Surgical microscope and methods for highlighting eye lens fragments

Abstract

Method for highlighting eye lens fragments in an image obtained from an eye (3) using a surgical microscope (1, 101), wherein the surgical microscope (1, 101) comprises at least one observation beam path for generating an optical image of the eye (3), an illumination device (40) for illuminating the eye (3), at least one digital camera (21, 121) for capturing the optical image of the eye (3), and an image processing unit (50, 150), wherein: - the eye (3) is illuminated by means of the illumination device (40) with an illumination light that contrasts with the eye lens fragments in order to generate an optical contrast image contrasting with the eye lens fragments using the observation beam path (9) as the optical image of the eye (3), wherein the illumination light contrasting with the eye lens fragments is light reflected from the retina; - the optical contrast image is processed with the at least one digital camera (21,121) is recorded and converted into a digital contrast image, - areas of increased contrast are located in the digital contrast image with the aid of the image processing unit (50, 150), - an overlay image representing the areas of increased contrast is generated by the image processing unit (50, 150), the size of which is adapted at least to the optical contrast image or the digital contrast image, - the overlay image is superimposed at least on the optical contrast image or the digital contrast image, and - at least the optical contrast image or the digital contrast image superimposed with the overlay image is output as the image obtained from the eye (3) by means of the operating microscope (1, 101).

Description

[0001] The present invention relates to a method for highlighting fragments of the eye lens in an image obtained of an eye using an operating microscope. The invention further relates to an operating microscope suitable for carrying out this method.

[0002] In cataract surgery, clouded lenses are removed and replaced with intraocular lenses. The eye's lens consists of a lens capsule and a lens nucleus. During cataract surgery, the lens nucleus is fragmented and aspirated, and the intraocular lens is inserted into the remaining lens capsule. This fragmentation and aspiration is performed, for example, using a tube whose tip vibrates at an ultrasonic frequency, breaking up the lens nucleus so that the fragments can be suctioned out. This procedure is known as phacoemulsification. Instead of ultrasound, the lens nucleus can also be fragmented using a laser. In cases of very soft cataracts, aspiration may even be possible without fragmenting the lens nucleus.To visualize the lens fragments during phacoemulsification, contrasting illumination is typically used, such as red-reflection illumination, in which the retina is illuminated and the red light reflected from the retina makes the transparent lens fragments appear contrasty. Although red-reflection illumination provides a contrasting view of the lens fragments, the contrast is sometimes weak, making the lens fragments difficult to see, especially, but not exclusively, for surgeons with poor vision.

[0003] From DE 10 2009 053 208 A1, a device for monitoring the implantation of an intraocular lens is known. In this device, an image processing unit in conjunction with an operating microscope serves to overcome problems associated with the poor visual visibility of the lens capsule after removal of the lens nucleus and the intraocular lens during cataract surgery. The image processing unit and a human-machine interface transmit information to the surgeon for quality assurance of their actions. This information can include warning signals or directional arrows indicating the direction in which the surgeon may rotate or move the instrument or the intraocular lens.

[0004] The object of the present invention is to provide a method and an operating microscope that make it possible to clearly show lens fragments in the image of the operating microscope during the shattering of the lens for the treating physician.

[0005] This problem is solved by a method for highlighting eye lens fragments according to claim 1 or by a surgical microscope according to claim 9. The dependent claims contain advantageous embodiments of the invention.

[0006] According to the invention, a method for the highlighted display of lens fragments, i.e., fragments of the lens nucleus, in an image obtained from an eye using a surgical microscope is provided. The surgical microscope comprises at least one observation beam path for generating an optical image of the eye, an illumination device for illuminating the eye, at least one digital camera for capturing the optical image of the eye, and an image processing unit. In the method, the eye is illuminated with the illumination device using light that contrasts with the lens fragments in order to generate an optical contrast image of the lens fragments using the observation beam path. The optical contrast image is captured with the at least one digital camera and converted into a digital contrast image.In the digital contrast image, areas of increased contrast are detected using the image processing unit, and the image processing unit generates a superimposed image representing these areas of increased contrast. This superimposed image is at least as large as the optical or digital contrast image. It is then superimposed on either the optical or digital contrast image. At least the optical or digital contrast image superimposed on the superimposed image is then displayed as the image obtained from the eye using the operating microscope.

[0007] The method according to the invention allows the surgeon to easily identify pieces of the eye lens during cataract surgery, even when the contrasting illumination, such as red reflex illumination, results in only weak contrast. This significantly facilitates cataract surgery for the surgeon, particularly for surgeons with poor eyesight.

[0008] The at least one observation beam path can lead to at least one eyepiece of the operating microscope. In this case, the superimposed image in the observation beam path leading to the at least one eyepiece can be superimposed on the optical contrast image by means of at least one mirror device, so that the lens fragments of the eye are highlighted in the eyepiece image. The at least one eyepiece can be a purely optical eyepiece, which allows direct viewing of the image of the eye superimposed on the superimposed image, or an electronic eyepiece, which allows the image to be displayed using a monitor, smart glasses, or the like.

[0009] A typical operating microscope is designed as a stereomicroscope and therefore has two eyepieces. In this case, it may also have two cameras and two collimators, namely one camera and one collimator for each stereoscopic partial beam path of the stereomicroscope. The observation beam path then comprises a first stereoscopic partial beam path leading to a first eyepiece and a second stereoscopic partial beam path leading to a second eyepiece. The optical contrast image is, in this case, a stereoscopic optical contrast image with a first optical contrast sub-image and a second contrast sub-image. In each of the stereoscopic partial beam paths, the respective optical contrast sub-image is captured by a digital camera, which creates a first and second digital contrast sub-image, respectively, from the corresponding optical contrast sub-image.The image processing unit then detects areas of increased contrast in the first and second digital contrast sub-images, generates a first overlay image representing these areas in the first digital contrast sub-image, and a second overlay image representing these areas in the second digital contrast sub-image. The first and second overlay images are sized to match the first and second optical contrast sub-images, respectively, and together they form a stereoscopic overlay image.In the first stereoscopic observation beam path, a first image-imaging device superimposes the first image onto the first optical contrast image. In the second stereoscopic observation beam path, a second image-imaging device superimposes the second image onto the second optical contrast image. The first optical contrast image superimposed on the first image and the second optical contrast image superimposed on the second image are then output as a stereoscopic image of the eye obtained through the operating microscope. In this way, the treating physician can be presented with a three-dimensional image with highlighted sections of the eye's lens.

[0010] If superimposing the inset image(s) onto the optical contrast image(s) is not desired, or is not possible (e.g., due to the lack of a mirror in the observation beam path), the inset image can be superimposed onto the digital contrast image using an electronic superposition unit. This electronic superposition is also possible, of course, if the inset image(s) are superimposed onto the optical contrast image(s), for example, for documentation purposes or when a cataract operation is being displayed on an external monitor for teaching purposes.

[0011] Light reflected from the retina can be used to provide contrasting illumination for the eye lens fragments. This type of illumination is also called red-reflection illumination because the operating microscope's illumination system essentially illuminates the retina, and the reddish light reflected back from the retina then contrasts with the eye lens fragments. This is typically achieved using an illumination system that enables so-called 0° illumination or coaxial illumination. With 0° illumination, the light is directed primarily along the optical axis of the microscope's main objective or at a very small angle to it (max. 6°), allowing even deep surgical channels to be illuminated and, in particular, enabling illumination of the retina through the eye's aperture.In coaxial illumination, the illumination occurs along the optical axes of the two stereoscopic observation beam paths, which also enables the illumination of deep surgical channels and thus the illumination of the retina through the eye's aperture.

[0012] To locate areas of increased contrast, a high-pass filter can be used in the image processing unit. A high-pass filter enables the detection of edges in the image, i.e., areas with large differences in brightness. Typically, a threshold value is set for the difference in intensity, which must be exceeded to identify the edge as such. In this way, the edges of eye lens fragments can be located and then displayed in the superimposed image. The areas of increased contrast can be represented in the superimposed image by, for example, highlighting the edges with color or by highlighting the areas enclosed by the edges with color.

[0013] Since the goal is merely to improve the visualization of the eye lens fragments, it is sufficient to locate the areas of increased contrast in the region of the eye's aperture, i.e., where the eye lens fragments are located. In an advantageous embodiment of the inventive method, the image processing unit can divide the contrast image into a central area corresponding to the eye's aperture and a peripheral area surrounding it. In this case, the detection of areas of increased contrast occurs only in the central area, i.e., in the region of the image corresponding to the eye's aperture. This reduces the processing effort. Furthermore, it avoids the need to highlight areas using the superimposed image that do not correspond to eye lens fragments.

[0014] An operating microscope according to the invention for generating an image of an eye, wherein lens fragments are highlighted in the image, comprises an observation beam path for generating an optical image of the eye and an illumination device for illuminating the eye. The illumination device is designed to illuminate the eye with light that contrasts with the lens fragments, in order to generate an optical contrast image of the eye that contrasts with the lens fragments when viewed via the observation beam path. It can, for example, be configured to enable 0° illumination and / or coaxial illumination, thus enabling red-reflected illumination. Furthermore, the illumination device can also enable oblique illumination, i.e.,An illumination system in which the optical axis of the illumination beam path forms an angle greater than 6° with the optical axis of the main objective, in order to illuminate the area surrounding the surgical site.

[0015] Furthermore, the surgical microscope according to the invention comprises at least one digital camera to which the optical contrast image is fed and which creates and outputs a digital contrast image from the optical contrast image. An image processing unit is connected to the digital camera for receiving the digital contrast image. This image processing unit is configured to detect areas of increased contrast in the digital contrast image and to generate and output an overlay image representing these areas of increased contrast. The size of the overlay image is adapted to the digital contrast image or the optical contrast image.

[0016] The surgical microscope according to the invention also comprises at least one superimposition device for superimposing the optical contrast image or the digital contrast image with the superimposed image and for outputting the optical contrast image superimposed with the superimposed image or the digital contrast image superimposed with the superimposed image as the image of the eye in which eye lens fragments are highlighted.

[0017] The operating microscope according to the invention makes it possible to carry out the method according to the invention, so that the properties and advantages described with reference to the method according to the invention can be realized with the operating microscope according to the invention.

[0018] In the surgical microscope according to the invention, the observation beam path can lead to at least one eyepiece. In this case, the superposition device can comprise a mirror device for superimposing image information into the observation beam path, wherein the mirror device for receiving the superimposed image is connected to the image processing unit and is configured to superimpose the received superimposed image onto the optical contrast image in the observation beam path leading to the at least one eyepiece. In this way, the lens fragments of the eye can be highlighted in the image viewed with the at least one eyepiece image. The at least one eyepiece can be a purely optical eyepiece or an electronic eyepiece, as has been explained with reference to the method according to the invention.

[0019] To prevent the superimposed image from interfering with the processing of the optical contrast image captured by at least one camera, the at least one camera can be positioned in at least one observation beam path such that it captures the optical contrast image without the superimposed image. For this purpose, the camera can be positioned upstream of the mirroring device in the observation beam path. If two observation beam paths are present, it is also possible to position the camera in one observation beam path and the mirroring device in the other.

[0020] The surgical microscope according to the invention can, in particular, be a stereomicroscope. In this case, the observation beam path comprises a first stereoscopic partial beam path leading to a first eyepiece and a second stereoscopic partial beam path leading to a second eyepiece. The optical contrast image is then a stereoscopic optical contrast image with a first optical contrast sub-image and a second contrast sub-image. Furthermore, a digital camera is arranged in each of the stereoscopic partial beam paths, to which the respective optical contrast sub-image is fed and which creates a first or second digital contrast sub-image from the respective optical contrast sub-image.Furthermore, the image processing unit is designed to detect areas of increased contrast in the digital contrast sub-images and to generate and output a first superimposed sub-image representing the areas of increased contrast in the first digital contrast sub-image and a second superimposed sub-image representing the areas of increased contrast in the second digital contrast sub-image, wherein the first superimposed sub-image and the second superimposed sub-image are adapted in size to the first optical contrast sub-image and the second optical contrast sub-image and together form a stereoscopic superimposed image.The superposition device comprises a first mirroring device for mirroring image information into the first stereoscopic observation beam path and a second mirroring device for mirroring image information into the second stereoscopic observation beam path, wherein the first mirroring device for receiving the first superimposed image and the second mirroring device for receiving the second superimposed image are connected to the image processing unit. The first mirroring device is configured to superimpose the received first superimposed image onto the first optical contrast image in the first stereoscopic observation beam path, and the second mirroring device is configured to superimpose the received second superimposed image onto the second optical contrast image in the second stereoscopic observation beam path.Such an operating microscope makes it possible to present a treating physician with a three-dimensional image showing highlighted parts of the eye's lens.

[0021] If superimposing the digital contrast image or partial images onto the optical contrast image or partial optical contrast images is not desired or is not possible, for example, due to the lack of a mirror in the observation beam path, the superimposition device of the surgical microscope according to the invention can include an electronic superimposition unit for electronically superimposing the digital contrast image with the digital contrast image. Naturally, this electronic superimposition is also provided when superimposing the digital contrast image or partial images onto the optical contrast image or partial optical contrast images, for example, for documentation purposes or when a cataract operation is displayed on an external monitor for teaching purposes.

[0022] To locate the areas of increased contrast, the image processing unit can include a high-pass filter with which edges in the contrast image can be located, as has been described with reference to the method according to the invention.

[0023] The image processing unit can also be designed to represent the areas of increased contrast in the superimposed image by means of color-highlighted areas or color-highlighted edges, as has already been described with reference to the method according to the invention.

[0024] The surgical microscope according to the invention can in particular be designed as a stereomicroscope, i.e., the observation beam path has two stereoscopic partial beam paths, each leading to a separate eyepiece. It is possible either to provide a camera and a mirror device in only one of the two stereoscopic partial beam paths or to provide a camera and a mirror device in each of the two stereoscopic partial beam paths.

[0025] Further features, properties and advantages of the present invention will become apparent from the following description of exemplary embodiments with reference to the accompanying figures.

[0026] Fig. Figure 1 essentially shows the optical components of a first embodiment of an operating microscope according to the invention.

[0027] Fig. Figure 2 essentially shows the electronic components of a first embodiment of an operating microscope according to the invention.

[0028] Fig. Figure 3 shows, using a flowchart, an exemplary embodiment for highlighting eye lens fragments in an image obtained using the operating microscope.

[0029] Fig. Figure 4 essentially shows the electronic components of a second embodiment of an operating microscope according to the invention.

[0030] The Fig. 1 and Fig. Figure 2 shows a schematic representation of a first embodiment of an operating microscope according to the invention. 1 , how it can be used in cataract surgery. This shows Fig. 1 essentially the optical components of the operating microscope 1 and Fig. 2 essentially the electronic components.

[0031] The operating microscope shown 1 encompasses an object of observation 3 lens to be turned 5 , which in the present example is represented as an achromatic lens constructed from at least two cemented partial lenses. The object field 3 , which in this case lies in the eye lens, is focused in the focal plane of the lens 5 arranged so that it is mapped to infinity, i.e., a projection from the observed object 3 outgoing divergent beam of rays 7 during its passage through the lens 5 into a parallel beam of rays 9 is converted.

[0032] Instead of just one achromatic lens, as used in the present example as the objective lens 5 If used, an objective lens system consisting of several individual lenses can also be used, such as a so-called varifocal lens, which allows the focal length of the operating microscope to be adjusted.1 , i.e., the distance of the focal plane from the lens 5 , which can be varied. By varying the cutting width, an operating microscope can 1 The variable lens can be adapted to different working distances without having to change the position of the operating microscope itself. Even in such a variable system, the object field arranged in the focal plane is 3 Imaged towards infinity, so that even with a varifocal lens, a parallel beam of rays is present on the observer's side.

[0033] observer side of the lens 5 is a magnifying device 11A , 11BThe lenses can be arranged in a way that allows for stepless changes in magnification, as in the example shown, or as a so-called Galilean changer for stepless changes in magnification. In a zoom system, exemplified by a lens combination with three lenses, the two lenses on the object side can be moved to vary the magnification. In reality, however, the zoom system can also have more than three lenses, for example, four or more, in which case the two outer lenses can be fixed. In contrast, a Galilean changer has several fixed lens combinations representing different magnifications that can be interchanged in the beam path. Both a zoom system and a Galilean changer transform a parallel beam of light from the object side into a parallel beam of light from the observer side with a different beam diameter.The magnifying device. 11A , 11B is often already part of the binocular beam path of the operating microscope. 1 , i.e., it has a separate lens combination for each stereoscopic observation beam path of the operating microscope. 1 on.

[0034] To the magnifying device 11A , 11B On the observer side, an outcoupling arrangement is completed. 8A , 8B with beam splitter prisms 10A , 10B on, with whose help each stereoscopic partial beam can be used 9A , 9B Each part is extracted and connected to the corresponding partial beam path of the operating microscope. 1 connected camera 21A , 21B with a digital image sensor 23A , 23B is forwarded. The cameras 21A , 21B , which are connected to the coupling arrangement 8A , 8Busing camera adapters 19A , 19B , with which a focal length adjustment is performed, are coupled to an image processing unit 50 connected (see Fig. 2), to which the image sensors 23A , 23B The generated digital images are output. In the present embodiment, the image processing unit includes 50 A high-pass filter is used to evaluate the digital images. 51 The evaluation of the digital images will be carried out later with reference to Fig. 3 will be explained. The image processing unit 50 In the present embodiment, the control of the magnification device is also included. 11A , 11B connected in order to receive the set magnification factor from it.

[0035] The operating microscope 1 It also includes displays. 37A , 37B, on which superimposed images can be displayed for superimposition into the observation beam paths. In this case, the superimposed images are generated by the image processing unit. 50 generated, with which the displays 37A , 37B are paired. Each display 37A , 37B is a drop-in lens 39A , 39B and a beam splitter prism 15A , 15B a coupling arrangement 13A , 13B assigned, with the help of which in the binocular tube 27 leading part of the observation beam path of the operating microscope 1 one from a display 37A , 37B outgoing beam representing an inset image to the corresponding stereoscopic partial beam 9A , 9B can be superimposed.

[0036] The binocular tube 27 , which connects to the coupling arrangement on the observer side 13A ,13B shoots, has two tube objectives 29A , 29B on, which the respective parallel beam of rays 9A , 9B to an intermediate image level 31A , 31B to focus, i.e., the object of observation 3 to the respective intermediate image level 31A , 31B to depict. The intermediate image planes 31A , 31B The intermediate images are then processed by ocular lenses. 35A , 35B The image is then projected to infinity, allowing a surgeon to view the intermediate image with relaxed eyes. Furthermore, this is achieved within the binocular tube using a mirror system or prisms. 33A , 33B an increase in the distance between the two partial beams 9A , 9B , in order to adjust it to the viewer's interpupillary distance. Using the mirror system or prisms. 33A , 33B Additionally, the image is straightened.

[0037] The operating microscope 1 It also comes with a lighting device 40 equipped with which the object of observation 3 It can be illuminated with lighting. For this purpose, the lighting device has a light source. 41 , for example a halogen incandescent lamp, a gas discharge lamp such as a xenon lamp, one or more LEDs, etc. The light source 41 can be done directly at the operating microscope 1 or from the operating microscope 1 It should be positioned remotely, for example on a microscope stand. 41 When positioned remotely, it is connected to an operating microscope via a light guide. 1 guided.

[0038] The light source 41 The light is deflected via a mirror. 43 towards the eye 3directed. In order to enable red-reflex illumination of the eye lens, in which the retina is illuminated with illumination light, which is then reflected by the retina mainly in the red spectral range and thus illuminates the eye lens from the back of the eye with reddish light, the illumination beam path in which in Fig. The operating microscope shown in Figure 1 is designed with so-called 0° illumination. In this type of illumination, the path of the illumination beam is determined by means of a deflecting mirror. 43 between the two partial beam paths 9A , 9B through the lens 5 through along the optical axis of the lens 5 – or at an angle of less than 6° to the optical axis of the lens 5 – towards the eye 3 into the main lens 5 coupled. Due to the small angle to the optical axis of the main lens. 5When observing the eye's lens, the illumination light can pass through the eye's aperture, i.e., the pupil, to the retina. Additionally or alternatively, an illumination beam path may be present, enabling so-called coaxial illumination. In coaxial illumination, a first illumination beam path and a second illumination beam path are present, which are connected via one or more beam splitters either coaxially or at a small angle (less than 6°) to the optical axes of the observation beam paths, i.e., coaxially with the stereoscopic beam bundles. 9A , 9B, can be coupled into the operating microscope. As with 0° illumination, red-reflection illumination of the eye lens can also be achieved with coaxial illumination. With the aid of red-reflection illumination, lens fragments are displayed with higher contrast in the image obtained with the operating microscope during phacoemulsification compared to conventional illumination. To avoid damage to the retina from focused illumination, the illumination device is designed accordingly. 40 a lighting optic 42 present, which are responsible for a slightly defocused illumination of the retina of the eye. 3 provides.

[0039] Additionally, an operating microscope may also incorporate an illumination beam path designed as so-called oblique illumination. In such oblique illumination, the beam path runs at a relatively large angle (6° or more) to the optical axis of the objective lens. 5and can be completely outside the lens 5 Alternatively, it is also possible to direct the illumination beam path of the oblique lighting through an edge area of ​​the lens. 5 to allow the light to pass through. Oblique illumination can be used, for example, to illuminate the area around the surgical site during phacoemulsification.

[0040] An embodiment of the inventive method for highlighting eye lens fragments in the image of the operating microscope. 1 The following flowchart will be used to illustrate this. Fig. 3 described.

[0041] The procedure is performed while the eye lens or lens components are illuminated during phacoemulsification using red-reflect illumination, i.e., while the eye is illuminated with light that contrasts with the lens components. In the first step, S1, the image sensor is used during red-reflect illumination or other illumination suitable for contrasting the lens tissue. 23A , 23B at least one of the cameras 21A , 21B An image of the eye, hereinafter referred to as a contrast image, is taken, which is then sent as a digital contrast image to the image processing unit. 50 is issued.

[0042] In step S2, the image processing unit 50A suitable algorithm is used to locate areas of increased contrast in the digital contrast image. In the present embodiment, the algorithm is in the form of a high-pass filter. 51 This filter detects edges in the image, i.e., areas where high differences in brightness meet. When the high-pass filter is activated... 51 When used, the image processing unit can register a brightness difference as an edge if the brightness difference exceeds a certain predefined threshold. In red-reflection illumination, parts of the eye's lens are displayed with contrast, meaning that brightness differences appear at their edges in the captured image compared to the surroundings. The edges detected by the high-pass filter, i.e., the areas of increased contrast, therefore represent the edges of the eye's lens.

[0043] The image processing unit generates images based on the detected areas of increased contrast. 50 then a pop-up image for the display 37A , 37B , which is located in the same stereoscopic partial beam path as the camera 21A , 21B , with which the contrast image was captured. It should be noted here that it is sufficient if a contrast image is captured in one of the two stereoscopic partial beam paths, in which the high-pass filter is then used. 51Areas of increased contrast are detected, and the image processing unit generates a superimposed image for the display in the corresponding partial beam path based on these detected areas of increased contrast. If the eye lens components are also to be highlighted stereoscopically, a stereoscopic contrast partial image is acquired in each of the two partial beam paths, and a superimposed partial image is generated for each partial beam path based on the acquired contrast partial image. The two superimposed partial images then combine to form a stereoscopic superimposed image.

[0044] The pop-up image generated in step S3 may, for example, contain colored markers that indicate the high-pass filter. 51The detected edges are represented. In this case, the superimposed image shows the contours of the eye lens fragments. Since the eye lens fragments are usually surrounded by closed edges, it is also possible to color the areas enclosed by the edges in the superimposed image. In both cases, the generated superimposed image is adjusted in size and position to match the contrast image obtained during red-reflex illumination with the operating microscope and is then displayed on the screen. 37A , 37B The corresponding stereoscopic partial beam path is output. Adjusting the size of the superimposed image can be done based on the zoom factor received from the zoom system's control unit.

[0045] In step S4, the overlay image is then displayed on the screen and used with the overlay optics. 39A , 39B and the beam splitter prism 15A , 15BThe corresponding stereoscopic partial beam path is superimposed on the contrast image obtained using the operating microscope. In the eyepiece tube 27 In the leading part of the stereoscopic partial beam path, there is therefore a superposition of the purely optically generated contrast image and the superimposed image, so that at the corresponding eyepiece 35A , 35B An image can be viewed in which the lens fragments are artificially highlighted. This makes it easier for the treating surgeon to locate and remove the lens fragments.

[0046] To limit the detection of areas of increased contrast to the area of ​​interest in the eye, i.e., the area where the eye lens is located, there is an optional possibility to extract the digital contrast image from the image processing unit. 50The area can be divided into a central region corresponding to the eye's aperture and a peripheral region surrounding the aperture. Locating areas of increased contrast then only needs to be done in the central region.

[0047] Fig. Figure 4 shows in a schematic representation essentially the electronic components of a second embodiment of an operating microscope according to the invention. 101 , as it can be used in cataract surgery. The optical components and the camera(s) can be the same as those of the first embodiment and are therefore not described again.

[0048] In the second embodiment, according to the with reference to Fig. 3 described methods using an image processing unit 150 , which corresponds to the image processing unit of the first embodiment, based on a camera 121A superimposed image is generated from the recorded contrast image to highlight parts of the eye lens. Unlike the first embodiment, however, the superimposed image is not overlaid on an optical contrast image, but rather on the digital contrast image. For this purpose, the operating microscope includes 101 one with the camera 121 for receiving the digital contrast image and with the image processing unit 150 Electronic overlay unit connected to receive the superimposed image 152 , in which the displayed image is electronically superimposed on the digital contrast image. The digital contrast image superimposed on the displayed image is then displayed on a monitor. 154 passed on, on which it is displayed. Alternatively or additionally, the digital contrast image superimposed with the overlay image can also be passed on to a recorder for storage (e.g. for documentation purposes).

[0049] As in the first embodiment, in the second embodiment there is also the possibility that the image processing unit 150 to divide the digital contrast image into a central area corresponding to the eye's aperture and a peripheral area surrounding the eye's aperture, in order to limit the detection of areas of increased contrast to the area of ​​interest in the eye, i.e., the area where the eye lens is located.

[0050] The electronic overlay unit 152 In addition to the displays described with reference to the first embodiment, 37A , 37B and beam splitter prisms 15A , 15B, with which the superimposed image or partial superimposed images in the observation beam path are superimposed on the optical contrast image or partial optical contrast images, e.g., to display images of the eye with highlighted lens fragments on a monitor for teaching purposes during cataract surgery, or to record images of the eye with highlighted lens fragments for documentation purposes during cataract surgery. Alternatively, the electronic superimposition unit can 152 also used when in the operating microscope 101 no displays 37A , 37B and beam splitter prisms 15A , 15B are present. During the operation, the attending physician can then verify, by looking at the monitor, whether he has captured all the eye lens fragments.

[0051] The present invention has been described in more detail with reference to exemplary embodiments for illustrative purposes. However, a person skilled in the art will recognize that deviations from the described exemplary embodiments are possible. For example, the first exemplary embodiment includes a coupling device. 13A , 13B and a coupling device 8A , 8B , in which their arrangement ensures that the superimposed image is taken from the cameras 21A , 21Bnot included in the recording. However, there are also surgical microscopes in which a large beam splitter cube extending across both stereoscopic partial beam paths is present. This cube is used both to couple images displayed on screens into the stereoscopic partial beam paths and to couple partial beam paths to cameras. In this case, the stereoscopic partial images superimposed with the interlaced images are fed to the cameras. Suitable measures must be taken to ensure that the interlaced images are not recorded by the cameras, as this would interfere with the evaluation by the image processing unit. Furthermore, other types of beam splitters, such as partially reflective mirrors, can be used in the output and / or input arrangement instead of beam splitter prisms.The invention is therefore not to be limited to specific combinations of features of the exemplary embodiment, but only by the attached claims. Reference symbol list 1 operating microscope 3. Object of observation / eye 5 lens 7 beams 8A, B Coupling device 9A, B Partial beam path 10A, B beam splitter prism 11A, B Magnifying device 13A, B Coupling device 15A, B beam splitter prism 19A, B Camera adapter 21A, B Camera 23A, B image sensor 27 Binocular tube 29A, B Tube Objectives 31A, B Intermediate image plane 33A, B Prism 35A, B eyepiece lens 37A, B Display 39A, B Blend-in optics 40 Lighting device 41 Light source 42 Lighting optics 43 Deflection mirrors 50 image processing units 51 High-pass filters 101 Operating microscope 121 Camera 150 image processing units 152 superposition unit 154 Monitor S1 image capture S2 Detection of areas of increased contrast S3 Generating a pop-up image S4 Displaying the overlay image QUOTES INCLUDED IN THE DESCRIPTION

[0052] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0053] DE 102009053208 A1

[0003]

Claims

[1] Method for highlighting eye lens fragments in an image taken by an eye ( 3 ) using an operating microscope ( 1 , 101 ) is obtained using the operating microscope ( 1 , 101 ) at least one observation beam path to generate an optical image of the eye ( 3 ), a lighting device ( 40 ) to illuminate the eye ( 3 ), at least a digital camera ( 21 , 121 ) to capture the optical image from the eye ( 3 ) and an image processing unit ( 50 , 150 ) includes - the eye ( 3 ) with the help of the lighting device ( 40 ) is illuminated with a light source that contrasts with the eye lens fragments, in order to form an optical image of the eye using the observation beam path ( 3 ) to create an optical contrast image that contrasts with the eye lens fragments, – the optical contrast image with at least one digital camera ( 21 , 121 ) is recorded and converted into a digital contrast image, – in the digital contrast image using the image processing unit ( 50 , 150 Areas of increased contrast are found, – from the image processing unit ( 50 , 150 ) an overlay image is generated that depicts the areas of increased contrast and whose size is at least adapted to the optical contrast image or the digital contrast image, – the superimposed image is at least overlaid on the optical contrast image or the digital contrast image, and – at least the optical contrast image superimposed on the inset image or the digital contrast image superimposed on the inset image as that obtained using the operating microscope ( 1 , 101 ) from the eye ( 3The image obtained is displayed. [2] Method according to claim 1, in which the observation beam path to at least one eyepiece ( 35 ) of the operating microscope ( 1 ) leads and the superimposed image in which at least one eyepiece ( 35 ) leading observation beam path to the optical contrast image with the aid of at least one mirroring device ( 37 , 39 , 15 ) is overlaid. [3] Method according to claim 2, wherein – the observation beam path ( 9 ) a first stereoscopic partial beam path ( 9A ), which leads to a first eyepiece ( 35A ) leads to, and a second stereoscopic partial beam path ( 9B ), which leads to a second eyepiece ( 35B ) leads, includes, – the optical contrast image is a stereoscopic optical contrast image with a first optical contrast sub-image and a second contrast sub-image, – in each of the stereoscopic partial beam paths ( 9A , 9B ) the respective optical contrast partial image with a digital camera ( 21A , 21B ), which creates a first or second digital contrast sub-image from the respective optical contrast sub-image, is recorded, – the image processing unit ( 50 ) detects areas of increased contrast in the first digital contrast sub-image and the second digital contrast sub-image, and generates and outputs a first overlay image representing the areas of increased contrast in the first digital contrast sub-image and a second overlay image representing the areas of increased contrast in the second digital contrast sub-image, wherein the first overlay image and the second overlay image are adapted in size to the first optical contrast sub-image and the second optical contrast sub-image respectively, and together form a stereoscopic overlay image, and – in the first stereoscopic observation beam path ( 9A ) by means of a first mirroring device ( 37A , 39A , 15A ) to reflect image information, the first superimposed image is overlaid on the first optical contrast image and in the second stereoscopic observation beam path ( 9B ) by means of a second mirroring device ( 37B , 39B , 15B ) to reflect image information, the second inset image is superimposed on the second optical contrast image, and – the first optical contrast image superimposed on the first inset image and the second optical contrast image superimposed on the second inset image as a single image using the operating microscope ( 1 ) from the eye ( 3 The stereoscopic image obtained will be output. [4] Method according to any one of claims 1 to 3, in which the superimposed image is superimposed on the digital contrast image by means of an electronic overlay unit ( 152 ) is overlaid. [5] Method according to any one of claims 1 to 4, in which the illumination light contrasting the eye lens pieces is light reflected from the retina. [6] Method according to any one of claims 1 to 5, wherein in the image processing unit ( 50 , 150 ) to locate the areas of increased contrast, a high-pass filter ( 51 ) is used [7] Method according to any one of claims 1 to 6, in which the areas of increased contrast in the superimposed image are represented by color-highlighted areas or color-highlighted edges. [8] Method according to any one of claims 1 to 7, wherein the image processing unit ( 50 , 150 ) the electronic contrast image into the eyehole of the eye ( 3) corresponding central area and the eyehole of the eye ( 3 ) surrounding edge area subdivided and areas of increased contrast are only found in the central area. [9] Operating microscope ( 1 , 101 ) to generate an image of an eye ( 3 ), where eye lens fragments are highlighted in the image, with – an observation beam path ( 9 ) to generate an optical image of the eye ( 3 ), – a lighting device ( 40 ) to illuminate the eye, wherein the lighting device ( 40 ) is designed to illuminate the eye with contrasting illumination light from a lens piece, in order to align with the observation beam path ( 9 ) as an optical image from the eye ( 3 ) to create an optical contrast image that contrasts with the eye lens fragments, – at least one digital camera ( 21 , 121), which receives the optical contrast image and creates and outputs a digital contrast image from the optical contrast image, – one with a digital camera ( 21 , 121 ) image processing unit connected to receive the digital contrast image ( 50 , 150 ), which is designed to detect areas of increased contrast in the digital contrast image and to generate and output an overlay image representing the areas of increased contrast, wherein the overlay image is adapted in size to the digital contrast image or the optical contrast image, and – at least one superposition device ( 37 , 39 , 15 , 152) to superimpose the optical contrast image or the digital contrast image with the overlay image and to output the optical contrast image superimposed with the overlay image or the digital contrast image superimposed with the overlay image as the image of the eye ( 3 ), in which eye lens fragments are highlighted. [10] Operating microscope ( 1 ) according to claim 9, in which the observation beam path ( 9 ) to at least one eyepiece ( 35 ) leads to the superposition device being a single-mirror device ( 37 , 39 , 15 ) for mirroring image information into the observation beam path ( 9 ) includes the mirroring device ( 37 , 39 , 15 ) to receive the displayed image with the image processing unit ( 50 ) is connected and is designed to include at least one eyepiece ( 35 ) leading observation beam path (9 ) to overlay the received inset image onto the optical contrast image. [11] Operating microscope ( 1 ) according to claim 10, in which the at least one camera ( 21 ) is arranged in such a way that it captures the optical contrast image without the superimposed inset image. [12] Operating microscope ( 1 ) according to claim 10 or claim 11, in which – the observation beam path ( 9 ) a first stereoscopic partial beam path ( 9A ), which leads to a first eyepiece ( 35A ) leads to, and a second stereoscopic partial beam path ( 9B ), which leads to a second eyepiece ( 35B ) leads, includes, – the optical contrast image is a stereoscopic optical contrast image with a first optical contrast sub-image and a second contrast sub-image, – in each of the stereoscopic partial beam paths ( 9A , 9B ) a digital camera (21A , 21B ) is arranged, to which the respective optical contrast sub-image is supplied and which creates a first or second digital contrast sub-image from the respective optical contrast sub-image, – the image processing unit ( 50 ) is designed to locate areas of increased contrast in the digital contrast sub-images and to generate and output a first superimposed image representing the areas of increased contrast in the first digital contrast sub-image and a second superimposed image representing the areas of increased contrast in the second digital contrast sub-image, wherein the first superimposed image and the second superimposed image are adapted in size to the first optical contrast sub-image and the second optical contrast sub-image respectively and together form a stereoscopic superimposed image, and – the superposition device a first single-mirror device ( 37A , 39A ,15A ) for mirroring image information into the first stereoscopic observation beam path ( 9A ) and a second mirroring device ( 37B , 39B , 15B ) for mirroring image information into the second stereoscopic observation beam path ( 9B ) includes, wherein the first mirroring device ( 37A , 39A , 15A ) for receiving the first inset image and the second mirroring device ( 37B , 39B , 15B ) to receive the second inset image with the image processing unit ( 50 ) are connected, the first mirroring device ( 37A , 39A , 15A ) is designed to be used in the first stereoscopic observation beam path ( 9A ) to superimpose the received first inset image onto the first optical contrast image and the second inset mirroring device ( 37B , 39B , 15B) is designed to be used in the second stereoscopic observation beam path ( 9B ) to superimpose the received second inset image onto the second optical contrast image. [13] Operating microscope ( 101 ) according to one of claims 9 to 12, in which the superposition device ( 152 ) includes an electronic overlay unit for electronically overlaying the digital contrast image with the superimposed image. [14] Operating microscope ( 1 , 101 ) according to one of claims 9 to 13, wherein the lighting device enables 0° illumination and / or coaxial illumination. [15] Operating microscope ( 1 , 101 ) according to claim 14, wherein the lighting device also enables oblique lighting. [16] Operating microscope ( 1 , 101 ) according to one of claims 9 to 15, wherein in the image processing device ( 50 ,150 ) to locate the areas of increased contrast, a high-pass filter ( 51 ) is available. [17] Operating microscope ( 1 , 101 ) according to one of claims 9 to 16, in which the image processing unit ( 50 , 150 ) is designed to represent areas of increased contrast in the overlay image by color-highlighted areas or color-highlighted edges.

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