Constant downforce assembly for wide angle visualization based on contact lenses

Abstract

A contact-based wide angle visualization system ("WAVS") for use in an ophthalmic suite with a microscope includes a constant downforce (CDF) assembly and a contact lens device. The CDF component has a proximal end and a distal end. The proximal end is connected to an optical head of a microscope via an intermediate connecting arm. A contact lens device is connected to a distal end of the CDF assembly and includes a contact lens configured to be worn on a cornea of a patient's eye located in an ophthalmic suite. The CDF assembly provides a constant downforce to the contact lens device and is self-leveled to maintain the contact lens device in a generally parallel orientation relative to a floor of the ophthalmic suite.

Description

[0001] Cross-reference to related applications

[0002] This application claims the benefit of priority to U.S. Provisional Application No. 63 / 506,713, filed June 7, 2023, which is hereby incorporated in its entirety by reference. Background Technology

[0003] This disclosure relates to wide-angle visualization of the internal anatomy of a patient's eye. As those skilled in the art will understand, proper prognosis and diagnosis of retinal tears and other intraocular conditions often require physicians to use high-definition optical systems. Such systems magnify the eye using a microscope to aid visualization and can also capture images via a digital camera as needed. In this way, physicians can clearly observe the retina, macula, vitreous humor, and surrounding tissues within the eye in real time.

[0004] During ophthalmic visualization procedures, physicians may require a wider field of view of the patient's vitreous cavity than is typically achievable using the lenses and visualization hardware of a microscope. For example, when monitoring conditions such as retinal tears or detachments, physicians may find it beneficial to observe areas of the peripheral retina. Wide-angle visualization can be performed using specially constructed optical lenses, which in some implementations are placed directly on the patient's cornea ("contact-based"). In other implementations, the lens is kept at a short distance from the cornea ("non-contact-based"). In either case, the shape and construction of the lens are designed to provide the desired wide-angle field of view with the aid of intraocular illumination. Summary of the Invention

[0005] This document discloses a contact-based wide-angle visualization system (“WAVS”) for use in an ophthalmic suite equipped with a microscope. The contact-based WAVS, as envisioned herein, includes a constant downforce (CDF) assembly having a proximal and distal end arranged in opposite directions. The proximal end of the CDF assembly can be connected to the microscope via an intermediate connecting arm (e.g., one or more articulated or translational arms as described herein). A contact lens device can be connected to the distal end of the CDF assembly, wherein the contact lens device has a contact lens configured to be worn on the cornea of ​​a patient's eye located in the ophthalmic suite. The CDF assembly provides a predetermined / calibrated constant downforce to the contact lens device and its contact lens, the magnitude of which is sufficient to hold the contact lens on the cornea without causing corneal deformation. Additionally, the CDF assembly is configured to self-level, thereby maintaining the contact lens device in a generally parallel orientation relative to the floor of the ophthalmic suite, for example, within a truly parallel range of approximately ±5° to 10°.

[0006] In one or more embodiments, the gimbal is connected to the distal end of the CDF assembly and to the contact lens device, thereby maintaining the aforementioned generally parallel orientation of the contact lens, for example, by limiting the pitch and / or tilt of the contact lens device, wherein limited tilt / skew allows for better observation of the critical peripheral retina.

[0007] In one or more embodiments, the contact lens device includes a support frame and a support frame arm. In this configuration, the support frame is configured to support the contact lens. The support frame arm is connected to the support frame and to the CDF assembly. In this particular non-limiting exemplary configuration, the CDF assembly includes a shaft externally connected to a bearing housing containing an instrument bearing, wherein the bearing housing is translatable along the longitudinal axis of the shaft, for example in response to forces from the contact lens device due to patient movement.

[0008] In one possible implementation, one or more constant force springs may be connected to or surround a shaft. In other implementations, the CDF assembly includes miniature gas springs.

[0009] In an alternative configuration, the four-bar linkage can be operatively connected to a low-friction cylinder having a piston disposed therein. To ensure unobstructed view of ocular anatomy, in this embodiment, the longitudinal axis of the piston can be laterally offset from the four-bar linkage by a short distance, for example, using short interconnects. The end of the piston can be operatively connected to the contact lens device described above.

[0010] The low-friction cylinder according to a non-limiting exemplary embodiment is constructed of glass (e.g., borosilicate glass) or another low-friction material suitable for the application, wherein a low-friction piston can move within the cylinder.

[0011] The above-described features and advantages, as well as other possible features and advantages, of this disclosure will become apparent from the following detailed description of the best mode for implementing this disclosure, taken in conjunction with the accompanying drawings. Attached Figure Description

[0012] Figure 1 This is a schematic diagram of an exemplary ophthalmology suite equipped with a contact-based wide-angle visualization system (“WAVS”) as described herein.

[0013] Figure 2A and Figure 2B Contact-based WAVS are shown when used with articulated connecting arms and translational connecting arms, respectively.

[0014] Figure 3 This demonstrates a possible construction based on a linear bearing and a constant force spring. Figures 1 to 2B Contact-based WAVS.

[0015] Figure 4 An alternative embodiment including a cylinder is described. Figures 1 to 3 Contact-based WAVS.

[0016] Figure 5 It is based on including a four-bar linkage and Figure 4 Possible structures of the cylinder Figures 1 to 4 A diagram of contact-based WAVS.

[0017] The accompanying drawings are not necessarily drawn to scale and may present simplified representations of various features of the disclosure herein, including, for example, specific dimensions, orientations, positions, and shapes. Details associated with such features will be determined in part by the specific intended application and environment of use. Detailed Implementation

[0018] This document describes embodiments of the disclosure. However, it should be understood that the disclosed embodiments are merely examples, and other embodiments may take various alternative forms. The accompanying drawings are not necessarily drawn to scale. Some features may be exaggerated or minimized to show details of specific components. Therefore, the specific structural and functional details disclosed herein should not be construed as limiting, but rather as a representative basis for teaching those skilled in the art to employ the disclosure in different ways.

[0019] In the following description, certain terms may be used for illustrative purposes only and are therefore not intended to be limiting. For example, terms such as “above” and “below” refer to directions referenced in the accompanying drawings. Terms such as “front,” “rear,” “before,” “after,” “left,” “right,” “rear,” and “side” describe the orientation and / or position of portions of a component or element within a consistent but arbitrary frame of reference, as will become clear from the text describing the component or element under discussion and the associated accompanying drawings. Furthermore, terms such as “first,” “second,” and “third” may be used to describe individual components. Such terms may include the words specifically mentioned above, their derivatives, and words with similar meanings.

[0020] Referring to the accompanying drawings, in which the same reference numerals refer to the same parts, Figure 1 A representative ophthalmology suite 10 is schematically shown. The ophthalmology suite 10 includes an optical system 12 operable for visualizing a portion of the intraocular anatomy 140 of a patient's eye, projecting onto... Figure 1 On a high-resolution monitor 24. Although for the sake of simplicity, Figure 1The surgeon and patient are omitted from the text, but those skilled in the art will understand that the patient will be positioned on platform 16, for example, on an operating table or reclining in a chair, while the surgeon sits on stool 160 adjacent to platform 16. The surgeon will then use an optical system 12 with magnification provided by the system (e.g., via a commercially available optical system from Alcon, Inc.). The 3D visualization system allows for electronic observation of the patient's eyes in a "head-up" manner.

[0021] According to this disclosure, the optical system 12 as envisioned herein includes a contact-based wide-angle visualization system (“WAVS”) 17. While non-contact methods for wide-angle observation remain prevalent in the art, this document recognizes that non-contact alternatives can be challenging to implement properly. For example, a non-contact WAVS alternative involves using an optical head 260 attached to an ophthalmic microscope 26 instead of a lens worn on the patient's eye 140. Consequently, non-contact alternatives for wide-angle observation are highly sensitive to patient movement, requiring near-constant xy-plane translation correction of the microscope 26. The required correction is typically driven by physician foot pedal input, which in turn can exacerbate patient movement. Furthermore, for proper wide-angle observation, the external / non-contact lens must be placed very close to the cornea. This results in frequent impacts to the corneal surface from the external lens, causing viscoelastic material to transfer from the cornea to the lens, thus requiring frequent lens cleaning.

[0022] In contrast, contact-based wide-angle viewing eliminates corneal asphericity, such as that caused by previous radial keratotomy, astigmatic keratotomy, or penetrating keratoplasty, or by corneal lacerations and other factors. Simultaneously, contact-based methods offer an increase of approximately 10° in the field of view compared to comparable non-contact techniques. However, current contact-based wide-angle viewing alternatives face their own unique challenges, including difficulties for surgical assistants in placing and maintaining the contact lens on the cornea due to factors such as patient head or eye movement. This applies whether such movement is low-amplitude and repetitive (e.g., due to normal breathing) or more sudden and unexpected (e.g., large head movements when the patient suddenly wakes up or convulses, for example, due to sleep apnea or sneezing, coughing, or otherwise experiencing a startle reflex). Therefore, the improvements described in detail below aim to address these and other safety concerns, as well as other potential problems commonly associated with contact-based wide-angle viewing.

[0023] As understood in the art and described in detail below with reference to the accompanying drawings, the contact-based WAVS17 is configured to provide a constant and balanced downward pressure (arrow DF) to the contact lens 22L when it is worn on the patient's eye 140. Simultaneously, the constant downward pressure prevents the formation of bubbles or cavitation beneath the contact lens 22L. Therefore, through Figure 1 The envisioned contact-based construction of WAVS17 mitigates the potential problems of corneal deformation due to excessive downforce and trapped air bubbles due to insufficient downforce, as described below. Figures 2A to 5 An exemplary embodiment of the constant downforce (CDF) component 18 of the WAVS is described.

[0024] Figure 1 The illustrated optical system 12 includes a microscope 26, such as a digital or analog medical-grade microscope device with a handle 26H and an eyepiece or lens (not shown). In some embodiments, the microscope 26 may be connected to a digital camera 23 to allow physicians or healthcare professionals to capture digital pixel images of the eye 140 as needed. Visualization of the eye 140 can be enhanced via live video broadcast from one or more monitors in monitor 24, such as medical-grade 4K or other ultra-high-definition organic light-emitting diode (OLED) panels, located within easy viewing range for surgeons and other healthcare professionals in the ophthalmology suite 10.

[0025] As part of this method, Figure 1 The optical system 12 shown is configured to magnify and clearly visualize the intraocular anatomy 14 of the eye 140 in real time. For this purpose, the microscope 26 can be suspended overhead, for example, connected to and / or supported by a multi-axis robotic arm 25. The contact-based WAVS 17, as described herein, can be directly attached or use mechanically engaged elements (e.g., respectively on...). Figure 2A and Figure 2B The connecting arm 40A or 40B (as depicted in the image) is indirectly attached to the optical head 260 of the microscope 26. A non-limiting exemplary microscope 26 includes those from Alcon. Revalia TM Ophthalmic microscopes and OPMI from Carl Zeiss Meditec, Inc. 700. Other commercially available microscopes, such as, but not limited to, the Aesculap AEOS from Aesculap, Inc. TM Digital microscopes abandon the use of eyepiece lenses.

[0026] To achieve the various software-based control aspects of this disclosure, the electronic control unit (ECU) 30 can be positioned to network and communicate with the microscope 26 and the robot 25, wherein such bidirectional communication is... Figure 1 The middle is marked by a double-headed arrow CC 25 Instructions. ECU 30 may be configured to execute computer-readable code or instructions to perform one or more tasks involving the use of optical system 12. Although ECU 30 is schematically shown as a single device for simplicity of illustration, ECU 30 may include one or more networked computer devices and associated computer-readable media or memory, including non-transitory (e.g., tangible) media involved in providing data / instructions that can be read by one or more processors (not shown).

[0027] The memory used for this purpose can take various forms, including but not limited to non-volatile and volatile media. As will be understood, non-volatile media may include optical discs and / or magnetic disks and other persistent storage, while volatile media may include dynamic random access memory (DRAM), static RAM (SRAM), etc., any or all of which may constitute main memory. Communication with microscope 26 and robot 25 may be achieved via a network connection to the input / output circuitry of ECU 30. Other hardware not depicted but established in the art may be included as part of ECU 30, including but not limited to local oscillators or high-speed clocks, signal buffers, digital signal filters, etc. ECU 30 may be enclosed in a movable cabinet 35 or another suitable structure (e.g., the base 250 of robot 25, which is mounted to or securely positioned on the floor 11 of ophthalmic suite 10) to protect ECU 30 from moisture or debris intrusion, cool ECU 30, and provide necessary network and power connections. As part of this solution, ECU 30 may be connected via display signals (CC) 24 It communicates with the display monitor 24.

[0028] Brief Reference Figure 2A and Figure 2B As envisioned herein, the constant downforce (CDF) component 18 is configured to connect to the configuration described above. Figure 1 The optical head 260 of the microscope 26 is shown. As understood in the art, depending on the construction of the microscope 26, there are various commercial options for attaching external lenses to the microscope. Typically, the CDF assembly 18 can be connected via... Figure 2A and Figure 2B Either of the connecting arms 40A or 40B located in the middle is attached to the microscope 26.

[0029] First refer to Figure 2AThe connecting arm 40A may include a connecting ring 41 connected to the optical head 260. In this representative embodiment, for example, a commercially available one from Carl Zeiss Medical Technologies is used. A series of connecting pieces 42, positioned opposite each other at the first end E1 of the connecting arm 40A, are connected to or formed together with the connecting ring 41, and engage with the connecting arm 40A via a rotary joint 44 to form a fork-shaped or trumpet-shaped arrangement, as shown in the figure. Therefore, the physician can rotate the connecting ring 41 about the optical axis AA and swing the connecting arm 40A about the rotation axis RR of the rotary joint 44, thereby positioning the first end E1 of the connecting arm 40A at a desired position within its available range of motion.

[0030] In this embodiment, the second end E2 of the connecting arm 40A may include another rotary joint 144 or another suitable attachment mechanism. According to this disclosure, the CDF assembly 18 is connected to the connecting arm 40A alone or in conjunction with a high-power lens (L1) 46. As understood in the art, this lens 46 may be approximately 70-90 diopters, and a physician may selectively move it to be aligned with or off the optical axis (AA) as needed. Therefore, the lens 46 will be positioned between the optical head 260 and the CDF assembly 18 during use.

[0031] The contact lens device 22 is itself connectable to the CDF assembly 18, as shown. The contact lens device 22 includes the aforementioned contact lens (L2) 22L, which is configured to, in itself, when the patient... Figure 1 The contact lens 22L is worn on the cornea 14C of the eye 140 within the ophthalmic suite 10. As described above, the CDF assembly 18 is configured to provide a constant downforce DF to the contact lens 22L, for example, about 0.1 to 0.5 psig or another suitable downforce, and to self-level, thereby maintaining the contact lens 22L in a generally parallel orientation relative to the floor 11 of the ophthalmic suite 10. As used herein, “generally parallel” means within a range of about ±5° to 10° of true parallel or within another suitable range of true parallel, while avoiding a truly parallel orientation.

[0032] To ensure the desired orientation, the gimbal 36 can be connected to the distal end of the CDF assembly 18 and to the contact lens assembly 22. The gimbal 36 can be used to maintain the approximately parallel orientation of the contact lens 22L by limiting the pitch and / or tilt of the contact lens assembly 22. Although for the sake of simplicity... Figure 2AThe diagram is schematic, but those skilled in the art will understand that commercially available gimbals, for example, used for camera stabilization and robot end effectors, typically comprise an arrangement of rings connected at right angles to each other. Since each constituent ring of the gimbal 36 can rotate independently of the other rings, the contact lens assembly 22 will also be able to rotate along multiple axes, while relative to... Figure 1 The floor 11 shown maintains the desired orientation.

[0033] refer to Figure 2B Alternatively, the connecting arm 40B can be a vertically translatable rod connected at end E1 to an angled bracket 48. The angled bracket 48 can then be connected to a body 49, which is further connected via a ring 141 (e.g., is...). (ready-made kits) connected to Figure 1 The aforementioned optical head 260. As understood in the art, a physician can swing the body 49 and all connected components toward and away from the optical axis AA, as indicated by the double-headed arrow BB. Therefore, the CDF assembly 18 described below can be used with different types of connecting arms, including but not limited to corresponding... Figure 2A and Figure 2B Connecting arms 40A and 40B. Now, special reference will be made to... Figures 3 to 5 Describe three possible configurations of CDF component 18, where the corresponding Figure 2A and Figure 2B Connecting arms 40A and 40B are collectively referred to as 40 in the rest of the drawings.

[0034] Now for reference Figure 3 The aforementioned contact lens device 22 includes a contact lens 22L, which is configured to be worn on the cornea 14C of the patient's eye 140, such as... Figure 2A As shown. The contact lens 22L can be constructed from a rigid or semi-rigid, breathable material, such as fluorosilicone acrylate, silicone acrylate, or another suitable material that provides the desired field of view. Figures 1 to 2B In the illustrated embodiment of the CDF assembly 18, the contact lens device 22 may be connected to the distal end of the CDF assembly 180. For example, the contact lens device 22 may include a support frame 122 and a support frame arm 123. In such an embodiment, the support frame 122 is configured to support the contact lens, for example, around the periphery or circumference of the contact lens 22L. The support frame arm 123 may be welded to the support frame 122, integrally formed with the support frame, or otherwise connected to the support frame, and in different embodiments may also be removably or permanently connected to the CDF assembly 180.

[0035] exist Figure 3 In a non-limiting embodiment, the CDF component 180 is shown connected to the connecting arm 40, for example, correspondingly Figure 2Aand Figure 2B Either of the connecting arms 40A or 40B. The CDF assembly 180 in the illustrated configuration includes a cylindrical rod or shaft 50 externally connected to a bearing housing 52. The bearing housing 52 contains an instrument-grade ball bearing 54, which is translatable along the longitudinal axis (LL) of the shaft 50. As understood in the art, linear ball bearings are used to minimize friction and ensure controlled and smooth linear motion in linear motion systems, such as the illustrated bearing housing 52 and the contact lens device 22L connected thereto. This motion can be... Figure 2A The movement of the patient's eyes (140°) and / or head is caused by the patient's eye movements. Linear instrument bearings are commercially available, for example, from Regal Rexnord Corporation of Belot, WI. A series of linear bearings. The bearing housing 52 translates along the longitudinal axis (LL) of the shaft 50 via a ball track (not shown), within which the instrument ball bearing 54 is captured.

[0036] In one or more embodiments, a suitable damping mechanism can be used for optimization. Figure 3 The vertical movement of the contact lens assembly 22L. For example, in some embodiments, one or more constant force springs 55 may be connected to and / or surrounding the shaft 50. As understood in the art, constant force springs are configured to maintain a consistent force output during extension and compression. In this application, the constant force spring 55 will compress as the bearing housing 52 moves toward the optical head 260 of the microscope (see...). Figure 1 When the patient returns to a stationary position, the compressed constant force spring 55 slowly releases its stored energy, thereby precisely controlling the descent rate of the contact lens device 22L.

[0037] Now for reference Figure 4 , Figure 1 The desired constant downforce and self-leveling benefits of the contact-based WAVS17 can be achieved in other ways within the scope of this disclosure. For example, the CDF assembly 280 may include a miniature gas spring 60 to provide precise downforce and control up / down movement (double-headed arrow VV). As understood in the art, miniature gas springs are designed to provide precise and controlled movement, typically within a space-constrained area. Typically, the miniature gas spring 60, as contemplated herein, may include a gas-filled cylinder 62 and a low-friction piston 64 that translates within the cylinder 62.

[0038] In this application, this translation responds to the patient's eye at a 140° angle. Figure 2AThis occurs due to the movement of the patient's eye 140 or the patient's head (not shown). Pressure changes acting on the piston 64 produce a smooth, near-frictionless linear motion. The gas spring 60 can be configured to slow the movement of the piston 64 when force is applied to the patient's eye 140 and / or the patient's head. Additional resistance and damping can be applied to the movement of the contact lens assembly 22 and the connected wide-angle contact lens (L2) 22L to achieve optimal low-friction performance.

[0039] refer to Figure 5 In yet another possible embodiment, Figure 1 The contact-based WAVS17 may include a CDF assembly 380 equipped with a four-bar linkage 70. As contemplated herein and as understood in the art, the four-bar linkage 70 includes first, second, third, and fourth links or bars 70A, 70B, 70C, and 70D interconnected via rotary joints J1, J2, J3, and J4, as shown. This arrangement thus provides upward / downward movement and keeps the contact lens assembly 22 substantially parallel to... Figure 1 Floor 11, for example, in such Figure 2A Within the truly parallel minute tolerances allowed by the universal joint 36 or other suitable structure.

[0040] In one or more embodiments, the four-bar linkage 70 can be operatively connected to a low-friction cylinder 75, which is supplied with regulated pneumatic pressure (not shown) to maintain a constant downforce, for example, about 0.1 psig to 0.5 psig, or another constant downforce suitable for the patient and application. The low-friction cylinder 75 then has a low-friction piston 76 disposed therein. The longitudinal axis (LL2) of the piston 76 can be laterally offset from the four-bar linkage 70, for example, via an interconnect 77 connected to the low-friction cylinder 75, as shown. The contact lens assembly 22 is then connected to the end 78 of the piston 76 of the low-friction cylinder 75, such that the cylinder 75 provides the aforementioned constant downforce to the contact lens (L2) 22L. Meanwhile, the optional four-bar linkage 70 relative to... Figure 1 The floor 11 maintains a desired, generally parallel orientation, but does not allow for a truly parallel orientation, while the contact lens device 22 moves up or down in response to movement applied by the patient. Thus, the low-friction cylinder 75 balances the vertically guided load, in this case, which includes the contact lens device 22, its support frame 122, and its support arm 123.

[0041] Low-friction cylinders, such as those from Norwalk, Connecticut. company( Commercially available from the Corporation of Norwalk, CT. The cylinder is configured to provide smooth, efficient, and substantially frictionless linear motion, and is therefore suitable for use within the scope of this disclosure. This is achieved, in terms of minimal friction, by constructing the cylinder 75 from a material with a low coefficient of friction (e.g., borosilicate glass) and through process steps (e.g., machining). When used in conjunction with the illustrated four-bar linkage, the low-friction cylinder 75 and the low-friction piston 76 disposed therein smoothly and efficiently apply the desired constant downforce.

[0042] As those skilled in the art will understand from the foregoing disclosure, the solution presented above ensures a constant downward pressure on the contact lens 22L in a precise manner, thereby preventing corneal deformation. Simultaneously, it prevents air bubbles from entering behind the contact lens 22L. The contact lens 22L is relative to... Figure 1 The floor of the ophthalmology suite, 11, rather than the plane of the iris, is maintained in a substantially parallel (but not truly parallel) orientation. For example, by... Figure 2A The slight non-parallel tolerance achieved by the universal joint ensures this orientation. Thus, the patient's head can move up or down with breathing, achieving the lowest possible friction in terms of both static friction (“static friction”) and Coulomb friction along this vertical axis of movement. The embodiments described above can be autoclaved or disposable with different configurations, thereby facilitating wider adoption of this instruction. These and other incidental benefits will be readily understood by those skilled in the art in light of the foregoing disclosure.

[0043] The detailed descriptions and accompanying drawings are intended to be supportive and descriptive of this disclosure, but the scope of this disclosure is defined only by the claims. While some best modes and other embodiments for implementing the claimed disclosure have been described in detail, various alternative designs and embodiments exist to practice the disclosure as defined in the appended claims.

[0044] Furthermore, the features of the embodiments shown in the accompanying drawings or the various embodiments mentioned in this specification are not necessarily to be construed as independent embodiments. Rather, each feature described in one of these examples of embodiments may be combined with one or more other desired features from other embodiments to produce other embodiments not described in words or with reference to the accompanying drawings. Accordingly, such other embodiments fall within the scope of the appended claims.

Claims

1. A contact-based wide-angle visualization system ("WAVS") for use in an ophthalmic suite equipped with a microscope, the contact-based WAVS comprising: A constant downforce (CDF) assembly having a proximal end and a distal end, wherein the proximal end of the CDF assembly is configured to be connected to the optical head of the microscope via an intermediate connecting arm; and A contact lens device, connectable to the distal end of the CDF assembly, and including a contact lens configured to be worn on the cornea of ​​a patient's eye located in the ophthalmology suite, wherein the CDF assembly is configured to (i) provide a constant downforce to the contact lens device and (ii) self-level, thereby maintaining the contact lens device in a generally parallel orientation relative to the floor of the ophthalmology suite.

2. The contact-based WAVS as described in claim 1, further comprising: A gimbal, connected to the distal end of the CDF assembly and to the contact lens device, wherein the gimbal maintains the generally parallel orientation by limiting the pitch and / or tilt of the contact lens device.

3. The contact-based WAVS as described in claim 1, wherein, The contact lens device includes: A support frame, configured to support the contact lens; and A support frame arm, which is connected to the support frame and to the CDF assembly.

4. The contact-based WAVS as described in claim 1, wherein, The CDF assembly includes a shaft externally connected to a bearing housing containing an instrument bearing, wherein the bearing housing is capable of translation along the longitudinal axis of the shaft.

5. The contact-based WAVS as described in claim 4, further comprising: One or more constant force springs, the one or more constant force springs being connected to or surrounding the shaft.

6. The contact-based WAVS as described in claim 1, wherein, The CDF assembly includes a miniature gas spring.

7. The contact-based WAVS as described in claim 1, wherein, The CDF assembly includes a four-bar linkage operably connected to a low-friction cylinder having a low-friction piston disposed therein, wherein the longitudinal axis of the piston is laterally offset from the four-bar linkage.

8. The contact-based WAVS as described in claim 7, wherein, The end of the piston is operatively connected to the contact lens device.

9. The contact-based WAVS as described in claim 8, wherein, The low-friction cylinder is constructed of borosilicate glass.

10. The contact-based WAVS as described in claim 1, further comprising: The connecting arm located in the middle.

11. A contact-based wide-angle visualization system ("WAVS") for use in an ophthalmic suite equipped with a microscope, the contact-based WAVS comprising: A constant downforce (CDF) assembly having a proximal end and a distal end, wherein the proximal end of the CDF assembly is configured to be connected to the optical head of the microscope via an intermediate connecting arm; A contact lens assembly, connectable to a distal end of the CDF assembly, and comprising: a contact lens configured to be worn on the cornea of ​​a patient's eye located in the ophthalmology suite; a support frame configured to support the contact lens; and a support frame arm connected to the support frame and connected to the CDF assembly; and A gimbal, connected to the distal end of the CDF assembly and to the contact lens device, wherein the CDF assembly is configured to provide a constant downforce to the contact lens device and self-level, thereby maintaining the contact lens device in a generally parallel orientation relative to the floor of the ophthalmology suite, and wherein the gimbal maintains the generally parallel orientation by limiting the pitch and / or tilt of the contact lens device.

12. The contact-based WAVS as described in claim 11, wherein, The CDF assembly includes a shaft externally connected to a bearing housing containing an instrument bearing, wherein the bearing housing is capable of translation along the longitudinal axis of the shaft.

13. The contact-based WAVS as described in claim 12, further comprising: One or more constant force springs, the one or more constant force springs being connected to or surrounding the shaft.

14. The contact-based WAVS as described in claim 11, wherein, The CDF assembly includes a miniature gas spring.

15. The contact-based WAVS as described in claim 11, wherein, The CDF assembly includes a four-bar linkage operatively connected to a low-friction cylinder.

16. The contact-based WAVS as described in claim 15, wherein, The low-friction cylinder has a piston disposed therein, the longitudinal axis of the piston being laterally offset from the four-bar linkage, and the end of the piston being operatively connected to the contact lens device.

17. A system comprising: A connecting arm configured to connect to the optical head of a microscope; as well as A contact-based wide-angle visualization system ("WAVS") for use in ophthalmic suites equipped with microscopes, the contact-based WAVS comprising: A constant downforce (CDF) assembly having a proximal end and a distal end, wherein the proximal end of the CDF assembly is configured to connect to the connecting arm, wherein the CDF assembly includes a shaft externally connected to a bearing housing containing an instrument bearing, the bearing housing being translatable along the longitudinal axis of the shaft, and wherein one or more constant force springs are connected to or surrounding the shaft; and A contact lens device, connectable to the distal end of the CDF assembly, and including a contact lens configured to be worn on the cornea of ​​a patient's eye located in the ophthalmology suite, wherein the CDF assembly is configured to provide a constant downforce to the contact lens device and to self-level, thereby maintaining the contact lens device in a generally parallel orientation relative to the floor of the ophthalmology suite.

18. The system of claim 17, further comprising: A gimbal, connected to the distal end of the CDF assembly and to the contact lens device, wherein the gimbal maintains the generally parallel orientation by limiting the pitch and / or tilt of the contact lens device.

19. The system of claim 17, wherein, The contact lens device includes: A support frame configured to support the contact lens.

20. The system of claim 19, wherein, The contact lens device includes: A support frame arm, which is connected to the support frame and to the CDF assembly.

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