positioning device

Abstract

In ophthalmological laser treatment, it is essential for the treatment result that the patient's eye is precisely positioned relative to the treatment system. The object of the present invention is to introduce a solution for a positioning device which allows an accurate positioning of the laser treatment system relative to the patient's eye. This object is achieved by a positioning device having a first acquisition unit and a second acquisition unit, which provide acquisition data from different acquisition devices, and a movement unit for moving the relative position of the eye relative to an optical opening of the laser treatment system based on control instructions, and a control unit which is configured to generate the control instructions based on the acquisition data. Furthermore, this object is also achieved by a positioning device which further has a display unit for displaying the acquisition data and an input unit for inputting input data, wherein the control unit is configured here to generate the control instructions based on the acquisition data and / or based on the input data and to provide the control instructions to the movement unit. Finally, the object is achieved by a corresponding positioning method.

Description

Technical Field

[0001] This invention relates to a positioning device for an ophthalmic laser treatment system having an optical opening, the positioning device being used to position the eye relative to the optical opening. The invention also relates to the ophthalmic laser treatment system itself. Ultimately, the invention relates to a method for positioning the eye of a patient relative to the optical opening in an ophthalmic laser treatment system having an optical opening. Background Technology

[0002] During ophthalmic laser treatment, a laser treatment device that uses laser radiation to create slices in the eye tissue, or to ablate or coagulate the eye tissue, is usually combined with an observation device for controlling and monitoring different steps during the treatment procedure.

[0003] This is highly advantageous, for example, in laser-assisted ophthalmic surgery for correcting refractive errors or treating other eye conditions, such as cataract surgery. Monitoring the procedure is also crucial in refractive error correction, such as in SMILE treatment (small incision lenticule extraction), lenticule implantation, or other corneal repairs, so that the incision can be interrupted if necessary. After the incision is made in the eye tissue, the lenticule is removed (or repaired) or an implant is inserted under observation, for example, through a surgical microscope (also known as OPMI).

[0004] A crucial step in preparing for ophthalmic laser treatment (especially when using femtosecond lasers) is aligning the laser treatment system with the eye and even the eye fixation device. This is typically achieved when contact elements (such as contact lenses) are used, and the operator (surgeon, assistant, or general user) must bring the contact element into contact with the patient's eye. The eye is then fixed relative to the laser treatment system. If necessary, the device parameters are adjusted according to the relative position of the fixed eye to the laser treatment system. Only then can the user begin the treatment process, and the user must typically monitor the progress of the treatment.

[0005] DE 102005013949 describes an ophthalmic laser treatment system for treating human eyes, having a radiation source and apparatus for focusing laser radiation at the eye for three-dimensional scanning (x, y, z). Here, a contact lens is located on the cornea of ​​the eye, close to the cornea. A beam splitter is arranged in the optical path of the laser treatment system, which at least partially deflects the radiation beam from the eye toward a tube with an eyepiece (for direct observation by the operator) or a lens with a camera. This allows for simultaneous observation of the cornea while the eye is being treated with femtosecond laser light (treatment). Although the described arrangement allows for monitoring of the treatment, the positioning of the laser treatment system relative to the patient's eye and the control of aligning the eye with the contact lens are provided solely by a common observation device arranged axially with the treatment optical path.

[0006] An ophthalmic laser treatment system is described in WO 2016 / 058931, which includes a laser system (for treatment) and a surgical microscope (for examination) that are interconnected. The arrangement disclosed herein also allows for monitoring of the treatment without providing control over eye positioning.

[0007] Other laser treatment systems, such as those described in DE 102005032946A1 and US 10123696B2, only allow observation (and monitoring) of the eye using an optical path that extends axially relative to the treatment optical path. Therefore, in DE 102005032946A1, the same image is coupled between two portions of the binocular optical path of the surgical microscope; here, the observation direction extends axially relative to the treatment optical path. A camera system disclosed in WO 2019 / 068866 is aligned with the eye at an observation angle relative to the treatment optical path, and this camera system, likewise, can only be used for observation during treatment (or directly before the eye is brought close to the contact element).

[0008] None of these systems are suitable for positioning the eye relative to ophthalmic laser treatment systems. Summary of the Invention

[0009] Therefore, the object of the present invention is to eliminate the disadvantages of the prior art and provide a solution for a positioning device for an ophthalmic laser treatment system, which allows for accurate, rapid, user-friendly and intuitive positioning of the laser treatment system relative to the patient's eye.

[0010] The first aspect of the invention relates to a positioning device for an ophthalmic laser treatment system having an optical opening, the positioning device being used to position the eye relative to the optical opening.

[0011] Ophthalmic laser treatment systems are constructed to perform ophthalmic treatments when applied by a user (operator, surgeon, specialist). Here, ophthalmic treatment should be understood as any treatment that alters the tissues of the eye during the procedure. Specifically, ophthalmic treatment includes corresponding laser surgical procedures in which the eye's tissues are cut by photodestruction (e.g., lenticules or flaps) using a laser, preferably a pulsed laser (e.g., femtosecond laser or excimer laser), are removed by excision, or the eye tissues are "bonded" together by coagulation, or the refractive index of materials (i.e., eye tissue or implants) is altered by laser radiation.

[0012] Through the optical opening of an ophthalmic laser treatment system, light rays from a laser source can be emitted from the system and, when positioned at or near the target location, penetrate the patient's eye to perform the planned treatment. The optical opening can also serve as an exit port for the therapeutic radiation (laser exit port). Furthermore, the optical opening allows light reflected or scattered by the eye to be directed into the laser treatment system and, when properly positioned at or near the target location, to be examined (or observed during "manual" surgical procedures such as microlens removal). The optical opening can also serve as an entrance port for examination radiation.

[0013] Optical openings can be shaped into contact elements or contact lenses. Optical openings can also be the terminal lenses of surgical microscopes.

[0014] According to the present invention, the positioning device further comprises a first acquisition unit (also referred to as an observation unit), which is configured to provide first acquisition data (also referred to as observation data) of the eye from a first acquisition direction (also referred to as an observation angle). Furthermore, the positioning device comprises a second acquisition unit, which is configured to provide second acquisition data of the eye from a second acquisition direction. Here, the second acquisition direction is different from the first acquisition direction. The acquisition direction of the acquisition unit is understood as a vector pointing from the acquisition unit to the direction in which acquisition data can be acquired; this vector points to the "line of sight" of the acquisition unit, preferably, the target position of the eye is located within the line of sight of the acquisition unit. The angle between the two acquisition directions is preferably not 180°. Therefore, the two acquisition units allow the eye to be observed at two different angles, and the acquisition unit can, for example, be designed as a camera having a planar sensor and a camera optical system (also referred to as an acquisition optics system or an observation optics system).

[0015] The acquisition unit is preferably small, i.e., the visible optical system diameter of the acquisition optical system is less than 10 mm, particularly preferably less than 5 mm, and / or the F-number is greater than 2. Furthermore, the sensor of the acquisition unit (e.g., charge-coupled device (CCD), complementary metal-oxide-semiconductor (CMOS)) is preferably less than 10 mm × 8 mm, the sensor pixel size is less than 3 μm × 3 μm, and / or the sensor has at least 1900 × 2500 pixels. Preferably, the acquisition unit has a volume of less than 3 cm × 3 cm × 3 cm.

[0016] The positioning device also includes a moving unit configured to move the relative position of the eye with respect to the optical opening based on control commands. Here, the moving unit can be configured, for example, to move the optical opening. Alternatively or additionally, the moving unit can be configured to move the eye, for example, by moving the patient's bed. Preferably, movement is achieved in all three spatial directions. The direction and speed of movement are controlled via control commands. According to the invention, the control commands are provided by a control unit, which is also part of the positioning device. The control unit can be a computer having a processor and a memory. The control unit is configured to generate control commands based on acquired data. This can be achieved by calculating the acquired data (e.g., in a computing unit, which is part of the control unit). Here, the position of the eye relative to the ophthalmic laser treatment system and the optical opening of the ophthalmic laser treatment system can be calculated via acquired data from planes with two different acquisition directions. Preferably, when calculating the three-dimensional position of the eye, the relative position of the acquisition unit and the acquisition direction of the acquisition unit (and / or, for example, the magnification or focus position) is considered. When calculating the relative position between the optical opening and the eye, the relative position of the optical opening with respect to the acquisition unit can be additionally considered. The control commands required for the moving unit can be derived from the measured position of the eye relative to the optical opening.

[0017] The positioning device according to the invention allows the eye to be automatically positioned relative to the optical opening of the ophthalmic laser treatment system.

[0018] Positioning can also include the alignment of the contact lens. The positioning result can be verified by the operator; in this case, the verification does not necessarily need to be performed through the positioning device. After verification, the operator can repeat the positioning or begin the treatment of the eye.

[0019] The acquisition unit is preferably fixedly connected to the ophthalmic laser treatment system. The ophthalmic laser treatment system has a fixed device base and a device head that is movable (e.g., laterally in the xy direction and / or at height z), so the acquisition unit is preferably fixed at the device head. If a laser pivot arm (for providing therapeutic radiation) or an examination pivot arm (for examining radiation) is fixed at the device head, both having optical openings capable of movement relative to the device base (preferably in the z direction, but also in the xy direction), then other acquisition units are preferably fixed at one of the pivot arms, particularly preferably at the laser pivot arm. Therefore, positioning at the laser pivot arm is preferred because accurate positioning of the eye relative to the optical opening is significantly more critical for treatment than for examination. Furthermore, the acquisition optics system is preferably arranged near the optical opening.

[0020] An alternative positioning device for an ophthalmic laser treatment system (which has an optical opening) includes a first acquisition unit configured to provide first acquisition data of the eye from a first acquisition direction for positioning the eye relative to the optical opening. The positioning device also includes a second acquisition unit configured to provide second acquisition data of the eye from a second acquisition direction, wherein the second acquisition direction is different from the first acquisition direction. Furthermore, the positioning device includes a movement unit configured to move the relative position of the eye with respect to the optical opening based on control commands. The above-mentioned description of the acquisition unit and the movement unit also applies to the alternative positioning device.

[0021] Additionally, the positioning device has a display unit for displaying first and second acquired data from the eye. The acquired data can be first converted into display data. Based on the different acquisition orientations of the acquisition unit, the operator can identify the three-dimensional position of the eye on the display unit, as long as the eye is within the field of view (often also called the crop field) of the acquisition unit.

[0022] Preferably, the display unit is located near the location occupied by the operator during treatment or in preparation (e.g., when aligning the eye with the contact lens). Advantageously, the display unit is positioned in the line of sight and within the operator's assumed viewing distance. The display unit can be connected, for example, to a laser pivot arm or an examination pivot arm. The operator can also additionally display information or menus for controlling the laser treatment system on the display unit.

[0023] The positioning device also includes an input unit that enables an operator to input data. The input unit can be, for example, one or more buttons, a keyboard, a knob, and / or a slider. The input unit can also be integrated into a display unit as a touchscreen. Preferably, it is a joystick, which may additionally have one or more buttons.

[0024] Furthermore, the positioning device has a control unit. This control unit is configured to provide control commands based on acquired data (according to the above-mentioned description of the control unit). Additionally or alternatively, the control unit is configured to generate control commands based on input data from the input unit. The input data can also be converted by the control unit into control commands for the movement unit; this preferably occurs in a computing unit, which can be part of the control unit. The generated control commands can be provided to the movement unit. The control unit can be a computer, which has a processor and memory.

[0025] The operator can use this positioning device to identify the position of the eye on the display unit and manually control the moving unit via the input unit, thus aligning the optical opening of the ophthalmic laser treatment system relative to the eye. Alternatively or additionally, positioning can be performed automatically. The acquired data displayed on the display unit can be used by the operator to monitor the positioning process and / or verify the positioning results.

[0026] In an advantageous design of the positioning device, the first acquisition unit includes a first acquisition optical system and the second acquisition unit includes a second acquisition optical system. Here, at least one acquisition optical system has a digital aperture of less than 0.25 (preferably less than 0.1, particularly preferably less than 0.05) on the object side, i.e., at the eye. In this way, before reaching the target position of the eye (e.g., before the cornea comes into contact with the contact element), for example, when the distance to the contact element is already 100mm to 200mm, the eye has been advantageously and sufficiently clearly imaged, thereby enabling the operator to begin positioning and / or enabling the control unit to generate control commands for moving the unit.

[0027] Typically, ophthalmic laser treatment systems have an optical system. According to the design of the positioning device used in such a treatment system, the first acquisition unit includes a first acquisition optical system. Here, a portion of the optical system of the ophthalmic laser treatment system is identical to a portion of the first acquisition optical system.

[0028] Particularly preferably, a portion of the laser optics system of the laser pivot arm or a portion of the inspection optics system of the inspection pivot arm is identical to a portion of the first acquisition optics system. That is, a portion of the optics system of the laser pivot arm used to guide the laser beam from the laser source into the eye is also used by the acquisition optics system of the first acquisition unit for observing the eye (or a portion of the optics system of the inspection pivot arm). The shared optics system can include optical openings. The optical path of the first acquisition unit can be configured at an angle of less than 20° relative to the optical path in the laser pivot arm or the inspection pivot arm. The optical path can also be coaxially configured.

[0029] To achieve a compact construction, the first acquisition optics system advantageously features a small diameter and a large F-number on the sensor side.

[0030] The imaging ratio of the first acquisition optical system is preferably selected such that the entire treatment or examination area of ​​the eye (e.g., approximately 10 mm in diameter in a specific positioning or docking configuration) is clearly imaged. For this purpose, the acquisition optical system can be designed such that its focal point coincides with the focal point of the laser optical system or examination optical system, for example, on or just behind the machined surface of the contact element (i.e., at the eye).

[0031] The acquisition unit, featuring a shared optical system, allows for a "positive viewing angle" on the eye. This positive viewing angle is particularly suitable for centering the eye relative to the optical opening. Simultaneously, it allows for observation of the treatment process during surgery (OP).

[0032] Typically, in a shared optical system, the optical path of the acquisition unit is separated (or combined) from the optical path of the laser optics or inspection optics via a beam splitter. The beam splitter can be shaped as a beam-splitting cube. If the first acquisition optics additionally has a small digital aperture on the object side (as described above), the beam splitter can advantageously be shaped as a flat plate oriented at an angle in the optical path. Here, again advantageously, the optical path of the acquisition unit is transmitted, and the optical path of the laser optics or inspection optics is reflected. Through the small digital aperture on one side of the eye, the imaging of the acquisition unit maintains high quality. The use of a flat plate saves cost and, especially, weight.

[0033] In a particularly advantageous improvement to the design, the first acquisition optical system is configured such that the field of view of the observed area is imaged with a constant field of view size or a larger field of view size as the distance from the first acquisition optical system increases.

[0034] A constant field of view (often referred to as field size) can be achieved by designing the acquisition optics telecentrically on the object side. This means that, for example, with a distance from the optical aperture to the contact element ranging from 100 mm to 200 mm, the observation area is imaged with a diameter of 10 mm. A larger field of view can be achieved by telecentrically offsetting the acquisition optics from the object side, thereby magnifying the observation area with increased spacing and allowing a larger portion of the eye or patient's head to be seen. This magnification is advantageous because it achieves a larger "capture area"; that is, the eye remains within the field of view of the acquisition unit even when the target position of the eye is significantly deviated from the optical aperture.

[0035] The aforementioned embodiment for providing a positive viewing angle using a first acquisition unit is also suitable for observing the eye and thus monitoring the treatment during laser therapy. Therefore, the application of this embodiment is not limited to the positioning process.

[0036] Acquisition units that do not provide a "positive viewing angle" can also have an acquisition optics system configured to image the field of view of the observation area at a constant or larger field of view size as the distance from the first acquisition optics system increases. This also achieves an improvement in the "capture area".

[0037] According to the design of the positioning device, the acquisition unit has a field of view of at least 30mm × 30mm in the focal plane, preferably at least 40mm × 40mm, and particularly preferably at least 50mm × 50mm; that is, an object of this size in the focal plane is clearly imaged onto the sensor of the acquisition unit. The focal plane of the acquisition unit (or the acquisition optical system of the acquisition unit) is preferably located in (or near) the target position of the eye. Even if the treatment area or examination area is only about 10mm in diameter, if the eye is not in its target position, the larger field of view according to the invention still enables eye recognition because the field of view also includes the structure of the patient's head surrounding the eye. In this way, the "capture area" can be advantageously further improved by the above solution.

[0038] In the design of the positioning device, the angle between the first acquisition direction and the second acquisition direction is 90°±30°, preferably 90°±10°, and particularly preferably 90°±5°.

[0039] In other words, the eye receives data from two acquisition units from two directions in space, with these two directions at an angle of approximately 90° to each other. Compared to smaller angles, this angle allows for a more accurate determination of the eye's position.

[0040] Preferably, at least one acquisition direction corresponds to the direction of movement of the moving unit. Furthermore, preferably, the acquisition direction is as parallel as possible to the direction of the laser beam guided from the optical system of the laser pivot arm to the eye. Particularly preferably, the acquisition unit having this acquisition direction has an acquisition optical system, wherein a portion of the optical system of the ophthalmic laser treatment system is identical to a portion of the first acquisition optical system.

[0041] The first acquisition direction can be, for example, a frontal view, which particularly well achieves centering of the eye relative to the optical opening. The second acquisition direction can be a lateral view over the eye. This particularly well achieves close proximity between the eye and the optical opening. Advantageously, the lateral view has a large field of view in the focal plane (as described above) to enable the detection of parts of the patient's head surrounding the eye (e.g., the eye socket, forehead, and nose). Precise centering can be achieved during the frontal view, while the lateral view allows for accurate (axial) proximity of the optical opening relative to the eye (especially when a large capture area is achieved).

[0042] According to another design, the positioning device has a third acquisition unit, which is configured to provide third acquisition data from a third acquisition direction, wherein the third acquisition direction is different from the first acquisition direction and the second acquisition direction.

[0043] For this purpose, the third acquisition unit (or the acquisition angle of the third acquisition unit relative to the target position of the eye) can form a Cartesian coordinate system. However, the third acquisition units can also have small angles relative to each other. For example, it is sufficient if the third acquisition unit is arranged outside the plane separated by the two other acquisition units and the target position of the patient's eye, in order to improve the calculation of the position of the eye relative to the optical opening in the control unit (or, if necessary, in the computing unit included therein). The third acquisition data can also be displayed by a display unit that is present if necessary.

[0044] Preferably, the third acquisition unit also has a large field of view in the focal plane. If both acquisition units are designed to have large field of view, the "capture area" used for positioning is further improved.

[0045] In a preferred variant of the positioning device, the third acquisition direction and the first acquisition direction have an angle between each other of greater than 10° and less than 90°, preferably between 20° and 70°, and particularly preferably between 30° and 60°.

[0046] On the one hand, the angle according to the invention ensures that the acquisition unit can "see" the eye: because the patient's eye is located within the eye socket, it cannot be seen from any direction. Besides the frontal view (e.g., achieved via the first acquisition unit) and the lateral view (e.g., via the second acquisition unit), a third acquisition direction perpendicular to the two acquisition directions does not allow free gaze at the eye, thus the so-called angle should be less than 90°. On the other hand, the angle according to the invention improves the calculation of the relative position between the eye and the optical opening, because the third acquisition direction provides a new, independent "viewing direction" relative to the eye relative to the first acquisition direction. Because the operator's direct gaze at the patient's eye can be partially obscured by the ophthalmic laser treatment system, the third acquisition unit is preferably positioned at the laser treatment system if the optical opening and the eye are well positioned (close) to each other for treatment, such that the acquisition data is acquired at an observation angle (i.e., with the acquisition direction) corresponding to the operator's direct, unadjusted gaze relative to the eye. This is ensured by the so-called angle region. Therefore, the third acquisition unit can achieve a so-called "top-down view" on the eye. Preferably, the acquisition data is also displayed on a display unit present if necessary.

[0047] Preferably, the third acquisition direction and the second acquisition direction have an angle of 90°±30° with each other, more preferably 90°±10°, and particularly preferably 90°±5°.

[0048] In another design, the positioning device has a fourth acquisition unit configured to provide fourth acquisition data from a fourth acquisition direction. Here, the fourth acquisition direction differs from the first, second, and third acquisition directions. Specifically, the angle between the fourth acquisition direction and the first, second, or third acquisition direction is 180°±30°, preferably 180°±10°, and particularly preferably 180°±5°.

[0049] If, for example, the second acquisition unit is able to achieve the lateral view of the first (e.g., the right) eye, then the fourth acquisition unit is able to achieve, for example, the lateral view of the second (e.g., the left) eye, and the lateral gaze of the eye is not limited by, for example, the patient's nose or other parts of the head.

[0050] If the acquired data is displayed by two or more acquisition units, it is advantageous to display only image segments of the acquired data (so-called "regions of interest," ROIs) instead of the entire acquired data. The ROI can be selected, for example, by the computing unit, such that the displayed acquired data includes the eye. The ROI of the first acquisition unit providing a frontal view is particularly advantageously rectangular, square (e.g., 900×900 pixels) or circular, and the ROI of the second or third acquisition unit providing a side or top view has a rectangular shape (e.g., 700×450 pixels). The ROI can be converted in real time (preferably with a delay of less than 0.5 seconds between image acquisition and display) into a common video format (e.g., in the computing unit) and displayed by the display unit. The resulting video, for example, has a minimum size of 1600×900 pixels.

[0051] In another design of the positioning device, the control unit includes a computing unit configured to calculate the acquired data from the acquisition unit, which includes target markers for display. The control unit is then able to provide the display data.

[0052] The target marker can be a mark indicating the target position of the eye relative to an optical opening (e.g., a contact lens). The mark can be shaped as a line, cross, circle, or other symbol. The mark can also be a (non-realistic) display of the contact lens (and, if necessary, the entire adjacent optical system). The target marker can be superimposed on the acquired data in the computing unit and collectively converted into display data, which is then displayed on the display unit. The target marker is preferably displayed such that it has good contrast (e.g., brightness and / or color) relative to the displayed acquired data.

[0053] With the overlay of target markers and acquired data, the image content of the acquired data can be evaluated by the computing unit in order to identify, for example, the eye, parts of the eye such as the iris or pupil, and / or parts of an ophthalmic laser treatment system such as an optical opening (or contact lens) in the data.

[0054] The display of the target mark on the display unit can improve the eye's positioning relative to the optical opening, because the operator has visual support for manually controlling the movement of the unit.

[0055] To this end, the control unit can be configured to calculate movement data based on the acquired data, which may display, for example, the direction or path of movement. The movement data can also be displayed on a display unit, for example, as arrows marking the direction or path of movement, preferably superimposed on the acquired data. In this way, it is possible to show the user how they should control the movement unit (via the input unit).

[0056] In another design, the positioning device has an illumination unit configured to apply illumination light to the eyes.

[0057] The use of an illumination unit can improve the quality of the acquired data, thereby enabling the operator or control unit to generate control commands for a more precise moving unit.

[0058] The illumination unit can guide illumination light, for example, through an optical opening (e.g., through a contact lens). This can particularly improve image quality at the orthographic viewing angle. The illumination unit can also be a "planar" illumination device fixed near the optical opening (e.g., at a laser pivot arm or an inspection pivot arm); this can improve image quality at the top-down viewing angle. It can also be an illumination device positioned near the acquisition unit to apply illumination light to the eyes (and surrounding areas of the head) from there. It can also be a dark-field illumination device. The illumination light can be, for example, visible light (VIS) or infrared light (IR).

[0059] According to another design of the positioning device, the control unit has a computing unit configured to perform the following calculations when the collected data is applied: patient facial recognition, recognition of the patient's left or right eye, detection of the patient's movement, and reading of barcodes.

[0060] In order to perform so-called computation, the computing unit includes a corresponding program that analyzes the collected data and provides results.

[0061] Facial recognition can be used to effectively verify a patient's identity. This method can avoid errors caused by using incorrect patient data.

[0062] Identifying the patient's right or left eye ensures that the optical opening is positioned in front of the eye to be treated. Here, a large field of view is particularly advantageous because (preferably in a "top-down" view) data acquisition including the patient's nose simplifies eye differentiation. This also helps to avoid errors.

[0063] If an error is detected, an alert can be generated.

[0064] Using acquired data (e.g., data from side and / or top views) allows for reading barcodes or other codes, such as identifying serial numbers on contact elements (or the package to which they belong, e.g., data matrix encoding). This is also used to improve the quality of laser treatment by avoiding errors. In this case, a large depth of field, a large field of view, and / or digital zoom (which can only be achieved through high pixel values ​​of the sensor) of the acquisition unit's acquisition optics system is advantageous.

[0065] In addition to calculations that can preferably be performed before eye positioning, patient movement can be monitored during laser treatment. This also allows for the generation of alarm signals, interruption signals, or triggering of treatment interruption. Furthermore, patient comfort can be detected (primarily) during laser treatment, which requires patient cooperation and coordination (e.g., gazing at a fixed light).

[0066] For the so-called calculations, top-down and / or side-down view acquisition data are preferably applied. The corresponding acquisition unit preferably has a large field of view in its focal plane. Because solutions according to the prior art only provide acquisition data in a positive field of view for the patient's eye itself, i.e., a small field of view, the solution according to the invention is able to produce particular added value here.

[0067] The positioning device can have multiple display units. For example, an additional display unit can be placed next to the location occupied by the operator during positioning and / or treatment, which displays data for an assistant, thereby enabling the assistant to monitor / observe the positioning (and treatment).

[0068] The positioning device can also have a display unit with a speaker. In addition to visual display data, the displayed data can also include audio data (broadcast signals). The audio data can be commands or alarms. The generation of this broadcast data can be implemented in the computing unit.

[0069] The control unit of the positioning device preferably has an interface to a data acquisition unit, a display unit, an input unit, a movement unit, and / or an illumination unit. Data exchange between the units of the positioning device can be achieved via this interface (which may also have sub-interfaces for communication with only one or a few units). The control unit may also have an interface to an ophthalmic laser treatment system. Information such as patient data and treatment data (or alarms, status reports) can be exchanged via this interface. This information can be added to display data (e.g., in a computing unit).

[0070] According to a preferred design of the positioning device, the control unit has a data interface. Furthermore, the control unit is configured to create and provide data streams via the data interface. Here, the data stream includes acquired data and / or displayed data. The interface can be connected to a storage unit, which can be part of the positioning device. Additionally or alternatively, the interface can be connected to an ophthalmic laser treatment system, whereby the data stream can be further processed or stored in the storage unit.

[0071] Advantageously, the data stream includes other data such as control commands, input data, information from the illumination unit or ophthalmic laser treatment system (e.g., parameters of the treatment laser or patient data), movement data, and / or additional calculations from the acquired data. If the laser treatment system or positioning device has a microphone for acquiring microphone data (e.g., acquiring conversations before or during treatment), that microphone data can also be part of the data stream.

[0072] Using a data stream (and preferably a memory for the data stream), the operator can record the treatment. The (stored) data stream can therefore be used as a surgical report. Here, the data stream preferably includes not only the preparation for the surgical procedure (such as eye positioning or contact lens docking) but also the entire execution process. For this purpose, the data in the data stream can be timestamped.

[0073] A second aspect of the invention relates to an ophthalmic laser treatment system having an optical opening. According to the invention, the laser treatment system includes a positioning device according to one of the above embodiments.

[0074] The third aspect relates to a method for a positioning device in an ophthalmic laser treatment system having an optical opening, the method being used to position a patient's eye relative to the laser opening. The positioning device has a first acquisition unit and a second acquisition unit configured to provide first acquisition data of the eye from a first acquisition direction, and the second acquisition unit configured to provide second acquisition data of the eye from a second acquisition direction. Here, the second acquisition direction is different from the first acquisition direction. The positioning device also includes a movement unit and a control unit configured to move the relative position of the eye with respect to the optical opening based on control commands. The method according to the invention has the following steps:

[0075] - Receive the first and second data acquisitions.

[0076] - Calculate the acquired data in the control commands, and

[0077] - Export control commands to the mobile unit.

[0078] An alternative method for positioning devices in ophthalmic laser treatment systems is used to position a patient's eye relative to an optical opening, wherein the ophthalmic laser treatment system has an optical opening. The positioning device has a first acquisition unit and a second acquisition unit, the first acquisition unit being configured to provide first acquisition data of the eye from a first acquisition direction, and the second acquisition unit being configured to provide second acquisition data of the eye from a second acquisition direction. Here, the second acquisition direction is different from the first acquisition direction. The positioning device also includes a display unit for displaying the first and second acquisition data of the eye and a movement unit, the movement unit being configured to move the relative position of the eye with respect to the optical opening based on control commands. Furthermore, the positioning device has an input unit and a control unit, the input unit being configured to input input data. The method according to the invention includes the following steps:

[0079] - Receive the first and second data acquisitions.

[0080] - Display the collected data on the display unit.

[0081] - Receive input data,

[0082] - Calculate the input data in the control commands, and

[0083] - Export control commands to the mobile unit.

[0084] It should be noted that the method is performed prior to the actual treatment of the eye; the method is only for preparation for treatment and is not part of the treatment itself.

[0085] It goes without saying that the features mentioned above and to be described below are not limited to the combinations mentioned, but can also be applied to other combinations or used alone, without departing from the scope of protection of this invention. Attached Figure Description

[0086] The invention will now be described in detail, for example, with reference to the accompanying drawings. These drawings disclose features that are essential to the invention.

[0087] The attached diagram shows:

[0088] Figure 1 A schematic diagram of an exemplary ophthalmic laser treatment system with a positioning device is shown;

[0089] Figure 2 A schematic diagram showing the display of acquired data on the display unit is shown;

[0090] Figure 3a , Figure 3b , Figure 3c A cross-sectional view of an embodiment of the acquisition optical system of the acquisition unit is shown;

[0091] Figure 4 A schematic diagram of an embodiment of the positioning device is shown. Detailed Implementation

[0092] exist Figure 1 A schematic diagram of an exemplary ophthalmic laser treatment system 50 is shown.

[0093] An example of an ophthalmic laser treatment system 50 comprises a device base 2 and a device head 1 that is adjustable on the device base 2 at a height above its bottom plane, i.e., in the z-direction, and in the plane of the base's location, i.e., in the x-direction and y-direction. The device head 1 includes a first part of a laser optics system necessary for performing laser treatment. In the illustrated example, the device head 1 also includes a laser source necessary for generating laser radiation corresponding pulses, which is here a femtosecond laser source.

[0094] The second part of the laser optical system is located in the laser pivot arm 3. This laser pivot arm can be arranged about a horizontal axis (not shown) from an original position (in the original position, the laser pivot arm protrudes approximately vertically upwards) to a working position (in the working position, the laser pivot arm is arranged approximately horizontally at the device head 1, i.e., approximately parallel to the bottom plane) to a working position, and then pivot back. Therefore, the laser pivot arm 3 can pivot above the patient for laser treatment of the patient's eyes. However, in a step (in which the laser pivot arm 3 is not needed), the laser pivot arm can be returned to its original position so that the space above the working position can be used for other purposes. The optical opening, i.e., the laser emission port, is located at the laser pivot arm 3 (when the laser pivot arm 3 is in...). Figure 1 (As shown in the working position) the therapeutic laser radiation is guided from the optical opening to the treatment position in the patient's eye. The laser exit port is movably arranged inside the laser pivot arm 3.

[0095] The first acquisition unit of the positioning device is configured as camera 11, located at the laser pivot arm 3. This acquisition unit has an optical path to the patient's eye, a portion of which is identical to the optical path of the therapeutic radiation. That is, a portion of the laser optics system in the laser pivot arm 3 is identical to a portion of the optical system of the acquisition optics system of camera 11. A contact lens (not shown) is part of the shared optical system. Camera 11 allows acquisition data of the patient's eye in a "positive view". The positioning device has other cameras 9 and 19 (second and third acquisition units). These cameras are configured to generate acquisition data of the patient in an acquisition direction, that is, to generate acquisition data of the patient's eyes and the head portion around the eyes, which deviates from the acquisition direction of camera 11. Additionally, the acquisition directions of cameras 9 and 19 are also different. Camera 9 allows a "side view" of the patient's eye; the acquisition directions between cameras 11 and 9 have an angle of approximately 90° with each other (relative to the target position of the eye). Camera 19 allows a "top view" of the patient and the patient's eye. The angle between the acquisition directions of the second acquisition unit (camera 9) and the third acquisition unit (camera 19) is also approximately 90°. The angle between the acquisition directions of the first acquisition unit (camera 11) and the third acquisition unit (camera 19) is approximately 55°. Cameras 11, 9, and 19 establish a coordinate system that enables three-dimensional detection of the head and the patient's eyes. Based on the arrangement of cameras 11 and 9, it is already possible to detect the three-dimensional position of the eyes via the two cameras; when applying the data acquired by camera 19, the determination of eye position becomes more accurate or more intuitive for users who want to perform manual positioning.

[0096] A movable unit (here, part of the patient bed 40) is configured to control the movement of the device head 1 relative to the device base 2. Furthermore, the movable unit allows for movement of the laser exit port at the laser pivot arm 3. In this way, the laser exit port can move relative to the patient's eyes in all three spatial dimensions.

[0097] Input unit 20 is configured as a joystick. This joystick is located at the laser pivot arm 3. The operator can generate input data via the joystick (by moving the joystick or triggering a switch or regulator located thereon). This input data is exported at the control unit (not shown) and converted into control commands (in the calculation unit, not shown). The control commands are then exported again at the movement unit. The control unit (with the calculation unit) is located in the device head 1 in this example.

[0098] The display unit of the positioning device is configured as a monitor and is also fixed to the laser pivot arm 3. The display unit is connected to the laser pivot arm 3 via a rotation axis (not shown) to ensure horizontal alignment of the monitor 12 for both the static and working positions. The monitor 12 is configured as a touch screen; the input unit 20 can then be integrated into the display unit.

[0099] The positioning device additionally includes additional display units 22, which are side-mounted to the device head 1. The monitor 22 is positioned so that other observers of the treatment can easily view the monitor when it is in an ergonomic position for the surgeon (operator).

[0100] Display units 12 and 22 show the data acquired by cameras 11, 9 and 19 at the frontal view 30, side view 32 and top view 34 of the patient's eyes.

[0101] The laser treatment system 50 also has a separate examination pivot arm 14, which is movable via a pivot axis (not shown). The examination pivot arm 14 is also pivotable between a rest position and a working position. A surgical microscope 15 is connected via the examination pivot arm 14 via a rotatable axis (not shown). The pivot axis and the rotatable axis are designed such that the working position of the surgical microscope 15 in the working position coincides with the treatment position. Alternatively or additionally, in addition to placing the first acquisition unit 11 at the laser pivot arm 3, the acquisition unit can also be fixed at the examination pivot arm 14. Here, the acquisition unit can be configured, for example, such that it has an optical path to the patient's eye that is partially identical to the optical path of the examination radiation. That is, a portion of the examination optics in the examination pivot arm 14 is identical to a portion of the optical system of the camera's acquisition optics. The camera's acquired data can also be displayed on display units 12, 22 and / or stored in storage units for recording after shifting from the laser pivot arm 3 above the patient's eyes to the examination pivot arm 14 above the patient's eyes (with the examination pivot arm 14 in its working position and the laser pivot arm 3 in its original position). The recorded and stored data can also include video signals, microphone data, or patient and treatment data. The acquired data displayed on display units 12, 22 can be used to select which pivot arm is in its working position. Preferably, only the acquired data from the acquisition unit connected to the corresponding pivot arm is shown at a frontal view, with that pivot arm precisely in its working position.

[0102] It should be noted that the positioning device according to the invention is not limited to the application of an ophthalmic laser treatment system 50 having a laser pivot arm 3 and an examination pivot arm 14. Specifically, its use is equally feasible and advantageous in a laser treatment system 50 having a laser pivot arm 3, which, while capable of positioning, cannot be moved to its original position, and / or a laser treatment system without an examination pivot arm 14.

[0103] exist Figure 2 The diagram illustrates the display of acquired data on display units 12 and 22. According to the invention, display units 12 and 22 are used to show the operator a top-down view 34 obtained using camera 19, a side view 32 generated using camera 9, and an orthographic view 30 generated using camera 11 through the contact lens during positioning of the patient's eye relative to optical openings (e.g., laser exit ports and / or contact lenses). The display of camera 19 and its image 34 on monitor 12 improves the surgeon's ergonomics because the patient is partially obscured during surgery (OP) by the laser pivot arm 3, which includes a laser optics system. Advantageously, the acquired data (e.g., top-down view) is also displayed after eye positioning, for example, for monitoring treatment.

[0104] The displayed acquired data is overlaid with target markers 38. Target markers 38 improve the positioning of the eye relative to the optical opening. In particular, the operator can quickly and intuitively see in which direction he must move / control the joystick 20 to bring the patient's eye to its target position.

[0105] Additionally, information data 36 is displayed on display units 12 and 22. This information data is provided by the laser therapy system of the control unit via an interface. Furthermore, alarm output is also possible, provided by the laser therapy system or the control unit (or computing unit).

[0106] exist Figure 3a , Figure 3b , Figure 3cA cross-sectional view of the acquisition optical system of the acquisition unit 100 is shown. Here, the acquisition unit 100 has an acquisition optical system that is partially identical to the laser optical system of an ophthalmic laser treatment system. An eye 170, a lens 150 with a contact element 160 for laser treatment, a beam splitter 140, a camera lens 120 with an aperture 130, and a sensor 110 (CCD detector or CMOS detector) are shown. Here, the contact element 160, lens 150, and beam splitter 140 are used jointly by the laser optical system and the acquisition optical system. The optical design of the acquisition optical system is thus shown, giving it a small digital aperture to ensure a high depth of field. In this way, the eye 170 is clearly imaged at a distance of 100 mm to 200 mm from the contact element 160, enabling the centering of the eye 170. The free diameter of the optical elements and the imaging ratio are selected such that a field of view with a diameter of 10 mm is clearly imaged (at the contact element 160, which serves as the target position of the eye).

[0107] exist Figure 3a In this design, the radiation path from sensor 110 to contact element 160 is configured such that a 10mm diameter area is imaged at the same size for a spacing of 100mm to 250mm. For this purpose, aperture 130 is positioned to ensure telecentricity on the object side. This is illustrated by a radiation beam 190 (solid line) for the center of the area to be imaged and a radiation beam 192 (dashed line) for the edge areas of the area to be imaged. Figure 3a The intermediate radiation beams 190 and 192 extend in parallel, and their spacing remains unchanged.

[0108] In response, Figure 3b Advantageous variants are shown here. An optical design is employed such that the field of view of the imaging area is enlarged with a greater distance from the contact element 160, thereby allowing a larger portion of the eye or patient's head to be imaged on the camera sensor 110. This allows for improved "capture" of the eye at the start of positioning while the eye 170 and contact element 160 remain at a large distance from each other. This is illustrated by the radiating beam 190 (solid line) at the center of the area to be imaged, the radiating beam 192 (dashed line) at the edge region, and the radiating beam 194 (dotted line) in the middle region of the area to be imaged. The distance between the radiating beams 190, 192, and 194 increases with the distance from the contact element 160.

[0109] Contact element 160 can be shaped as a flat or curved (as shown here) contact lens. Telecentricity (or its deviation) is determined by the distance between lens 150 and camera lens 120 or its aperture 130.

[0110] The optical paths of the acquisition unit and the laser optical system are combined in the beam splitter 140. The beam splitter is located in... Figure 3a , Figure 3b , Figure 3c It is constructed as a beam splitter cube. However, it is also feasible to implement it as a distribution plate.

[0111] exist Figure 3c The radiation path of the therapeutic radiation 180 of the optical system used by both sides is shown as a dashed line for illustration. Here, the eye 170 is located at the target position of the eye; the eye is in contact with the contact element 160.

[0112] exist Figure 4 A schematic diagram of an embodiment of the positioning device 200 is shown. The positioning device 200 includes a data acquisition unit 210, a second data acquisition unit 220, a display unit 230, and a movement unit 240. Embodiments of the positioning device 200 also include an input unit 260, an illumination unit 270, and a storage unit 280. Data exchange between the units and the control unit 250 is achieved via an interface (shown as a box at the control unit). Here, data exchange is achieved via cable; however, data exchange can also be performed wirelessly. Furthermore, an interface is provided for exchanging data with the laser therapy system 50 (shown via a wire that exits the positioning device 200, shown by a dashed line). The control unit 250 includes a calculation unit 255, which allows for the calculation of movement data.

[0113] Hereinafter, the features mentioned above and described in different embodiments of the present invention are available not only in the given exemplary combinations, but also in other combinations or individually, without departing from the scope of protection of the present invention.

[0114] The description of the method features of the device is similarly applied to the corresponding methods involving these features, while the method features represent the corresponding functional features of the device being described.

Claims

1. A positioning device (200) for an ophthalmic laser treatment system (50), the ophthalmic laser treatment system having an optical opening that allows light from a laser source to exit the ophthalmic laser treatment system, the positioning device being used to position a patient's eye (170) relative to the optical opening, wherein, The positioning device (200) includes: - First acquisition unit (11, 210), the first acquisition unit is configured to provide first acquisition data from a first acquisition direction to the eye (170); - A second acquisition unit (9, 220), configured to provide second acquisition data from a second acquisition direction to the eye (170). Wherein, the second acquisition direction is different from the first acquisition direction; The positioning device (200) further includes a third acquisition unit (19), which is configured to provide third acquisition data from a third acquisition direction, wherein the third acquisition direction is different from the first acquisition direction and the second acquisition direction. - A moving unit (240), configured to move the relative position of the eye (170) with respect to the optical opening based on control commands; and - Control unit, which is configured to generate control commands based on the first acquired data, the second acquired data and the third acquired data and to provide the control commands to the mobile unit (240).

2. A positioning device (200) for an ophthalmic laser treatment system (50), the ophthalmic laser treatment system having an optical opening that allows light from a laser source to exit the ophthalmic laser treatment system, the positioning device being used to position a patient's eye (170) relative to the optical opening, wherein, The positioning device (200) has: - First acquisition unit (11, 210), the first acquisition unit is configured to provide first acquisition data from a first acquisition direction to the eye (170); - A second acquisition unit (9, 220), configured to provide second acquisition data from a second acquisition direction to the eye (170). Wherein, the second acquisition direction is different from the first acquisition direction; The positioning device (200) further includes a third acquisition unit (19), which is configured to provide third acquisition data from a third acquisition direction, wherein the third acquisition direction is different from the first acquisition direction and the second acquisition direction. - Display unit (12, 22, 230) for displaying the first and second acquisition data of the eye (170); - A moving unit (240) configured to move the relative position of the eye (170) with respect to the optical opening based on control commands; - Input unit (20, 260), the input unit being configured to implement the input of input data; and - Control unit (250), the control unit is configured to generate control commands based on the first acquired data, the second acquired data and the third acquired data and / or based on input data, and to provide the control commands to the mobile unit (240).

3. The positioning device (200) according to claim 1 or 2, characterized in that, The first acquisition unit (11, 210) includes a first acquisition optical system and the second acquisition unit (9, 220) includes a second acquisition optical system, wherein at least one of the acquisition optical systems has a digital aperture of less than 0.25 on the object side.

4. The positioning device (200) according to claim 1 or 2, wherein, The ophthalmic laser treatment system (50) has an optical system, characterized in that the first acquisition unit (11, 210) includes a first acquisition optical system, wherein a portion of the optical system of the ophthalmic laser treatment system (50) is consistent with a portion of the first acquisition optical system.

5. The positioning device (200) according to claim 3, characterized in that, The first acquisition optical system is configured such that the field of view of the observation area is imaged with a constant field of view size or a larger field of view size as the distance from the first acquisition optical system increases.

6. The positioning device (200) according to claim 1 or 2, characterized in that, The acquisition unit has a field of view of at least 30mm × 30mm on the focusing plane.

7. The positioning device (200) according to claim 1 or 2, characterized in that, The first acquisition direction and the second acquisition direction are 90° apart. An angle of 30°.

8. The positioning device (200) according to claim 1, characterized in that, The third acquisition direction and the first acquisition direction have an angle between each other between 10° and 90°.

9. The positioning device (200) according to claim 1 or 2, characterized in that, The control unit (250) has a computing unit (255) configured to calculate the acquisition data of the acquisition unit having a target flag (38) for the display data, and to enable the control unit (250) to provide the display data.

10. The positioning device (200) according to claim 1 or 2, characterized in that, The positioning device (200) has an illumination unit (270) configured to apply illumination light to the eye (170).

11. The positioning device (200) according to claim 1 or 2, characterized in that, The control unit (250) has a computing unit (255) configured to perform one of the following calculations by applying the acquired data: - Identify the patient's face, - Identify the patient's right or left eye. - Read the barcode. - Detect the patient's movement.

12. The positioning device (200) according to claim 1 or 2, characterized in that, The control unit (250) has a data interface and is configured to create a data stream, the data stream including acquired data and / or displayed data, and the data stream is provided via the data interface.

13. An ophthalmic laser treatment system (50) having an optical opening and a positioning device (200) according to any one of claims 1 to 12.

14. A method for positioning a device (200) for an ophthalmic laser treatment system (50), the ophthalmic laser treatment system having an optical opening that allows light from a laser source to exit the ophthalmic laser treatment system, the positioning device being used to position a patient's eye (170) relative to the optical opening, wherein, The positioning device (200) has: - First acquisition unit (11, 210), the first acquisition unit is configured to provide first acquisition data from a first acquisition direction to the eye (170); - A second acquisition unit (9, 220), configured to provide second acquisition data from a second acquisition direction to the eye (170). Wherein, the second acquisition direction is different from the first acquisition direction; The positioning device (200) further includes a third acquisition unit (19), which is configured to provide third acquisition data from a third acquisition direction, wherein the third acquisition direction is different from the first acquisition direction and the second acquisition direction. - A moving unit (240), configured to move the relative position of the eye (170) with respect to the optical opening based on control commands; and -Control unit (250); Furthermore, the method includes the following steps: - Receive the first collected data, the second collected data, and the third collected data. - Calculate the acquired data in the control commands, and - Export the control commands to the mobile unit (240).

15. A method for positioning a device (200) for an ophthalmic laser treatment system (50), the ophthalmic laser treatment system having an optical opening that allows light from a laser source to exit the ophthalmic laser treatment system, the positioning device being used to position a patient's eye (170) relative to the optical opening, wherein, The positioning device (200) has: - First acquisition unit (11, 210), the first acquisition unit is configured to provide first acquisition data from a first acquisition direction to the eye (170); - A second acquisition unit (9, 220), configured to provide second acquisition data from a second acquisition direction to the eye (170). Wherein, the second acquisition direction is different from the first acquisition direction; The positioning device (200) further includes a third acquisition unit (19), which is configured to provide third acquisition data from a third acquisition direction, wherein the third acquisition direction is different from the first acquisition direction and the second acquisition direction. - Display units (12, 22, 230) for displaying the first and second acquisition data of the eye (170); - A moving unit (240) configured to move the relative position of the eye (170) with respect to the optical opening based on control commands; - Input unit (20, 260), the input unit being configured to implement the input of input data; and -Control unit (250); Furthermore, the method includes the following steps: - Receive the first collected data, the second collected data, and the third collected data. - The collected data is displayed on the display units (12, 22, 230). - Receive input data, - Calculate the input data in the control commands, and - Export the control commands to the mobile unit (240).

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