Handheld fiber probe for laser treatment of medical tissue, especially for glaucoma treatment

Abstract

The handheld fiber probe (2) is used for laser treatment of medical tissue, in particular for glaucoma treatment. At least in the assembled state, it comprises an optical fiber cable (8). The fiber probe (2) has a housing (10) with a front end (18) providing an exit point for laser light. The fiber probe (2) has a front and a rear lens (16A, 16B), which can be adjusted relative to one another by the user, so that the focus of the laser beam can be varied by varying a distance (A) between the two lenses (16A, 16B).

Description

The invention relates to a hand-held fibre probe for laser treatment of medical tissue, in particular for glaucoma treatment, having the features of the preamble of claim 1.Such a fiber probe can be taken, for example, from DE 10 2017 104 673 A1 or EP 3 478 205 B1.Increased intraocular pressure (IODO) is a major risk factor for glaucoma development. By means of a therapeutic laser treatment using such fibre probes, the intraocular pressure is lowered, for example by limiting the formation of aqueous humour and / or by improving the outflow of aqueous humour.During the treatment with laser light, tissue parts of the eye in the interior of the eye are specifically treated. The fiber probe is placed on the eye with a front, distal contact end.DE 10 2017 104 673 A1 describes an attachment which can be screwed onto a handpiece to which an optical waveguide cable is connected. A bore is formed within the attachment, into which an optical fiber (optical fiber) of the optical fiber cable can be inserted. The bore terminates within the cap so that the forward contact end is closed. This prevents liquid from penetrating into an annular space between the optical fiber and the bore by capillary action during the laser treatment and thus contaminating the attachment. Furthermore, an optical element for beam shaping and, for example, for focusing the laser beam is mounted on the end face of the front contact end.EP 3 478 205 B1 likewise discloses a hand-held fiber probe in which a disposable attachment can be mounted on a handpiece, in which attachment an optical fiber is mounted, which protrudes at the front end at the front contact end and interacts with an optical element in the handpiece in order to focus the laser light.In medical practice, the following problems have, among other things, become apparent when using such fiber probes-depending on the type of fiber probe:Since the fiber probe is placed on the eye with a certain pressure during the treatment and / or a large amount of energy is introduced via the laser light, the treatment is often perceived as painful by the patients. This results in such treatments being frequently performed under anaesthesia.During the treatment bleeding can occur which, for example, lead to contamination of the attachment as a result of capillary effects, which can lead to a restriction of the effectiveness of the introduced laser light during the treatment. For example, the transmission is reduced and thermal heating occurs as a result of undesired absorption of laser light in the attachment.The guidance of the hand-guided fiber probe by the medical personnel requires experienced medical personnel due to different anatomy of the patients. In part, an intermediate layer, for example a thin silicone part, is still placed between the distal contact end of the fiber probe and the eye manually by the medical personnel.Proceeding from this, the object of the invention is to specify a hand-held fiber probe for laser treatment of medical tissue, in particular for glaucoma treatment, with which at least some of the problems described above are at least reduced.The object is achieved according to the invention by a hand-guided fiber probe for laser treatment of medical tissue and in particular for glaucoma treatment. An optical waveguide cable is connected to the fiber probe at least in the assembled state. The fiber probe has a housing which has a front end, which is also referred to below as a distal contact end, which is designed to rest on the eye. For this purpose, the contact end has, in particular, a concavely curved surface adapted to the human eye. At this front contact end, an exit location for laser light is formed. Furthermore, the fiber probe has an optics for beam shaping, in particular for focusing the laser light. This optics has at least two lenses, namely a front and a rear lens, which can be adjusted relative to one another by the user, so that the laser beam can be varied by varying a distance between the two lenses, i.e. a desired beam shaping, in particular focusing, takes place.In this embodiment, the variation of the focusing and thus the change of a focal point of the laser beam by the medical personnel themselves is to be emphasized. This makes it possible for the physician to change the focusing during the treatment and to adapt it specifically to the anatomy of the respective patient.The focusing is varied by changing the distance between the two lenses. For this purpose, an adjustment mechanism is generally configured, which can be actuated by the respective operator (doctor, medical personnel) with the hand for varying the distance.Due to the possibility that the physician himself varies the focusing during the treatment, the physician can focus the laser energy in a targeted and highly accurate manner onto a respective treatment site. A manual distance variation, for example due to the partially practiced arrangement of an intermediate layer (silicone pad) between the front end and the eye, is therefore dispensed with. The operability of the fiber probe is thereby improved. The better focusing also increases the efficiency and reduces the overall laser energy introduced. This leads to a significantly gentler and also painless treatment. This also makes it possible in particular to dispense with anaesthesia.The two lenses generally provide adjustable optics which allow variation of the focusing of the laser beam. The lens system used for this purpose is formed in particular finally by the two (individual) lenses described here.As an alternative to the configuration as two individual lenses that can be adjusted relative to one another, a more complex optical system with a plurality of lenses can also be used in particular for the front lens, for example in the manner of an objective. The preferred variant is, however, the configuration with the two individual lenses.The fiber probe is designed, as a whole, to be manually guided by the user (doctor) during the treatment and to be placed with the contact end in front from the outside onto a body part, in particular onto the eye.In a preferred development, a fiber end piece of an optical fiber is located in the housing, wherein the latter is designed for light guiding the laser light. At one fiber end of this optical fiber, the one rear lens is formed. The rear lens is therefore in particular a part of the optical fiber itself. The rear lens is achieved, for example, by melting the fiber end, so that the fiber material is transformed at the end into a lens shape, in particular into a spherical shape. The optical fiber is in particular a glass fiber.The other, front lens is preferably formed at the exit location.Both lenses are preferably each designed as a spherical lens. They consist in particular of quartz glass. Accordingly, a glass fiber is used for the fiber end piece.In a preferred development, a guide channel formed by a free space is formed at least between the two lenses, wherein at least one of the lenses is adjustable within this guide channel for varying the distance.A distance between the two lenses is preferably in the range between 2 mm and 5 mm and in particular 3.5 mm. The distance can preferably be varied by a (maximum) distance difference. This difference in distance between the two lenses is preferably in the range of a few millimeters and in particular in the range of less than 3.5 mm. The preferred distance between the two lenses is also dependent in particular on the diameter of the optical fiber. The smaller the diameter, the smaller the distance. The optical fiber typically has a diameter of a few or a few 100 μm. Typical values are 200 μm, 400 μm or 600 μm. The above-mentioned values for the distance apply in particular to a fiber with a diameter of 600 μm.The geometric conditions, i.e. for example the distance between the lenses, the diameter and / or the curvature of the lenses, are preferably selected such that-at a predetermined wavelength of the laser light (for example 810 nm)-the light emerging from the rear lens enters directly into the front lens at least for the most part (more than 90%, preferably more than 95%, of the intensity), without reflection taking place at channel walls of the guide channel.In a preferred embodiment, the front lens is arranged in a fixed position at the exit location and the rear lens is arranged displaceably within the guide channel. The front lens is in particular directly attached to a front end face, namely to an opening which is formed by the guide channel.In a preferred development, the two lenses have different lens diameters. Namely, the rear lens has a smaller lens diameter than the front lens.The guide channel preferably has a constant channel diameter over its length, at least within a longitudinal section in which the two lenses are arranged.The lens diameter of the rear lens is adapted to the channel diameter of the guide channel in such a way that a displacement is possible. In particular, a tolerance gap is formed between the rear lens and the guide channel.The front lens preferably has a diameter of greater than 0.8 mm and in particular a diameter in the range from 1 mm to 3 mm.The rear lens, in contrast, has a smaller diameter, for example in the range from 0.2 mm to 1 mm. The diameter of the rear lens is preferably smaller by a factor of 1.1 to 3 than that of the front lens.The front lens preferably has a diameter which is greater than the diameter of the guide channel. The front lens is therefore placed from the outside onto the opening of the guide channel and rests on an opening edge of this opening.In a preferred embodiment, an opening, especially a channel opening and in particular the previously described opening of the guide channel, is generally formed at the front end, which is sealingly closed by the front lens. For this purpose, in particular-as explained above-the diameter of the front lens is larger than the diameter of the opening. The front lens therefore rests sealingly on an opening edge of this opening.This aspect of the sealing termination of such a channel opening at the front end of the housing of the fiber probe is considered an independent inventive idea independent of the configuration with the adjustable lenses. The filing of a partial application on this aspect and thus on a combination of features of the preamble of claim 1 with the additional features of claim 8 is reserved. Such an independent claim is followed by the further preferred embodiments described here as preferred refinements.In a preferred embodiment, the front lens is connected to the opening in a materially integral manner and specifically to this opening edge. This is effected, for example, via an adhesive and preferably by melting. The front end is made of glass in particular, so that by appropriate thermal treatment a cohesive connection can be made by fusion between the front end and the front lens. This achieves a reliable seal. There is therefore no risk of contamination by liquid penetrating into the channel, especially as a result of capillary action.In a preferred embodiment, the fiber probe has an adjustment mechanism that can be operated in particular by the user and is specifically manually operated, by means of which the distance between the two lenses can be varied. With the aid of the adjusting mechanism, the distance is therefore changed by a mechanical displacement of the lenses relative to one another.For this purpose, the adjustment mechanism preferably has a manually actuatable adjustment element, so that it can be actuated manually by the medical personnel. The adjusting element is, for example, a sliding element, a rotating element or also an adjusting wheel. The adjusting element is arranged in particular on a jacket side of the housing of the fiber probe or is itself formed by a jacket region and thus a section of the housing.To form the adjusting mechanism, in a preferred development, the adjusting mechanism has an adjusting part which is adjustable in a longitudinal direction and which is connected to the at least one lens for the adjustment thereof. The adjusting movement of this adjusting part is initiated via the positioning element.The adjusting part is preferably a housing part which is relatively adjustable with respect to a further housing part.In one embodiment variant, the adjustment takes place, for example, by a rotational movement, in particular of the actuating part itself, in particular in such a way that the actuating part is rotatably mounted via a thread on a further part, for example on the further housing part, and can thus be displaced in the longitudinal direction relative to this further part.In a preferred embodiment, the fiber end piece is held by the adjusting part and is firmly connected to the latter in particular in a materially bonded manner, for example by adhesive bonding. The connection is made at a distance from the rear lens. The adjustment of the rear lens is therefore effected indirectly via an adjustment of the fiber end piece. This can be implemented in a simple design.The fiber end piece has in particular a rear part which is held by the adjusting part and in particular lies in it. The adjusting part has in particular a channel which is in particular a part or an extension of the aforementioned guide channel through which the fiber end piece is passed. In this channel, the rear part of the fiber end piece is situated, for example, with an exact fit and, in particular, with friction fit or with material fit, and is thereby fastened in the adjusting part.The rear part is preferably surrounded by a jacket, for example a protective tube, which is fastened in the locating element, for example by frictional or bonded connection, with a sufficient holding force, so that during an adjusting movement of the locating element, the fiber end piece and with it the rear lens is displaced in the longitudinal direction relative to the front lens.In an expedient embodiment, the housing has a rear housing part which is in particular designed as a handpiece, which is therefore designed to be held by the physician's hand during operation.Furthermore, the housing has a front housing part which is preferably reversibly detachably connected to the rear housing part. This front housing part is therefore an exchangeable tip or an exchangeable attachment.The housing preferably consists of these two housing parts, i.e. of the handpiece and the replaceable attachment.The above-described guide channel extends from the rear housing part into the front housing part and extends as far as the exit location. The guide channel is in particular formed as a continuous guide channel which extends from a rear, proximal opening of the housing to the front distal opening at the front end, at which the guide channel is sealed in particular by the front lens.The rear housing part generally preferably has a continuous channel which is a part or an extension of the guide channel through which the fiber end piece can be pushed.In an expedient embodiment, the front housing part consists of a transparent material and in particular of glass or alternatively of a polymer.As an alternative to the transparent design, a non-transparent design of the front housing part is used. In this case, it is made of metal or ceramic, for example.According to an optional embodiment, a coating is furthermore applied in the region of the guide channel in order to reflect laser light on the channel walls. Such reflective coatings are useful, for example, in lenses in order to reduce Fresnel reflections and thus increase the transmission.In contrast, the rear housing part preferably consists of a non-transparent material and, for example, of plastic, but preferably of metal, for example of aluminum, in particular a colored aluminum anodized, for example, in black, blue or red.The fiber probe is in particular a preconfigured one-way or multipath part, to which the optical waveguide cable is already connected. The optical waveguide cable has at its proximal end, for example, a connection part, in particular a plug part, for connection, in particular for plug connection, to an optical component. The optical component is, for example, a laser or also a further optical waveguide cable, as it were, as an extension for connection to a laser.An exemplary embodiment of the invention is explained in more detail below with reference to the figures. These are shown in simplified representations: FIG. 1 shows a sectional side view in the manner of a sectional illustration of a fiber probe, FIGS. 2A, 2B are schematic diagrams for explaining the variable setting of the focus of a laser beam by a distance variation of two lenses spaced apart from one another, and FIGS. 3A-3B show a fiber probe with a further optical attachment element in different variants in greatly simplified representations.A manually actuatable fiber probe 2 shown in FIG. 1 serves for the therapeutic treatment of medical tissue and in particular for glaucoma treatment by means of laser light. The laser light has a wavelength of 810 nm, for example. The laser light is provided by a laser, not shown here, and is coupled into an optical fiber 4 (optical waveguide fiber), which is part of an optical waveguide cable 6. The optical waveguide cable 6 has, in particular, a jacket 8, which is designed, for example, as a tube in which the optical fiber 4 is guided.The fiber probe 2 is a preconfigured component in which the optical waveguide cable 6 is already part of the fiber probe 2. This therefore only needs to be connected to a laser by a rear end of the optical waveguide cable 6.The fiber probe 2 has a housing 10 which is two-part in the exemplary embodiment and has a rear housing part which forms a handpiece 10A. A front housing part is fastened to this handpiece 10A, for example, via a screw connection and is generally preferably reversibly exchangeable. This front housing part is in this respect a cap 10B. The housing 10 extends in a longitudinal direction L from the handpiece 10A to the attachment 10B.The two housing parts 10A, 10B form an inner, continuous channel which is referred to as guide channel 12. In the exemplary embodiment, this has a constant diameter D 1. A fiber end piece 14 of the optical fiber 4 extends into this guide channel 12, wherein the latter is divided inside the housing 10 into a rear section 14A and a front section 14B. In the rear section 10A, the fiber 4 is still surrounded by the sheath 8, whereas it is exposed in the front section 14B.At the front fiber end of the fiber end piece 14, as viewed in the longitudinal direction L, an in particular spherical rear lens 16A is formed on the fiber 4 at the end. This is formed in particular by melting the fiber 4. The rear lens 16A has a lens diameter D 2.The housing 10, in particular the attachment 10B, has a front end 18 (distal contact end) as viewed in the longitudinal direction L. The end face formed there is typically adapted to the curvature of the human eye and is formed in particular as a concavely curved end face which is also oriented overall obliquely to the longitudinal direction L.The guide channel 12 opens at this front end 18 at an opening which is closed by a front lens 16B. The front lens 16B simultaneously defines an exit location for the laser light. Preferably, both the attachment 10B and the front lens 16B consist of glass and the front lens 16B is connected to the attachment 10B by melting in a materially bonded manner. As a result, the front lens 16B reliably seals the opening and thus the guide channel 12 and prevents the penetration of dirt particles or liquid, which can lead to contamination and thus in particular also to an impairment of the propagation of the laser light during operation.The two lenses 16A, 16B are adjustable relative to one another in the longitudinal direction L, such that a distance A between the two lenses 16A, 16B can be varied. The focusing of the laser light can be changed during operation by the distance variation.The front lens 16B is fixed in relation to the housing 10 and the rear lens 16A is slidably disposed within at least a portion of the guide channel 12. Namely, the rear lens 16A is slidable together with the fiber tip 14 relative to the front lens 16B.For varying the distance A, the fiber probe 2 has an adjusting mechanism 20, which is illustrated only in a greatly simplified manner in the figures. This adjusting mechanism has an adjusting element 22 which can be actuated manually by the operator. The adjustment element 22 brings about the relative adjustment of the two lenses 16A, 16B with respect to one another.The adjusting element 22 is arranged in particular on the outside of the housing, i.e. on the casing, or is formed by the latter itself. For example, it is an adjusting wheel which can be actuated by the fingers by a rotational movement.The adjusting mechanism 20 further comprises an adjusting part 24, which in the exemplary embodiment is formed in particular by the handpiece 10A and thus by a housing part. The actuator 24 is generally connected to the slidable rear lens 16A. In particular, it is suitably fastened to the jacket 8 of the fiber end piece 14, for example by frictional engagement and in particular by material engagement, for example by adhesive bonding, so that the entire fiber end piece 14 is displaced by an adjusting movement of the adjusting part 24 in or counter to the longitudinal direction L.In the preferred embodiment, in which the adjusting part 24 is formed as a housing part, the two housing parts 10A, 10B can be displaced relative to one another in the longitudinal direction L.The adjustment of the adjusting part 24 is effected by the adjusting element 22, which converts a rotational movement into a longitudinal movement of the adjusting element 22, for example via a worm wheel. In principle, other mechanical actuating devices are also possible. Thus, for example, a separate adjusting part 24 can be arranged in the interior of the housing 10, which engages the fiber end piece 14, in particular in the rear part 14A. The adjusting part 24 is designed, for example, in the manner of a slide which lies in a subsection of the guide channel 16.Especially in an embodiment variant in which the housing parts 10A, 10B are displaced relative to one another in the longitudinal direction L, the adjusting element 22 is formed, for example, by a jacket region or a recessed grip on the handpiece 10A and the two housing parts 10A, 10B are connected to one another via a thread, so that the desired change in distance is achieved by a rotation of the two housing parts 10A, 10B relative to one another.The two housing parts are, for example, two parts of the hand part 10A which are connected to one another by means of a thread.The mode of operation is explained with reference to FIGS. 2A and 2B: two housing parts 10A, 10B are shown by way of example in the two figures, which housing parts have a distance between them, which can be varied in the longitudinal direction L. As a result, the distance A between the two lenses 16A, 16B is changed.In the exemplary embodiment, both lenses 16A, 16B are convexly curved. They are therefore designed as converging lenses because of their convexly curved shape and in particular lens shape or also spherical shape. Possible beam paths of the laser light as a function of the distance A are illustrated in the two figures. In the situation according to FIG. 2A, an in particular maximum distance A is set, at which a focal point 26 of the laser beam generated by the two lenses is set as close as possible to the front lens 16B. With increasingly shorter distance A, the laser beam widens or the focal point 26 shifts forward in the longitudinal direction L.As an alternative to this illustrated embodiment variant, in which the front lens 16B is a simple lens, the front lens 16B can also be designed as a complex lens system and / or as an objective. In this case, concave lens surfaces can then also occur.The preferred variant is, however, the configuration shown in FIGS. 1 and 2A and 2B with two simple individual lenses.Finally, it is also possible to arrange an additional further optical unit 28 as part of an attachment element 30 or directly also as the attachment element 30 itself on the housing 10, as is illustrated in FIGS. 3A to 3B. This further optical unit 28 is therefore generally arranged downstream of the two lenses 16A, 16B that are adjustable relative to one another in the beam direction. In alternative, preferred variants, however, further optical units 28 and / or attachment elements 30 are dispensed with.The housing 10 is shown in a greatly simplified manner in FIGS. 3A to 3B, without the two housing parts 10A, 10B and the adjusting mechanism 20 for the relative adjustment of the two lenses 16A, 16B to one another being explicitly shown. The attachment element 30 is mounted in particular in a fixed position with respect to the front housing part 10B. For example, it is fixed to this front case 10B. Alternatively, it can also be mounted stationary with respect to the rear housing part 10A.For this purpose, the further attachment element 30 has a sleeve-shaped section, for example, with which it is attached to the housing 10. In particular, the placement element 30 is placed on the housing 10 and is suitably fixed and held there. The attachment element 30 can preferably be reversibly interchangeably fixed, so that, if necessary, the fiber probe 2 can be used without or with different attachment elements 30.Depending on the field of application and requirement, the placement element 30 is designed differently. According to FIG. 3A, a separate element is attached in or on the placement element 30 as the optical unit 28, which element is designed, for example, as an objective with a plurality of lenses. The optical unit 28 generally serves for further beam shaping, e.g. focusing or also expansion of the laser beam.According to FIG. 3B and also FIG. 3C, the attachment element 30 itself forms an optical unit 28. In this case, the attachment element 30 as such forms a light-conducting element.According to FIG. 3B, this is designed in the manner of a prism. This serves in particular for beam deflection.According to FIG. 3C, the attachment element 30, in particular in addition to a prismatic configuration for deflection analogous to FIG. 3B, itself forms a lens which serves for further beam shaping. In the exemplary embodiment, a convexly curved lens for beam focusing is shown.Overall, the adjusting mechanism 20 achieves a special construction of the fiber probe 2 with the adjustable optics formed by the two lenses 16A, 16B, which enables a simple, manual change of the focusing of the laser beam by the operator.The fiber probe 2 is generally used for the treatment of medical (human / animal) tissue by means of laser irradiation, for example on the skin surface. Due to the variable focus, the fiber probe 2 is especially advantageous for the treatment of the eye, in particular in glaucoma treatment, and is designed for this, in which tissue is treated with the laser beam with the laser in the interior of the eye.Particular advantages of the fiber probe 2 described here are:manually adjustable variable focus of the laser beam,reliable sealing of the interior of the fiber probe 2 by the front lens 16B,thereby option of multiple use,lower laser energy is required because of the focusability, thus gentler and more painless treatment,This makes it possible to dispense with anaesthesia.List of reference characters2 Fiber probe 4 Optical fiber 6 Optical fiber cable 8 Jacket 10 Housing 10 A, handpiece 10B Attachment 12 Guide channel 14 Fiber end piece 14A Rear section 14B Front section 16A Rear lens 16B Front lens 18 Front end 20 Adjusting mechanism 22 Adjusting element 24 Adjusting part 26 Focal point 28 Further optical system 30 Attachment element A Distance D 1 Diameter Guide channel D 2 Diameter Rear lens D 3 Diameter Front lensReferences included in the specificationThis list of documents cited by the applicant has been produced in an automated manner and is only included for the better information of the reader. The list is not part of the German patent application or utility model application. The DPMA does not take any adhesion for any faults or omissions.Patent Literature citedDE 10 2017 104 673 A1 [0002, 0005]EP 3 478 205 B1 [0002, 0006]

Claims

Hand-held fibre probe (2) for laser treatment of medical tissue, in particular for glaucoma treatment, which at least in the assembled state has an optical fibre cable (8), having a housing (10) which has a front end (18) with an exit location for laser light, characterized in that a front and a rear lens (16A, 16B) are arranged, which are adjustable relative to one another by the user, so that the laser beam can be varied by varying a distance (A) between the two lenses (16A, 16B).Fibre probe (2) according to the preceding claim, characterized in that a fibre end piece (14) of an optical fibre (4) is arranged in the housing (10), on which end piece the one, rear lens (16A) is formed.Fibre probe (2) according to one of the preceding claims, characterized in that a guide channel (12) is formed between the lenses (16A, 16B) and at least one of the lenses (16A) is adjustable within the guide channel (12) for varying the distance (A).Fibre probe (2) according to one of the preceding claims, characterized in that the front lens (16B) is arranged in a fixed manner at the exit location and the rear lens (16A) is arranged displaceably within the guide channel (12).Fibre probe (2) according to one of the preceding claims, characterized in that the two lenses (16A, 16B) have different lens diameters (D1, D2).Fibre probe (2) according to one of the preceding claims, characterized in that the front lens (16B) has a diameter (D2) of greater than 0.8 mm and in particular a diameter (D2) in the range from 1 mm to 3 mm.Fibre probe (2) according to one of the preceding claims, characterized in that an opening is formed at the front end (18), which opening is sealingly closed by the front lens (16B), wherein the front lens (16B) is fastened to the opening in particular in a materially bonded manner for this purpose.Fibre probe (2) according to one of the preceding claims, characterized in that it has an adjusting mechanism (20), by means of which the distance (A) between the two lenses can be varied.Fibre probe (2) according to the preceding claim, characterized in that the adjusting mechanism (20) can be manually operated and has an adjusting element (22), which is arranged in particular on the housing (10) or is formed by a section of the housing (10).Fiber probe (2) according to one of the two preceding claims, characterized in that the adjusting mechanism (20) has an adjusting part (24), in particular a housing part (10A), which is adjustable in a longitudinal direction (L) and which is connected to the at least one lens (16A) for adjusting the latter.Fibre probe (2) according to the preceding claim, characterised in that the fibre end piece (14) is held by the adjusting part (24, 16A) and is in particular connected thereto in a materially bonded manner.Fibre probe (2) according to the preceding claim, characterized in that the fibre end piece (14) has a rear part (14A) with a jacket (8), and in that the rear part (14A) is fastened to the adjusting part (24) in particular in a materially bonded manner.Fibre probe (2) according to one of the two preceding claims, characterized in that the housing (10) has a rear housing part designed as a handpiece (10A) and a front housing part with the front end (18), wherein the front housing part is fastened preferably reversibly releasably to the handpiece (10A) as a cap (10B) and is preferably formed from a transparent material, especially glass.Fibre probe (2) according to one of the preceding claims, characterized in that a further optical system (28), in particular as an attachment element (30) or as part of an attachment element (30), is attached to the housing (10) in the region of the front end (18).

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