a surgical procedure on the patient eye 14 using the eye surgery visualization device 10.

[0066] In step 128, stereoscopic image data for displaying this three-dimensional structure by the display device 48 are calculated as a stereoscopic image in the first and second partial observation beam paths 28, 30 using the displays 50, 52. In step 126, a first stereoscopic partial image for display 50 and a second stereoscopic partial image for display 52 are specified for this purpose. These second stereoscopic partial images have such a disparity with the first stereoscopic partial image that, for an observer viewing the surgical site 12 through the first and second binocular viewing ports 44, 46 of the binocular tube 42, a stereoscopic visual impression of the three-dimensional structure is superimposed on the image of the surgical site 12, which corresponds to the stereoscopic visual impression of the surgical site 12.

[0067] The one in Fig. The ophthalmic surgery visualization system 10 shown in Figure 1 includes an autofocus system 130 connected to the computer unit 54. This autofocus system is connected to a stepper motor 132 for adjusting the main objective system 20 and to a stepper motor 134 for adjusting the magnification system 26. The ophthalmic surgery visualization system 10 has an xy-adjustment unit 136 with a motorized drive that moves the device 16 for acquiring stereoscopic image data in a plane perpendicular to the optical axis 21 of the main objective system 20, as indicated by arrows 136a and 136b. The autofocus system 130 has a focus state interface 138 for providing z-focusing, xy-scaling, and xy-positioning of the imaging optics in the device 16 for acquiring stereoscopic image data.

[0068] The autofocus system 130 can be operated in a first mode that enables automatic focusing on a structure of the patient's eye 14 in the form of the iris or the sclera. For this purpose, an image of the patient's eye 14, captured by the first or second image sensor 32, 36, is subjected to a focus evaluation, and the actuating motor 100 is adjusted by means of the autofocus system 98 for maximum image sharpness.

[0069] In a second mode, the autofocus system 130 enables automatic focusing on a structure of model 102 of the patient's eye 14 or on a structure in the Fig. 9 shown point of interest 140 of the patient eye model 102 corresponding point 140' in the patient eye 14, as shown by the Fig. Figure 3 shows. For automatic focusing on a location 140' in the patient's eye 14 corresponding to a structure of the model 102 of the patient's eye 14 or to a point of interest 140 of the model 102 of the patient's eye, the computer program of the computer unit 54 contains a program routine which serves to set a z-focus, an xy-scaling and an xy-positioning of the imaging optics in the device 16 for the stereoscopic visualization of an object area in order to enable a sharp image of the point 140' in the patient's eye 14.

[0070] The Fig. Figure 10 is a flowchart 142 of this program routine, which can be operated in two different modes.

[0071] In the first mode, the image data acquired by the first image sensor 32 are subjected to a sharpness evaluation in step 144, which is based on determining the contrast k of the underlying image in a predefined image area. In step 146, control data for the actuator 132 for z-focusing, the actuator 134 for xy-scaling, and the actuator for xy-positioning of the imaging optics by means of the xy-adjustment unit 136 in the ophthalmic surgery visualization system 10 are varied so that the contrast k determined in step 144 is maximized. The control data for maximum contrast k max corresponding to the control data sought then 148 a setting for the z-focusing, the xy-scaling and the xy-positioning of the imaging optics in the eye surgery visualization system 10.

[0072] In the second mode, 150 units in the model coordinate system 77' are converted to a value in the Fig. 10. Point of interest 140 shown in the patient eye model 102' registered and adapted to the patient eye 14, control data for the z-focusing, the xy-scaling and the xy-positioning of the imaging optics in the ophthalmic surgery visualization system 10 are calculated by linking setting data for the imaging optics from coordinates of the point of interest 140 or the area in the model coordinate system 77' with optical imaging parameters of the device 16 for the stereoscopic visualization of an object area.

[0073] This tax data means that the amount of tax payable to the person in the Fig. 10 Point of interest 140 corresponding place 140' in which in the Fig.3 patient eye 14 shown on the optical axis of the main objective system 20 of the eye surgery visualization system 10 lies in the focal plane of the main objective system 20, whereby the xy scaling is set to a constant value by tracking the magnification system 26.

[0074] In summary, the following preferred features are particularly noteworthy: An ophthalmic surgery visualization system 10 has a device 16 for the stereoscopic visualization of an object area with a surgical site 12 on a patient eye 14, wherein the device 16 for the stereoscopic visualization of an object area comprises an image acquisition device 33 for acquiring object area image data, which contains image data for at least one patient eye registration structure 76. The ophthalmic surgery visualization system 10 has a computing unit 54, which includes a computer program and a biometric data interface 70 for providing patient eye biometric data, which defines a patient eye model 102 with a model registration structure 76' corresponding to the patient eye registration structure 76 and a model coordinate system 77'.The computer program has a program routine for registering the patient eye model 102 to the patient eye 14 using the patient eye registration structure 76 and the model registration structure 76', in which object area image data acquired by means of the image acquisition device 33 are linked to an image of the patient eye 14 with optical imaging parameters of the image acquisition device 33 in order to provide a patient eye coordinate system 77 fixed to the patient eye 14 in the form of data, which is referenced to the model coordinate system 77'. Reference symbol list 10 Eye Surgery Visualization System 12. Surgical site 14 patient eye 16. Equipment for capturing stereoscopic image data Section 18 Patient's Eye 20 Main lens system 21 optical axis 22 Basic shapes 24 Lighting equipment 26 magnification system 28 first stereoscopic partial observation beam path 30 second stereoscopic partial observation beam path 31 Focus plane 32 first image sensor 33 Image capture device 34 lens system 36 second image sensor 38 lens system 40 Device for providing stereoscopic images 42 Binocular tube 44 first binocular view 46 second binocular view 48 Display unit 50 Display for mirroring image data into the first stereoscopic beam path 52" display for mirroring image data into a second stereoscopic beam path 54, 54' computer unit 56 User interface 57 System for capturing patient eye biometric data 58 OCT device 59 Camera 60 OCT scan beam 62, 64 Scan mirror 66 beam splitters 68 Main lens system 70 Biometric data interface 72 Image plane 74 Sclera 76 Model Registration Structure 77 Patient eye coordinate system 77' Model coordinate system 78 Scattering center for PCT scan beam 80, 82, 84, 86 OCT scanning plane 88 Cornea 90 anterior chamber depth 91 Anterior chamber 92 lens 94 lens thickness 96 Retina 98 posterior chamber depth 99.1, 99.2, 99.3, 99.4 Patient eye biometric data 100 rear chamber 101 Image of the patient's eye 101.1 Iris 101.2 White-to-White 102 Patient eye model 102' adapted patient eye model 104 Iris 106 optical axis 108 image 110 Center of the pupil 112 pupils 114 Flowchart 116, 118 Routine 120 Correlation routine 122 Structure 124 Flowchart Steps 126 and 128 130 autofocus system 132, 134 Actuator 136 xy adjustment unit 136a, 136b Arrow 138 Focus state interface 140 Point of Interest 140' corresponding point to point of interest 142 Flowchart Steps 144, 146, 150 148 tax data

Claims

[1] Ophthalmic Surgery Visualization System (10) with a device (16) for stereoscopic visualization of an object area with an operating site (12) on a patient eye (14), which includes an image acquisition device (33) for acquiring object area image data containing image data for at least one patient eye registration structure (76), with a computing unit (54), and with a biometric data interface (70) for providing patient eye biometric data, which defines a patient eye model (102) with a model registration structure (76') corresponding to the patient eye registration structure (76) and a model coordinate system (77'), characterized by , that The computer unit (54) contains a computer program with a program routine for registering the patient eye model (102) to the patient eye (14) using the patient eye registration structure (76) and the model registration structure (76'), in which the object area image data acquired by means of the image acquisition device (33) are linked with optical imaging parameters of the image acquisition device (33) in order to provide a patient eye coordinate system (77) fixed to the patient eye (14) in the form of data, which is referenced to the model coordinate system (77'), wherein a stereoscopic display device (48) is provided for displaying image information in a stereoscopic visual impression, wherein the computer program has a program routine for calculating stereoscopic display information in the patient eye coordinate system (77),wherein the program routine serves to provide display information data which can be displayed on the display device (48) as a spatially extended structure (122) superimposed on the visualized object area, wherein the device (16) for stereoscopic visualization of an object area includes an adjustable imaging optic with an autofocus system (130) for automatically focusing on a structure (76) of the patient's eye or for automatically focusing on a point (140') in the patient's eye (14) corresponding to a structure (76') of the patient's eye model (102) or to a point (140') in the patient's eye (14) corresponding to a point of interest (140) of the patient's eye model (102), which has a focusing state interface (138) for providing z-focusing and / or xy-scaling of the imaging optics as well as xy-positioning of the device (16) for acquiring stereoscopic image data in a plane perpendicular to an optical axis (21) of a main objective (20) of the imaging optics, wherein the computer program receives information from the group z-focusing, xy-scaling of the imaging optics, xy-positioning from the focusing state interface (138) and receives patient eye biometric data from the biometric data interface and takes this into account for calculating the display information data. [2] Ophthalmic surgery visualization system according to claim 1, characterized by , that the spatially extended structure (122) is a structure from the group rhexis circle at the location of the capsular bag, IOL axis position, cornea incision. [3] Ophthalmic surgery visualization system according to claim 1 or claim 2, characterized by , that the patient eye model (102) describes at least one physiological parameter of the patient eye (14) from the group corneal curvature (74), corneal thickness (74), anterior chamber depth (90), lens extent (92), sclera diameter, iris extent (80), pupil extent, lens thickness (92), posterior chamber depth, retina extent (96) and / or that the patient eye registration structure (76) is at least one structure from the group iris structure, retina structure, structure of at least one scleral vessel, white-to-white geometry of the patient eye. [4] Ophthalmic surgery visualization system according to any one of claims 1 to 3, characterized by, that the device (16) for stereoscopic visualization of an object area includes an adjustable imaging optic with an autofocus system (130) for automatic focusing on a structure (76) of the patient's eye, wherein the computer program has a program routine for a sharpness evaluation for images (108) based on object area image data acquired by means of the image acquisition device (33), wherein the program routine is designed to provide control data for adjusting a z-focusing of the imaging optic. [5] Ophthalmic surgery visualization system according to any one of claims 1 to 4, characterized by, that the device (16) for stereoscopic visualization of an object area includes an autofocus system (130) for automatically focusing on a point (140') in the patient eye (14) corresponding to a structure (76') of the patient eye model (102) or to a point (140') of interest in the patient eye model (102), wherein the computer program includes a program routine that sets a z-focusing and / or an xy-scaling and / or an xy-positioning of the imaging optics for sharply imaging a point or area of ​​the patient eye (14) corresponding to a point of interest (140) or a model area of ​​the patient eye model (102), by applying setting data for the imaging optics from coordinates of the point of interest (140) or the area in the model coordinate system (77') with optical imaging parameters of the device (16) for stereoscopic visualization of an object area. [6] Ophthalmic surgery visualization system according to any one of claims 1 to 5, characterized by , that the biometric data interface (70) is designed for providing intraoperatively acquired patient eye biometric data. [7] Ophthalmic surgery visualization system according to any one of claims 1 to 6, characterized by , that the patient eye biometric data include OCT data of the patient eye and / or lengths derived from OCT data of the patient eye (14). [8] Eye surgery visualization system according to claim 7, characterized by , that the patient eye biometric data include an eye position image underlying the OCT data of the patient eye (14). [9] Ophthalmic surgery visualization system according to any one of claims 1 to 8, characterized by , that the image acquisition device (33) is designed for the acquisition of stereoscopic image data and includes a first image sensor (32) and a second image sensor (34) for this purpose. [10] Operating procedure for an ophthalmic surgery visualization system (10) in which Object area image data are acquired using an image acquisition device (33) which shows at least one registration structure of the patient's eye (14), and in which Patient eye biometric data are provided, defining a patient eye model (102) with a model coordinate system, characterized by , that The patient eye model (102) is registered to the patient eye (14) by linking object area image data acquired by the image acquisition device (33) to an image of the patient eye (14) with optical imaging parameters of the device (32, 36) and with data of the patient eye model (102) in order to provide a patient eye coordinate system (77) fixed to the patient eye in the form of data referenced to the model coordinate system (77'), wherein display information data for displaying a spatially extended structure (122) superimposed on the visualized surgical site are provided in the patient eye coordinate system (77), wherein imaging optic setting data for sharply imaging a point of interest (140`) or area in the patient eye coordinate system (77) from the group z-focusing of an imaging optic, xy-scaling of the imaging optic,The xy position of a device (16) for acquiring stereoscopic image data is provided in a plane perpendicular to the optical axis (21) of a main objective (20) of the imaging optics, and the patient eye biometry data and the imaging optics setting data are taken into account for calculating the display information data. [11] Computer program for performing all of the process steps specified in claim 10 on a computer unit (54).

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