An external scleral photocoagulation banding system and apparatus

Abstract

This specification provides an operating system and device for transscleral photocoagulation, relating to the field of intelligent healthcare. The system includes: a surgical field establishment module configured to expose the target scleral region and provide a surgical field of view; an integrated operating device module configured to integrate a pressure unit, an illumination unit, and a laser emission unit; and an operation execution module configured to control the integrated operating device module to perform the following operations within the surgical field of view: activating the illumination unit; moving and pressing the pressure unit on the scleral surface to form an illumination area on the retina using illumination light transmitted through the sclera; observing the illumination area to locate and position the retinal tear; after locating the retinal tear, maintaining pressure on the corresponding scleral region of the tear with the pressure unit; switching from illumination mode to laser mode; activating the laser emission unit; performing transscleral laser photocoagulation on the retinal tissue surrounding the retinal tear; and directly observing the area until a laser spot appears around the tear to confirm the photocoagulation response.

Description

Technical Field

[0001] This invention relates to the field of intelligent medical care, and more specifically, to an operating system and device for scleral photocoagulation buckles. Background Technology

[0002] Rhegmatogenous retinal detachment (RRD) is a common blinding eye disease. Scleral buckling surgery is one of the important surgical procedures for treating rhegmatogenous retinal detachment. Its core principle is to place a pad on the outer wall of the eyeball (sclera) to make the sclera bulge inward, press and close the retinal tear, and drain the subretinal fluid, so that the retina can be repositioned.

[0003] The basic principles of scleral buckling surgery design are: simplicity, minimal combination, minimal surgical volume, and external eye surgery as much as possible. The key to the success of this surgery lies in: (1) intraoperative localization and marking of the retinal tear, and (2) adhesive closure of the retina and retinal pigment epithelium (RPE) around the tear. Accurate localization of the tear. For (1) above, the traditional method relies on the surgeon to observe through an indirect ophthalmoscope and use a purely mechanical locator to press on the sclera to indirectly determine the location of the tear. The operation relies on experience, and there are errors in judging the spatial correspondence between the pressure point and the retinal tear, especially when combined with proliferative vitreoretinopathy (PVR), the edge of the tear is difficult to identify clearly. For (2) above, the existing standard technique generally adopts the "buckle + external scleral cryotherapy" mode, that is, after locating the tear, a special cryopen is used to freeze the scleral area corresponding to the tear, and the inflammatory response induced by low temperature causes adhesion between the retina and RPE. However, this technique has significant drawbacks: First, the intensity of cryotherapy is difficult to control precisely. Excessive cryotherapy can damage the blood-retinal barrier, significantly increasing the risk of subretinal and vitreous proliferative membrane formation after surgery, which is one of the important reasons for postoperative re-detachment. Second, the cryotherapy operation itself requires additional specialized equipment (cryotherapy machine and cryopen), and the observation of the freezing reaction (ice ball formation and thawing) is delayed, affecting the smoothness and accuracy of the operation.

[0004] Although laser photocoagulation is a mature, precise adhesion technique with fewer side effects in ophthalmology (such as the treatment of fundus diseases), it has not been able to replace cryotherapy in scleral buckling surgery due to the limited functionality of traditional surgical instruments. If the surgeon wants to use photocoagulation, an intraocular fiber must be inserted after the buckling surgery to perform intraocular photocoagulation, which greatly increases the complexity, trauma, and risk of the procedure. Summary of the Invention

[0005] This invention aims to at least solve one of the technical problems existing in the prior art. To this end, this invention provides a scleral photocoagulation buckling system and device, which integrates illumination positioning and laser photocoagulation functions into a single device, realizing a new "buckle + photocoagulation" mode during surgery. This replaces uncontrollable condensation with controllable transscleral laser photocoagulation under direct vision, thereby reducing surgically induced proliferation and improving the long-term retinal reattachment rate.

[0006] The first aspect of this application discloses an external scleral light-coating buckle operating system, comprising: The surgical field creation module is configured to expose the target scleral region and provide a surgical field of view; An integrated operating device module is configured to integrate an abutting part for pressing the sclera, an illumination unit for generating visible illumination, and a laser emitting unit for generating therapeutic laser, wherein the optical paths of the illumination unit and the laser emitting unit are guided to the working end of the abutting part; The operation execution module is configured to control the integrated operation device module to perform the following operations within the surgical field: The illumination unit is activated, and the pressing part moves and presses against the scleral surface. The illumination area is formed on the retina by the illumination light transmitted through the sclera. The illumination area is observed to locate and position the retinal tear. The illumination provided by the illumination unit is used to enhance the visibility of the pressing position and clearly show the boundary of the retinal tear. After locating the retinal tear, maintain the pressure of the top pressure portion on the scleral area corresponding to the tear, switch from illumination mode to laser mode, activate the laser emission unit, and perform transscleral laser photocoagulation on the retinal tissue around the retinal tear. Directly observe in the field of view until a laser spot appears around the tear to confirm the photocoagulation reaction.

[0007] A second aspect of this application discloses an integrated scleral photocoagulation strap operating device for implementing the system described in the first aspect of this application, the device comprising: handle, The pressure part is located at the front end of the handle. The integrated light source system within the device includes a separate illumination source and a laser generator. The mode switching control located on the handle is used to switch between the illumination source and the laser generator to switch between illumination mode and laser mode; wherein the light beams emitted by the illumination source and the laser generator are focused and guided to the working end of the top pressure section, so that in illumination mode, the working end emits visible light for retinal illumination, and in laser mode, the working end emits laser light for retinal photocoagulation.

[0008] This application has the following beneficial effects: 1. This application discloses an integrated scleral photocoagulation buckling device that combines pressure, positioning, marking, illumination, and laser photocoagulation. It optimizes the surgical steps of scleral buckling and innovatively introduces scleral laser photocoagulation into scleral buckling to replace the cryotherapy step. This changes the previous buckling + cryotherapy mode to a buckling + photocoagulation mode. Precise and energy-controllable laser photocoagulation replaces uncontrollable cryotherapy, avoiding damage to the blood-retinal barrier caused by excessive low temperature. It significantly reduces subretinal and vitreous proliferation caused by the surgical procedure itself, reduces the risk of postoperative retinal proliferation, and improves the long-term postoperative repositioning rate.

[0009] 2. The integrated illumination function of this application allows the operator to directly observe the illumination area corresponding to the instrument pressure on the retina, which enhances the visibility of the pressure position under direct vision of the indirect ophthalmoscopy headlamp when locating retinal tears. The illumination can clearly show the boundary of retinal tears (especially when combined with proliferation) and the retinal proliferation status, solving the problem of unclear positioning in traditional pure mechanical pressure.

[0010] 3. This application integrates the two key steps of "positioning" and "closure" into a single instrument's continuous operation, enabling transscleral photocoagulation while positioning, forming a retinal-choroidal photocoagulation effect from outside the sclera. This eliminates the need for a scleral freezing step, achieving "coagulation upon location," avoiding position loss and secondary adjustments caused by changing instruments (from the locator to the cryoplasty pen). The process is smoother, reducing operational difficulty and improving photocoagulation accuracy, while shortening critical operation time. More importantly, animal experiments (ex vivo pig eyes) based on this application have already been completed.

[0011] 4. In this application, the laser photocoagulation reaction (the appearance of a white photocoagulation spot) is immediately visible, and the effect is intuitive and clear. Unlike the condensation reaction, which has a delay and ambiguous degree of judgment, this application's solution is easier to master and avoids operational differences caused by differences in operator experience. Attached Figure Description

[0012] To more clearly illustrate the technical solutions in the embodiments of the present invention, the accompanying drawings used in the description of the embodiments will be briefly introduced below. Obviously, the accompanying drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0013] Figure 1 This is a schematic diagram of an operating system provided in the first aspect of the present invention; Figure 2 This is a schematic diagram of the operation preparation and scleral pressure application using an isolated pig eye as an example, provided by an embodiment of the present invention. Figure 2 A is a schematic diagram showing the connection of the optical fiber and the adjustment of the lighting after powering on. Figure 2B is a schematic diagram of the operation of pressing the sclera with the top pressure section; Figure 3 This is a schematic diagram illustrating the direct observation and locating of lacerations and the formation of scleral indentations using an isolated pig eye as an example, provided by an embodiment of the present invention. Figure 3 A is a schematic diagram of the operation for direct observation to find cracks (it can also be done under a microscope and an indirect ophthalmoscope). Figure 3 B is a schematic diagram illustrating the process of forming scleral indentations. Figure 4 This is a schematic diagram illustrating the guidance for subretinal fluid drainage and transscleral photocoagulation spot formation using an isolated pig eye as an example, provided by an embodiment of the present invention. Figure 4 A is a schematic diagram of the formation of transscleral photocoagulation spots (within the green box, suitable laser parameters were determined through trial and error). Figure 4 B is a schematic diagram illustrating the procedure for discharging subretinal fluid (it can also be done under a microscope or an indirect ophthalmoscope). Detailed Implementation

[0014] To enable those skilled in the art to better understand the present invention, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings.

[0015] In some of the processes described in the specification, claims, and accompanying drawings of this invention, multiple operations appearing in a specific order are included. However, it should be clearly understood that these operations may not be executed in the order they appear herein, or may be executed in parallel. The operation numbers, such as 101, 102, etc., are merely used to distinguish different operations and do not represent any execution order. Furthermore, these processes may include more or fewer operations, and these operations may be executed sequentially or in parallel. It should be noted that the descriptions such as "first," "second," etc., in this document are used to distinguish different messages, devices, modules, etc., and do not represent a sequential order, nor do they limit "first" and "second" to different types.

[0016] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0017] Figure 1 This is a schematic diagram of an operating system for an external scleral photocoagulation strap provided in an embodiment of the present invention. Specifically, the system is executed by a robot and includes: The surgical field creation module 101 is configured to expose the target scleral region and provide a surgical field of view; In some embodiments, the subject of operation herein refers to any animal (e.g., a mammal), including but not limited to humans, non-human primates, rodents, etc., which will become the recipient of a particular treatment. Generally, the terms "subject" and "patient" are used interchangeably herein when referring to human subjects. Preferably, the subject is a human, but it can also be a pig.

[0018] In some embodiments, the surgical field of view includes the surgical field of view provided under indirect ophthalmoscopy conditions or surgical microscope conditions.

[0019] In some more specific embodiments, taking indirect ophthalmoscopy as an example, the surgical field of view provided by the target scleral region is obtained through the following operations: Step 1: Disinfection The patient lies supine, and two drops of topical anesthetic are applied to the conjunctival sac. The conjunctival sac is then rinsed with 0.025% povidone-iodine solution, and the skin of the eyelids and forehead is disinfected with 0.5% povidone-iodine solution.

[0020] Step 2: Retrobulbar anesthesia: The puncture point is chosen at the junction of the middle and outer thirds of the infraorbital margin. When inserting the needle, instruct the patient to look upwards towards the nose. Using a 26G needle, first insert it parallel to the orbital floor and vertically posteriorly to the equator, then turn posterior to the eyeball, slowly advancing between the lateral and inferior rectus muscles, reaching the posterior end of the eyeball within the muscle cone. The bevel of the needle tip should face the eyeball, and the insertion depth should not exceed 35 mm, positioning the needle tip between the ciliary ganglion and the posterior wall of the eyeball. Once no blood is aspirated, inject 2.5–3.0 mL of local anesthetic (1 mL every 10 seconds). Withdraw the needle posteriorly to the orbital septum, simultaneously injecting 1.5 mL of anesthetic (1 mL every 20 seconds) to stabilize the eyeball.

[0021] Step 3: Lay out the surgical drape, apply sterile film, and cut the palpebral fissure film. Use an eyelid speculum to open the eyelid, and make a circular cut in the bulbar conjunctiva along the corneal limbus at the location of the eye opening, in 1-2 quadrants.

[0022] Step 4: Separate the bulbar fascia: Use ophthalmic scissors to insert under the conjunctiva to open the anterior bulbar fascia, and then probe down to the equator of the eyeball to fully stretch the bulbar fascia and cut the restraining ligament.

[0023] Step 5, Suspension and Traction of the Rectus Oculi: Select the adjacent rectus muscles around the retinal detachment area and the foramen. Use a strabismus hook to hook the rectus tendon, pass a 2-0 silk suture under the muscle, tie two knots, and secure the suture with a vascular clamp for suspension. Separately, use a 4-0 needle with suture to ligate the tendons of two other rectus muscles as traction lines. Expose the sclera between the rectus muscles, check the location of the vortex veins, and note whether all muscle fibers are suspended and whether oblique muscle fibers are being tractioned.

[0024] Steps 1-5 above are all specific operations under indirect ophthalmoscope conditions, which are mature operations in the prior art. The operation under surgical microscope conditions is basically the same as the above operations, except that the indirect ophthalmoscope conditions are changed to surgical microscope conditions.

[0025] The integrated operating device module 102 is configured to integrate an abutting portion for pressing against the sclera, an illumination unit for generating visible illumination, and a laser emitting unit for generating therapeutic laser, wherein the optical paths of the illumination unit and the laser emitting unit are guided to the working end of the abutting portion; as shown in the figure. Figure 2 A is a schematic diagram of connecting the optical fiber and adjusting the lighting after powering on; In some embodiments, the operating device is a handheld or head-mounted device, and the illumination unit and the laser emission unit share at least one optical fiber to realize the transmission and switching between illumination light and therapeutic laser.

[0026] Operation execution module 103 is configured to control the integrated operation device module to perform the following operations within the surgical field: Step 6: Activate the illumination unit. The pressing part moves and presses against the scleral surface, forming an illuminated area on the retina using light transmitted through the sclera. Observe this illuminated area to locate and position the retinal tear. The illumination provided by the illumination unit enhances the visibility of the pressing position and clearly displays the boundary of the retinal tear. Figure 2 B is a schematic diagram of the operation of pressing the sclera with the top pressure section. Figure 3 A is a schematic diagram of the operation for direct observation to find cracks (it can also be done under a microscope and an indirect ophthalmoscope). In some more specific embodiments, the steps for locating a retinal tear are described using indirect ophthalmoscopy as an example. Wearing an indirect ophthalmoscopy headlamp, with one hand holding two 4-0 sutures taut and adjusting them to a position convenient for the retinal detachment area, the indirect ophthalmoscopy is held to observe the detached area and locate the tear. The product's illumination is turned on and the brightness adjusted. The sclera is gently pressed, and the device is moved from the ora serrata towards the equator. The retina in the illuminated area is located under the indirect ophthalmoscopy, and the tear is located. The conventional step 6 – locating the tear – involves gently pressing the sclera with the cryo-pen tip, moving it from the ora serrata towards the equator, and locating the tear under the indirect ophthalmoscopy.

[0027] Step 7: After locating the retinal tear, maintain the pressure of the pressure point on the corresponding scleral area of ​​the tear, switch from illumination mode to laser mode, activate the laser emission unit, and perform transscleral laser photocoagulation on the retinal tissue around the retinal tear. Observe directly in the field of view until a laser spot appears around the tear to confirm the photocoagulation reaction. Figure 4 A is a schematic diagram of the formation of transscleral photocoagulation spots (within the green box), and suitable laser parameters were determined through trial and error.

[0028] In some more specific embodiments, taking indirect ophthalmoscopy as an example, the specific steps of external scleral photocoagulation are described. After the tear is detected, the laser light source is switched and the aiming beam is turned on. The top pressure part of this product is used to press against the edge of the tear, and goggles are worn to perform external scleral photocoagulation. The energy is 200-500mW and the duration is 200-500ms. The laser penetrates the sclera and choroid, and a white laser spot appears on the retina, directly visible around the tear. The conventional step 7 is the scleral cryotherapy step, specifically: after the tear is detected, the cryotherapy pen tip is used to press against the edge of the tear to perform scleral cryotherapy. The cryotherapy pen tip penetrates the sclera and choroid, and the position of the cryotherapy pen tip is directly visible on the retina. Cryotherapy is stopped when the color of the cryotherapy reaction reaches white. The cryotherapy temperature is below -70℃, and the cryotherapy range is 2-5mm.

[0029] In some embodiments, the laser parameters emitted by the laser emitting unit are: energy 200-500mW, duration 200-500ms.

[0030] In some embodiments, the operation execution module is further configured to: after confirming the photocoagulation reaction, use the pressure portion of the same integrated operation device module to make a pressure mark on the scleral surface corresponding to the photocoagulated retinal tear, such as... Figure 3 B is a schematic diagram of the operation for forming an indentation on the scleral surface. In some more specific embodiments, taking indirect ophthalmoscopy as an example, the specific steps are as follows: Step 8, using this product to press against the sclera, lifting the tear under the observation of the indirect ophthalmoscopy headlamp, applying pressure with the annular surface of the front end of this product, and forming a positioning indentation on the scleral surface.

[0031] In some embodiments, the system further includes a buckling surgery execution module configured to perform subsequent pad fixation operations based on the pressure mark, thereby realizing a scleral buckling surgery that incorporates transscleral photocoagulation.

[0032] In some more specific embodiments, taking indirect ophthalmoscopy as an example, specifically: Step 9, Methylene Blue Marking: Use 2% methylene blue injection solution to stain the end of a cotton swab, and gently press and stain the circular indentation formed on the outside of the sclera. The cotton swab picks up excess dye to form a positioning point for staining the outside of the sclera.

[0033] Step 10, Pre-fabricate the stitches: Design prefabricated sutures in a circular or radial pattern, centered on the suture hole location mark. Apply pressure with a sponge or silicone block at the suture span before, after, or to the sides of the suture hole, adding 2mm to the width of the suture. Hold tweezers or a cotton swab in one hand to apply pressure and fix the eyeball, while using 5-0 polyester suture or 6-0 Prolene suture to stitch the two ends sequentially in a mattress or figure-eight pattern. Pass through 1 / 2 to 1 / 3 of the sclera's thickness, travel approximately 3-5mm, exit the needle, wrap the suture 2-4 times, and tie a slip knot. Repeat this process to create several more prefabricated sutures.

[0034] Step 11, as follows Figure 4 Figure B shows a schematic diagram for guiding the drainage of subretinal fluid (this can also be done under a microscope or indirect ophthalmoscopy). Select the highest point of the retinal bulge or a location that allows safe access to the subretinal space. Insert the scalpel at a 45° angle into the sclera for approximately 1-2 mm. Once the scalpel is withdrawn, subretinal fluid will flow out. Gently press the lower lip of the incision with the scalpel tip, and use a cotton swab or forceps to gently press the eyeball to help drain the fluid. When the fluid flow slows or a small amount of pigment flows out, the drainage is complete; stop the drainage procedure at this point. Maintain constant pressure on the eyeball.

[0035] Step 12: Pre-fix the padding material, loosen the pre-made sutures, insert the curved tweezers between the sclera and the sutures in sequence, pull the padding material in from one end, adjust the position of the padding material and the sutures and the contact surface with the sclera, tighten the pre-made sutures and tie them into slip knots one by one.

[0036] Step 13: Verify the location of the eye tear. Put the headlamp back on. With one hand, use tweezers to hold the center of the padding material and press it towards the center of the eyeball. With the other hand, hold an indirect lens to observe the position, height, and relationship of the padding ridge formed inside the eye to the eye tear location. Ideally, the eye tear should be completely located on the anterior slope of the padding ridge. For radial padding, the left and right edges of the eye tear must also be on the padding ridge. If the eye tear is flat, it is an ideal padding. If the intraocular pressure is low or the eye tear is open like a fish mouth, inject an appropriate amount of air into the eye from 4mm behind the cornea to increase the intraocular pressure and flatten the eye tear.

[0037] Step 14, Secure the padding material Loosen the loose knots from the above steps and tighten the stitches further. The tightness should be such that the height of the sclera when the stitches are tightened is flush with the edge of the padding. Finally, tie three knots and cut the thread ends, leaving 3mm.

[0038] Step 15, close the conjunctival incision. Using 8-0 absorbable sutures, intermittently suture the free end of the conjunctiva at the radial incisions near the cornea, ensuring the conjunctiva is precisely restored to its anatomical position. The number of sutures depends on the number of radial incisions. Simultaneously, at the conjunctival flap with greater free space at the corneal limbus, several intermittent sutures are made across the superficial sclera to fix the conjunctiva and prevent it from covering the cornea later. Excess bulbar fascia is trimmed to prevent poor conjunctival healing.

[0039] Step 16: After the procedure, remove the eyelid speculum, peel off the sterile dressing, apply eye ointment, and bandage the eye.

[0040] Steps 8-16 above are all specific operations under indirect ophthalmoscopy conditions, which are mature operations in the prior art. The operation under surgical microscope conditions is basically the same as the above operations, except that the indirect ophthalmoscopy conditions are changed to surgical microscope conditions.

[0041] The second aspect of this application discloses an integrated scleral photocoagulation strap operating device for implementing the system described in the first aspect of this application, the device comprising: handle, The pressure part is located at the front end of the handle. The integrated light source system within the device includes a separate illumination source and a laser generator. The mode switching control located on the handle is used to switch between the illumination source and the laser generator to switch between illumination mode and laser mode; wherein the light beams emitted by the illumination source and the laser generator are focused and guided to the working end of the top pressure section, so that in illumination mode, the working end emits visible light for retinal illumination, and in laser mode, the working end emits laser light for retinal photocoagulation.

[0042] In some embodiments, the device further includes at least one optical fiber, one end of which is coupled to the illumination source and / or the laser emitting unit, and the other end extends to the working end of the top pressure section.

[0043] In some embodiments, the lighting source and the laser emitting unit share at least one optical fiber.

[0044] In some embodiments, the working end of the pressure portion is used to form an indentation on the scleral surface as a positioning mark.

[0045] The exemplary embodiments of this disclosure described in detail above are merely illustrative and not restrictive. Those skilled in the art will understand that various modifications and combinations can be made to these embodiments or their features without departing from the principles and spirit of this disclosure, and such modifications should fall within the scope of this disclosure.

Claims

1. A scleral photocoagulation buckle operating system, characterized in that, include: The surgical field creation module is configured to expose the target scleral region and provide a surgical field of view; An integrated operating device module is configured to integrate an abutting part for pressing the sclera, an illumination unit for generating visible illumination, and a laser emitting unit for generating therapeutic laser, wherein the optical paths of the illumination unit and the laser emitting unit are guided to the working end of the abutting part; The operation execution module is configured to control the integrated operation device module to perform the following operations within the surgical field: The illumination unit is turned on, and the pressing part moves and presses against the scleral surface. An illumination area is formed on the retina by the illumination light transmitted through the sclera. The illumination area is observed to find and locate the retinal tear. After locating the retinal tear, maintain the pressure of the top pressure portion on the scleral area corresponding to the tear, switch from illumination mode to laser mode, activate the laser emission unit, and perform transscleral laser photocoagulation on the retinal tissue around the retinal tear. Directly observe in the field of view until a laser spot appears around the tear to confirm the photocoagulation reaction.

2. The scleral photocoagulation buckle operating system according to claim 1, characterized in that, The laser parameters emitted by the laser emitting unit are: energy 200-500mW, duration 200-500ms.

3. The scleral photocoagulation buckle operating system according to claim 1, characterized in that, The surgical field of view includes the surgical field of view provided under indirect ophthalmoscopy or surgical microscope conditions.

4. The scleral photocoagulation buckle operating system according to claim 1, characterized in that, The operating device is a handheld or head-mounted device. The illumination unit and the laser emission unit share at least one optical fiber to realize the transmission and switching between illumination light and therapeutic laser.

5. The scleral photocoagulation buckle operating system according to claim 3, characterized in that, The operation execution module is further configured to: after confirming the photocoagulation reaction, use the pressure section of the same integrated operation device module to make a pressure mark on the scleral surface corresponding to the photocoagulated retinal tear.

6. The scleral photocoagulation buckle operating system according to claim 1, characterized in that, The procedure also includes a buckling surgery execution module, configured to perform subsequent padding fixation operations based on the pressure mark, thereby realizing a scleral buckling surgery that integrates transscleral photocoagulation.

7. An integrated scleral photocoagulation strap operating device for implementing the system according to any one of claims 1-6, characterized in that, The device includes: handle, The pressure part is located at the front end of the handle. The integrated light source system within the device includes a separate illumination source and a laser generator. The mode switching control located on the handle is used to switch between the illumination source and the laser generator to switch between illumination mode and laser mode; wherein the light beams emitted by the illumination source and the laser generator are focused and guided to the working end of the top pressure section, so that in illumination mode, the working end emits visible light for retinal illumination, and in laser mode, the working end emits laser light for retinal photocoagulation.

8. The integrated scleral external light gel buckle operating device according to claim 7, characterized in that, The device further includes at least one optical fiber, one end of which is coupled to the illumination source and / or the laser emitting unit, and the other end extends to the working end of the top pressure section.

9. The integrated scleral external light gel buckle operating device according to claim 8, characterized in that, The lighting source and the laser emitting unit share at least one optical fiber.

10. The integrated scleral external light gel buckle operating device according to claim 7, characterized in that, The working end of the top pressing part is used to form an indentation on the scleral surface as a positioning mark.

Images