Surgical microscope using red reflection illumination

Abstract

Devices, methods, and systems related to surgical microscopes using red reflected illumination are provided. According to one aspect of the present invention, there is a red reflective surgical microscope system that may have a red reflective illumination source, an objective lens, and an aperture stop. In some embodiments, an aperture stop is located between the illumination source and the objective lens. An image of the aperture stop may be imaged near the objective lens, and a size of a light beam reflected from the objective lens is shortened based on a proximity of the image of the aperture stop to the objective lens. Other embodiments described herein include a red reflective surgical microscope system for use in conjunction with OCT and coupled via a dichroic mirror in which an obstacle is configured to minimize glare by being positioned on or adjacent a side of the dichroic mirror that does not reflect OCT light. Other embodiments include a tilted white light illumination source. Additional embodiments are also described herein.

Description

Priority Statement

[0001] This application claims priority to U.S. Provisional Application No. 63 / 478,813, filed January 6, 2023, entitled “SURGICAL MICROSCOPES USING REDREFLEX ILLUMINATION,” the contents of which are incorporated herein by reference in their entirety. By incorporating via reference

[0002] All disclosures and patent applications mentioned in this specification are incorporated herein by reference in their entirety, to the extent that each individual disclosure or patent application is expressly and individually indicated by reference as incorporated herein by reference. field

[0003] Aspects of the present invention relate to surgical microscopes, and more specifically, to ophthalmic surgical microscopes using red reflective illumination. background

[0004] Ophthalmic surgical microscopes typically require bright and uniform illumination of the surgical area, and more specifically, illumination that can utilize light backscattered from the retina to provide uniform illumination of the eye's pupil. This backscattered light from the retina exhibits a slightly reddish-orange hue and is known as red reflex. The brightness and uniformity of red reflex depend on coaxial illumination, where the observation beam path is within a few degrees of the illumination path. It is known in the art that perfectly coaxial illumination (i.e., at 0° to the observation beam path) produces the highest quality red reflex in terms of brightness and uniformity. However, during cataract surgery, after the lens has been removed and small fragments of the broken lens remain, visualization of these residual fragments is crucial for their removal to avoid surgical complications. To best visualize these fragments, some edge sharpness is required, and it has been shown that using red reflex illumination that deviates a few degrees from the observation beam path (i.e., not perfectly coaxial) produces better contrast for these structures.

[0005] Other devices known in the art use a beam pickoff with general internal illumination for its red reflection illumination, where white light illumination enters near the outer edge and is just above the objective, and a series of mirrors outside the observation beam path deflects a portion of this white light illumination to make it nearly coaxial with the observation beam path. However, this is unlikely to be readily implemented once optical coherence tomography (OCT) is introduced above the objective. Intraoperative OCT-guided surgery helps determine tissue planes and optimal lens positioning. Introducing OCT below the objective is possible, but a dichroic beam splitter below the objective reduces the operating space (called the working distance) below the objective. Furthermore, the optical quality of the observation beam is reduced when a dichroic beam splitter is introduced below the objective. Other devices known in the art have introduced OCT above the objective in the collimation space, but either the OCT is already small enough to have a very low numerical aperture (NA), or the large OCT beam requires sufficient space between the objective and the observation optics, making glare from red reflections or internally tilted white light illumination used for the surgical area potentially interfere with imaging performance.

[0006] Furthermore, in some fields, the beam deflectors used are not dynamic but simply snap into two positions to avoid the path of the observed beam, thus making fully coaxial (i.e., at 0° angle to the path of the observed beam) illumination impossible. While some devices in the art are known to have dynamic beam deflection illumination, these devices may produce shadows in general-illumination surgical areas.

[0007] Furthermore, optical systems used for red reflection are typically fixed and have adjustable apertures to control the size of the red reflection at the eye's pupil. This is not an efficient use of light, especially for a small field of view (FOV). In cases where it is desirable to stop red reflection illumination, existing systems typically require reducing the size of the red reflection aperture stop (if it is fully adjustable), thereby discarding most of the usable light.

[0008] It is worth noting that typical red-reflected illumination uses a white light source, in which green and blue light are absorbed by the retina, and there are limiting factors on the brightness of red-reflected illumination to avoid retinal damage. This makes power often wasted because it cannot effectively contribute to the red-reflected backscattered light.

[0009] What is needed are systems and methods for reducing red reflection in image-guided systems for combined microscopy and OCT. Public Overview

[0010] According to one example of the invention, there is a red-reflection surgical microscope system comprising: a red-reflection illumination source, an objective lens, and an aperture stop, wherein the aperture stop is located between the illumination source and the objective lens, wherein the image of the aperture stop is imaged near the objective lens, and wherein the size of the beam reflected from the objective lens is shortened based on the proximity of the image of the aperture stop to the objective lens.

[0011] According to one embodiment of this example, the imaging system is fixed.

[0012] According to one embodiment of this example, the imaging system is a continuously adjustable zoom system, wherein the continuously adjustable zoom system adjusts the magnification of the light beam reflected from the objective lens.

[0013] According to one embodiment of this example, the size of the beam reflected from the objective lens is adjusted by adjusting one or more of the following: (i) a set of lenses, (ii) a prism, and (iii) a mirror.

[0014] According to one embodiment of this example, the lens group is one or more of a positive lens and a negative lens, wherein the lens is adjusted from its nominal position to its maximum position away from the objective lens.

[0015] According to one embodiment of this example, the red reflective illumination source illuminates at a wavelength corresponding to the micro-red-orange spectrum, wherein the red reflective illumination source includes one or more of LEDs and broadband light sources, and wherein the surgical microscope system includes one or more of the following: a surgical microscope, a stereo microscope, and a multi-channel microscope configured for cataract surgery.

[0016] According to one embodiment of this example, the size of the beam from the red reflective illumination source at the object plane is changed by an aperture stop that adjusts the beam magnification, wherein a fixed amount of optical power used by the illumination source allows for higher irradiance at the objective lens.

[0017] According to another example of the invention, there is a red-light backflow surgical microscope system comprising: a red-light reflection illumination system having: a red-light reflection illumination source, an objective lens and an aperture stop; an optical coherence tomography (OCT) system; and an obstacle; wherein the red-light reflection illumination system and the OCT system are coupled via a dichroic mirror, wherein the red-light backflow surgical microscope system is configured to minimize glare from the objective lens by positioning the obstacle on or adjacent to the dichroic mirror.

[0018] According to one embodiment of this example, a back reflection occurs from the bottom surface of the objective lens.

[0019] According to one embodiment of this example, there is a dichroic beam splitter positioned below the objective lens, wherein the OCT is also positioned below the objective lens, and the beam splitter is configured to reduce the operating space (“working distance”) below the objective lens.

[0020] According to one embodiment of this example, an anti-reflective (AR) coating configured to reduce glare is used on one or more of the objective lens and dichroic mirror, wherein the AR coating is configured to optimize performance for the orange-red region of the visible spectrum.

[0021] According to yet another example, there is a tilting white light surgical microscope system comprising: a white light illumination system having a white light source, an objective lens, and an aperture stop; an optical coherence tomography (OCT) system; and an obstacle, wherein the white light illumination system and the OCT system are coupled via a dichroic mirror, wherein the tilting white light surgical microscope system is configured to minimize glare and backscattering from the objective lens by positioning the obstacle on or adjacent to the non-reflective side of the dichroic mirror to the OCT light.

[0022] According to one embodiment of this example, the white light illumination system is configured to eliminate glare from the white light source by angling the luminaire towards the center of the objective lens.

[0023] According to one embodiment of this example, there are multiple tilted illuminators located outside the white light illumination system.

[0024] According to another example of the invention, there is a method for red reflection illumination for a surgical field of view, comprising: emitting red reflection light from a light source through an illumination path of an aiming objective; setting an observation beam path substantially coaxial with the illumination path; implementing optical zoom and a fixed aperture stop in the observation beam path to image the red reflection aperture stop near the objective, thereby producing a minimum beam diameter under collimated light; and preventing backscattered light from propagating through the observation beam path.

[0025] According to one embodiment of the method, the emission step emits red reflected light of a slightly red-orange illumination wavelength.

[0026] According to one embodiment of the method, the faint red-orange illumination is in the range of 590 nm to 750 nm.

[0027] According to one embodiment of the method, the setup step further includes: generating improved visual contrast of the illumination path by changing the illumination path relative to the observation beam path by more than 0 degrees and at most 6 degrees.

[0028] According to one embodiment of the method, the optical zoom from the implementation step includes a positive lens and a negative lens for magnification.

[0029] According to one embodiment of the method, the step of preventing backscattered light transmission is performed by placing an obstacle as a non-OCT reflective surface adjacent to a dichroic mirror.

[0030] According to one embodiment of the method, white light is emitted from a light source, wherein glare from the white light is eliminated by positioning the light source at a minimum tilt angle relative to the objective lens. Brief description of the attached diagram

[0031] Figure 1 An isometric view of a lighting device according to various aspects of the present invention is depicted.

[0032] Figure 2 A side view of the lighting device is shown.

[0033] Figure 3A and Figure 3B Examples of zoom systems in their nominal and alternative configurations are shown.

[0034] Figure 4 An exemplary source spectrum is depicted.

[0035] Figure 5A and Figure 5B In one specific embodiment, the nominal operating mode and alternative operating modes of the lighting are shown.

[0036] Figure 6A and Figure 6B Alternative embodiments of red reflective illumination are described.

[0037] Figure 7A and Figure 7B Peak illuminance is shown using both nominal and alternative source sizes.

[0038] Figure 8 One mode of glare control is shown in a specific embodiment.

[0039] Figure 9 A side view of glare control with some mechanical components is shown in one specific embodiment. Detailed description

[0040] Various aspects of the present invention are intended to improve upon the aforementioned limitations when a wide field of view and a relatively large NA OCT scanning beam are introduced above the objective lens.

[0041] By using an optical zoom system 100 for red reflection (see...) Figure 1This invention overcomes some of the previously mentioned limitations. The use of an optical zoom 114 for red reflection alters the relationship between the power used by the light source and the field of view (FOV). A fixed aperture stop 108 can be used in conjunction with the optical zoom system 114, instead of an adjustable aperture stop. This allows for efficient use of red reflected light, especially for small FOVs. For the same amount of optical power, it allows for higher irradiance at the object plane. This can result in improved transmission of the observed beam path by biasing the red reflection beam splitter 122, which will be described in more detail below.

[0042] Furthermore, the use of a zoom optics system 114 after aperture stop 108 (which also images the red-reflection aperture stop 108 near objective 126) minimizes back reflections, which becomes possible with a large space between objective 126 and the observation optics to allow for a large dichroic beam splitter 122. When light approaches the center of objective 126, glare has a greater chance of entering the observation beam path as light diverges from ordinary white light in the red-reflection optics using a beam deflector nearly coaxial with the observation beam path. Imaging the aperture stop 108 for red reflection onto objective 126 allows for the smallest possible beam diameter while still using collimated light, thus minimizing troublesome back reflections from imperfect anti-reflective (AR) coatings on the optics.

[0043] To further minimize glare, it was found that placing an appropriately sized obstruction on or above the back side (the side that does not reflect OCT light) of the dichroic mirror 124 allows for a clear path of the observation beam while completely blocking the possibility of backscattered light from certain surfaces of the objective lens, which would otherwise be transmitted through the path of the observation beam and detected, thus causing unpleasant glare.

[0044] Furthermore, in order to eliminate glare from oblique white light illumination used in surgical areas in such a system 100, luminaire 160 (see Figures 8-9 The objective lens is positioned as far outside the objective lens as possible to keep the tilt angle reasonably small, which allows for a smaller objective lens, but with the trade-off of having a tilt illumination greater than the conventional 6°.

[0045] Finally, regarding glare management and optical efficiency, the use of LEDs in the micro-red-orange range, with their limited bandwidth of red-reflected light, allows for the application of higher-performance AR coatings to red-reflected optics, thereby reducing the intensity of backscattered light from those elements. In some instances, the micro-red-orange range of the visible spectrum can be in the range of 590 nm to 750 nm (orange range 590 nm to 620 nm, and red range 620 nm to 750 nm). Furthermore, by not wasting light power in the blue-green region that is absorbed and does not return to the retina with sufficient light power, we have created a more efficient overall red-reflected illumination system 100, and as described above, transmission can be improved by a beam splitter, which is further described in detail below. Using micro-red-orange illumination wavelengths also improves patient safety by eliminating the photochemical hazards associated with blue-green wavelengths.

[0046] Figure 1 , Figure 2 , Figure 3A , Figure 3B , Figure 5A , Figure 5B , Figure 6A , Figure 6B , Figure 8 and Figure 9 Various views of the apparatus are shown in specific embodiments and are described in further detail below. Figure 1 and Figure 2 Isometric and front views of the illumination beam path are shown respectively through specific embodiments of the device. The left and right illumination paths of the light are now discussed separately, but they are symmetrical to each other. The light source 102 can be a substantially uniform light source from a large-core multimode fiber (not shown) or other sources with spatial homogeneity, guided by the optical system 100 and imaged onto the object plane 128 (see [reference]). Figure 2 The optical system 100 includes a collimating lens 106, an aperture stop 108, folding mirrors 110 and 112, an optical zoom system 114, deflecting prisms 116 and 118, a folding mirror 120, a beam splitter 122, a dichroic mirror 124, and a primary objective lens 126. The optical zoom system 114 includes positive lenses 130 and 132 and a negative lens group 134, wherein the negative lenses consist of identical negative lenses 136 and 138. The upper red reflector optical train from the light source 102 to the deflecting prism 118 is designated as upper red reflector 140. In alternative embodiments, all lenses in this optical zoom system can be configured to achieve a desired zoom range and aberration correction. According to some examples, a digital or analog microscope can be used. Similarly, the magnification of the red reflector system can be affected by various magnification and zoom mechanisms.

[0047] This critical illumination using the zoom system 114 allows for efficient use of light power and adjustment of the size of the red-reflected illumination at the object plane 128, which can be the pupil of the eye (not shown). By positioning the negative lens group 134 and the positive lens 130 while the positive lens 132 remains fixed, the illumination can be continuously adjusted by the overall optical system 100 magnification from 6x to 12x. Figure 3A and Figure 3B The side view shown in this specific embodiment illustrates the adjustment range of the optical zoom system 114. The negative lens group 134 can be adjusted from its nominal position, which achieves a total magnification of 6x for the optical system 100, to a maximum position further away from the fixed lens 132 by 9.7 mm. The positive lens 130 can be adjusted from its nominal position to a maximum position further away from the fixed lens 132 by 5.8 mm. Together, these two adjustments achieve a total magnification of 12x for red-reflective illumination of the overall optical system 100.

[0048] like Figure 1 and Figure 2 As shown, beam splitter 122 has a transmission-to-reflection ratio of 80% to 20%. However, depending on the brightness of light source 102 and the sensitivity and efficiency of the observation beam imaging system (not shown), any ratio can be used with a suitable optical coating for beam splitter 122.

[0049] Figure 4 Depicting Figure 1 and Figure 2 The light source 102 has a spectrum 402. The light source 102 is an LED (not shown) injected into a multimode optical fiber (not shown), with its bandwidth selected to be in the orange and red range. In an alternative embodiment, an additional filter can be used to further limit the LED bandwidth. When using such a spectrally limited bandwidth source 102, the use of optical power 404 becomes more efficient when backscattered from the retina. This contrasts with white light illumination, where the blue-green wavelength 406 would otherwise be absorbed by the retina and wasted in terms of the brightness of the red reflected illumination backscattered towards the path of the observed beam.

[0050] like Figure 5A and Figure 5B As depicted, the folding mirror 120 can be continuously adjusted vertically to achieve a substantially coaxial beam relative to the observation beam path between 0° and +2°, thereby allowing for excellent red reflection contrast and red reflection brightness. In this embodiment, the folding mirror 120 is adjusted to a position 7 mm from its nominal 0° coaxial red reflection illumination position. Figure 5B This angle of beam 104 relative to the optical axis 190 of the primary objective lens 126 is shown. In alternative embodiments, such as... Figure 6A and Figure 6BAs shown, the beam path and all optical elements from the light source 102 to the deflecting prism 118 can be spaced more widely. This allows for lateral continuous adjustment of the deflecting prism 118 to achieve a range of coaxial angles, from 0° to a maximum of 3.6°, relative to the observed beam path, using the same smaller Ø 60mm objective lens 126. For larger objectives, using a Ø 74mm objective lens with a focal length of 200mm, larger coaxial angles, up to a reasonable 6°, can be safely used. As the light 104 is collimated after the fixed lens 132 (see...), Figure 1 The imaging quality at 128° of the object plane remains unchanged, and the wider angular range allows for more exploration of trade-offs between red reflection brightness and edge contrast of small residual objects.

[0051] Figure 7A It shows when Figure 1 The light source 102 has a diameter substantially close to 1 mm and is positioned coaxially at 0° relative to the observation beam path, representing an exemplary spot size on a typical retina. However, a smaller source size may still be safe for the retina, as the source size is not the primary driver of irradiance at the retina when utilizing this type of illumination; rather, the imaging NA and the source relative to the master objective 126 (from...) Figure 1 The position of the back focal plane is the primary driving factor. In an alternative embodiment, a light source diameter of 0.6 mm will have the following characteristics: Figure 7B The light spot profile is shown. Although the peak irradiance is approximately 17% higher than that using a Ø 1 mm light source 102, the overall shape of the irradiance is different and not more detrimental than a 1 mm light source diameter. This raises the discussion that using critical illumination is simpler than using typical Köhler illumination and does not compromise optical quality due to differences in light source uniformity, shape, and size. The higher optical magnification of the red-reflective zoom system allows for even higher peak irradiance.

[0052] and Figure 2 Related, but not yet discussed, is that the red reflection illumination system 100 is designed to minimize potential glare from the primary objective 126. Due to the large gap between the primary objective 126 and the imaging system (not shown), which allows space for an exemplary large-size optical coherence tomography (OCT) scanning beam (not shown) to enter the optical system 100 above the primary objective 126 from the right and reflect downwards towards the objective plane 128 from the dichroic mirror 124, red reflection illumination may be more likely to produce glare compared to surgical microscopes without a large dichroic mirror above the primary objective. Figure 8As shown, to reduce glare, the obstruction 150 is carefully sized and positioned above and near or on the dichroic mirror, where unpleasant back reflections occur from the bottom surface of the objective lens 126. This prevents the observed beam from vignetting, minimizes glare that could pass directly through the imaging system (not shown), and does not interfere with the OCT optical system (not shown).

[0053] In another aspect of the red reflective lighting system 100 (not previously discussed), in order to minimize glare, such as Figure 2 As shown, the aperture stop 108 is imaged near the primary objective 126 to minimize the size of light reflected from the various surfaces of the primary objective. When the light ray 104 becomes too close to the center of the primary objective 126, it becomes difficult to minimize glare. If the aperture stop is not imaged substantially near the objective, the light will be scattered at the objective, thus greatly increasing the risk of glare transmission through the observation beam path imaging system.

[0054] Finally, as Figure 8 and Figure 9 As shown, four external and angled white general illumination fixtures 160 are brought to the outside of the primary objective lens 126 / 226 and angled toward the center of the object plane 128. This eliminates the risk of glare from any white light source and allows for a smaller and cheaper primary objective lens 126 / 226. To further reduce the chance of scattering, Figure 9 The beam collector 270 is shown positioned to capture any collimated light reflected from the folding mirror 120 and transmitted through the beam splitter 122. A tilted white general illumination is used outside the objective lens and is not part of the red-reflective illumination system 100. Furthermore, by using a slightly red-orange red-reflective illumination light, it is advantageous that a high-performance anti-reflective (AR) coating with minimal reflection near orange and red wavelengths can be used for all transmission optics that are part of the red-reflective illumination system 100 to further reduce potential glare.

[0055] While hoping to avoid being bound by theory, the embodiments of the optical system of the present invention described herein are believed to offer at least four advantages over conventional optical systems. First, a zoom system is incorporated into the red light return path by imaging the source into the pupil or other optical target. This approach severs the relationship between the total red reflected beam power and the illumination field of view (FOV) at the pupil, a typical feature of more standard constant irradiance methods. As a result, the system of the present invention is more energy-efficient, especially for small FOVs. As a result of this efficiency, the system allows the use of a lower-power source, either alone or in combination with a more efficient light collection from the patient's eye, achieved by a bias beam splitter to deflect the collection path. Second, there is a favorable optimization for using the "red" wavelength for red reflected illumination. In itself, this approach has the advantage of not exposing the patient's retina to blue-green wavelengths, which do not significantly contribute to red reflection and pose a potential photochemical hazard to the retina. Furthermore, this aspect, combined with a zoom system, more fully encompasses the use of the "red" wavelength because this combination better confines the light to remain within the pupil. This combination reduces or eliminates the coloration of the rest of the anterior chamber with red light. Conversely, such a scheme achieved using conventional aperture methods would result in a highly inefficient system when stopped. A third advantage is provided by incorporating an adjustable angle for red reflection. While it is desirable to optimize the angle for non-perfect coaxiality, conventional systems do not offer a way to achieve this desired orientation. Embodiments of the system of the present invention provide a component arrangement that enables dynamic angle adjustment and makes it possible to produce fully coaxial illumination operation. Additionally or alternatively, improvements for the dynamically adjustable implementation may also be provided. A fourth improvement comes from the implementation of improved glare management. In some embodiments of the improved illumination system, one or more of the following techniques are combined: (1) obstructions on the dichroic mirror, (2) removing the tilting illuminator from the microscope, and (3) using a higher-performance coating on a narrower bandwidth of red illumination.

[0056] It should be understood that all combinations of the foregoing concepts and the additional concepts discussed in more detail below (provided that these concepts are not inconsistent with each other) are considered to be part of the subject matter of the invention disclosed herein and can be used to achieve the benefits described herein.

[0057] The process parameters and order of steps described and / or illustrated herein are given by way of example only and may be changed as needed. For example, while the steps shown and / or described herein may be shown or discussed in a particular order, these steps do not necessarily need to be performed in the order shown or discussed. The various example methods described and / or illustrated herein may also omit one or more steps described or illustrated herein, or include additional steps besides those disclosed.

[0058] When a feature or element is referred to herein as "on another feature or element," it may be directly on the other feature or element, or there may be intermediate features and / or elements present. In contrast, when a feature or element is referred to as "directly on another feature or element," there are no intermediate features or elements. It will also be understood that when a feature or element is referred to as "connected," "attached," or "coupled" to another feature or element, it may be directly connected, attached, or coupled to that other feature or element, or there may be intermediate features or elements present. In contrast, when a feature or element is referred to as "directly connected," "directly attached," or "directly coupled" to another feature or element, there are no intermediate features or elements. Although one embodiment has been described or illustrated, the features and elements thus described or illustrated can be applied to other embodiments. Those skilled in the art will also recognize that references to structures or features positioned "adjacent" to another feature may have portions covering or located below the adjacent feature.

[0059] The terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit any aspect of the invention. For example, as used herein, the singular forms “a,” “an,” and “the” are also intended to include the plural forms unless the context clearly indicates otherwise. It will be further understood that, when used in this specification, the terms “comprises” and / or “comprising” specify the presence of stated features, steps, operations, elements, and / or components, but do not exclude the presence or addition of one or more other features, steps, operations, elements, components, and / or groups thereof. As used herein, the term “and / or” includes any one and all combinations of one or more of the associated listed items and may be abbreviated to “ / .”

[0060] Spatially related terms such as “under,” “below,” “lower,” “over,” “upper,” and similar terms may be used herein to readily describe the relationship between one element or feature and another, as illustrated in the accompanying drawings. It will be understood that spatially related terms are intended to encompass different orientations of the device in use or operation, in addition to those depicted in the drawings. For example, if the device in the drawings were inverted, an element described as “below” or “under” other elements or features would be oriented as “above” other elements or features. Thus, the exemplary term “under” can encompass both above and below orientations. The device may be oriented in other ways (rotated 90 degrees or in other orientations), and the spatially related descriptive terms used herein are interpreted accordingly. Similarly, the terms “upwardly,” “downwardly,” “vertical,” “horizontal,” and similar terms are used herein for interpretative purposes only, unless otherwise specifically indicated.

[0061] While the terms "first" and "second" may be used herein to describe various features / elements (including steps), these features / elements should not be limited by these terms unless the context otherwise requires. These terms may be used to distinguish one feature / element from another. Therefore, without departing from the teachings of embodiments of the invention, the first feature / element discussed below may be referred to as the second feature / element, and similarly, the second feature / element discussed below may be referred to as the first feature / element.

[0062] In this specification and the appended claims, unless the context otherwise requires, the term "comprise" and its variations such as "comprises" and "comprising" mean that various components may be used together in a method and article of manufacture (e.g., components and apparatus, including devices and methods). For example, the term "comprising" will be understood to imply the inclusion of any of the stated elements or steps, but does not exclude any other elements or steps.

[0063] Generally, any apparatus and method described herein should be understood as inclusive, but all or a subset of components and / or steps may optionally be exclusive and may be represented as “consisting of a variety of components, steps, sub-components or sub-steps” or optionally “consisting substantially of a variety of components, steps, sub-components or sub-steps”.

[0064] As used herein in the specification and claims, including in the examples, and unless otherwise expressly specified, all figures may be considered as if preceded by the words “about” or “approximately,” even if the term is not explicitly stated. The phrase “about” or “approximately” may be used when describing magnitude and / or location to indicate that the described value and / or location is within a reasonably expected range of value and / or location. For example, a numerical value may have a value of + / -0.1% of the stated value (or range of values), + / -1% of the stated value (or range of values), + / -2% of the stated value (or range of values), + / -5% of the stated value (or range of values), + / -10% of the stated value (or range of values), etc. Any numerical value given herein should also be understood to include approximately or about that value unless the context otherwise indicates. For example, if the value “10” is disclosed, then “about 10” is also disclosed. Any numerical ranges listed herein are intended to include all subranges contained therein. It should also be understood that when a value is disclosed, terms such as "less than or equal to" that value, "greater than or equal to" that value, and possible ranges between values ​​are also disclosed, as would be appropriately understood by someone skilled in the art. For example, if the value "X" is disclosed, then "less than or equal to X" and "greater than or equal to X" (e.g., where X is a numerical value) are also disclosed. It should also be understood that throughout the application, data is provided in a variety of different formats, and that this data represents the endpoints and starting points, as well as the range, of any combination of data points. For example, if specific data point "10" and specific data point "15" are disclosed, it should be understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15, as well as ranges between 10 and 15, are considered disclosed. It should also be understood that each unit between two specific units is also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.

[0065] While various illustrative embodiments have been described above, any of several changes may be made to the various embodiments without departing from the scope of the embodiments of the invention as described in the claims. For example, in alternative embodiments, the order in which the various described method steps are performed may typically be changed, and in other alternative embodiments, one or more method steps may be skipped together. Optional features of the various apparatus and system embodiments may be included in some embodiments but not in others. Therefore, the foregoing description is provided primarily for illustrative purposes and should not be construed as limiting the scope of the embodiments of the invention as set forth in the claims.

[0066] The examples and illustrations included herein are shown by way of illustration, not limitation, of specific embodiments in which the subject matter can be practiced. As mentioned, other embodiments can be utilized and derived therefrom, allowing for structural and logical substitutions and changes without departing from the scope of this disclosure. If more than one is actually disclosed, for convenience only, such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term "invention," and are not intended to voluntarily limit the scope of this application to any single aspect of the invention or inventive concept. Thus, while specific embodiments have been illustrated and described herein, any arrangement believed to achieve the same purpose may replace the specific embodiments shown. This disclosure is intended to cover any and all modifications or variations of the various embodiments. Upon reading the above description, those skilled in the art will understand the combinations of the above embodiments and other embodiments not specifically described herein.

Claims

1. A red-reflection surgical microscope system, comprising: Red reflective lighting source, Objective lens, and Aperture stop, The aperture stop is located between the illumination source and the objective lens, the image of the aperture stop is imaged near the objective lens, and the size of the light beam reflected from the objective lens is shortened based on the proximity of the image of the aperture stop to the objective lens.

2. The system according to claim 1, wherein, The imaging system is fixed.

3. The system according to claim 1, wherein, The imaging system is a continuously adjustable zoom system, wherein the continuously adjustable zoom system adjusts the magnification of the light beam reflected from the objective lens.

4. The system according to claim 1, wherein, The size of the beam reflected from the objective lens is adjusted by adjusting one or more of the following: (i) a set of lenses, (ii) a prism, and (iii) a mirror.

5. The system according to claim 4, wherein, The set of lenses is one or more of a positive lens and a negative lens, wherein the lens is adjusted from its nominal position to a maximum position away from the objective lens.

6. The system according to claim 1, wherein, The red reflective illumination source illuminates at a wavelength corresponding to the faint red-orange spectrum, wherein the red reflective illumination source includes one or more of LEDs and broadband light sources, and wherein the surgical microscope system includes one or more of the following: a surgical microscope, a stereo microscope, and a multi-channel microscope configured for cataract surgery.

7. The system according to claim 1, wherein, The size of the light beam from the red reflective illumination source at the object plane is changed by adjusting the aperture stop, which magnifies the light beam, wherein a fixed amount of optical power used by the illumination source allows for higher irradiance at the objective lens.

8. A red light return surgical microscope system, comprising: -- Red reflective lighting system, which includes: --- Red reflective lighting source, --- Objective lens, and --- Aperture stop; -- Optical coherence tomography (OCT) system; and -- Obstacles; The red reflective illumination system and the OCT system are coupled via a dichroic mirror, wherein the red light return surgical microscope system is configured to minimize glare from the objective lens by positioning the obstruction on or adjacent to the dichroic mirror.

9. The microscope system according to claim 8, wherein, Back reflection occurs from the bottom surface of the objective lens.

10. The microscope system of claim 8, further comprising a dichroic beam splitter positioned below the objective lens, wherein, The OCT is also located below the objective lens, wherein the beam splitter is configured to reduce the operating space ("working distance") below the objective lens.

11. The microscope system according to claim 8, wherein, An anti-reflective (AR) coating configured to reduce glare is applied to one or more of the objective lens and the dichroic mirror, wherein the AR coating is configured to optimize performance for the orange-red region of the visible spectrum.

12. A tilting white light surgical microscope system, comprising: -- White light illumination system, which includes: --- White light source, --- Objective lens, and --- Aperture stop; -- Optical coherence tomography (OCT) system; and -- Obstacles; The white light illumination system and the OCT system are coupled via a dichroic mirror, wherein the tilting white light surgical microscope system is configured to minimize glare and backscattering from the objective lens by positioning the obstacle on or adjacent to the non-reflective side of the dichroic mirror.

13. The tilting white light surgical microscope system according to claim 12, wherein, The white light illumination system is configured to eliminate glare from the white light source by angling the luminaire towards the center of the objective lens.

14. The tilting white light surgical microscope system of claim 12 further includes a plurality of tilting illuminators located outside the white light illumination system.

15. A method for red reflective illumination of a surgical field of view, comprising: Red reflected light is emitted from the light source through the illumination path of the aiming objective lens; Set the observation beam path to be substantially coaxial with the illumination path; Optical zoom and a fixed aperture stop are implemented in the observation beam path to image the red reflection aperture stop near the objective lens, thereby producing the minimum beam diameter under collimated light. as well as To prevent backscattered light from propagating through the path of the observed beam.

16. The method according to claim 15, wherein, The emission step emits red reflected light at a slightly red-orange illumination wavelength.

17. The method according to claim 16, wherein, The light-red to orange illumination is in the range of 590 nm to 750 nm.

18. The method according to claim 15, wherein, The setup steps further include: generating improved visual contrast of the illumination path by changing the illumination path relative to the observation beam path by more than 0 degrees and at most 6 degrees.

19. The method according to claim 15, wherein, The optical zoom derived from the implementation step includes a positive lens and a negative lens for magnification.

20. The method of claim 15, wherein, The step of preventing backscattered light transmission is performed by placing the obstacle as a non-OCT reflective surface adjacent to the dichroic mirror.

21. The method according to claim 15, wherein, White light is emitted from the light source, wherein glare from the white light is eliminated by positioning the light source at a minimum tilt angle relative to the objective lens.

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