Combined near-infrared and visible imaging in a compact microscope stack

Abstract

The present disclosure relates to combined near-infrared imaging and visible imaging in a compact microscope stack. Both a visible light camera and an IR camera are integrated without increasing the optical stack height of a surgical microscope used for ophthalmic surgery. The IR camera can be used to directly and intraoperatively capture a scanning OCT measurement beam using NIR light that is not visible to the human eye. IR images from the IR camera taken of the same surgical field displayed to the user of the surgical microscope can be displayed in the user's oculars, enabling visualization of the location of the OCT scan as well as the actual visible light image of the surgical field.

Description

[0001] This application is a divisional application of an application filed on December 4, 2018, with application number 201880080588.2, and invention name “Combined near-infrared imaging and visible imaging in a compact microscope stack”. Background Art Technical Field

[0003] The present disclosure relates to ophthalmic surgery, and more particularly to combined near-infrared and visible imaging in a compact microscope stack.

[0004] Related technical notes

[0005] In ophthalmology, eye surgery, or ophthalmic surgery, saves and improves vision for tens of thousands of patients each year. However, given the sensitivity of vision to even small changes in the eye and the tiny and fragile nature of many of the eye's structures, eye surgery is difficult to perform, and even a reduction in small or unusual surgical errors or a small improvement in the accuracy of surgical technique can make a huge difference to a patient's postoperative vision.

[0006] Ophthalmic surgery is performed on the eye and accessory visual structures and can include vitreoretinal surgery and cataract surgery, among others. Specifically, vitreoretinal surgery encompasses a variety of delicate procedures involving the internal parts of the eye, such as the vitreous humor and the retina. Different vitreoretinal surgical procedures (sometimes using lasers) are used to improve the visual perception of the treatment of many eye diseases, including epiretinal membranes, diabetic retinopathy, vitreous hemorrhage, macular holes, retinal detachment, and complications of cataract surgery, among others. During vitreoretinal surgery, an ophthalmologist typically uses a surgical microscope to view the fundus through the cornea, while surgical instruments that penetrate the sclera can be introduced to perform any of the various procedures. The surgical microscope provides imaging and optionally fundus illumination during ophthalmic surgery. The patient typically lies supine under the surgical microscope during surgery, and a speculum is used to keep the eye exposed. Depending on the type of optical system used, the ophthalmologist has a given fundus field of view that can vary from a narrow field of view to a wide field of view that can extend to the peripheral area of ​​the fundus.

[0007] During cataract surgery, which is performed on the externally visible front part of the eye, the diseased lens can be removed from the lens capsular bag and replaced with an artificial lens, such as an intraocular lens (IOL). During cataract surgery, a surgical microscope can be used to visualize the cornea and iris to enable the implantation of the artificial lens through an incision in the cornea and to align and properly seat the new artificial lens.

[0008] In addition to viewing the eye using visible light, surgical microscopes can be equipped with optical coherence tomography (OCT) systems to provide additional information about non-visible parts of the eye tissue that are relevant to ophthalmic surgery. The OCT system can also enable imaging of parts of the eye that are difficult to optically distinguish using a surgical microscope under visible light. The OCT images provided by the OCT system can guide the surgeon during ophthalmic surgical procedures, but because OCT typically operates using non-visible light (such as near-infrared (NIR) light), it can be difficult to correlate the position of the OCT measurement beam with the actual location in the eye viewed using the surgical microscope. Summary of the Invention

[0009] In one aspect, the disclosed method is for performing ophthalmic surgery using a surgical microscope. The method may include: scanning a surgical field using an OCT scanning system coupled to a surgical microscope for viewing visible light from the surgical field. In the method, the OCT scanning system may project NIR light onto the surgical field for scanning the surgical field. The method may further include: using a multi-beam beam splitter located in an optical path that transmits the visible light to a first eyepiece of the surgical microscope, redirecting a first portion of the NIR light and a second portion of the visible light to an imaging path of the surgical microscope. In the method, the imaging path may be located in a plane perpendicular to the optical path. The method may also include: using a dichroic mirror located in the imaging path to split the first portion of the NIR light from the second portion of the visible light; and using an IR camera to generate an IR image of the surgical field from the first portion of the NIR light, the IR image indicating the position of the scan of the surgical field in the surgical field. The method may further include generating a visible light image of the surgical field from the second portion of the visible light using a visible light camera, wherein the visible light camera and the IR camera are located in the plane.

[0010] In any of the disclosed embodiments, the method may include: acquiring the IR image from the IR camera; and sending the IR image to a controller to generate display light for viewing at a second eyepiece of the surgical microscope. In the method, at least a portion of the display light may follow a path of visible light transmitted to the second eyepiece.

[0011] In any of the disclosed embodiments, the method may include: acquiring the visible light image from the visible light camera; and sending the visible light image to the controller to generate the display light. In the method, at least a portion of the display light may follow the path of the visible light transmitted to the second eyepiece.

[0012] In any of the disclosed embodiments of the method, the first eyepiece and the second eyepiece may be the same eyepiece, and the display light may be reflected by the multi-beam beam splitter onto the optical path.

[0013] In any of the disclosed embodiments of the method, the first eyepiece and the second eyepiece can be different eyepieces, and the display light can be reflected by a beam combiner onto visible light that is transmitted to the second eyepiece.

[0014] In any of the disclosed embodiments, the method may include: using a first beam splitter to split the display light into a first display beam and a second display beam; using the multi-beam beam splitter to direct the first display beam to the first eyepiece; and using the beam combiner to direct the second display beam to the second eyepiece.

[0015] In any of the disclosed embodiments of the method, the first portion can be at least 90% of the NIR light and the second portion can be less than or equal to 30% of the visible light.

[0016] In any of the disclosed embodiments of the method, the visible light camera and the IR camera may be oriented perpendicular to each other.

[0017] In any of the disclosed embodiments, the method may include: using a second multi-beam beam splitter located in a second optical path that transmits visible light to a second eyepiece of the surgical microscope that is different from the first eyepiece, diverting a third portion of the NIR light and a fourth portion of the visible light to a second imaging path of the surgical microscope, wherein the imaging path and the second imaging path are in the plane. The method may further include: using a second dichroic mirror located in the second imaging path to split the third portion of the NIR light from the fourth portion of the visible light; using a second IR camera to generate a second IR image of the surgical field from the third portion of the NIR light, the second IR image indicating a position of the scan of the surgical field in the surgical field; and using a second visible light camera to generate a second visible light image of the surgical field from the fourth portion of the visible light, wherein the second visible light camera and the second IR camera are located in the plane.

[0018] In any of the disclosed embodiments, the method may include: acquiring a second IR image from a second IR camera; and sending the second IR image to the controller to generate a second display light for viewing at the second eyepiece. In the method, at least a portion of the second display light including the second IR image may follow a path of visible light transmitted to the second eyepiece. The method may further include: acquiring a second visible light image from the second visible light camera; and sending the second visible light image to the controller to generate the second display light. In the method, at least a portion of the display light including the second visible light image may follow a path of visible light transmitted to the second eyepiece.

[0019] In another aspect, a surgical microscope for performing ophthalmic surgery is disclosed. The surgical microscope may include an OCT scanning system coupled to the surgical microscope and configured to scan a surgical field, the surgical microscope configured to view visible light from the surgical field. In the surgical microscope, the OCT scanning system may project NIR light onto the surgical field for scanning the surgical field. The surgical microscope may further include a multi-beam beam splitter positioned in an optical path that transmits the visible light to a first eyepiece of the surgical microscope, the multi-beam beam splitter configured to redirect a first portion of the NIR light and a second portion of the visible light to an imaging path of the surgical microscope, wherein the imaging path is positioned in a plane perpendicular to the optical path. The surgical microscope may further include: a dichroic mirror located in the imaging path and configured to split the first portion of the NIR light from the second portion of the visible light; an IR camera configured to generate an IR image of the surgical field from the first portion of the NIR light, the IR image indicating a position of the scan of the surgical field in the surgical field; and a visible light camera configured to generate a visible light image of the surgical field from the second portion of the visible light, wherein the visible light camera and the IR camera are located in a plane.

[0020] In any of the disclosed embodiments, the surgical microscope may include: a controller configured to acquire the IR image from the IR camera and generate overlay information; and a display configured to receive the overlay information from the controller, the display configured to output display light for viewing at a second eyepiece of the surgical microscope. In the surgical microscope, at least a portion of the display light may follow a path of visible light transmitted to the second eyepiece.

[0021] In any of the disclosed embodiments, the surgical microscope may include the controller for acquiring the visible light image from the visible light camera and the display for receiving the visible light image from the controller. In the surgical microscope, at least a portion of the display light comprising the visible light image may follow a path of the visible light transmitted to the second eyepiece.

[0022] In any of the disclosed embodiments of the surgical microscope, the first eyepiece and the second eyepiece can be the same eyepiece, and the display light can be reflected by the multi-beam beam splitter onto the optical path.

[0023] In any of the disclosed embodiments of the surgical microscope, the first eyepiece and the second eyepiece may be different eyepieces, and the surgical microscope may further include a beam combiner for reflecting the display light onto visible light transmitted to the second eyepiece.

[0024] In any of the disclosed embodiments, the surgical microscope may include: a first beam splitter, the first beam splitter being used to split the display light into a first display beam and a second display beam, the multi-beam beam splitter being used to guide the first display beam to the first eyepiece; and the beam combiner being used to guide the second display beam to the second eyepiece.

[0025] In any of the disclosed embodiments of the surgical microscope, the first portion can be at least 90% of the NIR light and the second portion can be less than or equal to 30% of the visible light.

[0026] In any of the disclosed embodiments of the surgical microscope, the visible light camera and the IR camera can be oriented perpendicular to each other.

[0027] In any of the disclosed embodiments, the surgical microscope may include: a second multi-beam beam splitter located in a second optical path that transmits visible light to a second eyepiece of the surgical microscope that is different from the first eyepiece, the second multi-beam beam splitter being configured to redirect the third portion of the NIR light and the fourth portion of the visible light to a second imaging path of the surgical microscope, wherein the imaging path and the second imaging path are in a plane. The surgical microscope may further include: a second dichroic mirror located in the second imaging path, the second dichroic mirror being configured to redirect the third portion of the NIR light away from the fourth portion of the visible light; a second IR camera being configured to generate a second IR image of the surgical field from the third portion of the NIR light, the second IR image indicating a position of the scan of the surgical field in the surgical field; and a second visible light camera being configured to generate a second visible light image of the surgical field from the fourth portion of the visible light, wherein the second visible light camera and the second IR camera are in a plane.

[0028] In any of the disclosed embodiments, the surgical microscope may include: the controller for acquiring the second IR image from the second IR camera and generating the overlay information; and a second display that receives the overlay information from the controller, the second display for outputting second display light for viewing at the second eyepiece. In the surgical microscope, at least a portion of the second display light may follow the path of visible light transmitted to the second eyepiece. The surgical microscope may further include: the controller for acquiring the second visible light image from the second visible light camera and generating the overlay information; and the second display that receives the overlay information from the controller. In the surgical microscope, at least a portion of the second display light may follow the path of visible light transmitted to the second eyepiece. BRIEF DESCRIPTION OF THE DRAWINGS

[0029] For a more complete understanding of the present disclosure, reference is now made to the following description taken in conjunction with the accompanying drawings, in which:

[0030] Figure 1 is a depiction of selected elements of a surgical microscope scanning instrument;

[0031] Figure 2A 、 Figure 2B 、 Figure 2C and Figure 2D are depictions of selected elements of different visible / NIR imaging systems;

[0032] Figure 3A and Figure 3Bare depictions of selected elements of different visible / NIR imaging systems;

[0033] Figure 4 is a depiction of selected elements of a visible / NIR stereoscopic imaging system; and

[0034] Figure 5 is a flow chart of a method for performing ophthalmic surgery;

[0035] Figure 6 is a depiction of selected elements of the controller;

[0036] Figure 7 is a depiction of a multibeam splitter; and

[0037] Figure 8 is a depiction of a multibeam splitter. DETAILED DESCRIPTION

[0038] In the following description, details are set forth by way of examples to facilitate discussion of the disclosed subject matter. However, it will be apparent to one of ordinary skill in the art that the disclosed embodiments are exemplary and not exhaustive of all possible embodiments.

[0039] As used herein, hyphenated reference numerals refer to specific instances of an element, while unhyphenated reference numerals refer to the element collectively. Thus, for example, device '12-1' refers to an instance of a class of devices that may be collectively referred to as device '12', and any one of the devices in the class may be collectively referred to as device '12'.

[0040] As described above, during ophthalmic surgery, such as vitreoretinal surgery or cataract surgery, a surgeon may use a surgical microscope to view a portion of a patient's eye. For example, during vitreoretinal surgery, an ophthalmic lens (such as a contact or non-contact lens) that sees through the cornea may be used to view the fundus. During cataract surgery, a surgical microscope may be used to view the front of the eye through the cornea. In order to perform any of a variety of surgical procedures, the surgeon may wish to optically scan certain portions of the eye to generate a profile depth scan of the corresponding eye tissue (such as by using an OCT system to scan the eye tissue and generate an OCT image therefrom). A profile depth scan may reveal information about the eye tissue that is not easily visible from the optical image generated by the surgical microscope. A profile depth scan may be a point scan (A scan), a line scan (B scan), or an area scan (C scan). The image generated by a B scan will image the depth of the eye tissue along a certain line, while a C scan generates three-dimensional (3D) data that can be segmented to provide various views including a front view obtained from an optical perspective, but the data may be generated at different depths and for selected tissue layers.

[0041] Although OCT systems have been integrated with the optics of surgical microscopes, OCT systems (including scanners and scan controllers) are typically not inherently correlated with the visible light image of the surgical field provided by the surgical microscope. Therefore, additional methods and systems are used to correlate the position of the invisible OCT measurement beam within the surgical field viewed using visible light. Position indicators, such as visible light aiming laser beams, are known that indicate the intraoperative position of the OCT measurement beam on the visible light image of the surgical field. However, such position indicators may not be widely useful across different microscope designs with different optical zoom or magnifications and may be subject to inflexible constraints in applications, which is undesirable.

[0042] As will be described in further detail, a compact microscope stack is disclosed for combined near-infrared and visible imaging, which provides an infrared (IR) camera to directly capture an IR image of a NIR OCT measurement beam within the surgical field viewed by a surgical microscope. In addition to the visible light camera, an IR camera is provided to enable digital visualization of image content, visible imaging, and NIR imaging without increasing the stack height between the eyepiece and objective lenses of the surgical microscope, which could reduce the ergonomic usability of the surgical microscope. In the combined near-infrared and visible imaging in the compact microscope stack disclosed herein, the use of the IR camera to directly capture the OCT measurement beam enables flexible and unconstrained operation with a variety of microscope designs, objective lenses, and magnifications. In the combined near-infrared and visible imaging in the compact microscope stack disclosed herein, the IR camera and the visible light camera are integrated using an imaging path perpendicular to the stack height, thereby not increasing the stack height. The combined near-infrared and visible imaging in the compact microscope stack disclosed herein allows the surgeon to quickly and accurately determine the position of the OCT measurement beam within the surgical field, so as to correlate the position of the OCT measurement beam with the position of the ocular tissue undergoing surgical intervention. By avoiding the tedious and time-consuming operations involved in manually correlating the position of the OCT measurement beam with the position of ocular tissue, the combined near-infrared and visible imaging in the compact microscope stack disclosed herein can improve surgical workflow and positively impact patient safety.

[0043] Referring now to the accompanying drawings, Figure 1 FIG2 is a depiction of a surgical microscope scanning instrument 100. Instrument 100 is not drawn to scale or in perspective, but rather is schematically represented. As will be described in further detail, instrument 100 can be used to view and analyze a patient's eye 110 during ophthalmic surgery, such as vitreoretinal surgery. As shown, instrument 100 includes a surgical microscope 120, an OCT system 160, and a controller 162. Figure 1Also shown are a visible light / NIR imaging system 130, a display 136, an ophthalmic lens 140, as well as surgical tools 116 and an illuminator 114. It should be noted that in various embodiments, the microscope scanning instrument 100 may be implemented with different elements.

[0044] like Figure 1 As shown in , as indicated, surgical microscope 120 is depicted in schematic form to demonstrate optical and electrical functionality. It will be understood that in different embodiments, surgical microscope 120 may include various other electronic and mechanical components. Accordingly, objective lens 124 may represent a selectable objective lens for providing a desired magnification or view of the fundus of eye 110. Objective lens 124 may receive light from the fundus of eye 110 via an ophthalmic lens 140 resting on the cornea of ​​eye 110. Although ophthalmic lens 140 is shown as a contact lens for illustrative purposes, it should be noted that various types of ophthalmic lenses may be used with surgical microscope 120, including contact lenses and non-contact lenses. To perform vitreoretinal surgery, various tools and instruments may be used, including a tool that penetrates the sclera, represented by surgical tool 116. In addition to other light sources that may be used, illuminator 114 may be a specialized tool that provides light from within the fundus of eye 110.

[0045] exist Figure 1 , a surgical microscope 120 is shown having a binocular arrangement with two distinct but substantially equal optical paths 154 that enable viewing using binoculars 126, including left eyepiece 126-L and right eyepiece 126-R. A user (not shown) of instrument 100, such as a surgeon or other medical professional, can visualize a surgical field corresponding to the field of view of surgical microscope 120. During ophthalmic surgery, surgical tools 116 can be inserted into eye 110. During a vitrectomy procedure, for example, surgical tools 116 can be inserted into the vitreous cavity via an incision through the sclera in the pars plana. Surgical tools 116 can be cutting probes, vitrectomy probes, laser probes, ablation probes, vacuum probes, irrigation probes, scissors, forceps, other suitable ophthalmic devices, or various combinations thereof. During ophthalmic surgery, various other surgical tools, such as an illuminator 114 or an infusion cannula, can also be inserted into eye 110. The user can use surgical tools 116 to perform ophthalmic surgery in the surgical field. The surgical field may include various biological tissues in the eye 110, including the vitreous humor, the hyaline membrane, blood vessels, the retina, the macula, the fovea, the fovea, the juxtafovea, the perifovea, the optic disc, the optic cup, or other parts of the eye 110. The biological tissues may also include various layers of the retina, including the inner limiting membrane, the nerve fiber layer, the ganglion cell layer, the inner plexiform layer, the inner nuclear layer, the outer plexiform layer, the outer nuclear layer, the external limiting membrane, the rod and cone layers, or the retinal pigment epithelium.

[0046] As described above, the surgical microscope 120 is used to image the surgical field during ophthalmic surgery. The surgical microscope 120 can be any suitable surgical microscope configured for use during ophthalmic surgery. The surgical microscope can include analog or digital optical components or a combination thereof. Thus, the surgical microscope 120 can include various internal lenses (not shown), such as a focusing lens, a zoom lens, and an objective lens 124. The surgical microscope 120 can further include various different reflectors, filters, gratings, or other optical components that comprise an optical train. When operating with visible light, the surgical microscope 120 can receive visible light reflected from the surgical field and be used to view a visible light image corresponding to the visible light using at least one eyepiece 126 that provides viewing for the user's eyes. The visible light image can include a frontal, fundus image of the surgical field. In Figure 1 In the stereoscopic configuration shown, the surgical microscope 120 is depicted as having two optical paths 154 from the objective 124 to the eyepiece 126. Specifically, the left optical path 154-L transmits light to the left eyepiece 126-L, while the right optical path 154-R transmits light to the right eyepiece 126-R. As described herein, the optical path 156 can be used to transmit both a direct image from the objective 124 of the surgical field and a digital image of the surgical field generated by the display 136. The digital image of the surgical field can further include a visible light image and an IR image of the surgical field, which are generated by a visible light camera and an IR camera, respectively, included in the visible light / NIR imaging system 130, as explained in further detail herein. It should be noted that, as used herein, the designations of left and right can be arbitrary and interchangeable and can be used herein for reference only. Figure 1 The purpose of the description is specified.

[0047] exist Figure 1In the embodiment of the present invention, the OCT system 160 can include various components, including an OCT beam source, a collimator, a scanner, and optics including lenses, mirrors, filters, and gratings associated with a reference arm and a sample arm. The OCT beam source can output an OCT measurement beam 156 directed by a scanner to scan anatomical structures within the surgical field of the surgical microscope 120. The scanner can include one or more of the following: a scanning mirror, a micromirror device, a microelectromechanical system (MEMS) device, a deformable platform, a galvanometer-based scanner, a polygon scanner, or a resonant piezoelectric lead zirconate titanate (PZT) scanner. The scanner can be used to direct the OCT measurement beam 156 in any suitable scanning pattern across the ocular tissue. The OCT measurement beam 156 can include light having a wavelength in the NIR range, such as in the range of 0.2 microns to 1.8 microns, the range of 0.7 microns to 1.4 microns, or the range of 0.9 microns to 1.1 microns. When OCT measurement beam 156 uses NIR light, the position where OCT measurement beam 156 scans the eye tissue will not be visible to the naked eye, which is disadvantageous to the user of surgical microscope 120.

[0048] The OCT system 160 further includes a detector configured to detect an interference pattern based on a path length difference in the OCT sample beam 158. The detector can include a balanced light detector, an InGaAs PIN detector, an InGaAs detector array, a Si PIN detector, a charge coupled device (CCD) sensor, a complementary metal oxide semiconductor (CMOS) sensor, a pixel, or an array of any other type of sensor that generates an electrical signal based on detected light. Further, the detector can include a two-dimensional sensor array or a detector camera.

[0049] exist Figure 1 In the present invention, the OCT system 160 can be a Fourier domain system (spectral domain, swept source, etc.) or a time domain system. In a time domain OCT system, the reference arm can be moved to different distances from the OCT beam source, allowing the target biological tissue to be imaged at different depths. In a frequency domain OCT system, a spatially encoded frequency domain (SEFD) system, a spectral domain system, or a Fourier domain system, a depth scan of the target biological tissue can be obtained by analyzing the interference signal based on the wavelength of light. Because the frequency domain OCT system does not involve the movement of physical components (compared to the reference arm in the time domain OCT system), the scanning speed of the frequency domain OCT system may be faster than that of the time domain system. The SEFD system can use a dispersion detector to decompose the OCT beam into beams of different wavelengths. The OCT beam source in a swept source (SS-OCT) system can use a tunable laser that quickly sweeps through different wavelengths and can be used to obtain up to 100,000 A scans per second.

[0050] The OCT system 160 can be optically integrated into the surgical microscope 120 using various methods. Figure 1 As shown, a partially reflective mirror 129 can be used to redirect an incident OCT measurement beam 156 from an OCT system 160 into a right optical path 154-R, where the OCT measurement beam 156 is directed by the objective lens 124 and the ophthalmic lens 140 to an interior portion of the eye 110. The partially reflective mirror 129 can be dichroic and can selectively reflect NIR light while selectively transmitting visible light. Thus, visible light emitted from the eye 110 and carried along the right optical path 154-R can be transmitted by the partially reflective mirror 129 toward the right eyepiece 126-R, while NIR light reflected from the OCT measurement beam 156 can be reflected back to the OCT system 160 as an OCT sample beam 158, which includes photons from the OCT measurement beam 156. Since the OCT system 160 (particularly the OCT scanner accompanying the OCT system 160 ) is mounted in a fixed manner, when the OCT measurement beam 156 is scanned, different locations in the surgical field are scanned and the OCT sample beam 158 is reflected back to the OCT system 160 for detection and imaging.

[0051] Therefore, the OCT system 160 is used to receive the OCT sample beam 158 reflected from the target biological tissue in the surgical field and generate an OCT image. The OCT system 160 can generate an OCT image based on scanning the surgical field. Specifically, the OCT image can include a single A-scan, which images a certain depth of tissue at a single point in the surgical field. Multiple adjacent A-scans can be combined to form a B-scan, which is a line scan of multiple A-scans. The B-scan can generate a two-dimensional OCT image of the line scan and the depth of the tissue. The C-scan can generate a three-dimensional OCT image from multiple adjacent B-scans.

[0052] As described above, OCT system 160 can be integrated with surgical microscope 120 to scan the surgical field to generate OCT images. In particular, OCT system 160 can provide non-contact, high-resolution, and depth-resolved imaging capabilities during ophthalmic surgery. Controller 162 can further be configured to overlay or "inject" at least a portion of the OCT image onto the visible light image viewed at eyepiece 154. For example, controller 162 can receive an OCT image from OCT system 160 and cause the OCT image to be output by display 136. An image representing overlay information (such as the position of the OCT NIR light) can then be output to multi-beam splitter 128, which has various functionalities (as described in further detail below), where the image is reflected onto left optical path 154-L and transmitted to left eyepiece 154-L for viewing by the user. This image can be a cross-sectional OCT image overlaid on the field of view (operative field) of surgical microscope 120, allowing the user (surgeon) to view the cross-sectional OCT image along with the visible light image of the surgical field from objective lens 124 as a frontal, fundus image. Cross-sectional OCT images can show anatomical features within the eye tissue that may not be visible in en face, fundus images.

[0053] In addition to the overlay of cross-sectional OCT images described above, the visible light / NIR imaging system 130 can be used to digitally generate visible light images and IR images of the surgical field. In particular, the IR image can be used to show the actual position of the OCT measurement beam 156, which scans the desired interior portion of the eye 110 within the surgical field. Specifically, the reflected NIR light 134 from the OCT measurement beam 156 can reach the multi-beam splitter 128 in a manner substantially similar to the manner in which the OCT sample beam 158 reaches the partially reflective mirror 129. However, instead of using the NIR light 134 for OCT imaging of tissue depth (as with the OCT sample beam 158), the NIR light 134 can be acquired by an IR camera included in the visible light / NIR imaging system 130 and used to create an IR image that shows the actual position of the OCT measurement beam 156 in the surgical field. Because the IR image is generated using a separate IR camera and with the optics of the surgical microscope 120, Figure 1 The arrangement shown can be used with different types of surgical microscopes and any magnification.

[0054] Specifically, in Figure 115. In the embodiment of the present invention, from the objective lens 124, visible light 132 and NIR light 134 can reach the multibeam beam splitter 128 from the inner portion of the eye 110. The multibeam beam splitter 128 can be configured to selectively reflect a majority of the NIR light 134 arriving from the objective lens 124 along the left optical path 154-L, thereby redirecting the NIR light 134 toward the visible light / NIR imaging system 130. At the same time, the multibeam beam splitter 128 can be configured to selectively reflect a small portion of the visible light 132 arriving from the objective lens 124 along the left optical path 154-L, while transmitting a majority of the visible light 132 toward the left eyepiece 126-L. In some embodiments, the NIR light 134 reflected from the multibeam beam splitter 128 can be greater than 90% of the incident NIR light, while the visible light 134 reflected from the multibeam beam splitter 128 can be approximately 30% of the incident visible light. As described above, the multi-beam splitter 128 can additionally reflect visible light from the display 136 that reaches the opposite side so as to reflect the visible light from the display 136 along the left optical path 125-L toward the left eyepiece 126-L. Note that various filters can be used to balance the visible light levels observed between the left eyepiece 126-L and the right eyepiece 126-R in order to provide a balanced stereoscopic image when visible light of different intensities is transmitted by the left optical path 154-L and the right optical path 154-R. Note that Figure 1 The optical arrangement depicted in FIG. 5 is exemplary and may be different in other embodiments.

[0055] The visible light / NIR imaging system 130 can then receive the NIR light 134 and the visible light 132 from the multi-beam beam splitter 128. The visible light / NIR imaging system 130 can internally direct the NIR light 134 to the IR camera to generate an IR image of the surgical field, and can direct the visible light 132 to the visible light camera to generate a visible light image of the surgical field. As described above, the controller 162 can be used to display the visible and IR images from the visible light / NIR imaging system 130 on the display 136, similar to or in combination with the OCT images from the OCT system 160. Figure 2A-2D , Figure 3 and Figure 4 Various additional details of different embodiments of visible light / NIR imaging system 130 are described.

[0056] exist Figure 1 , the controller 162 may have an electrical interface with the display 136, for example, for outputting display data (see also Figure 6). Controller 162 can output the display image to display 136 for viewing at binoculars 126 using multi-beam splitter 128. Because the electrical interface with controller 162 can support digital image data, controller 162 can perform image processing in real time at a relatively high frame refresh rate, so that the user of surgical microscope 120 can experience substantially instantaneous feedback with user input to control the displayed image of eye 110, as well as other operations. Display 104 can be implemented as a liquid crystal display (LCD), a light emitting diode (LED) display, such as an organic LED (OLED), a computer monitor, a television, etc., a projector, a digital light processing (DLP) engine, or a liquid crystal on silicon (LCoS) device, as well as other types of display devices. Display 136 can conform to a display standard for a corresponding type of display (such as video graphics array (VGA), extended graphics array (XGA), digital video interface (DVI), high-definition multimedia interface (HDMI), etc.), as well as other standards. In some embodiments, display 136 may be a micro-device integrated with visible light / NIR imaging system 130, such as on a conventional optical device.

[0057] like Figure 1 As shown, the instrument 100 includes a visible light / NIR imaging system 130 that is integrated with the surgical microscope 120 in a manner that does not increase the stack height of the surgical microscope 120, which is given by the distance between the objective lens 124 and the binoculars 126. The stack height of the surgical microscope 120 can be an important ergonomic factor for the user. For example, when the stack height is too large, the ergonomics of the surgical microscope 120 can be significantly reduced, making it difficult for users below a certain height or with a certain arm length to operate the surgical microscope 120. As described above, in the instrument 100, the stack height associated with the visible light / NIR imaging system 130 is increased at least in part due to the fact that the functionality of the multi-beam splitter 128 is not increased. In addition, as described in detail in the following figures, the optical components included in the visible light / NIR imaging system 130 and the display 136 can be arranged in a plane that is perpendicular to the optical path 154 (e.g., FIG. Figure 1 ), perpendicular to the stack height, perpendicular to the optical axis of the objective lens 124, or perpendicular to the optical axis of the eye 110. As described in detail in the following figures, the arrangement of the visible light / NIR imaging system 130 in a plane can enable a compact microscope stack with a relatively small stack height, such as Figure 1 As shown, this is desirable.

[0058] Without departing from the scope of the present disclosure, modifications, additions, or omissions may be made to the surgical microscope scanning instrument 100. As described herein, the components and elements of the surgical microscope scanning instrument 100 may be integrated or separated depending on the specific application. The surgical microscope scanning instrument 100 may be implemented using more, fewer, or different components.

[0059] Now refer to Figure 2A-2D , Figure 3 and Figure 4 , showing different depictions of specific embodiments of visible light / NIR imaging system 130 . Figure 2A-2D , Figure 3 and Figure 4 The visible light / NIR imaging system 130 in FIG. 1 is an exemplary embodiment depicted schematically for purposes of description and is not necessarily drawn to scale or in an accurate perspective view. Figure 2A-2D , Figure 3 and Figure 4 The visible light / NIR imaging system 130 in FIG. 1 is shown and described in perspective view to illustrate the three-dimensional optical arrangement of the various components. More, fewer, or different components may be used to implement Figure 2A-2D , Figure 3 and Figure 4 Visible light / NIR imaging system 130 in. Figure 2A-2D , Figure 3 and Figure 4 , a visible light / NIR imaging system 130 is shown and described with respect to light paths, beams, and optical components to enable integration with a surgical microscope 120 (see Figure 1 ) integrated and used. For the sake of clarity, Figure 2A-2D , Figure 3 and Figure 4 Certain elements of surgical microscope 120 and surgical microscope scanning instrument 100 have been omitted, but as described herein, it should be understood that visible light / NIR imaging system 130 can be used with surgical microscope scanning instrument 100. Figure 2A-2D , Figure 3 and Figure 4 In the various depictions, for clarity of description, the optical integration includes the display 136, the eyepiece 126, and the optical path 154, and it will be understood that such elements may be external to any particular visible light / NIR imaging system 130. Figure 2A-2D , Figure 3 and Figure 4 , imaging path 202 illustrates a planar optical configuration of an optical path included in visible / NIR imaging system 130, while optical path 204 illustrates a planar optical configuration of an optical path associated with display 136. In various embodiments, imaging path 202 and display path 204 may be aligned to the same plane.

[0060] exist Figure 2A, the visible light / NIR imaging system 130-1 is shown in a left channel configuration, wherein the imaging path 202 and the display path 204 are integrated with a single eyepiece, arbitrarily represented as the left eyepiece 154-L and the left optical path 154-L. Specifically, in the imaging path 202 of the visible light / NIR imaging system 130-1, the image path 202 and the display path 204 are integrated with a single eyepiece, arbitrarily represented as the left eyepiece 154-L and the left optical path 154-L. Figure 1 ) A first portion of visible light 132-1 that arrives at multibeam splitter 128 along left optical path 154-L is transmitted along left optical path 154-L to left eyepiece 154-L. A second portion of visible light 132-1 is reflected by multibeam splitter 128 to imaging path 202 and arrives at dichroic mirror 210. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to visible light camera 232, which can be a digital camera. In certain embodiments, the first portion of visible light 132-1 can be approximately twice the intensity of the second portion of visible light 132-1. Simultaneously, in visible light / NIR imaging system 130-1, NIR light 134 (carrying an IR image of the surgical field) that arrives at multibeam splitter 128 from objective lens 124 along left optical path 154-L is reflected by dichroic mirror 210 toward IR camera 234, which can be a digital camera. In various embodiments, visible light camera 232 can be oriented perpendicular to IR camera 234. It will be appreciated that the dichroic operation of dichroic mirror 210 can be reversed such that visible light camera 232 and IR camera 234 can be swapped in position relative to dichroic mirror 210. In display path 204 of visible light / NIR imaging system 130-1, display 136 can output display light 132-2 (carrying a visible display image generated by display 136) from imaging path 202 to the opposite side of multibeam splitter 128. Multibeam splitter 128 can be particularly configured to reflect most or nearly all of display light 132-2 along left optical path 154-L toward left eyepiece 126-L.

[0061] exist Figure 2B , the visible light / NIR imaging system 130-2 is shown in another left channel configuration, wherein the imaging path 202 and the display path 204 are integrated with a single eyepiece, which is arbitrarily represented as the left eyepiece 154-L and the left optical path 154-L. Specifically, in the imaging path 202 of the visible light / NIR imaging system 130-2, the image path 202 and the display path 204 are integrated with a single eyepiece, which is arbitrarily represented as the left eyepiece 154-L and the left optical path 154-L. Figure 1) A first portion of visible light 132-1 that reaches multibeam splitter 128 along left optical path 154-L is transmitted along left optical path 154-L to left eyepiece 154-L. A second portion of visible light 132-1 is reflected by multibeam splitter 128 to imaging path 202, where first mirror 208-1 and second mirror 208-2 are used to divert the second portion of visible light 132-1 to dichroic mirror 210. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to visible light camera 232. In particular embodiments, the first portion of visible light 132-1 can be approximately twice the intensity of the second portion of visible light 132-1. Meanwhile, in visible light / NIR imaging system 130-2, NIR light 134 (carrying an IR image of the surgical field) travels along imaging path 202 (directed by mirrors 208-1, 208-2) to dichroic mirror 210 along a second portion of visible light 132-1. NIR light 134 is then reflected by dichroic mirror 210 toward IR camera 234. In various embodiments, visible light camera 232 may be oriented perpendicular to IR camera 234. It will be appreciated that the dichroic operation of dichroic mirror 210 may be reversed, such that visible light camera 232 and IR camera 234 may be swapped relative to dichroic mirror 210. In display path 204 of visible light / NIR imaging system 130-2, display 136 may output display light 132-2 (carrying a visible display image generated by display 136) from imaging path 202 to the opposite side of multi-beam splitter 128. The multibeam splitter 128 can be particularly configured to reflect most or nearly all of the display light 132-2 along the left optical path 154-L toward the left eyepiece 126-L.

[0062] exist Figure 2C , the visible light / NIR imaging system 130-3 is shown in a binocular configuration, where the corresponding Figure 1 In the configuration shown in FIG, the imaging path 202 and the display path 204 are each integrated with a different eyepiece. Specifically, in the imaging path 202 of the visible light / NIR imaging system 130-3, the objective lens 124 (see FIG Figure 1) A first portion of visible light 132-1 that arrives at multibeam splitter 128 along right optical path 154-R is transmitted along right optical path 154-R to right eyepiece 154-R. A second portion of visible light 132-1 is reflected by multibeam splitter 128 to imaging path 202 and arrives at dichroic mirror 210. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to visible light camera 232. In certain embodiments, the first portion of visible light 132-1 can be approximately twice as intense as the second portion of visible light 132-1. Simultaneously, in visible light / NIR imaging system 130-3, NIR light 134 (carrying an IR image of the surgical field) travels along imaging path 202 to dichroic mirror 210 along with the second portion of visible light 132-1. NIR light 134 is then reflected by dichroic mirror 210 toward IR camera 234. In various embodiments, visible light camera 232 can be oriented perpendicular to IR camera 234. It will be appreciated that the dichroic operation of dichroic mirror 210 can be reversed such that visible light camera 232 and IR camera 234 can be swapped in position relative to dichroic mirror 210. In display path 204 of visible light / NIR imaging system 130-3, display 136 can output display light 132-2 (carrying a visible display image generated by display 136) to partially reflective mirror 229, which reflects most or nearly all of display light 132-2 along left optical path 154-L toward left eyepiece 126-L. Simultaneously, Figure 2C , partially reflecting mirror 229 transmits visible light 132-1 along left optical path 154-L toward left eyepiece 126-L.

[0063] exist Figure 2D , a visible light / NIR imaging system 130-4 is shown in another monocular configuration, where the corresponding Figure 1 In the configuration shown in FIG, the imaging path 202 and the display path 204 are each integrated with a different eyepiece. Specifically, in the imaging path 202 of the visible light / NIR imaging system 130-4, the objective lens 124 (see FIG Figure 1) A first portion of visible light 132-1 that arrives at multibeam splitter 128 along left optical path 154-L is transmitted along left optical path 154-L to left eyepiece 154-L. A second portion of visible light 132-1 is reflected by multibeam splitter 128 to imaging path 202, where first and second mirrors 208-1, 208-2 are used to divert the second portion of visible light 132-1 to dichroic mirror 210. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to visible light camera 232. In certain embodiments, the first portion of visible light 132-1 can be approximately twice as intense as the second portion of visible light 132-1. Simultaneously, in visible light / NIR imaging system 130-4, NIR light 134 (carrying an IR image of the surgical field) travels along imaging path 202 to dichroic mirror 210 along with the second portion of visible light 132-1. The NIR light 134 is then reflected by the dichroic mirror 210 toward the IR camera 234. In various embodiments, the visible light camera 232 can be oriented perpendicular to the IR camera 234. It will be understood that the dichroic operation of the dichroic mirror 210 can be reversed, such that the visible light camera 232 and the IR camera 234 can be swapped in position relative to the dichroic mirror 210. In the display path 204 of the visible light / NIR imaging system 130-4, the display 136 can output the display light 132-2 (carrying the visible display image generated by the display 136) to the partially reflective mirror 229, which reflects most or nearly all of the display light 132-2 along the right optical path 154-R toward the right eyepiece 126-R. Simultaneously, Figure 2D , partially reflecting mirror 229 transmits visible light 132-1 along right optical path 154-R toward right eyepiece 126-R.

[0064] exist Figure 3A , the visible light / NIR imaging system 130-5 is shown in a stereoscopic configuration, where the display path 204 outputs the display image to two eyepieces, while the imaging path 202 is integrated with one eyepiece. Figure 3A Specifically, in the imaging path 202 of the visible light / NIR imaging system 130-5, the objective lens 124 (see Figure 1) A first portion of visible light 132-1 that reaches multibeam splitter 128 along right optical path 154-R is transmitted along right optical path 154-L to right eyepiece 154-R. A second portion of visible light 132-1 is reflected by multibeam splitter 128 to imaging path 202, where first and second mirrors 208-1, 208-2 are used to divert the second portion of visible light 132-1 to dichroic mirror 210. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to visible light camera 232. In certain embodiments, the first portion of visible light 132-1 can be approximately twice as intense as the second portion of visible light 132-1. Simultaneously, in visible light / NIR imaging system 130-5, NIR light 134 (carrying an IR image of the surgical field) travels along imaging path 202 to dichroic mirror 210 along with the second portion of visible light 132-1. The NIR light 134 is then reflected by the dichroic mirror 210 toward the IR camera 234. In various embodiments, the visible light camera 232 can be oriented perpendicular to the IR camera 234. It will be understood that the dichroic operation of the dichroic mirror 210 can be reversed so that the visible light camera 232 and the IR camera 234 can be swapped in position relative to the dichroic mirror 210. In the display path 204 of the visible light / NIR imaging system 130-5, the display 136 can output the display light 132-2 (carrying a visible display image generated by the display 136) to the beam splitter 328, which splits the display light 132-2 into a left portion and a right portion. The left portion of the display light 132-2 is output to the partial reflector 229, which reflects most or nearly all of the left portion of the display light 132-2 along the left optical path 154-L toward the left eyepiece 126-L. Figure 3A , the right portion of the display light 132-2 is reflected by the mirror 208-3 toward the multi-beam beam splitter 128 to be reflected along the right optical path 154-R toward the right eyepiece 126-R.

[0065] exist Figure 3B , the visible light / NIR imaging system 130-6 is shown in a stereoscopic configuration, where the display path 204 outputs the display image to two eyepieces, while the imaging path 202 is integrated with one eyepiece. Figure 3B Specifically, in the imaging path 202 of the visible light / NIR imaging system 130-6, the objective lens 124 (see Figure 1) A first portion of visible light 132-1 that arrives at multibeam splitter 128 along left optical path 154-L is transmitted along left optical path 154-L to left eyepiece 154-L. A second portion of visible light 132-1 is reflected by multibeam splitter 128 to imaging path 202, where first and second mirrors 208-1, 208-2 are used to divert the second portion of visible light 132-1 to dichroic mirror 210. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to visible light camera 232. In certain embodiments, the first portion of visible light 132-1 can be approximately twice as intense as the second portion of visible light 132-1. Simultaneously, in visible light / NIR imaging system 130-6, NIR light 134 (carrying an IR image of the surgical field) travels along imaging path 202 to dichroic mirror 210 along with the second portion of visible light 132-1. The NIR light 134 is then reflected by the dichroic mirror 210 toward the IR camera 234. In various embodiments, the visible light camera 232 can be oriented perpendicular to the IR camera 234. It will be understood that the dichroic operation of the dichroic mirror 210 can be reversed such that the visible light camera 232 and the IR camera 234 can be swapped in position relative to the dichroic mirror 210. In the display path 204 of the visible light / NIR imaging system 130-6, the display 136 can output the display light 132-2 (carrying a visible display image generated by the display 136) to the beam splitter 328, which splits the display light 132-2 into a left portion and a right portion. The right portion of the display light 132-2 is reflected by the reflector 208-3 toward the partial reflector 229, which reflects most or nearly all of the right portion of the display light 132-2 along the right optical path 154-R toward the right eyepiece 126-R. Figure 3B , the left portion of the display light 132-2 is output to the multi-beam beam splitter 128 to be reflected along the left optical path 154-L toward the left eyepiece 126-L.

[0066] exist Figure 4 , the visible light / NIR imaging system 130-7 is shown in a fully stereoscopic configuration, wherein the display path 204 outputs the display image to two eyepieces, and two separate imaging paths 202-L and 202-R are integrated with the corresponding eyepieces. Figure 4 In the embodiment of the present invention, the display 136 can support 3D display.

[0067] Specifically, in the imaging path 202-L of the visible light / NIR imaging system 130-7, the objective lens 124 (see Figure 1) A first portion of visible light 132-1 that arrives at left multi-beam splitter 128-L along left optical path 154-L is transmitted along left optical path 154-L to left eyepiece 154-L. A second portion of visible light 132-1 is reflected by left multi-beam splitter 128-L to left imaging path 202-L, where first and second mirrors 208-1, 208-2 are used to divert the second portion of visible light 132-1 to dichroic mirror 210 located in left imaging path 202-L. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to left visible light camera 232-L. In particular embodiments, the first portion of visible light 132-1 can be approximately twice as intense as the second portion of visible light 132-1. Meanwhile, in visible light / NIR imaging system 130-7, NIR light 134 (carrying an IR image of the surgical field) travels along imaging path 202-L with a second portion of visible light 132-1 to dichroic mirror 210 located in imaging path 202-L. NIR light 134 is then reflected by dichroic mirror 210 toward left IR camera 234-L. In various embodiments, visible light camera 232 can be oriented perpendicular to left IR camera 234. It will be appreciated that the dichroic operation of dichroic mirror 210 can be reversed, such that left visible light camera 232-L and right IR camera 234-L can be swapped in position relative to dichroic mirror 210 located in imaging path 202-L.

[0068] In the display path 204 of the visible light / NIR imaging system 130-7, the display 136 can output the display light 132-2 (carrying the visible display image generated by the display 136) to the beam splitter 328, which splits the display light 132-2 into a left portion and a right portion. The right portion of the display light 132-2 is reflected by the third reflector 208-3 toward the partial reflector 229, which reflects most or almost all of the right portion of the display light 132-2 along the right optical path 154-R toward the right eyepiece 126-R. Figure 4 , the left portion of the display light 132-2 is output to the multi-beam beam splitter 128 to be reflected along the left optical path 154-L toward the left eyepiece 126-L.

[0069] exist Figure 4 In the right imaging path 202-R of the visible light / NIR imaging system 130-6, the image is taken from the objective lens 124 (see Figure 1) A first portion of visible light 132-1 that arrives at right multi-beam splitter 128-R along right optical path 154-R is transmitted along right optical path 154-R to right eyepiece 154-L. A second portion of visible light 132-1 is reflected by right multi-beam splitter 128-R to right imaging path 202-R, where fourth mirror 208-4 and fifth mirror 208-5 are used to divert the second portion of visible light 132-1 to dichroic mirror 210 located in right imaging path 202-R. Dichroic mirror 210 can be used to transmit the second portion of visible light 132-1 (carrying a visible light image of the surgical field) to right visible light camera 232-R. In particular embodiments, the first portion of visible light 132-1 can be approximately twice as intense as the second portion of visible light 132-1. Meanwhile, in visible light / NIR imaging system 130-7, NIR light 134 (carrying an IR image of the surgical field) travels along right imaging path 202-R to dichroic mirror 210 along with the second portion of visible light 132-1. NIR light 134 is then reflected by dichroic mirror 210 toward right IR camera 234-R. In various embodiments, right visible light camera 232-R can be oriented perpendicular to right IR camera 234-R. It will be appreciated that the dichroic operation of dichroic mirror 210 can be reversed in right imaging path 202-R, such as the right visible light camera 232-R and the right IR camera 234-R can be swapped in position relative to dichroic mirror 210.

[0070] Now refer to Figure 5 , as described herein, depicts a flowchart of selected elements of a method 500 for performing ophthalmic surgery in the form of a flowchart. The method 500 describes steps and procedures that may be executed by the controller 162 when a user operates the surgical microscope scanning instrument 100 to view the fundus of an eye and perform a surgical procedure based on the view of the fundus. For example, the method 500 may be executed by the visible light / NIR imaging control 614 (see Figure 6 In certain embodiments, the OCT system 160 may perform at least some of the operations described below in the method 500. It should be noted that some of the operations described in the method 500 may be optional or may be rearranged in different embodiments.

[0071] Method 500 can begin at step 502 by scanning a surgical field using an OCT scanning system coupled to a surgical microscope for viewing visible light from the surgical field, wherein the OCT scanning system projects NIR light onto the surgical field for scanning the surgical field. At step 504, a first portion of the NIR light and a second portion of the visible light are diverted to an imaging path of the surgical microscope using a multi-beam beam splitter located in an optical path that transmits visible light to a first eyepiece of the surgical microscope, wherein the imaging path is located in a plane perpendicular to the optical path. At step 506, a dichroic mirror located in the imaging path is used to split the first portion of the NIR light from the second portion of the visible light. At step 508, an IR image of the surgical field is generated from the first portion of the NIR light using an IR camera, the IR image indicating the location of the scan of the surgical field in the surgical field. At step 510, a visible light image of the surgical field is generated from the second portion of the visible light using a visible light camera, wherein the visible light camera and the IR camera are located in a plane. At step 512, the acquired IR image is transmitted to a controller, which is configured to generate display light for viewing the second eyepiece of the surgical microscope, wherein at least a portion of the display light follows the path of the visible light transmitted to the second eyepiece. At step 514, the acquired visible light image is transmitted to the controller, wherein at least a portion of the display light follows the path of the visible light transmitted to the second eyepiece. The display light in steps 512 and 514 may include or represent overlay information for overlaying on the view of the surgical field.

[0072] Now refer to Figure 6 , presenting the above Figure 1 A depiction of selected components of the controller 162 is depicted. Figure 6 In the embodiment depicted in FIG, controller 162 includes a processor 601 coupled to a storage medium, generally referred to as memory 610 , via a shared bus 602 .

[0073] like Figure 6 As depicted in FIG, the controller 162 further includes a communication interface 620 that can interface the controller 162 to various external entities, such as the OCT system 160, the visible light / NIR imaging system 130, and the display 136. In some embodiments, the communication interface 620 is operable to enable the controller 162 to connect to a network ( Figure 6 (not shown). In some embodiments suitable for combining near-infrared imaging and visible imaging in a compact microscope stack, such as Figure 6 As depicted in , controller 162 includes a display interface 604 that connects shared bus 602 or another bus to output ports of one or more displays, such as display 136 or an external display.

[0074] exist Figure 66, memory 610 includes permanent and volatile media, fixed and removable media, and magnetic and semiconductor media. Memory 610 is operable to store instructions, data, or both. The illustrated memory 610 includes an instruction set or sequence (i.e., operating system 312) and a visible light / NIR imaging control application 614. Operating system 612 may be a UNIX or UNIX-like operating system, system operating system, or another suitable operating system.

[0075] Now refer to Figure 7 , a depiction of a multi-beam splitting instrument 128-1 that uses spatial beam separation to perform multi-beam splitting is shown. The multi-beam splitter 128-1 is not drawn to scale or in perspective, but is represented schematically. Figure 7 , the internal details describing the operation of the multi-beam splitter 128 as described above are explained. Various embodiments and configurations of the multi-beam splitter 128 are described in a U.S. patent application filed concurrently with the present application and entitled “MULTI-BEAM SPLITTING USING SPATIAL BEAM SEPARATION.” The multi-beam splitter 128-1 is shown in a general configuration having a first source A, a second source D, a first output B, and a second output C. For example, with Figure 1 Compared to the instrument 100 in FIG. 1 , the first source A can be an object viewed using a surgical microscope 120, such as the eye 110, and the first output B can be a viewing port of the microscope, such as the eyepiece 126. Additionally, the second source D can be a source of overlay content, such as the display 136, and the second output C can be a sensor port for acquiring images of the object at the first source A, such as the OCT system 160 or the visible light / NIR imaging system 130 in various embodiments.

[0076] exist Figure 7, a first light beam 710 arrives at the first surface 706-1 of the partially reflective mirror 706 from the first source A. Since the partially reflective mirror 706 is configured to partially reflect and partially transmit incident light at the first surface 706-1, the partially reflective mirror 706 transmits a first partial light beam 716 from the first light beam 710 and reflects a second partial light beam 712 from the first light beam 710. Specifically, the second partial light beam 712 reflected from the first surface 706-1 is shown to include light beams 712-1, 712-2, and 712-3, which are located on an area corresponding to the hole filter 704 located at the second output end C. The hole filter 704 includes an opaque field having a circular aperture with a second radius (r2), which is transparent and serves as an aperture for the second partial light beam 712-2 that arrives at the second output end C, while the second partial light beams 712-1 and 712-2 are blocked at the hole filter 704 by reaching the peripheral portion of the hole filter 704 outside the aperture. At the same time, the first partial light beam 716 is transmitted to the first output end B.

[0077] Also there Figure 7, a second light beam 714, shown as light beams 714-1, 714-2, and 714-3, arrives at the point filter 702 from the first source D. The point filter 702 includes a transparent field of circular opaque spots having a first radius (r1), which can be comparable to the second radius (r2) of the hole filter 704. In particular, the first radius (r1) can be greater than or equal to the second radius (r2). Accordingly, peripheral portions 714-1 and 714-3 of the second light beam 714 arrive at the second surface 706-2 of the partially reflective mirror 706, while the central portion 714-2 is blocked at the point filter 702. Since the partial reflector 706 is configured to partially reflect and partially transmit incident light at the second surface 706-2, the partial reflector 706 reflects the third partial beam 718 (shown as peripheral portions 718-1, 718-3) toward the first output end B, such that the third partial beam 718 is coaxially superimposed with the first partial beam 716, which enables the overlay content (or overlay information) from the second source D to be overlaid with the content from the first source A at the first output end B. At the same time, the second surface 706-2 also transmits the fourth partial beam 720 (peripheral portions 714-1, 714-3) from the second beam 714, such that only the peripheral portions of the fourth partial beams 720-1, 720-3 corresponding to the transparent field of the point filter 702 are transmitted to the second output end C. When the first radius (r1) is at least as large as or equal to the second radius (r2), the fourth partial beam 720 is therefore blocked at the hole filter 704 because the opaque field of the hole filter 704 will spatially correspond to the transparent field of the point filter 702. Therefore, the peripheral portions 720-1, 720-3 of the fourth partial beam are blocked by the hole filter 704, and the fourth partial beam 720 is blocked by the multibeam splitter 128-1. Since the central portion 712-2 of the second beam is blocked at the point filter 702, only the second partial beam 712-2 reaches the hole of the hole filter 704, thereby preventing the central portion of the fourth partial beam 720 from interfering with the second partial beam 712-2.

[0078] It should be noted that the absolute values ​​of the radii r1 and r2 can be selected relative to the size of the filters 702, 704 to define the ratio of light coupled to the second output port C relative to the light coupled to the first output port B. Since the radii r1 and r2 can be freely selected, this beam splitting ratio can be continuously varied as desired. It should also be noted that in some embodiments, the positions of the point filter 702 and the hole filter 704 can be interchanged. The point filter 702 and the hole filter 704 can be implemented using mechanical components or opaque coatings, and the points or holes can be formed differently in different shapes, as shown in FIG. Figure 7 An alternative to the circular shape shown in and described above.

[0079] existFigure 7 , the reflected beam path and the transmitted beam path can have different geometries in different embodiments of the multi-beam beam splitter 128. As shown, a first light beam 710 from a first source A to a first output B along a first optical axis can be perpendicular to a second light beam 714 from a second source D to a second output C along a second optical axis, and the partially reflective mirror 706 can be oriented at 45 degrees relative to both the first light beam 710 along the first optical axis and the second light beam 714 along the second optical axis.

[0080] Now refer to Figure 8 , shows a depiction of a multi-beam splitting instrument 128-2 for performing multi-beam splitting using spatial beam separation as described herein. The multi-beam splitter 128-2 is not drawn to scale or in perspective, but is a schematic representation shown at an askew angle for improved visibility. Figure 8 , an exemplary implementation of the multi-beam splitter 128-2 as a cube optical element is shown. At one face of the multi-beam splitter 128-2, a point filter 702 is formed, while a hole filter 704 is formed on the opposite face. A partial reflector 706 is also formed on the Figure 8 As can be seen in FIG, the partial reflector can be formed using the interface between two triangular prisms. In some implementations, the partial reflector 706 can have dichroic properties.

[0081] As disclosed herein, both visible light and infrared cameras can be integrated without increasing the optical stack height of a surgical microscope used for ophthalmic surgery. The infrared camera can be used to directly and intraoperatively capture a scanning optical coherence tomography (OCT) measurement beam that uses NIR light, which is invisible to the human eye. An infrared image from the infrared camera, captured of the same surgical field as displayed to the user of the surgical microscope during surgery, can be displayed in the user's eyepiece, enabling visualization of the location of the OCT scan as well as the actual visible light image of the surgical field.

[0082] The subject matter disclosed above is to be considered illustrative and not restrictive, and the appended claims are intended to cover all such modifications, enhancements, and other embodiments that fall within the true spirit and scope of the disclosure. Thus, to the maximum extent allowed by law, the scope of the present disclosure is to be determined by the broadest permissible interpretation of the following claims and their equivalents and shall not be restricted or limited to the foregoing specific embodiments.

Claims

1. A method for providing a fundus view, the method comprising: Scanning a surgical field using an optical coherence tomography (OCT) scanning system coupled to a surgical microscope for viewing visible light from the surgical field, wherein the OCT scanning system projects near-infrared (NIR) light onto the surgical field for scanning the surgical field; redirecting the first portion of the NIR light and the second portion of the visible light into an imaging path of the surgical microscope using a multibeam beam splitter positioned in an optical path that transmits the visible light to a first eyepiece of the surgical microscope; splitting the first portion of the NIR light from the second portion of the visible light using a dichroic mirror positioned in the imaging path; generating an IR image of the surgical field from the first portion of the NIR light using an infrared (IR) camera, the IR image indicating a position of the scan of the surgical field in the surgical field; and generating a visible light image of the surgical field from the second portion of the visible light using a visible light camera, wherein the visible light camera and the IR camera are located in a plane; The multi-beam splitter includes a point filter, a hole filter and a partial reflection mirror.

2. The method of claim 1, further comprising: acquiring the IR image from the IR camera; as well as The IR image is sent to a controller to generate display light for viewing at a second eyepiece of the surgical microscope, wherein at least a portion of the display light follows a path of visible light transmitted to the second eyepiece.

3. The method of claim 2, further comprising: acquiring the visible light image from the visible light camera; as well as The visible light image is sent to the controller to generate the display light, wherein at least a portion of the display light follows a path of the visible light transmitted to the second eyepiece.

4. The method according to claim 3, wherein: The first eyepiece and the second eyepiece are the same eyepiece, and the display light is reflected by the multi-beam splitter onto the optical path.

5. The method according to claim 3, wherein: The first eyepiece and the second eyepiece are different eyepieces, and the display light is reflected by a beam combiner onto visible light transmitted to the second eyepiece.

6. The method of claim 5, further comprising: Splitting the display light into a first display light beam and a second display light beam using a first beam splitter; directing the first display light beam to the first eyepiece using the multi-beam beam splitter; as well as The second display beam is directed to the second eyepiece using the beam combiner.

7. The method of claim 1, wherein: The first portion is at least 90% of the NIR light, and wherein the second portion is less than or equal to 30% of the visible light.

8. The method of claim 1, wherein: The visible light camera and the IR camera are oriented perpendicular to each other.

9. The method of claim 1, further comprising: redirecting the third portion of the NIR light and the fourth portion of the visible light into a second imaging path of the surgical microscope using a second multibeam beam splitter positioned in a second optical path that transmits visible light to a second eyepiece of the surgical microscope that is different from the first eyepiece, wherein the imaging path and the second imaging path lie in the plane; splitting the third portion of the NIR light from the fourth portion of the visible light using a second dichroic mirror located in the second imaging path; generating a second IR image of the surgical field from the third portion of the NIR light using a second IR camera, the second IR image indicating a location within the surgical field of the scan of the surgical field; and A second visible light image of the surgical field is generated from the fourth portion of the visible light using a second visible light camera, wherein the second visible light camera and the second IR camera are located in the plane.

10. The method of claim 9, further comprising: acquiring the second IR image from the second IR camera; sending the second IR image to a controller to generate second display light for viewing at the second eyepiece, wherein at least a portion of the second display light including the second IR image follows a path of visible light transmitted to the second eyepiece; acquiring the second visible light image from the second visible light camera; and The second visible light image is sent to the controller to generate the second display light, wherein at least a portion of the display light including the second visible light image follows a path of the visible light transmitted to the second eyepiece.

11. A surgical microscope for performing ophthalmic surgery, the surgical microscope comprising: an optical coherence tomography (OCT) scanning system, the OCT scanning system being coupled to the surgical microscope and configured to scan a surgical field, the surgical microscope being configured to view visible light from the surgical field, wherein the OCT scanning system projects near-infrared (NIR) light onto the surgical field for scanning the surgical field; a multi-beam beam splitter positioned in an optical path transmitting the visible light to a first eyepiece of the surgical microscope, the multi-beam beam splitter configured to redirect the first portion of the NIR light and the second portion of the visible light to an imaging path of the surgical microscope; a dichroic mirror located in the imaging path and configured to split the first portion of the NIR light from the second portion of the visible light; an infrared (IR) camera for generating an IR image of the surgical field from the first portion of the NIR light, the IR image indicating a position of the scan of the surgical field in the surgical field; and a visible light camera configured to generate a visible light image of the surgical field from the second portion of the visible light, wherein the visible light camera and the IR camera are located in a plane; The multi-beam splitter includes a point filter, a hole filter and a partial reflection mirror.

12. The surgical microscope of claim 11, further comprising: a controller configured to acquire the IR image from the IR camera and generate coverage information; as well as A display receives overlay information from the controller, the display being configured to output display light for viewing at a second eyepiece of the surgical microscope, wherein at least a portion of the display light follows a path of visible light transmitted to the second eyepiece.

13. The surgical microscope of claim 12, further comprising: the controller, configured to acquire the visible light image from the visible light camera; as well as The display receives the visible light image from the controller, wherein at least a portion of display light comprising the visible light image follows a path of visible light transmitted to the second eyepiece.

14. The surgical microscope according to claim 13, wherein: The first eyepiece and the second eyepiece are the same eyepiece, and the display light is reflected by the multi-beam splitter onto the optical path.

15. The surgical microscope according to claim 13, wherein: The first eyepiece and the second eyepiece are different eyepieces, and further include: A beam combiner is used to reflect the display light onto the visible light transmitted to the second eyepiece.

16. The surgical microscope of claim 13, further comprising: a first beam splitter, configured to split the display light into a first display light beam and a second display light beam; the multi-beam beam splitter, configured to guide the first display light beam to the first eyepiece; and The beam combiner is used to guide the second display beam to the second eyepiece.

17. The surgical microscope according to claim 11, wherein: The first portion is at least 90% of the NIR light, and wherein the second portion is less than or equal to 30% of the visible light.

18. The surgical microscope according to claim 11, wherein: The visible light camera and the IR camera are oriented perpendicular to each other.

19. The surgical microscope of claim 11, further comprising: a second multi-beam beam splitter positioned in a second optical path for transmitting visible light to a second eyepiece of the surgical microscope that is different from the first eyepiece, the second multi-beam beam splitter configured to redirect the third portion of the NIR light and the fourth portion of the visible light to a second imaging path of the surgical microscope, wherein the imaging path and the second imaging path are in the plane; a second dichroic mirror located in the second imaging path, the second dichroic mirror configured to redirect the third portion of the NIR light from the fourth portion of the visible light; a second IR camera for generating a second IR image of the surgical field from the third portion of the NIR light, the second IR image indicating a position of the scan of the surgical field within the surgical field; and A second visible light camera is configured to generate a second visible light image of the surgical field from the fourth portion of the visible light, wherein the second visible light camera and the second IR camera are located in the plane.

20. The surgical microscope of claim 19, further comprising: a controller configured to acquire the second IR image from the second IR camera and generate coverage information; a second display that receives overlay information from the controller, the second display being configured to output second display light for viewing at the second eyepiece, wherein at least a portion of the second display light follows a path of visible light transmitted to the second eyepiece; the controller, configured to acquire the second visible light image from the second visible light camera and generate the coverage information; and The second display receives the overlay information from the controller, wherein at least a portion of the second display light follows a path of visible light transmitted to the second eyepiece.

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